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Chafekar D. Optimizing chronic kidney disease management: The potential of a multi-strain probiotic formulation. World J Nephrol 2025; 14:101515. [DOI: 10.5527/wjn.v14.i1.101515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2024] [Revised: 10/21/2024] [Accepted: 12/03/2024] [Indexed: 01/20/2025] Open
Abstract
Chronic kidney disease (CKD), which represents a significant global health concern, is characterized by a gradual decline in kidney function, leading to complications such as electrolyte imbalance, cardiovascular disease, and immune dysfunction. Standard CKD management includes dietary modifications, ketoanalogues supplementation, blood pressure and blood glucose control, hydration maintenance, and treatment of the underlying causes. Emerging evidence has indicated a significant role of the gut microbiota in CKD, and that dysbiosis of the gut microbiota contributes to the progression of CKD towards end-stage renal disease. Probiotics and prebiotics have recently garnered attention owing to their potential to enhance gastrointestinal health and well-being by restoring the balance of the gut microbiota. Specific probiotic strains, including Lactobacillus and Bifidobacterium, promote beneficial bacterial growth, suppress harmful bacteria, and exert anti-inflammatory, antihypertensive, and antidiabetic effects. The combination of Streptococcus thermophilus, Lactobacillus acidophilus, Bifidobacterium longum, and Bacillus coagulans has demonstrated potential as a therapeutic formulation for CKD management in various studies, highlighting its promise in treating CKD; however, supporting evidence remains limited, making it crucial to conduct further investigations to determine the specific effects of different probiotic formulations on outcomes in patients with CKD.
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Affiliation(s)
- Deodatta Chafekar
- Dr V N Pawar Medical College, Director Supreme Kidney Care, Nashik 422005, Mahārāshtra, India
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Symeou S, Avramidou E, Papalois V, Tsoulfas G. Global transplantation: Lessons from organ transplantation organizations worldwide. World J Transplant 2025; 15:99683. [DOI: 10.5500/wjt.v15.i1.99683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2024] [Revised: 08/30/2024] [Accepted: 09/13/2024] [Indexed: 11/26/2024] Open
Abstract
Although national transplant organizations share common visions and goals, the creation of a unified global organization remains impractical. Differences in ethnicity, culture, religion, and education shape local practices and infrastructure, making the establishment of a single global entity unfeasible. Even with these social disparities aside, logistical factors such as time and distance between organ procurement and transplantation sites pose significant challenges. While technological advancements have extended organ preservation times, they have yet to support the demands of transcontinental transplantations effectively. This review presents a comparative analysis of the structures, operational frameworks, policies, and legislation governing various transplant organizations around the world. Key differences pertain to the administration of these organizations, trends in organ donation, and organ allocation policies, which reflect the financial, cultural, and religious diversity across different regions. While a global transplant organization may be out of reach, agreeing on best practices for the benefit of patients is essential.
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Affiliation(s)
- Solonas Symeou
- Medical School, University of Ioannina, Ioannina 45110, Greece
| | - Eleni Avramidou
- Department of Transplantation Surgery, Center for Research and Innovation in Solid Organ Transplantation, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki 54642, Greece
| | - Vassilios Papalois
- Imperial College Renal and Transplant Centre, Imperial College Healthcare NHS Trust, Hammersmith Hospital, London W120HS, United Kingdom
- Department of Surgery and Cancer, Imperial College London, London SW72AZ, United Kingdom
| | - Georgios Tsoulfas
- Department of Transplantation Surgery, Center for Research and Innovation in Solid Organ Transplantation, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki 54642, Greece
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Yang R, Liu W, Zhou Y, Cheng B, Liu S, Wu R, Liu Y, Li J. Modulating HIF-1α/HIF-2α homeostasis with Shen-Qi-Huo-Xue formula alleviates tubular ferroptosis and epithelial-mesenchymal transition in diabetic kidney disease. JOURNAL OF ETHNOPHARMACOLOGY 2025; 343:119478. [PMID: 39947365 DOI: 10.1016/j.jep.2025.119478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2024] [Revised: 02/03/2025] [Accepted: 02/09/2025] [Indexed: 02/18/2025]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Diabetic kidney disease (DKD) is one of the main types of chronic kidney disease, which seriously affects the quality of life of patients. Shen-Qi-Huo-Xue formula (SQHXF), based on the Shen-Qi-Di-Huang decoction, is a traditional Chinese medicine formula for DKD. This study explored the mechanism of action of SQHXF on DKD through analysis of drug components, in vivo and in vitro experiments. AIM OF THE STUDY To elucidate the regulatory mechanisms of HIF-1α/HIF-2α homeostasis on ferroptosis and epithelial-mesenchymal transition (EMT) in renal tubular epithelial cells and the mechanism of action of SQHXF against DKD. METHODS The components of SQHXF were analyzed using UPLC-Q Exactive HF/MS. The effects of SQHXF on renal function, urinary proteins, glucose-lipid metabolism, hepatic function, renal tissue hypoxia, ferroptosis and EMT were analyzed following gavage of DKD model mice with different SQHXF doses. The effects of changes in HIF-1α and HIF-2α expression on ferroptosis and EMT, as well as the modulatory effects of SQHXF-containing serum, were assessed in vitro. The potential feedback mechanism of HIFs/ferroptosis/EMT was elucidated using HIF-1α knockdown and a ferroptosis inhibitor. RESULTS One-hundred and fifty compounds in SQHXF were tested for bloodstream entry. In vivo study showed that SQHXF was able to reduce creatinine, uric acid, fasting plasma glucose, 24-h urinary protein, low-density lipoprotein cholesterol, and aspartate aminotransferase levels, up-regulate HIF-1α, down-regulate HIF-2α, reduce ferroptosis, and alleviate renal fibrosis and EMT in tubular epithelial cells. HIF-1α/HIF-2α imbalance promoted ferroptosis and EMT in HK-2 cells, which was attenuated by SQHXF-containing serum. HIF-1α knockdown decreased HIF-2α expression and reduced ferroptosis and EMT. Inhibition of ferroptosis reduced EMT but failed to regulate HIF-1α and HIF-2α. CONCLUSIONS SQHXF alleviated ferroptosis and EMT, improved liver and kidney function, reduced proteinuria, and alleviated renal lesions by maintaining equilibrium between HIF-1α and HIF-2α.
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Affiliation(s)
- Ronglu Yang
- Department of Traditional Chinese Medicine, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, China.
| | - Wu Liu
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, China.
| | - Yi Zhou
- Graduate School of Beijing University of Chinese Medicine, Beijing, 100029, China.
| | - Bin Cheng
- Outpatient Department, Anhui University of Traditional Chinese Medicine, Hefei, 230031, China.
| | - Shiyi Liu
- Department of Nephrology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, 100091, China.
| | - Ruiying Wu
- Department of Traditional Chinese Medicine, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, China.
| | - Yongjun Liu
- Department of Traditional Chinese Medicine, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, China.
| | - Jinhu Li
- Department of Traditional Chinese Medicine, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, China.
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Chen Y, Torta F, Koh HWL, Benke PI, Gurung RL, Liu JJ, Ang K, Shao YM, Chan GC, Choo JCJ, Ching J, Kovalik JP, Kalhan T, Dorajoo R, Khor CC, Li Y, Tang WE, Seah DEJ, Sabanayagam C, Sobota RM, Venkataraman K, Coffman T, Wenk MR, Sim X, Lim SC, Tai ES. Metabolomics profiling in multi-ancestral individuals with type 2 diabetes in Singapore identified metabolites associated with renal function decline. Diabetologia 2025; 68:557-575. [PMID: 39621102 DOI: 10.1007/s00125-024-06324-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Accepted: 09/19/2024] [Indexed: 02/19/2025]
Abstract
AIMS/HYPOTHESIS This study aims to explore the association between plasma metabolites and chronic kidney disease progression in individuals with type 2 diabetes. METHODS We performed a comprehensive metabolomic analysis in a prospective cohort study of 5144 multi-ancestral individuals with type 2 diabetes in Singapore, using eGFR slope as the primary outcome of kidney function decline. In addition, we performed genome-wide association studies on metabolites to assess how these metabolites could be genetically influenced by metabolite quantitative trait loci and performed colocalisation analysis to identify genes affecting both metabolites and kidney function. RESULTS Elevated levels of 61 lipids with long unsaturated fatty acid chains such as phosphatidylethanolamines, triacylglycerols, diacylglycerols, ceramides and deoxysphingolipids were prospectively associated with more rapid kidney function decline. In addition, elevated levels of seven amino acids and three lipids in the plasma were associated with a slower decline in eGFR. We also identified 15 metabolite quantitative trait loci associated with these metabolites, within which variants near TM6SF2, APOE and CPS1 could affect both metabolite levels and kidney functions. CONCLUSIONS/INTERPRETATION Our study identified plasma metabolites associated with prospective renal function decline, offering insights into the underlying mechanism by which the metabolite abnormalities due to fatty acid oversupply might reflect impaired β-oxidation and associate with future chronic kidney disease progression in individuals with diabetes.
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Affiliation(s)
- Yuqing Chen
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Republic of Singapore
| | - Federico Torta
- Singapore Lipidomics Incubator (SLING), Life Sciences Institute, National University of Singapore, Singapore, Republic of Singapore
- Precision Medicine Translational Research Programme and Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore
| | - Hiromi W L Koh
- Institute of Molecular and Cell Biology (IMCB), Agency for Science, Technology and Research (A∗STAR), Singapore, Republic of Singapore
| | - Peter I Benke
- Singapore Lipidomics Incubator (SLING), Life Sciences Institute, National University of Singapore, Singapore, Republic of Singapore
| | - Resham L Gurung
- Clinical Research Unit, Khoo Teck Puat Hospital, Singapore, Republic of Singapore
| | - Jian-Jun Liu
- Clinical Research Unit, Khoo Teck Puat Hospital, Singapore, Republic of Singapore
| | - Keven Ang
- Clinical Research Unit, Khoo Teck Puat Hospital, Singapore, Republic of Singapore
| | - Yi-Ming Shao
- Clinical Research Unit, Khoo Teck Puat Hospital, Singapore, Republic of Singapore
| | - Gek Cher Chan
- Division of Nephrology, Department of Medicine, National University Hospital, Singapore, Republic of Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Republic of Singapore
| | - Jason Chon-Jun Choo
- Department of Renal Medicine, Singapore General Hospital, Singapore, Republic of Singapore
| | - Jianhong Ching
- Cardiovascular and Metabolic Disorders Program, Duke-NUS Medical School, Singapore, Republic of Singapore
- KK Research Centre, KK Women's and Children's Hospital, Singapore, Republic of Singapore
| | - Jean-Paul Kovalik
- Cardiovascular and Metabolic Disorders Program, Duke-NUS Medical School, Singapore, Republic of Singapore
| | - Tosha Kalhan
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Republic of Singapore
| | - Rajkumar Dorajoo
- Genome Institute of Singapore (GIS), Agency for Science, Technology and Research (A∗STAR), Singapore, Republic of Singapore
| | - Chiea Chuen Khor
- Genome Institute of Singapore (GIS), Agency for Science, Technology and Research (A∗STAR), Singapore, Republic of Singapore
| | - Yun Li
- Department of Genetics, University of North Carolina, Chapel Hill, NC, USA
- Department of Biostatistics, University of North Carolina, Chapel Hill, NC, USA
- Department of Computer Science, University of North Carolina, Chapel Hill, NC, USA
| | - Wern Ee Tang
- National Healthcare Group Polyclinics, Singapore, Republic of Singapore
| | - Darren E J Seah
- National Healthcare Group Polyclinics, Singapore, Republic of Singapore
| | - Charumathi Sabanayagam
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore, Republic of Singapore
- Ophthalmology and Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore, Republic of Singapore
| | - Radoslaw M Sobota
- Institute of Molecular and Cell Biology (IMCB), Agency for Science, Technology and Research (A∗STAR), Singapore, Republic of Singapore
| | - Kavita Venkataraman
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Republic of Singapore
| | - Thomas Coffman
- Cardiovascular and Metabolic Disorders Program, Duke-NUS Medical School, Singapore, Republic of Singapore
| | - Markus R Wenk
- Singapore Lipidomics Incubator (SLING), Life Sciences Institute, National University of Singapore, Singapore, Republic of Singapore
- Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore
| | - Xueling Sim
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Republic of Singapore.
| | - Su-Chi Lim
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Republic of Singapore.
- Clinical Research Unit, Khoo Teck Puat Hospital, Singapore, Republic of Singapore.
- Diabetes Center, Khoo Teck Puat Hospital, Singapore, Republic of Singapore.
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Republic of Singapore.
| | - E Shyong Tai
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Republic of Singapore.
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Republic of Singapore.
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Du S, Yu Z, Li J, Jiang Y, Wang J, Hu J, Su N. Association of blood urea nitrogen to glucose ratio with 365-day mortality in critically ill patients with chronic kidney disease: a retrospective study. Sci Rep 2025; 15:6697. [PMID: 40000743 PMCID: PMC11862077 DOI: 10.1038/s41598-025-91012-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2024] [Accepted: 02/17/2025] [Indexed: 02/27/2025] Open
Abstract
Low blood glucose levels and high urea nitrogen levels affect patient prognosis, but few studies have investigated whether the blood urea nitrogen to glucose (BGR) ratio predicts the risk of death.This retrospective research examined the connection between the BGR and 365-day mortality in patients with chronic kidney disease (CKD) stages 1-4 admitted to an intensive care unit (ICU). The study utilized data from 6,380 patients in the Medical Information Mart for Intensive Care IV version 2.2 (MIMIC-IV v2.2), taking into account confounding factors such as demographics, vital signs, laboratory indicators, and comorbidities. The study employed both univariate and multivariate Cox regression analyses stratified by BGR quartiles. Additionally, restricted cubic spline regression and inflection point analysis were used to explore the linear relationship between BGR and 365-day mortality, while Kaplan-Meier curve analysis was used to observe mortality changes under different BGR stratifications. Subgroup and mediating effect analyses were performed to evaluate the robustness of BGR's effect on 365-day mortality. The study found a cumulative 365-day mortality rate of 34.2% among CKD stages 1-4 patients, with a 2.43-fold increase in the risk of death associated with BGR and at least a 44% increase in the risk of death for each unit increase in BGR (P = 0.022). A significant nonlinear relationship was identified, showing a stepwise change in the risk of death with a marked increase in the slope of the curve for BGR values below 0.52 and above 0.9 (P < 0.001). Subgroup analyses indicated interactions between BGR and factors such as age, sepsis, first-day antibiotic use, and cerebrovascular disease (P < 0.05). In conclusion, this study confirms that BGR is a significant and stable predictor of 1-year mortality risk in patients with CKD stages 1-4. Interventions aimed at timely adjustment, correction of metabolic imbalances, reduction of inflammation, and management of BGR levels are beneficial for reducing mortality in this patient population.
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Grants
- No.2022YFC2304800 The National Key Research and Development Program of China
- No.2022YFC2304800 The National Key Research and Development Program of China
- No.2022YFC2304800 The National Key Research and Development Program of China
- No.2022YFC2304800 The National Key Research and Development Program of China
- No.2022YFC2304800 The National Key Research and Development Program of China
- No.2022YFC2304800 The National Key Research and Development Program of China
- No.2022YFC2304800 The National Key Research and Development Program of China
- No. 2023A03J0539,2023A03J0992,2024A03J0580 Guangzhou Science and Technology Planning Project
- No. 2023A03J0539,2023A03J0992,2024A03J0580 Guangzhou Science and Technology Planning Project
- No. 2023A03J0539,2023A03J0992,2024A03J0580 Guangzhou Science and Technology Planning Project
- No. 2023A03J0539,2023A03J0992,2024A03J0580 Guangzhou Science and Technology Planning Project
- No. 2023A03J0539,2023A03J0992,2024A03J0580 Guangzhou Science and Technology Planning Project
- No. 2023A03J0539,2023A03J0992,2024A03J0580 Guangzhou Science and Technology Planning Project
- No. 2023A03J0539,2023A03J0992,2024A03J0580 Guangzhou Science and Technology Planning Project
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Affiliation(s)
- Shenghua Du
- Department of Nephrology, Guangzhou Chest Hospital, Guangzhou Medical University, Guangzhou, China
| | - Zhaoxian Yu
- State Key Laboratory of Respiratory Disease, Guangzhou Key Laboratory of Tuberculosis, Department of Critical Care Medicine, Guangzhou Chest Hospital, Institute of Tuberculosis, Guangzhou Medical University, Guangzhou, China
| | - Junghong Li
- State Key Laboratory of Respiratory Disease, Guangzhou Key Laboratory of Tuberculosis, Department of Critical Care Medicine, Guangzhou Chest Hospital, Institute of Tuberculosis, Guangzhou Medical University, Guangzhou, China
| | - Yingyi Jiang
- State Key Laboratory of Respiratory Disease, Guangzhou Key Laboratory of Tuberculosis, Department of Critical Care Medicine, Guangzhou Chest Hospital, Institute of Tuberculosis, Guangzhou Medical University, Guangzhou, China
| | - Juan Wang
- State Key Laboratory of Respiratory Disease, Guangzhou Key Laboratory of Tuberculosis, Department of Critical Care Medicine, Guangzhou Chest Hospital, Institute of Tuberculosis, Guangzhou Medical University, Guangzhou, China
| | - Jinxing Hu
- State Key Laboratory of Respiratory Disease, Guangzhou Key Laboratory of Tuberculosis Research, Department of Tuberculosis, Guangzhou Chest Hospital, Institute of Tuberculosis, Guangzhou Medical University, Guangzhou, China.
| | - Ning Su
- State Key Laboratory of Respiratory Disease, Guangzhou Chest Hospital, Guangzhou Medical University, Guangzhou, China.
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Wang X, Yan B, Zhang S, Zhou Y, Zhang Q, Li X. Management of volume load for patients undergoing hemodialysis via WeChat and home monitoring in China: a protocol for a cluster-randomized trial. BMC Nephrol 2025; 26:58. [PMID: 39910544 PMCID: PMC11800630 DOI: 10.1186/s12882-024-03932-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2024] [Accepted: 12/26/2024] [Indexed: 02/07/2025] Open
Abstract
BACKGROUND Volume overload is a major mortality risk in hemodialysis (HD) patients. Drug therapy and conventional dialysis limitations underscore the importance of managing volume load through effective lifestyle interventions. In this regard, WeChat, along with its built-in self-monitoring function, has demonstrated considerable potential for application. WeChat, a versatile social media platform in China, integrating Facebook, WhatsApp, Twitter, and PayPal functionalities, shows potential in managing volume load, especially when paired with home monitoring. This method may also reduce adverse events and improve patient outcomes. METHOD The study will be conducted at the Hemodialysis Center of the Hospital of Chengdu University of Traditional Chinese Medicine, recruiting 135 participants. All patients will be cluster randomly assigned to three group according to their HD schedules. The control group will receive standard care. The WeChat group will receive volume load management via WeChat message in addition to standard care. The home monitoring-feedback group will be required to monitor their blood pressure and weight at home, and upload the number to WeChat subscription account "Health Dialysis" in addition to standard care and volume load management via WeChat message. Data will be collected during the baseline period, one, two, and three months after the intervention starts, and three months after the intervention ends to evaluate the effectiveness of this intervention measure. DISCUSSION This study aims to effectively manage the volume load of HD patients and enhance their quality of life through a combination of intervention methods utilizing the WeChat platform and home monitoring. If this intervention measure proves effective, it will not only provide empirical evidence for managing HD patients through the WeChat platform but also serve as a reference model for other HD centers in addressing patient volume load issues. What's more, if significant differences are observed between the results of the WeChat groups and the home monitoring-feedback group, this will further substantiate the importance and impact of home monitoring in volume load management. TRIAL REGISTRATION ClinicalTrials.gov (NCT06333574). Registered 13 March 2024.
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Affiliation(s)
- Xiaocui Wang
- Clinical Medical College, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Bonan Yan
- Clinical Medical College, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Shipeng Zhang
- Clinical Medical College, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yuanke Zhou
- Clinical Medical College, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Qinxiu Zhang
- Clinical Medical College, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China.
| | - Xueying Li
- Clinical Medical College, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China.
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Zhong Y, Cao S, Chen L, Li T, Ye W. Frailty risk prediction models for patients undergoing maintenance hemodialysis in China: a systematic review. BMC Nephrol 2025; 26:57. [PMID: 39910478 PMCID: PMC11796139 DOI: 10.1186/s12882-025-03990-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2024] [Accepted: 01/28/2025] [Indexed: 02/07/2025] Open
Abstract
OBJECTIVE To promote the application of high-quality frailty risk prediction models in the field of debilitation among Chinese patients undergoing MHD, and to provide a basis for optimisation and improvement of future studies. METHODS A literature search was conducted in Chinese and English databases (PubMed, Web of Science, Cochrane Library, CINAHL, Embase, CNKI, Wanfang, VIP, SinoMed) and the cutoff date for which was April 30, 2024. Literature characteristics, types of studies, predictors, model construction methods and results were analysed and compared. RESULTS Ten studies met the inclusion criteria, and seven were focused on model development and validation. A total of 12 predictive models were included across these 10 studies; three of these were solely model development studies, while seven were both model development and validation. The area under the curve (AUC) for the subjects' operating characteristics was > 0.7 in all ten studies. The most frequently identified predictors in the models included age, nutritional status, the presence of multimorbidity, gender, and depression. While the overall applicability of the ten studies was deemed satisfactory, it is important to note that all studies exhibited a high risk of bias, particularly concerning the data analysis component. CONCLUSION The frailty risk prediction models for patients undergoing maintenance hemodialysis have demonstrated satisfactory applicability; however, they are all associated with a significant risk of bias and lack comprehensive external validation. To develop more accurate and practical prediction models, future studies must rely on large-sample, multicenter prospective cohort studies and adhere to a rigorous study design. CLINICAL TRIAL NUMBER Not applicable.
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Affiliation(s)
- Yu Zhong
- Affiliated Hospital of Jiangsu University, Zhenjiang, 212001, Jiangsu, China
| | - Songmei Cao
- Affiliated Hospital of Jiangsu University, Zhenjiang, 212001, Jiangsu, China.
| | - Liangying Chen
- Affiliated Hospital of Jiangsu University, Zhenjiang, 212001, Jiangsu, China
| | - Teng Li
- Medical College of Jiangsu University, Zhenjiang, 212001, Jiangsu, China
| | - Wei Ye
- Affiliated Hospital of Jiangsu University, Zhenjiang, 212001, Jiangsu, China
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Imanishi Y, Taniuchi S, Kodama S, Yoshida H, Ito T, Kawai R, Okubo N, Shintani A. Real-world fracture risk, osteoporosis treatment status, and mortality of Japanese non-dialysis patients with chronic kidney disease stages G3-5. Clin Exp Nephrol 2025; 29:236-247. [PMID: 39402308 PMCID: PMC11828842 DOI: 10.1007/s10157-024-02562-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Accepted: 09/10/2024] [Indexed: 02/16/2025]
Abstract
BACKGROUND Few studies have investigated fracture risk and mortality in a Japanese chronic kidney disease (CKD) stages G3-5 population using a large-scale clinical database. METHODS This retrospective cohort study extracted data from 1 April 2008 to 30 April 2023. A single age-sex-matched control without CKD was matched with each non-dialysis CKD (estimated glomerular filtration rate < 60 mL/min/1.73 m2) patient. The incidences of all and hip fractures and all-cause mortality after the index date were calculated. RESULTS Among 76,598 (38,299 per group) individuals matched, the incidence of all fractures did not differ between the CKD and control groups (5.7% vs 5.8%; hazard ratio [HR] 1.022 [95% confidence interval CI 0.952-1.098], P = 0.542). The CKD group had higher risk of hip fracture than the control group (incidence of hip fracture, 1.7% vs 1.3%; HR 1.415 [95% CI 1.234-1.622], P < 0.001). Multivariable regression analysis showed an increased risk for hip fracture in the CKD vs control groups, and a greater difference in this risk was observed with younger age. Osteoporosis treatment and bone mineral density (BMD) measurements were 10.0% and 5.3% in the CKD group and 4.4% and 4.4% in the control group, respectively. Mortality was also higher in the CKD group (HR 1.413 [95% CI 1.330-1.501], P < 0.001). CONCLUSIONS Japanese patients with CKD had higher risk of hip fracture than those without. Treatment and BMD measurement for fracture are insufficient in Japanese patients with CKD, and more adequate management of fracture risk is needed.
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Affiliation(s)
- Yasuo Imanishi
- Department of Metabolism, Endocrinology and Molecular Medicine, Osaka Metropolitan University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-Ku, Osaka, 545-8585, Japan.
| | - Satsuki Taniuchi
- Department of Medical Statistics, Osaka Metropolitan University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-Ku, Osaka, 545-8585, Japan
| | - Sho Kodama
- ASCA Primary Product Department, ASCA Business Division, Daiichi Sankyo Co., Ltd., 3-5-1 Nihonbashi Honcho, Chuo-Ku, Tokyo, 103-8426, Japan
| | - Hisako Yoshida
- Department of Medical Statistics, Osaka Metropolitan University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-Ku, Osaka, 545-8585, Japan
| | - Tetsuo Ito
- Oncology Medical Science Department II, Medical Affairs Division, Daiichi Sankyo Co., Ltd., 3-5-1 Nihonbashi Honcho, Chuo-Ku, Tokyo, 103-8426, Japan
| | - Ryota Kawai
- Department of Medical Statistics, Osaka Metropolitan University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-Ku, Osaka, 545-8585, Japan
| | - Naoki Okubo
- Data Intelligence Department, Global DX, Daiichi Sankyo Co., Ltd., 1-2-58 Hiromachi, Shinagawa-Ku, Tokyo, 140-8710, Japan
| | - Ayumi Shintani
- Department of Medical Statistics, Osaka Metropolitan University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-Ku, Osaka, 545-8585, Japan
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Yoh K, Nishimura T, Ikeda N, Takashima T, Aizawa N, Yuri Y, Kimura T, Yoshihara K, Yoshioka R, Kawata S, Kawase Y, Nakano R, Shiomi H, Fukunishi S, Shinzaki S, Nishiguchi S, Enomoto H. Possible Use of Body Surface Area Value for Estimating Skeletal Muscle Mass in Chronic Liver Disease. Diagnostics (Basel) 2025; 15:263. [PMID: 39941193 PMCID: PMC11817660 DOI: 10.3390/diagnostics15030263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2024] [Revised: 01/13/2025] [Accepted: 01/20/2025] [Indexed: 02/16/2025] Open
Abstract
Background/Objectives: Sarcopenia is an important clinical feature of patients with chronic liver disease (CLD). However, special devices are required to determine skeletal muscle mass. We evaluated the usefulness of body surface area (BSA) for estimating muscle mass and diagnosing sarcopenia in patients with CLD. Methods: We retrospectively studied 1889 Japanese patients with CLD who underwent bioimpedance analysis (BIA) (training cohort, n = 983; validation cohort, n = 906). The optimal cutoff values for predicting low skeletal muscle mass index (SMI) were determined using ROC analysis. We also assessed 1229 patients whose BSA and grip strength (GS) data were obtained on the same day and evaluated the diagnostic performance of the determined cutoff values of BSA for the diagnosis of sarcopenia. Results: In the training cohort, a strong correlation was observed between the SMI and BSA (r = 0.883, p < 0.0001). The cutoff values of BSA for predicting low SMI were 1.68 m2 for men and 1.48 m2 for women. Regarding the presence of low SMI, 776 (78.9%) and 730 (80.5%) patients were correctly diagnosed in the training and validation cohorts, respectively. The sensitivity and specificity of the combination of BSA and GS for sarcopenia were 82.7% and 97.1%, respectively, and 1175 patients (95.6%) were correctly diagnosed. Conclusions: BSA was highly correlated with SMI, suggesting that BSA could facilitate noninvasive estimation of low skeletal muscle mass in patients with CLD.
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Affiliation(s)
- Kazunori Yoh
- Department of Gastroenterology, Hyogo Medical University, Mukogawa-cho 1-1, Nishinomiya 663-8501, Japan; (K.Y.); (T.N.); (N.I.); (T.T.); (N.A.); (Y.Y.); (T.K.); (K.Y.); (R.Y.); (S.K.); (Y.K.); (R.N.); (H.S.); (S.F.); (S.S.)
- Yoh Digestive Clinic, Wakayama 640-8269, Japan
| | - Takashi Nishimura
- Department of Gastroenterology, Hyogo Medical University, Mukogawa-cho 1-1, Nishinomiya 663-8501, Japan; (K.Y.); (T.N.); (N.I.); (T.T.); (N.A.); (Y.Y.); (T.K.); (K.Y.); (R.Y.); (S.K.); (Y.K.); (R.N.); (H.S.); (S.F.); (S.S.)
| | - Naoto Ikeda
- Department of Gastroenterology, Hyogo Medical University, Mukogawa-cho 1-1, Nishinomiya 663-8501, Japan; (K.Y.); (T.N.); (N.I.); (T.T.); (N.A.); (Y.Y.); (T.K.); (K.Y.); (R.Y.); (S.K.); (Y.K.); (R.N.); (H.S.); (S.F.); (S.S.)
| | - Tomoyuki Takashima
- Department of Gastroenterology, Hyogo Medical University, Mukogawa-cho 1-1, Nishinomiya 663-8501, Japan; (K.Y.); (T.N.); (N.I.); (T.T.); (N.A.); (Y.Y.); (T.K.); (K.Y.); (R.Y.); (S.K.); (Y.K.); (R.N.); (H.S.); (S.F.); (S.S.)
| | - Nobuhiro Aizawa
- Department of Gastroenterology, Hyogo Medical University, Mukogawa-cho 1-1, Nishinomiya 663-8501, Japan; (K.Y.); (T.N.); (N.I.); (T.T.); (N.A.); (Y.Y.); (T.K.); (K.Y.); (R.Y.); (S.K.); (Y.K.); (R.N.); (H.S.); (S.F.); (S.S.)
| | - Yukihisa Yuri
- Department of Gastroenterology, Hyogo Medical University, Mukogawa-cho 1-1, Nishinomiya 663-8501, Japan; (K.Y.); (T.N.); (N.I.); (T.T.); (N.A.); (Y.Y.); (T.K.); (K.Y.); (R.Y.); (S.K.); (Y.K.); (R.N.); (H.S.); (S.F.); (S.S.)
| | - Taro Kimura
- Department of Gastroenterology, Hyogo Medical University, Mukogawa-cho 1-1, Nishinomiya 663-8501, Japan; (K.Y.); (T.N.); (N.I.); (T.T.); (N.A.); (Y.Y.); (T.K.); (K.Y.); (R.Y.); (S.K.); (Y.K.); (R.N.); (H.S.); (S.F.); (S.S.)
| | - Kohei Yoshihara
- Department of Gastroenterology, Hyogo Medical University, Mukogawa-cho 1-1, Nishinomiya 663-8501, Japan; (K.Y.); (T.N.); (N.I.); (T.T.); (N.A.); (Y.Y.); (T.K.); (K.Y.); (R.Y.); (S.K.); (Y.K.); (R.N.); (H.S.); (S.F.); (S.S.)
| | - Ryota Yoshioka
- Department of Gastroenterology, Hyogo Medical University, Mukogawa-cho 1-1, Nishinomiya 663-8501, Japan; (K.Y.); (T.N.); (N.I.); (T.T.); (N.A.); (Y.Y.); (T.K.); (K.Y.); (R.Y.); (S.K.); (Y.K.); (R.N.); (H.S.); (S.F.); (S.S.)
| | - Shoki Kawata
- Department of Gastroenterology, Hyogo Medical University, Mukogawa-cho 1-1, Nishinomiya 663-8501, Japan; (K.Y.); (T.N.); (N.I.); (T.T.); (N.A.); (Y.Y.); (T.K.); (K.Y.); (R.Y.); (S.K.); (Y.K.); (R.N.); (H.S.); (S.F.); (S.S.)
| | - Yuta Kawase
- Department of Gastroenterology, Hyogo Medical University, Mukogawa-cho 1-1, Nishinomiya 663-8501, Japan; (K.Y.); (T.N.); (N.I.); (T.T.); (N.A.); (Y.Y.); (T.K.); (K.Y.); (R.Y.); (S.K.); (Y.K.); (R.N.); (H.S.); (S.F.); (S.S.)
| | - Ryota Nakano
- Department of Gastroenterology, Hyogo Medical University, Mukogawa-cho 1-1, Nishinomiya 663-8501, Japan; (K.Y.); (T.N.); (N.I.); (T.T.); (N.A.); (Y.Y.); (T.K.); (K.Y.); (R.Y.); (S.K.); (Y.K.); (R.N.); (H.S.); (S.F.); (S.S.)
| | - Hideyuki Shiomi
- Department of Gastroenterology, Hyogo Medical University, Mukogawa-cho 1-1, Nishinomiya 663-8501, Japan; (K.Y.); (T.N.); (N.I.); (T.T.); (N.A.); (Y.Y.); (T.K.); (K.Y.); (R.Y.); (S.K.); (Y.K.); (R.N.); (H.S.); (S.F.); (S.S.)
| | - Shinya Fukunishi
- Department of Gastroenterology, Hyogo Medical University, Mukogawa-cho 1-1, Nishinomiya 663-8501, Japan; (K.Y.); (T.N.); (N.I.); (T.T.); (N.A.); (Y.Y.); (T.K.); (K.Y.); (R.Y.); (S.K.); (Y.K.); (R.N.); (H.S.); (S.F.); (S.S.)
| | - Shinichiro Shinzaki
- Department of Gastroenterology, Hyogo Medical University, Mukogawa-cho 1-1, Nishinomiya 663-8501, Japan; (K.Y.); (T.N.); (N.I.); (T.T.); (N.A.); (Y.Y.); (T.K.); (K.Y.); (R.Y.); (S.K.); (Y.K.); (R.N.); (H.S.); (S.F.); (S.S.)
| | - Shuhei Nishiguchi
- Department of Gastroenterology, Kano General Hospital, Osaka 531-0041, Japan;
| | - Hirayuki Enomoto
- Department of Gastroenterology, Hyogo Medical University, Mukogawa-cho 1-1, Nishinomiya 663-8501, Japan; (K.Y.); (T.N.); (N.I.); (T.T.); (N.A.); (Y.Y.); (T.K.); (K.Y.); (R.Y.); (S.K.); (Y.K.); (R.N.); (H.S.); (S.F.); (S.S.)
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10
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Chen HH, Huang YL, Wu CY, Chen MC, Shiue HS, Hsu SL, Lin YC, Hsueh YM. Plasma myeloperoxidase interactions with cadmium, lead, arsenic, and selenium and their impact on chronic kidney disease. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2025; 290:117726. [PMID: 39826409 DOI: 10.1016/j.ecoenv.2025.117726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2024] [Revised: 12/21/2024] [Accepted: 01/11/2025] [Indexed: 01/22/2025]
Abstract
Myeloperoxidase (MPO) is an oxidative stress biomarker, with elevated MPO levels linked to chronic kidney disease (CKD) progression. Metal exposure is a risk factor for CKD, and is also correlated to MPO expression, with specific MPO genotypes linked to MPO expression. Therefore, we examined whether MPO plasma levels or MPO polymorphisms were linked to CKD, and explored whether these factors modified associations between CKD and metal concentrations. Accordingly, we recruited 395 age- and sex-matched controls and 215 patients with CKD (persistent estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2 for a minimum of 12 weeks without hemodialysis). We identified no associations between several MPO genotypes and CKD. However, after multivariate adjustment, plasma MPO concentrations were positively correlated with CKD odds ratio (OR) = 5.87 (95 % confidence interval [CI]: 3.14-10.96). Significant additive interactions were observed between high plasma MPO concentrations and elevated blood cadmium (Cd) and lead (Pb) levels, and total urinary arsenic (As), or low plasma selenium (Se) concentrations, leading to increased ORs for CKD, with significant synergy indices recorded. High plasma MPO concentrations also showed multiplicative interactions with elevated blood Pb levels or low plasma Se concentrations, which increased the ORs for CKD (p-values = 0.005 and 0.009, respectively). Our study is the first to show a significant interaction between plasma MPO concentration and metals affecting the OR of CKD.
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Affiliation(s)
- Hsi-Hsien Chen
- Division of Nephrology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Division of Nephrology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan
| | - Ya-Li Huang
- Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chih-Yin Wu
- Department of Family Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; Department of Family Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Mei-Chieh Chen
- Department of Microbiology and Immunology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Graduate Institute of Medical Sciences, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Horng-Sheng Shiue
- Department of Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Sheng-Lun Hsu
- Department of Family Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; Department of Family Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Ying-Chin Lin
- Department of Family Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; Department of Family Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Department of Geriatric Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yu-Mei Hsueh
- Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Department of Family Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
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11
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Zhuang M, Lv X, Zhu Y, Zheng N, Zhan Y. Trends in the prevalence of Chronic Kidney Disease in the United States, 1999-2018. Front Med (Lausanne) 2025; 11:1499225. [PMID: 39882533 PMCID: PMC11774909 DOI: 10.3389/fmed.2024.1499225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2024] [Accepted: 12/16/2024] [Indexed: 01/31/2025] Open
Abstract
Background Chronic Kidney Disease (CKD) is an escalating public health concern in the United States, linked with significant morbidity, mortality, and healthcare costs. Despite known risk factors like age, hypertension, and diabetes, comprehensive studies examining temporal trends in CKD prevalence are scarce. This study aims to analyze these trends using data from the National Health and Nutrition Examination Survey (NHANES). Methods This cross-sectional study analyzed NHANES data spanning 20 years (1999-2018), including 55,081 adults aged 20 years and above. Key renal function indicators like estimated glomerular filtration rate (eGFR) and albumin-to-creatinine ratio (ACR) were assessed, and CKD stages were categorized accordingly. Results A fluctuating trend in CKD prevalence was observed, with early CKD stages (G1-G3) increasing from 9.28% in 1999-2000 to 12.93% in 2017-2018. Advanced CKD stages (G4-G5) showed a slight increase in prevalence from 0.3% in 1999-2000 to 0.51% in 2017-2018. Notable disparities were observed across age groups, diabetes status, and racial categories. Relatively, the elderly, women, and non-Hispanic whites have a higher prevalence of CKD, while individuals with diabetes have a consistently higher prevalence of early CKD from 1999 to 2018. The increasing prevalence of diabetes during the study period highlights its significant role as a CKD risk factor. Conclusion The prevalence of CKD in the U.S. has been rising over the period 1999-2018, and varying across demographic groups, underscoring significant disparities and risk factors. These insights are crucial for healthcare planning, policy formulation, and targeted interventions for CKD management.
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Affiliation(s)
- Mansi Zhuang
- Department of Epidemiology, School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
- Department of Health Education, Futian Institute of Health Education, Shenzhen, China
| | - Xiaogang Lv
- Department of Epidemiology, School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Yanan Zhu
- Department of Epidemiology, School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Nan Zheng
- Department of Health Education, Futian Institute of Health Education, Shenzhen, China
| | - Yiqiang Zhan
- Department of Epidemiology, School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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12
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Qian T, He Y, Han C, Yan R, He W. Current status and prospects of traditional Chinese medicine combined with stem cell therapy for chronic kidney disease. Front Pharmacol 2025; 15:1505206. [PMID: 39877385 PMCID: PMC11772437 DOI: 10.3389/fphar.2024.1505206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2024] [Accepted: 12/24/2024] [Indexed: 01/31/2025] Open
Abstract
Renal fibrosis is one of the main pathological features of chronic kidney disease (CKD), and its treatment has been a hot research topic. Recent studies have shown that stem cell therapy can repair renal pathological changes and slow the progression of CKD. In addition, a large number of experiments have confirmed that traditional Chinese medicine (TCM), especially Chinese medicine compound preparations, has the advantage of multitargeting interventions to improve renal fibrosis. Therefore, stem cell therapy combined with TCM is expected to provide new therapeutic ideas and measures to solve kidney problems. This article reviews the current status of TCM combined with stem cell therapy for CKD, discusses existing problems, and proposes future prospects.
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Affiliation(s)
- Tianyang Qian
- Division of Nephrology, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
- The First School of Clinical Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Yining He
- Division of Nephrology, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
- The First School of Clinical Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Chao Han
- The First School of Clinical Medicine, Nanjing University of Chinese Medicine, Nanjing, China
- Yancheng Dafeng Hospital of Chinese Medicine, Teaching Hospital of Nanjing University of Chinese Medicine, Yancheng, China
| | - Ruxue Yan
- Division of Nephrology, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
- The First School of Clinical Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Weiming He
- Division of Nephrology, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
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13
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Laradhi AO, Shan Y, Allawy ME. Psychological wellbeing and treatment adherence among cardio-renal syndrome patients in Yemen: a cross section study. Front Med (Lausanne) 2025; 11:1439704. [PMID: 39839638 PMCID: PMC11747712 DOI: 10.3389/fmed.2024.1439704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Accepted: 12/19/2024] [Indexed: 01/23/2025] Open
Abstract
Background Anxiety and depression are associated with adverse outcomes in cardiorenal syndrome patients undergoing hemodialysis, including decreased quality of life, poorer clinical parameters, and lower treatment adherence. Objective This study aimed to examine the level of psychological wellbeing and its relationship with treatment adherence among dialysis patients with cardiorenal syndrome. Methods This cross-sectional descriptive study was conducted between February and May 2021 on convenience sampling of 100 patients in two dialysis centers in Hadhramout, Yemen. Patients' depression and anxiety levels were assessed using the Hospital Anxiety and Depression Scale (HADS)-Arabic version, and patient treatment adherence was assessed using the Treatment Adherence Questionnaire (TAQ). Descriptive statistics, Pearson's correlation analysis, and multiple linear regression analyzes were performed to analyze data with a significance level set at p < 0.05. Results The mean age ± standard deviation of participants was 53.46 ± 14.24 years. Most (90%) of patients had moderate to high levels of anxiety and depression. Most of the patients (87%) had a low level of treatment adherence. The findings revealed that psychological wellbeing is significantly association with treatment adherence t = 2.577 (95% CI 0.029, 0.225), p = 0.011. Conclusion Anxiety and depression symptoms occurred more frequently among dialysis patients with cardiorenal syndrome, and there was a significant association between psychological wellbeing and treatment adherence. Our findings suggest that nurse managers should take into account that adding psychotherapies into the present cardiorenal syndrome treatment programs would improve patients' clinical and psychological parameters and, consequently, their clinical outcomes while taking patient heterogeneity and resource limitations into consideration.
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Affiliation(s)
- Adel Omar Laradhi
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China
- College of Nursing, University of Hail, Hail, Saudi Arabia
| | - Yan Shan
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China
| | - Mohamed Elsayed Allawy
- Department of Nursing Sciences, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Wadi Alddawasir, Saudi Arabia
- Medical- Surgical Nursing Department, Faculty of Nursing Suez Canal University, Ismailia, Egypt
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Chunyan F, Zhenbin J, Weiyi J, Haiyan M, Jinrong Z, Yue W, Song W, Chunyan S. The influence of near-infrared therapy on arteriovenous fistula patency in haemodialysis patients: A multicentre, randomised, controlled clinical trial. J Vasc Access 2025; 26:315-321. [PMID: 38708826 DOI: 10.1177/11297298241251501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2024] Open
Abstract
BACKGROUND Arteriovenous fistula (AVF) is the preferred vascular access for patients undergoing haemodialysis (HD). AVF malfunction remains a major clinical problem and is a significant independent risk factor for death. Although far-infrared (FIR) therapy has been shown to reduce complications and improve the patency rate of AVFs in various studies, it has been cautiously recommended by the Kidney Disease Outcome Quality Initiative (KDOQI) guidelines for AVF care due to insufficient evidence. Therefore, it is necessary to identify more effective methods for preventing AVF dysfunction. Many in vitro studies and few clinical studies have examined the effects of near-infrared (NIR) therapy on the vasculature. This study will examine the effects of NIR therapy on AVF. METHODS A randomised, controlled, open-label, multicentre trial will compare the effect of NIR on AVF patency after 1 year of therapy with that of a control group of patients with existing AVF. One group of patients received NIR treatment above their AVFs, whereas the control group received regular care. The primary outcome is the primary fistula patency rate within 12 months. In addition, acute changes in inflammatory, vasodilatory and haemodynamic parameters after a single treatment in the first 40 participants will be examined. This study was registered in the Clinical Trials Registry (ChiCTR2300071305) at https://register.clinicaltrials.gov/. DISCUSSIONS This study will explore the long-term and acute effects of NIR on AVFs. The study findings will provide information that can be used to develop new technical support for the prevention of AVF dysfunction in patients undergoing haemodialysis.
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Affiliation(s)
- Feng Chunyan
- Department of Nephrology, Peking University Third Hospital, Beijing, China
| | - Jiang Zhenbin
- Department of Nephrology, Peking University Third Hospital, Beijing, China
| | - Jin Weiyi
- Department of Nephrology, Peking University Third Hospital, Beijing, China
| | - Men Haiyan
- Department of Nephrology, Peking University Third Hospital, Beijing, China
| | - Zhu Jinrong
- Department of Nephrology, Peking University Third Hospital, Beijing, China
| | - Wang Yue
- Department of Nephrology, Peking University Third Hospital, Beijing, China
| | - Wang Song
- Department of Nephrology, Peking University Third Hospital, Beijing, China
| | - Su Chunyan
- Department of Nephrology, Peking University Third Hospital, Beijing, China
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15
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Tripathi RK, Pilliwar C, Gajbhiye SV, Bhilwade SK, Jamale T. Evaluation of self medication practices and prescription patterns in patients of chronic kidney disease: A cross-sectional, questionnaire based study. Perspect Clin Res 2025; 16:23-30. [PMID: 39867525 PMCID: PMC11759236 DOI: 10.4103/picr.picr_308_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 02/27/2024] [Accepted: 03/20/2024] [Indexed: 01/28/2025] Open
Abstract
Background Pharmacotherapy of chronic kidney disease (CKD) consists of prescribing myriad of drugs such as antihypertensives, antidiabetics, and phosphate binders to delay disease progression and control the comorbidities, resulting in inherent variability in prescriptions. In addition, tendency to self-medicate may further aggravate the condition. Hence, the present study was planned to assess self-medication practices and variability in prescription patterns in CKD patients. Methodology A cross-sectional, questionnaire-based study approved by the ethics committee was conducted in CKD patients attending the nephrology outpatient department. The prescription details which included drug name, dosage form, dose, frequency, duration, and dosage instructions were recorded and prescription completeness was checked. To assess the tendency of CKD patients to self-medicate, each patient was administered a prevalidated [Content Validity Ratio (CVR) = 0.76] 8-item questionnaire which had dichotomous responses "Yes" and "No" and was scored as 2 and 0, respectively (total score 16). Results Three hundred CKD patients (150 on hemodialysis and 150 nondialysis) yielded 300 prescriptions with 1272 drugs. It was evident that 33% of patients did self-medicate themselves with analgesics, and the mean score (7.81 ± 3.01) of self-medication practices was perceived significantly higher in the nondialysis group (8.41 ± 3.46). The most common classes of drugs prescribed in CKD patients were calcium channel blockers (41%), antidiabetic drugs (39%), diuretics (35%), gastrointestinal drugs (35%), and multivitamins (27%), with the average number of drugs being 5.84 ± 0.51. Conclusion Nearly one-third of CKD patients were self-medicating with paracetamol, nonsteroidal anti-inflammatory drugs; more in the nondialysis group emphasizing reinforcement of patient education programs. The most common drugs prescribed were amlodipine, followed by metformin, and the average number of drugs was less in our setting, indicating vigilant dose prescribing in CKD patients.
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Affiliation(s)
- Raakhi K Tripathi
- Department of Pharmacology and Therapeutics, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
| | - Chaitali Pilliwar
- Department of Pharmacology and Therapeutics, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
| | | | - Sujeet K. Bhilwade
- Department of Pharmacology and Therapeutics, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
| | - Tukaram Jamale
- Department of Nephrology, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
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16
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Chang ST, Liou JY, Wu BJ, Chen HK. Prevalence and risk factors for chronic kidney disease among older adult patients with schizophrenia in Taiwan. Int J Psychiatry Med 2025; 60:87-96. [PMID: 38763912 DOI: 10.1177/00912174241256164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/21/2024]
Abstract
OBJECTIVES There is an increasing incidence and prevalence of patients with chronic kidney disease (CKD) worldwide. Little is known the prevalence of CKD among older patients with schizophrenia. The purpose of this study was to investigate the prevalence of CKD and its risk factors in older adults with schizophrenia. METHODS In this cross-sectional study, a convenience sample of 240 patients with schizophrenia age 50 or older was recruited. In addition to demographic and clinical data, participants' estimated glomerular filtration rate was calculated using the Modification of Diet in Renal Disease equation based on age, sex, ethnicity, and serum creatinine level determined from a blood sample taken from participants. RESULTS The overall prevalence of CKD was 11.3%. Those with CKD were older, had a longer duration of psychiatric illness, a higher body mass index (BMI), and diagnoses of hypertension compared to those in the non-CKD group. Independent of other risk factors, older age and BMI were significantly associated with CKD. CONCLUSIONS This study found that the overall prevalence of CKD in older patients with schizophrenia was 11.3%. Independent risk factors for CKD in this population were older age and higher BMI. In addition to early identification and early treatment of CKD in older patients with schizophrenia, clinicians should actively manage the risk factors identified in this study.
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Affiliation(s)
- Shu-Ting Chang
- Department of Psychiatry, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Jiunn-Ying Liou
- Department of Psychiatry, Yuli Hospital, Ministry of Health and Welfare, Hualien, Taiwan
| | - Bo-Jian Wu
- Department of Psychiatry, Yuli Hospital, Ministry of Health and Welfare, Hualien, Taiwan
| | - Hsing-Kang Chen
- Department of Psychiatry, Yuli Hospital, Ministry of Health and Welfare, Hualien, Taiwan
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17
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Panda SK, Maloth RK, Upadyayalu V, Mishra A, Noronha S. Detections of Chemicals and Migratory Plastics in Peritoneal Dialysis Fluids. Indian J Nephrol 2025; 35:34-39. [PMID: 39872250 PMCID: PMC11763172 DOI: 10.25259/ijn_515_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 03/03/2024] [Indexed: 01/30/2025] Open
Abstract
Background Peritoneal dialysis (PD) is an important modality of renal replacement therapy (RRT). Peritonitis and ultrafiltration failure are complications that have a long-term impact on PD patients. Besides touch contamination, procedural errors and clinical reasons of peritonitis, contaminants, and constituents of peritoneal dialysis fluids (PDFs) have been implicated in causing peritonitis and ultrafiltration failure. This study was aimed to test the PDFs in India for the presence of migratory plastics. Materials and Methods PDFs from the two manufacturers in India were tested using liquid chromatography mass spectrometry (LCMS) and gas chromatography mass spectrometry (GCMS) with headspace analysis (volatile compounds) and pyrolysis of plastics (polymer compounds). The storage conditions and handling were uniform. Results The results revealed impurities of acetate compounds and aldehyde derivatives of glucose degradation products (GDPs) with contaminants and leachable plastics. There were high levels of GDP derivative in the form of 5-hydroxymethylfurfural compounds (5-HMF). The analysis revealed the presence of plastic softeners in very high concentrations. Conclusion The study unmasks the presence of chemicals and GDPs that can be implicated in pathogenesis of sterile peritonitis and ultrafiltration failure. The study demonstrated the presence of leachable plastics. In conclusion, LCMS and GCMS studies can be used to test PDFs for unwanted chemicals prior to human use.
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Affiliation(s)
| | - Rama Krishna Maloth
- Department of Analytical and Structural Chemistry, CSIR-Indian Institute of Chemical Technology, Hyderabad, Tarnaka, India
| | - Vijayasarthi Upadyayalu
- Department of Analytical and Structural Chemistry, CSIR-Indian Institute of Chemical Technology, Hyderabad, Tarnaka, India
| | - Ankita Mishra
- Department of Chemical Engineering, Indian Institute of Technology, Hyderabad, Tarnaka, India
| | - Santosh Noronha
- Department of Chemical Engineering, Indian Institute of Technology, Hyderabad, Tarnaka, India
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18
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Chen Q, Ou L. Meta-analysis of the association between the dietary inflammatory index and risk of chronic kidney disease. Eur J Clin Nutr 2025; 79:7-14. [PMID: 39138357 DOI: 10.1038/s41430-024-01493-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Revised: 08/01/2024] [Accepted: 08/05/2024] [Indexed: 08/15/2024]
Abstract
To explore the relationship between Dietary Inflammatory Index (DII) and chronic kidney disease (CKD) risk, we obtained 6 studies (3 prospective studies and 3 cross-sectional studies) from PubMed, CBM, Cochrane Library, and Embase, as of March 6, 2023. Our results revealed a positive link between the CKD risk and rising DII that signified a pro-inflammatory diet. With medium heterogeneity (Overall RR = 1.44, 95%CI: 1.22, 1.71; I2 = 64.7%, P = 0.015), individuals in the highest DII exposure category had a 44% greater overall risk of developing CKD than those in the lowest DII exposure category. According to risk estimations from cross-sectional studies, individuals in the highest DII exposure category had a 64% higher risk of developing CKD than those in the lowest DII exposure category, with significant heterogeneity (RR = 1.64, 95%CI: 1.18, 2.29; I2 = 70.9%, P = 0.032). The risk estimates in cohort studies revealed individuals in the highest DII exposure category had a 28% higher risk of CKD than those in the lowest DII exposure category, with a low heterogeneity (RR = 1.28, 95%CI: 1.14, 1.44; I2 = 17.2%, P = 0.015). Cross-sectional studies showed a nonlinear dose-response relationship between DII and CKD risk, while cohort studies indicated a linear dose-response relationship. Meta-regression results showed publication year, study design, and country had no significant correlation with the meta-analysis. The subgroup analysis results remained consistent. Results support the significance and importance of adopting a better anti-inflammatory diet in preventing CKD. These findings further confirm DII as a tool of the inflammatory potential of the diet to prevent and delay the onset and progression of CKD.
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Affiliation(s)
- Qiujin Chen
- Department of Immunization, The Affiliated Wuxi Center for Disease Control and Prevention of Nanjing Medical University, Wuxi Center for Disease Control and Prevention, Wuxi, 214023, China
| | - Liang Ou
- Department of Infection Control, Wuxi No.2 People's Hospital, Wuxi, 214000, China.
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19
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Azeez A, Ambatipudi S. Caregiver burden and quality of life among family caregivers of hemodialysis patients from South India. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2024; 13:486. [PMID: 39850309 PMCID: PMC11756677 DOI: 10.4103/jehp.jehp_273_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 05/06/2024] [Indexed: 01/25/2025]
Abstract
BACKGROUND Hemodialysis (HD) patients require assistance from family caregivers in performing daily activities. This additional responsibility may cause caregivers to feel burdened, resulting in a poor quality of life. The current study envisaged assessing the degree of caregiver burden (CB) and quality of life among the primary caregivers of HD patients. MATERIALS AND METHODS A cross-sectional study was conducted among conveniently sampled, consenting family caregivers (N = 200) of HD patients in tertiary care dialysis centers in Thiruvananthapuram, Kerala, India, from March 2022 to May 2022. A structured interview schedule was used to collect sociodemographic data from participants. The caregiver burden and quality of life were assessed using the Zarit Burden Interview and the World Health Organization (WHO) Quality of Life (QoL) BREF scale. Univariate and multivariate analyses were performed to determine the association between the variables. RESULTS Fifty-eight percent of the caregivers reported CB. Caregivers with no leisure time (ORadj = 3.29 [95% CI: 1.73-6.41]), perceived financial stress (ORadj = 2.27 [95% CI: 1.16-4.49]), and having comorbidities (ORadj = 2.92 [95% CI: 1.43-6.12]) had an increased odds of experiencing caregiver burden. The CB score was inversely correlated with all domains of QoL. Moreover, the QoL score was lower among family caregivers with CB than those without CB. CONCLUSION The present study highlights a high prevalence of caregiver burden, which negatively impacts the QoL of family caregivers of HD patients. This study opens up new directions for possible policy-making to reduce caregiver burden and improve the QoL of family caregivers.
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Affiliation(s)
- Afina Azeez
- Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Medical College, Thiruvananthapuram, Kerala, India
| | - Srikant Ambatipudi
- Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Medical College, Thiruvananthapuram, Kerala, India
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20
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Hsu HC, Mazibuko MS, Robinson C, Dlongolo N, Woodiwiss A, Teckie G, Tade G, Dessein PH. Diabetic Nephropathy-Associated Impaired Aortic Function Is Not Mediated by Mean Arterial Pressure and Its Determinants. J Clin Med 2024; 13:7827. [PMID: 39768750 PMCID: PMC11727795 DOI: 10.3390/jcm13247827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2024] [Revised: 12/10/2024] [Accepted: 12/19/2024] [Indexed: 01/16/2025] Open
Abstract
Objective: The study aimed to assess the potential impacts of mean arterial pressure (MAP) and its determinants (cardiac output and systemic vascular resistance) on diabetic nephropathy (DNP)-associated impaired aortic function. Methods: This multi-ethnic study included 115 chronic kidney disease (CKD) patients (67 non-dialysis and 48 dialysis). Six aortic function measures were evaluated by SpygmoCor. The stroke volume was determined by echocardiography. Results: Hypertensive nephropathy (HNP) (53.9%), DNP (32.2%), glomerulonephritis (19.1%), and HIV-associated nephropathy (7.8%) composed the major CKD etiologies. Concurrent HNP and DNP were present in 31.1% of the patients. Participants with compared with those without concurrent HNP and DNP experienced more frequent established cardiovascular disease (43.2% versus 14.9%, p = 0.01), a faster pulse wave velocity (p = 0.001), and smaller total arterial compliance as an indicator of proximal aortic stiffness (p = 0.03). DNP was associated with each aortic function measure (p < 0.001-0.02) independent of potential confounders and MAP, as well as its determinants. HNP was not related to aortic function (p > 0.05 for all relationships). MAP and its determinants did not mediate the potential impact of DNP on aortic function (-4.1-6.4% contribution). Covariates that were associated with impaired aortic function measures included MAP and its determinants (p < 0.001-0.01). Conclusions: Mean or distending arterial pressure and its determinants were associated with impaired aortic function in the overall CKD population. However, these hemodynamic factors did not mediate DNP-associated impaired aortic function. Our results suggest that blood pressure lowering can be anticipated to improve impaired aortic function in the overall CKD population but not when it is solely induced by DNP.
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Affiliation(s)
- Hon-Chun Hsu
- Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2193, South Africa; (H.-C.H.); (M.S.M.); (C.R.); (A.W.); (G.T.)
- Nephrology Unit, Milpark Hospital, Johannesburg 2193, South Africa
| | - Makabongwe S’kholiwe Mazibuko
- Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2193, South Africa; (H.-C.H.); (M.S.M.); (C.R.); (A.W.); (G.T.)
| | - Chanel Robinson
- Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2193, South Africa; (H.-C.H.); (M.S.M.); (C.R.); (A.W.); (G.T.)
| | - Noluntu Dlongolo
- Rheumatology Unit, Rosebank Hospital, Johannesburg 2193, South Africa;
| | - Angela Woodiwiss
- Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2193, South Africa; (H.-C.H.); (M.S.M.); (C.R.); (A.W.); (G.T.)
| | - Gloria Teckie
- Division of Nephrology, Department of Medicine, Chris Hani Baragwanath Hospital and Faculty of Health Sciences, University of Witwatersrand, Johannesburg 2193, South Africa;
| | - Grace Tade
- Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2193, South Africa; (H.-C.H.); (M.S.M.); (C.R.); (A.W.); (G.T.)
| | - Patrick Hector Dessein
- Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2193, South Africa; (H.-C.H.); (M.S.M.); (C.R.); (A.W.); (G.T.)
- Rheumatology Unit, Rosebank Hospital, Johannesburg 2193, South Africa;
- Internal Medicine Department, University of the Witwatersrand, Johannesburg 2193, South Africa
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21
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Kwon MJ, Kang HS, Kim JH, Kim JH, Bang WJ, Yoo DM, Lee NE, Han KM, Kim NY, Choi HG, Kim MJ, Kim ES. Chronic Kidney Disease and Infection Risk: A Lower Incidence of Peritonsillar Abscesses in Specific CKD Subgroups in a 16-Year Korean Nationwide Cohort Study. Microorganisms 2024; 12:2614. [PMID: 39770818 PMCID: PMC11679683 DOI: 10.3390/microorganisms12122614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2024] [Revised: 12/13/2024] [Accepted: 12/14/2024] [Indexed: 01/11/2025] Open
Abstract
Peritonsillar abscesses and deep neck infection are potentially serious infections among patients with chronic kidney disease (CKD), posing risks for severe complications and drawing significant public health concern. This nationwide, population-based longitudinal study (2002-2019) assessed the extended relationship between chronic kidney disease (CKD) and the likelihood of peritonsillar abscess and deep neck infection in a Korean cohort. Using a 1:4 propensity score overlap-weighted matching, we included 16,879 individuals with CKD and 67,516 comparable controls, accounting for demographic variables and comorbidities to ensure balanced group comparisons. Hazard ratios (HRs) and 95% confidence intervals (CIs) for deep neck infection and peritonsillar abscesses in relation to CKD history were calculated with a propensity score overlap-weighted Cox proportional hazards model. Our results revealed no significant increase in the overall incidence of deep neck infections or peritonsillar abscesses in CKD patients compared to controls. Interestingly, CKD patients demonstrated a 50% reduced likelihood of developing peritonsillar abscesses (HR 0.50; 95% CI = 0.30-0.83; p = 0.007), particularly among subgroups aged 70 years or older, females, non-smokers, rural residents, overweight individuals, and those with lower comorbidity burdens (e.g., absence of hypertension, hyperlipidemia, or hyperglycemia). In summary, the results suggest that lifestyle modifications and the effective management of comorbidities could reduce the risk of peritonsillar abscess in certain CKD subgroups. Our findings may help to alleviate public health concerns regarding peritonsillar abscesses and deep neck infections as CKD-related comorbidities.
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Affiliation(s)
- Mi Jung Kwon
- Department of Pathology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Republic of Korea;
| | - Ho Suk Kang
- Division of Gastroenterology, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Republic of Korea;
| | - Joo-Hee Kim
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Republic of Korea;
| | - Ji Hee Kim
- Department of Neurosurgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Republic of Korea;
| | - Woo Jin Bang
- Department of Urology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Republic of Korea;
| | - Dae Myoung Yoo
- Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang 14068, Republic of Korea; (D.M.Y.); (N.-E.L.); (K.M.H.)
- Laboratory of Brain and Cognitive Sciences for Convergence Medicine, Hallym University College of Medicine, Anyang 14068, Republic of Korea
| | - Na-Eun Lee
- Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang 14068, Republic of Korea; (D.M.Y.); (N.-E.L.); (K.M.H.)
- Laboratory of Brain and Cognitive Sciences for Convergence Medicine, Hallym University College of Medicine, Anyang 14068, Republic of Korea
| | - Kyeong Min Han
- Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang 14068, Republic of Korea; (D.M.Y.); (N.-E.L.); (K.M.H.)
- Laboratory of Brain and Cognitive Sciences for Convergence Medicine, Hallym University College of Medicine, Anyang 14068, Republic of Korea
| | - Nan Young Kim
- Hallym Institute of Translational Genomics and Bioinformatics, Hallym University Medical Center, Anyang 14068, Republic of Korea;
| | - Hyo Geun Choi
- Suseo Seoul E.N.T. Clinic, 10, Bamgogae-ro 1-gil, Gangnam-gu, Seoul 06349, Republic of Korea;
| | - Min-Jeong Kim
- Department of Radiology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Republic of Korea;
| | - Eun Soo Kim
- Department of Radiology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Republic of Korea;
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22
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Çelik NB, Losekoot M, Işık E, Gönç EN, Alikaşifoğlu A, Kandemir N, Özön ZA. Long-term Growth Hormone Therapy in a Patient with IGF1R Deletion Accompanied by Delayed Puberty and Central Hypothyroidism. J Clin Res Pediatr Endocrinol 2024; 16:481-488. [PMID: 36688726 PMCID: PMC11629727 DOI: 10.4274/jcrpe.galenos.2022.2022-8-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 12/17/2022] [Indexed: 01/24/2023] Open
Abstract
Insulin-like growth factor-1 (IGF-1) is the main driver of growth during prenatal life and acts through IGF-1 receptor (IGF1R). Patients with IGF1R defects exhibit variable phenotypic features. A 10.9-year-old boy presented with severe short stature, microcephaly, minor dysmorphic features and mental retardation. Genetic analysis for IGF1R revealed heterozygous deletion of the complete IGF1R. At the age of 12.3 years, daily subcutaneous recombinant human growth hormone (rhGH) was started and continued for a total of 5.7 years in two courses with improvement of height velocity as well as final height. Puberty was delayed and eventually he did not achieve full puberty, suggesting partial hypogonadotropic hypogonadism. Hypothyroidism initially developed during rhGH therapy. However, low T4 levels persisted after cessation of rhGH therapy and thus central hypothyroidism is a likely diagnosis. rhGH has partial effect for induction of growth in cases with IGF1R defects. However, long-term treatment with an early initiation may have more beneficial effects. In addition, patients with IGF1R defects should be followed for delayed puberty-hypogonadism, and hypothyroidism.
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Affiliation(s)
- Nur Berna Çelik
- Hacettepe University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Endocrinology, Ankara, Turkey
| | - Monique Losekoot
- Leiden University Medical Centre, Department of Clinical Genetics, Leiden, The Netherlands
| | - Emregül Işık
- Hacettepe University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Endocrinology, Ankara, Turkey
| | - E. Nazlı Gönç
- Hacettepe University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Endocrinology, Ankara, Turkey
| | - Ayfer Alikaşifoğlu
- Hacettepe University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Endocrinology, Ankara, Turkey
| | - Nurgün Kandemir
- Hacettepe University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Endocrinology, Ankara, Turkey
| | - Z. Alev Özön
- Hacettepe University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Endocrinology, Ankara, Turkey
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23
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Han S, Jia M, Yuan W, Wang Y, Lu Y, Xu Y, Shang L. The association between peripheral eosinophil count and chronic kidney disease: evidence from NHANES 1999-2018. Ren Fail 2024; 46:2319324. [PMID: 38390735 PMCID: PMC10896169 DOI: 10.1080/0886022x.2024.2319324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 02/09/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND Renal impairment has been previously linked to peripheral eosinophil count (PEC), prompting an investigation into its potential relationship with chronic kidney disease (CKD). This cross-sectional study utilized data from the National Health and Nutrition Examination Survey (NHANES 1999-2018) to comprehensively explore the association between PEC and CKD. METHODS Survey-weighted generalized multivariate linear regression was employed to evaluate the associations between PEC, urinary albumin-to-creatinine ratio (UACR), and estimated glomerular filtration rate (eGFR), with meticulous adjustment for potential covariates. To assess non-linear correlations, a restricted cubic spline analysis was conducted. Sensitivity analysis was performed to test the stability of results. RESULTS The study included a total of 9224 participants with non-dialysis CKD. In the multivariate linear regression model, after comprehensive adjustment for potential covariates, PEC showed a negative association with eGFR (β per 100 cells/uL increase in PEC, -0.71; 95% CI, -1.04, -0.37), while demonstrating a positive trend with UACR (β per 100 cells/uL increase in PEC, 10.21; 95% CI, 1.37, 19.06). The restrictive cubic spline curve analysis suggested that these associations occurred within the range of 0 to 400 cells/uL for PEC. Sensitivity analysis supported the stability of the observed results. CONCLUSIONS Circulating eosinophil levels are negatively correlated with eGFR and demonstrate a positive trend with UACR, when PEC falls within the range of less than 400 cells/uL among adults with CKD. Further research is warranted to validate these findings.
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Affiliation(s)
- Shisheng Han
- Department of Nephrology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Meng Jia
- Department of Nephrology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Wenli Yuan
- Department of Nephrology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yi Wang
- Department of Nephrology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yan Lu
- Department of Nephrology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yanqiu Xu
- Department of Nephrology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Li Shang
- Institute of Science, Technology and Humanities, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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24
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Huang J, Mao J, Liu H, Li Z, Liang G, Zhang D, Yang J, Qin W, Wen P, Jiang Y, Mo Z. Association between exposure to arsenic, cadmium, and lead and chronic kidney disease: evidence from four practical statistical models. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2024; 47:6. [PMID: 39614915 DOI: 10.1007/s10653-024-02318-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2024] [Accepted: 11/25/2024] [Indexed: 01/11/2025]
Abstract
BACKGROUND Environmental exposure to arsenic (As), lead (Pb) and cadmium (Cd) may cause chronic kidney disease (CKD), with varying independent effects and unclear combined impact. This study aimed to evaluate these effects on CKD. METHODS 1,398 individuals were included. Urine arsenic (UAs) was determined by atomic fluorescence method. Urinary cadmium (UCd) and blood lead (BPb) levels were determined by graphite-furnace atomic absorption spectrometry. CKD was defined as an estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73m2 or proteinuria. Generalized linear models (GLM), restricted cubic spline (RCS) models, weighted quantile sum (WQS) regression, and Bayesian kernel machine regression (BKMR) models were employed to study the independent and combined effects of exposure to As, Pb and Cd on CKD risk. RESULTS Compared with non-CKD subjects, UAs, UCd, BPb, and creatinine adjusted urinary cadmium (UCdCr) were all significantly higher in CKD subjects. Compared with the lowest quartiles, the ORs (95%CIs) of CKD risk in the highest quartiles were 2.09 (1.16-3.74) for UAs, 2.84(1.56-5.18) for UCd, and 1.79 (1.05-3.06) for UCdCr, respectively. UAs, UCd, and UCdCr were all significantly positively associated with CKD risk in p-trend tests. RCS models revealed non-linear links between UAs, UCd, UCdCr and CKD risk, while a linear dose-response existed for BPb and CKD risk. The OR (95%CI) in WQS models were 1.72 (1.25-2.36) with UAs being the highest weighing metal(loid). BKMR models showed co-exposure mixture linked to higher CKD risk when the ln-transformed metal(loid)s above their 55th percentile. The ln-transformed UAs and UCdCr was significantly positively associated with CKD risk when the other two ln-transformed metals levels were all fixed at their different percentile levels. Synergism between Cd and Pb was also apparent. CONCLUSIONS Single As, and Cd exposure were positively associated with an increased CKD risk. Co-exposure to As, Pb and Cd was positively associated with CKD risk, with As playing a dominant role.
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Affiliation(s)
- Jiongli Huang
- Scientific Research Academy of Guangxi Environmental Protection, Nanning, 530022, China
- Department of Toxicology, School of Public Health, Guangxi Medical University, Nanning, 530021, China
| | - Jingying Mao
- Scientific Research Academy of Guangxi Environmental Protection, Nanning, 530022, China
| | - Huilin Liu
- Scientific Research Academy of Guangxi Environmental Protection, Nanning, 530022, China
| | - Zhongyou Li
- Department of Preventive Medicine, School of Public Health and Management, Guangxi University of Chinese Medicine, Nanning, 530200, China
| | - Guiyun Liang
- Scientific Research Academy of Guangxi Environmental Protection, Nanning, 530022, China
| | - Dabiao Zhang
- Scientific Research Academy of Guangxi Environmental Protection, Nanning, 530022, China
| | - Junchao Yang
- Scientific Research Academy of Guangxi Environmental Protection, Nanning, 530022, China
| | - Wen Qin
- Scientific Research Academy of Guangxi Environmental Protection, Nanning, 530022, China
| | - Pingjing Wen
- Department of Preventive Medicine, School of Public Health and Management, Guangxi University of Chinese Medicine, Nanning, 530200, China
| | - Yueming Jiang
- Department of Toxicology, School of Public Health, Guangxi Medical University, Nanning, 530021, China
| | - Zhaoyu Mo
- Scientific Research Academy of Guangxi Environmental Protection, Nanning, 530022, China.
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25
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Lim LM, Kuo HT, Chao YL, Shen FC, Chen YK, Chiu YW, Hwang SJ, Hung CC. Malnutrition-Inflammation Score of Patients with Chronic Kidney Disease from Early Stage to Initiation of Dialysis. Nutrients 2024; 16:4014. [PMID: 39683409 DOI: 10.3390/nu16234014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2024] [Revised: 11/18/2024] [Accepted: 11/22/2024] [Indexed: 12/18/2024] Open
Abstract
Background: The malnutrition-inflammation score (MIS) is a practical and accessible tool for evaluating protein energy wasting (PEW) in patients on dialysis. However, the severity of PEW at each stage of chronic kidney disease (CKD), especially with late dialysis initiation, is unclear. Methods: We evaluated the MIS of 3659 patients with CKD stages 1-5 and the changes in their MIS results at baseline and at the time before dialysis initiation. Patients were defined to have PEW if they had a subjective global assessment (SGA) rating of C or lower. Results: The MIS increased substantially over a follow-up period of 6.12 years for 1124 patients just starting dialysis, with 49.3% having an MIS of 8. The pre-dialysis MIS was associated with baseline MIS, age, cardiovascular disease, and cancer. The prevalence of PEW based on an SGA rating of C or lower increased from 10.5% at baseline to 61.2% immediately before dialysis. The prevalence of PEW based on an MIS of ≥8 increased from 28.5% at baseline to 49.3% immediately before dialysis. In CKD stage 5 patients, 29.4% had PEW based on an MIS of 8 or less, and 11.6% had an SGA rating of C. The MIS was revealed to be associated with renal function, nutritional markers, and cardiometabolic disease (diabetes or cardiovascular disease). Conclusions: In conclusion, the MIS increased as CKD progressed to stages 4 and 5, as well as just prior to dialysis. Our study identified patients who required PEW assessment on the basis of their MIS results.
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Affiliation(s)
- Lee-Moay Lim
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807378, Taiwan
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807378, Taiwan
| | - Hung-Tien Kuo
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807378, Taiwan
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807378, Taiwan
| | - Yu-Lin Chao
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807378, Taiwan
| | - Feng-Ching Shen
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807378, Taiwan
| | - Yi-Kong Chen
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807378, Taiwan
| | - Yi-Wen Chiu
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807378, Taiwan
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807378, Taiwan
| | - Shang-Jyh Hwang
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807378, Taiwan
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807378, Taiwan
| | - Chi-Chih Hung
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807378, Taiwan
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807378, Taiwan
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Tafese ST, Abera EG, Mersha MD, Woldemariam MB. Clinical characteristics and outcomes of patients on haemodialysis at Jimma medical center, Ethiopia: a 7-Year review. BMC Nephrol 2024; 25:420. [PMID: 39578801 PMCID: PMC11583399 DOI: 10.1186/s12882-024-03860-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2024] [Accepted: 11/15/2024] [Indexed: 11/24/2024] Open
Abstract
BACKGROUND Haemodialysis is the primary kidney replacement therapy modality in Africa. In Ethiopia, the number of patients undergoing Haemodialysis is increasing, yet data on their outcomes is scarce. This study assesses the clinical characteristics and outcomes of Haemodialysis patients at Jimma Medical Center. METHODS A retrospective cross-sectional study was conducted from April 08 to 12, 2024, involving patients who underwent Haemodialysis at Jimma Medical Center from June 2017 to March 2024. The data were coded and entered into EpiData version 3.1, then exported to the Statistical Package for Social Sciences version 26.0 for analysis. Descriptive statistics summarized the patients' clinical characteristics and outcomes, and Kaplan-Meier curves were used to assess survival status. RESULTS During the seven-year study period, 68 patients underwent Haemodialysis at Jimma Medical Center, with a predominance of males (69.1%). The average age of patients was 42.7 (± 12.8) years with 69.1% (95% CI: 57.5-79.1%) diagnosed with chronic kidney disease, while 30.9% (95% CI: 20.9-42.5%) had acute kidney injury. Among chronic kidney disease patients, common clinical features included nausea and vomiting (100%), proteinuria (95.7%), and body swelling (82.9%), while acute kidney injury patients frequently presented with oliguria (100%), nausea and vomiting (90.5%), and hematuria (52.4%). Hypertensive nephropathy was the leading cause of chronic kidney disease (40.4%), and acute glomerulonephritis (38.1%) and severe malaria (33.3%) were the predominant causes of acute kidney injury. Mortality was observed at 47.6% (95% CI: 27.7-68.6%) in acute kidney injury patients and 40.4% (95% CI: 27.3-54.7%) in chronic kidney disease patients. Emergency vascular access was required in 95.7% of chronic kidney disease and 100% of acute kidney injury patients. CONCLUSION This study highlights the substantial burden of chronic kidney disease and acute kidney injury among hemodialysis patients at Jimma Medical Center, revealing distinct clinical profiles and outcomes. Although acute kidney injury patients exhibited a longer median survival time, the significant mortality risk within the first year underscores the urgent need for improved treatment access and resource allocation. Enhancing early intervention and ensuring the availability of critical medications, such as erythropoietin, are essential for optimizing patient outcomes for both chronic kidney disease and acute kidney injury groups. CLINICAL TRIAL NUMBER Not applicable.
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Affiliation(s)
| | - Eyob Girma Abera
- Department of Public Health, Jimma University, Jimma, 378, Oromia, Ethiopia.
- Jimma University Clinical Trial Unit, Jimma, Oromia, Ethiopia.
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Cai Y, Lv H, Yuan M, Wang J, Wu W, Fang X, Chen C, Mu J, Liu F, Gu X, Xie H, Liu Y, Xu H, Fan Y, Shen C, Ma X. Genome-wide association analysis of cystatin c and creatinine kidney function in Chinese women. BMC Med Genomics 2024; 17:272. [PMID: 39558362 PMCID: PMC11575226 DOI: 10.1186/s12920-024-02048-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2024] [Accepted: 11/07/2024] [Indexed: 11/20/2024] Open
Abstract
BACKGROUND With increasing incidence and treatment costs, chronic kidney disease (CKD) has become an important public health problem in China, especially in females. However, the genetic determinants are very limited. The estimated glomerular filtration rate (eGFR) based on creatinine is commonly used as a measure of renal function but can be easily affected by other factors. In contrast, eGFR based on both creatinine and cystatin C (eGFRcr-cys) improved the diagnostic accuracy of CKD. To our knowledge, no genome-wide association analysis of eGFRcr-cys has been conducted in the Chinese population. METHODS By conducting a Genome-Wide association study(GWAS), a method used to identify associations between genetic regions (genomes) and traits/diseases, we examined the relationship between genetic factors and eGFRcr-cys in Chinese women, with 1983 participants and 3,838,121 variants included in the final analysis. RESULT One significant locus (20p11.21) was identified in the Chinese female population, which has been reported to be associated with eGFR based on cystatin C (eGFRcys) in the European population. More importantly, we found two new suggestive loci (1p31.1 and 11q24.2), which have not yet been reported. A total of three single nucleotide polymorphisms were identified as the most important variants in these regions, including rs2405367 (CST3), rs66588571(KRT8P21), and rs626995 (OR8B2). CONCLUSION We identified 3 loci 20p11.21, 1p31.1, and 11q24.2 to be significantly associated with eGFRcr-cys. These findings and subsequent functional analysis describe new biological clues related to renal function in Chinese women and provide new ideas for the diagnosis and treatment development of CKD.
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Affiliation(s)
- Yang Cai
- College of Public Health, Southwest Medical University, Luzhou, Sichuan, China
- Department of Epidemiology, College of Preventive Medicine, Third Military Medical University (Army Medical University), Chongqing, China
| | - Hongyao Lv
- Department of Epidemiology, College of Preventive Medicine, Third Military Medical University (Army Medical University), Chongqing, China
| | - Meng Yuan
- Department of Epidemiology, College of Preventive Medicine, Third Military Medical University (Army Medical University), Chongqing, China
| | - Jiao Wang
- Department of Epidemiology, College of Preventive Medicine, Third Military Medical University (Army Medical University), Chongqing, China
| | - Wenhui Wu
- Department of Epidemiology, College of Preventive Medicine, Third Military Medical University (Army Medical University), Chongqing, China
| | - Xiaoyu Fang
- Department of Epidemiology, College of Preventive Medicine, Third Military Medical University (Army Medical University), Chongqing, China
| | - Changying Chen
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Jialing Mu
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Fangyuan Liu
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Xincheng Gu
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Hankun Xie
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Yu Liu
- Institute for the prevention and control of chronic non-communicable diseases, Center for Disease Control and Prevention of Jurong City, Jurong, China
| | - Haifeng Xu
- Institute for the prevention and control of chronic non-communicable diseases, Center for Disease Control and Prevention of Jurong City, Jurong, China
| | - Yao Fan
- Department of Clinical Epidemiology, Geriatric Hospital of Nanjing Medical University, Nanjing, China
| | - Chong Shen
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China.
| | - Xiangyu Ma
- College of Public Health, Southwest Medical University, Luzhou, Sichuan, China.
- Department of Epidemiology, College of Preventive Medicine, Third Military Medical University (Army Medical University), Chongqing, China.
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Kumaresan M, Vijayan A, Ramkumar M, Philip NE. Unraveling the enigma: chronic kidney disease of unknown etiology and its causative factors with a specific focus on dissolved organic compounds in groundwater-reviews and future prospects. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2024; 46:510. [PMID: 39527132 DOI: 10.1007/s10653-024-02287-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2024] [Accepted: 10/24/2024] [Indexed: 11/16/2024]
Abstract
Chronic kidney disease is globally recognized as a highly impactful non-communicable disease. The inability of early identification contributes to its high mortality rate and financial burden on affected individuals. Chronic kidney disease of uncertain etiology (CKDu) constitutes a significant global public health concern. This condition does not arise from traditional risk factors such as diabetes, hypertension, or glomerulonephritis. More than 150 articles were analysed to understand risk factors of CKDu. This study aimed to investigate the potential association between dissolved organic compounds, such as Polycyclic Aromatic Hydrocarbons and Humic Acid, and the incidence of CKDu. Through a comprehensive literature review, we identified CKDu clusters worldwide, including notable nephropathies, and explored their potential links with organic compounds. Our analysis revealed that organic compounds can leach from sediments and low-rank lignite deposits into groundwater, subsequently contaminating water supplies and food. These compounds have been implicated in the development of diabetes and increased heavy metal mobility, both of which are risk factors for kidney disease. Our findings suggest that exposure to organic compounds may contribute to the etiology of CKDu, underscoring the need for regular monitoring and establishment of baseline and threshold values in water and soil. We also emphasize the importance of analyzing organic compounds in groundwater in CKDu hotspots and establishing distinct registries for CKD and CKDu implementation.
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Affiliation(s)
- Madhumitha Kumaresan
- Department of Geology, Central University of Tamil Nadu, Thiruvarur, Tamil Nadu, 610005, India
| | - Anjali Vijayan
- Department of Geology, Central University of Tamil Nadu, Thiruvarur, Tamil Nadu, 610005, India.
| | - Mu Ramkumar
- Department of Geology, Periyar University, Salem, 636011, India
| | - Neena Elezebeth Philip
- Department of Epidemiology and Public Health, Central University of Tamil Nadu, Thiruvarur, Tamil Nadu, 610005, India
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Ning L, Tang J, Chen Z, Zeng X, Liu Q, Tan L, He M. Association between hemoglobin-to-red blood cell distribution width ratio and chronic kidney disease: A cross sectional study. Medicine (Baltimore) 2024; 103:e40224. [PMID: 39533601 PMCID: PMC11556961 DOI: 10.1097/md.0000000000040224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2024] [Accepted: 10/04/2024] [Indexed: 11/16/2024] Open
Abstract
The hemoglobin-to-red blood cell distribution width ratio (HRR) is recognized as a novel prognostic biomarker; however, studies exploring its relationship with chronic kidney disease (CKD) are scarce. This study used data from the National Health and National Health and Nutrition Examination Survey database from 2005 to 2018. The analysis included individuals aged ≥ 20 years who had complete HRR and CKD data. Weighted univariate and multivariate logistic regression analyses were used to assess the association between the HRR and CKD prevalence. Additionally, restricted cubic spline and subgroup analyses were conducted for further validation. Ultimately, 19,426 participants were included in this study. After adjusting for confounders, multivariate logistic regression analysis revealed a negative association between HRR and CKD (OR = 0.35, 95% CI = 0.22-0.56). In addition, restricted cubic spline regression analysis revealed a negative linear association between HRR and CKD, with higher levels of HRR associated with a lower prevalence of CKD. The subgroup analysis revealed that the negative association between HRR and CKD was stronger in the male population. HRR is negatively associated with the prevalence of CKD in the adult population of the US. HRR is a potential indicator for assessing the prevalence of CKD and provides a rationale for personalized management.
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Affiliation(s)
- Lin Ning
- Department of Nephrology, Yuebei People’s Hospital, Shaoguan, China
| | - Junping Tang
- Department of Nephrology, Yuebei People’s Hospital, Shaoguan, China
| | - Zhiqiang Chen
- Department of Nephrology, Yuebei People’s Hospital, Shaoguan, China
| | - Xiaolin Zeng
- Department of Nephrology, Yuebei People’s Hospital, Shaoguan, China
| | - Quan Liu
- Department of Nephrology, Yuebei People’s Hospital, Shaoguan, China
| | - Liming Tan
- Department of Nephrology, Yuebei People’s Hospital, Shaoguan, China
| | - Min He
- Department of Nephrology, Yuebei People’s Hospital, Shaoguan, China
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Singh R, Sahu N, Tyagi R, Alam P, Akhtar A, Walia R, Chandra A, Madan S. Integrative Network Pharmacology, Molecular Docking, and Dynamics Simulations Reveal the Mechanisms of Cinnamomum tamala in Diabetic Nephropathy Treatment: An In Silico Study. Curr Issues Mol Biol 2024; 46:11868-11889. [PMID: 39590299 PMCID: PMC11592827 DOI: 10.3390/cimb46110705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2024] [Revised: 10/15/2024] [Accepted: 10/21/2024] [Indexed: 11/28/2024] Open
Abstract
Diabetic nephropathy (DN) is a serious diabetes-related complication leading to kidney damage. Cinnamomum tamala (CT), traditionally used in managing diabetes and kidney disorders, has shown potential in treating DN, although its active compounds and mechanisms are not fully understood. This study aims to identify CT's bioactive compounds and explore their therapeutic mechanisms in DN. Active compounds in CT were identified using the Indian Medicinal Plants, Phytochemicals and Therapeutics database, and their potential targets were predicted with PharmMapper. DN-related targets were sourced from GeneCards, and therapeutic targets were identified by intersecting the compound-target and disease-target data. Bioinformatics analyses, including the Kyoto Encyclopedia of Genes and Genomes and Gene Ontology enrichment studies, were performed on these targets. A protein-protein interaction network was constructed using STRING and Cytoscape. Molecular docking and dynamics simulations validated the most promising compound-target interactions. Six active compounds in CT were identified, along with 347 potential therapeutic targets, of which 70 were DN-relevant. Key targets like MMP9, EGFR, and AKT1 were highlighted, and the PPAR and PI3K-AKT signaling pathways were identified as the primary mechanisms through which CT may treat DN. CT shows promise in treating DN by modulating key pathways related to cellular development, inflammation, and metabolism.
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Affiliation(s)
- Rashmi Singh
- Amity Institute of Pharmacy, Amity University, Noida 201303, Uttar Pradesh, India; (R.S.); (R.W.)
- Metro College of Health Sciences & Research, Greater Noida 201310, Uttar Pradesh, India
| | - Nilanchala Sahu
- Sharda School of Pharmacy, Sharda University, Greater Noida 201310, Uttar Pradesh, India; (N.S.); (A.C.)
| | - Rama Tyagi
- Galgotias College of Pharmacy, Greater Noida 201310, Uttar Pradesh, India;
| | - Perwez Alam
- Department of Pharmacognosy, College of Pharmacy, King Saud University, P.O. Box 2457, Riyadh 11451, Saudi Arabia;
| | - Ali Akhtar
- Department of Pharmacognosy, College of Pharmacy, King Saud University, P.O. Box 2457, Riyadh 11451, Saudi Arabia;
| | - Ramanpreet Walia
- Amity Institute of Pharmacy, Amity University, Noida 201303, Uttar Pradesh, India; (R.S.); (R.W.)
| | - Amrish Chandra
- Sharda School of Pharmacy, Sharda University, Greater Noida 201310, Uttar Pradesh, India; (N.S.); (A.C.)
| | - Swati Madan
- Amity Institute of Pharmacy, Amity University, Noida 201303, Uttar Pradesh, India; (R.S.); (R.W.)
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Zhang DL, Chen S, Xu JM, Na-Lin, Wu HY, Zhou JM, Chen ZP, Huang XR, Wei LX, Liu DX. The value of tissue quantitative diffusion analysis of ultrasound elastography in the diagnosis of early-stage chronic kidney disease. BMC Nephrol 2024; 25:328. [PMID: 39354395 PMCID: PMC11446147 DOI: 10.1186/s12882-024-03762-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 09/18/2024] [Indexed: 10/03/2024] Open
Abstract
PURPOSE To explore the value of tissue quantitative diffusion analysis of ultrasound elastography in the diagnosis of early-stage chronic kidney disease (CKD). METHODS The observation group comprised 54 patients with early-stage CKD treated at Fuzhou No 7 Hospital, and the control group consisted of 40 healthy individuals who underwent physical examinations at the same hospital. The renal parenchyma of the participants were examined using ultrasonography, color Doppler ultrasonography, and tissue quantitative diffusion analysis of ultrasound elastography. Renal dimensions (diameter, thickness, and renal parenchyma thickness), interlobar artery blood flow parameters, and 11 elastic characteristic values were analyzed and compared between the two groups. The area under the receiver-operating characteristic (ROC) curve, cut-off values, sensitivity, and specificity were calculated using the ROC curve analysis. RESULTS There were no significant differences in the blood flow parameters of the interlobar artery and the dimensions of renal meridians between the two groups. In the observation group, the mean (MEAN) decreased, while the blue area ratio and skewness, increased, compared to the control group (p < 0.05). In addition, the ROC curve revealed that the blue area ratio, MEAN, and skewness had significant diagnostic value (the area under the curve > 0.7). Notably, the best cut-off value of the MEAN was found to be 106, indicating that a MEAN value less than 106 represented early-stage CKD. Also, this cutoff value had a sensitivity of 80% and a specificity of 81%. CONCLUSION Tissue quantitative diffusion analysis of ultrasound elastography can quantitatively evaluate renal parenchymal damage in early-stage CKD using quantitative diffusion parameters, with the MEAN parameter, having a cutoff of 106, being particularly effective. This parameter and cutoff value offer a valuable tool for the early detection and diagnosis of CKD, potentially improving patient outcomes through earlier intervention. CLINICAL TRIAL NUMBER Not applicable.
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Affiliation(s)
- Dan-Ling Zhang
- Department of Ultrasonography, Fujian Medical University Union Hospital, Fuzhou, Fujian, 350001, China.
- Department of Ultrasonography, Fuzhou No 7 Hospital, Fuzhou, Fujian, 350005, China.
| | - Sheng Chen
- Department of Ultrasonography, Fujian Medical University Union Hospital, Fuzhou, Fujian, 350001, China
| | - Jia-Ming Xu
- Department of Nephrology, Fujian Medical University Union Hospital, Fuzhou, Fujian, 350001, China
| | - Na-Lin
- Department of Ultrasonography, Fuzhou No 7 Hospital, Fuzhou, Fujian, 350005, China
| | - Hai-Yan Wu
- Department of Ultrasonography, Fuzhou No 7 Hospital, Fuzhou, Fujian, 350005, China
| | - Jin-Mei Zhou
- Department of Ultrasonography, Fuzhou No 7 Hospital, Fuzhou, Fujian, 350005, China
| | - Zhao-Ping Chen
- Department of Ultrasonography, Fuzhou No 7 Hospital, Fuzhou, Fujian, 350005, China
| | - Xu-Ri Huang
- Department of Physician, Fuzhou No 7 Hospital, Fuzhou, Fujian, 350005, China
| | - Li-Xin Wei
- Department of Nephrology, Fujian Medical University Union Hospital, Fuzhou, Fujian, 350001, China
| | - Dai-Xiang Liu
- Department of Physician, Fuzhou No 7 Hospital, Fuzhou, Fujian, 350005, China
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Dhingra C, Rao N, Singh S, Pathak AK, Tiwari V, Kulshrestha MR, Verma J. Comparative Analysis of HbA1c Estimation Using Immunoturbidimetry and High-Pressure Liquid Chromatography Methods in Non-Dialysis Chronic Kidney Disease Patients. EJIFCC 2024; 35:195-205. [PMID: 39507575 PMCID: PMC11536278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/08/2024]
Abstract
Background Chronic kidney disease (CKD) concomitant with diabetes mellitus (DM), anemia and uremia. Thus, monitoring HbA1c levels presents a complex clinical challenge. Methods This analytical cross-sectional study was conducted from May 2022 to April 2023 at Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow. We compared HbA1c values obtained by the turbidimetric inhibition immunoassay (TINIA) and high-pressure liquid chromatography (HPLC) methods among non-dialysis CKD patients (n=127). Results HbA1c was not detectable among 27 patients by TINIA but measurable with HPLC, all being's anemic. The remaining 100 patients, it was detectable by both the methods. Among these 100 patients, linear regression analysis showed a very strong positive correlation between TINIA-HbA1c and HPLC-HbA1c (R2=0.861; p<0.0001). The agreement between methods was substantial (Cohen's kappa 0.657; p<0.0001). However, HbA1c levels were detected significantly higher with HPLC (Median 7.9, IQR 2.7) than that of TINIA (Median 7.0, IQR 2.9;p=0.025) in diabetics while the difference was not significant in non-diabetic group with both HPLC (Median 5.4,IQR 0.8) and TINIA (Median 5.1,IQR 1.1). Carbamylated Hb (CHb; as detected by HPLC as a side product) was correlated to both HbA1c by HPLC (r=0.299;p=0.007) and TINIA (r=0.336;p=0.006) as well as to serum urea levels (r=0.439;p<0.0001). Conclusion HPLC estimates all HbA1c patients in our study group while TINIA failed to do so in around 21.26% cases. The very low hemoglobin levels and high carbamylated hemoglobin were apparent as two most common causes. Also, the values with TINIA are significantly lower in comparison to HPLC among diabetics with CKD.
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Affiliation(s)
- Chanchal Dhingra
- Department of Biochemistry, Dr Ram Manohar Institute of Medical Sciences, Lucknow, Uttar Pradesh
| | - Namrata Rao
- Department of Biochemistry, Dr Ram Manohar Institute of Medical Sciences, Lucknow, Uttar Pradesh
| | - Shefali Singh
- Department of Biochemistry, Dr Ram Manohar Institute of Medical Sciences, Lucknow, Uttar Pradesh
| | - Anumesh K Pathak
- Department of Biochemistry, Dr Ram Manohar Institute of Medical Sciences, Lucknow, Uttar Pradesh
| | - Vandana Tiwari
- Department of Biochemistry, Dr Ram Manohar Institute of Medical Sciences, Lucknow, Uttar Pradesh
| | - Manish R Kulshrestha
- Department of Biochemistry, Dr Ram Manohar Institute of Medical Sciences, Lucknow, Uttar Pradesh
| | - Juhi Verma
- Department of Biochemistry, Dr Ram Manohar Institute of Medical Sciences, Lucknow, Uttar Pradesh
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Li PKT, Ng JKC, Cai GY, Chen W, Chow KM, Fan S, He JC, Hooi LS, Pei Y, Teo BW, Wong MG, Wu IW, Zhou J, Tian N, Ye Z, Yu X. Navigating the Global Economic Landscape of Dialysis: A Summary of Expert Opinions from The 4th International Congress of Chinese Nephrologists. KIDNEY DISEASES (BASEL, SWITZERLAND) 2024; 10:384-397. [PMID: 39430291 PMCID: PMC11488833 DOI: 10.1159/000540152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2024] [Accepted: 06/26/2024] [Indexed: 10/22/2024]
Abstract
Background Chronic kidney disease (CKD) continues to be a significant global public health issue. The escalating burden of CKD is probably driven by the aging population and the rising prevalence of diabetes. CKD not only adversely impacts an individual's health and well-being, but also poses significant challenge on the economy of the society. Summary Experts from ten countries and regions around the world (Australia, Canada, China, Hong Kong, Malaysia, New Zealand, Singapore, Taiwan, United Kingdom, and United States) convened in the 4th International Congress of Chinese Nephrologists on December 1, 2023 to discuss the global dialysis burden. Although the cost of kidney replacement therapy (KRT) accounts for 2-3% of total healthcare expenditure in developed countries, patients with end stage kidney disease (ESKD) only represent a small percentage (<0.5%) of the population. Importantly, the economic impact of ESKD is not limited to direct medical costs, but extends to indirect societal costs, such as productivity loss by patients and caregivers. Primary prevention of CKD, early screening and treatment to delay progression to ESKD (where treatment costs rise dramatically), and utilization of home-based dialysis therapy (including peritoneal dialysis and home hemodialysis) shall be implemented as part of cost-containment strategy. Kidney transplant provides better outcomes than dialysis and is cost-effective in long run, whereas conservative kidney management should be considered for elderly frail patients. Key Messages Implementation of preventive measures and cost-effective treatment strategies are the cornerstone to combat the global CKD epidemic.
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Affiliation(s)
- Philip Kam-Tao Li
- Carol and Richard Yu Peritoneal Dialysis Research Centre, Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR
| | - Jack Kit-Chung Ng
- Carol and Richard Yu Peritoneal Dialysis Research Centre, Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR
- Li Ka Shing Institute of Health Sciences (LiHS), Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR
| | - Guang-yan Cai
- Department of Nephrology, First Medical Center of Chinese PLA General Hospital, National Key Laboratory of Kidney Diseases, Beijing, China
| | - Wei Chen
- Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Kai Ming Chow
- Carol and Richard Yu Peritoneal Dialysis Research Centre, Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR
| | - Stanley Fan
- William Harvey Research Institute, Queen Mary University of London, London, UK
| | - John Cijiang He
- Department of Medicine, Division of Nephrology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Lai Seong Hooi
- Department of Medicine and Haemodialysis Unit, Hospital Sultanah Aminah Johor Bahru, Johor Bahru, Malaysia
| | - York Pei
- Division of Nephrology, Department of Medicine, University Health Network, Toronto, ON, Canada
| | - Boon Wee Teo
- Division of Nephrology, Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Muh Geot Wong
- Department of Renal Medicine, Concord Repatriation General Hospital, Sydney, NSW, Australia
| | - I-Wen Wu
- Division of Nephrology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Jianhui Zhou
- Department of Nephrology, First Medical Center of Chinese PLA General Hospital, National Key Laboratory of Kidney Diseases, Beijing, China
| | - Na Tian
- Department of Nephrology, General Hospital of Ningxia Medical University, Yinchuan, China
| | - Zhiming Ye
- Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Xueqing Yu
- Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
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Li X, Shi C, Zhou R, Chen X, Xu Q, Zhao C, Ma M, Ao X, Liu Y. Modified EBP-bFGF targeting endogenous renal extracellular matrix protects against renal ischemia-reperfusion injury in rats. J Biomed Mater Res A 2024; 112:1827-1839. [PMID: 38700258 DOI: 10.1002/jbm.a.37730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 03/29/2024] [Accepted: 04/24/2024] [Indexed: 05/05/2024]
Abstract
Acute kidney injury (AKI) is a life-threatening disease primarily caused by renal ischemia-reperfusion (I/R) injury, which can result in renal failure. Currently, growth factor therapy is considered a promising and effective approach for AKI treatment. Basic fibroblast growth factor (bFGF), an angiogenic factor with potent activity, efficiently stimulates angiogenesis and facilitates regeneration of renal tissue. However, the unrestricted diffusion of bFGF restricts its clinical application in AKI treatment. Therefore, developing a novel sustained released system for bFGF could enhance its potential in treating AKI. In this study, we genetically engineered a multifunctional recombinant protein by fusing bFGF with a specific peptide (EBP). EBP-bFGF effectively binds to the extracellular matrix in the injured kidney, enabling slow release of bFGF in AKI. Furthermore, following orthotopic injection into I/R rats' ischemic kidneys, EBP-bFGF exhibited stable retention within the tissue. Additionally, EBP-bFGF suppressed apoptosis of renal cells, reduced renal fibrosis, and facilitated recovery of renal function. These findings suggest that EBP-bFGF delivery system represents a promising strategy for treating AKI.
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Affiliation(s)
- Xiaoge Li
- Department of Biochemistry and Molecular Biology, School of Basic Medicine, Qingdao University, Qingdao, China
| | - Chunying Shi
- Department of Human Anatomy, Histology and Embryology, School of Basic Medicine, Qingdao University, Qingdao, China
| | - Runxue Zhou
- Department of Human Anatomy, Histology and Embryology, School of Basic Medicine, Qingdao University, Qingdao, China
| | - Xinhui Chen
- Department of Biochemistry and Molecular Biology, School of Basic Medicine, Qingdao University, Qingdao, China
| | - Qingling Xu
- Department of Biochemistry and Molecular Biology, School of Basic Medicine, Qingdao University, Qingdao, China
| | - Chunyige Zhao
- Department of Biochemistry and Molecular Biology, School of Basic Medicine, Qingdao University, Qingdao, China
| | - Mengyao Ma
- Department of Biochemistry and Molecular Biology, School of Basic Medicine, Qingdao University, Qingdao, China
| | - Xiang Ao
- Department of Biochemistry and Molecular Biology, School of Basic Medicine, Qingdao University, Qingdao, China
| | - Ying Liu
- Institute for Translational Medicine, The Affiliated Hospital of Qingdao University, Qingdao Medical College, Qingdao University, Qingdao, China
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Hwang J, Kim K, Coresh J, Inker LA, Grams ME, Shin JI. Estimated GFR in the Korean and US Asian Populations Using the 2021 Creatinine-Based GFR Estimating Equation Without Race. Kidney Med 2024; 6:100890. [PMID: 39319209 PMCID: PMC11420506 DOI: 10.1016/j.xkme.2024.100890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2024] Open
Abstract
Rationale & Objective In 2021, the new Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) updated the creatinine-based estimated glomerular filtration rate (eGFR) equation and removed the coefficient for race. The development and validation of this equation involved binarizing race into African American and non-African American, involving few Asian participants. This study aimed to examine the difference between the 2021 equation and the previous 2009 equation on CKD prevalence estimates in 2 Asian populations. Study Design Observational study using 2 national surveys. Setting & Participants Participants from the 2019 Korea National Health and Nutrition Survey and participants self-reported as Asian from the 2011-2020 US National Health and Nutrition Survey. Exposure eGFR using 2009 and 2021 CKD-EPI creatinine equation. Outcomes Prevalence of CKD (eGFR <60 mL/min/1.73 m2 or urine albumin-creatinine ratio ≥30 mg/g). Analytical Approach Sampling-weighted prevalence estimated using the 2009 and 2021 equations as well as the percentage of individuals with CKD G3+ using the 2009 equation being reclassified as not having CKD G3+ using the 2021 equation. Results The prevalence of CKD estimated using the 2021 equation was 9.75% (95% confidence intervals [CI], 8.80-10.80%) in Koreans and 11.60% (95% CI, 10.23-13.13%) in US Asians. The prevalence of CKD estimated using the 2021 equation was slightly lower than that using the 2009 equation in both Korean and US Asian populations by 0.63% (95% CI, 0.44-0.90%) and 0.84% (95% CI, 0.52-1.34%), respectively. Furthermore, 32.8% and 30.2% of Koreans and US Asians with CKD G3-5, respectively, estimated using the 2009 equation were reclassified as not having CKD G3-5 when the eGFR was calculated using the 2021 equation. Limitations Measured GFR was not available. Conclusions Use of the 2021 CKD-EPI creatinine equation leads to a small decrease in CKD prevalence in both Korean and US Asian populations, and of similar magnitude, resulting in significant reclassification among those originally classified as having CKD G3+.
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Affiliation(s)
- Jimin Hwang
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Kwanghyun Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
- Department of Public Health, Graduate School, Yonsei University, Seoul, Korea
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- Center for Humanitarian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Josef Coresh
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD
| | - Lesley A Inker
- Division of Nephrology, Department of Internal Medicine, Tufts Medical Center, Boston, MA
| | - Morgan E Grams
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD
- Division of Precision Medicine, Department of Medicine, New York University Grossman School of Medicine, New York City, NY
| | - Jung-Im Shin
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD
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Wang B, Jiang C, Qu Y, Wang J, Yan C, Zhang X. Nonlinear association between atherogenic index of plasma and chronic kidney disease: a nationwide cross-sectional study. Lipids Health Dis 2024; 23:312. [PMID: 39334373 PMCID: PMC11429454 DOI: 10.1186/s12944-024-02288-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2024] [Accepted: 09/08/2024] [Indexed: 09/30/2024] Open
Abstract
BACKGROUND The interplay between metabolic disorders and chronic kidney disease (CKD) has been well-documented. However, the connection between CKD and atherogenic index of plasma (AIP) remains understudied. This research delves into the correlation between these two factors, aiming to shed new light on their potential association. METHODS The relationship between AIP and CKD was evaluated using a weighted multivariate logistic regression model, and the curvilinear relationship between AIP and CKD was explored through smooth curve fitting. We engaged a recursive partitioning algorithm in conjunction with a two-stage linear regression model to precisely determine the inflection point. By conducting stratified analyses, the heterogeneity within subpopulations was explored. RESULTS In the regression model that accounted for all covariates, ORs (95% CI) for the association between CKD and AIP were 1.12 (0.91, 1.36), indicating no significant association between AIP and CKD. However, sensitivity analyses suggested that the relationship between them may be non-linear. Smooth curve analysis confirmed the non-linear relationship between AIP and CKD, identifying an inflection point at -0.55. Below this threshold, AIP exhibited a significant inverse correlation with CKD. Conversely, above this threshold, a pronounced positive correlation was detected. Stratified analyses elucidated that a non-linear association between AIP and CKD was observed among female participants and those aged 50 and above. CONCLUSION We found a curvilinear relationship between chronic kidney disease and atherogenic index of plasma.
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Affiliation(s)
- Bo Wang
- Central Hospital of Jinan City, No. 105, Jiefang Road, Jinan City, Shandong Province, China
| | - Chunqi Jiang
- Affiliated Hospital of Shandong University of Traditional Chinese Medicine, No. 16369, Jingshi Road, Jinan City, Shandong Province, China
| | - Yinuo Qu
- Affiliated Hospital of Shandong University of Traditional Chinese Medicine, No. 16369, Jingshi Road, Jinan City, Shandong Province, China
| | - Jun Wang
- Affiliated Hospital of Shandong University of Traditional Chinese Medicine, No. 16369, Jingshi Road, Jinan City, Shandong Province, China
| | - Chuanzhu Yan
- Affiliated Hospital of Shandong University of Traditional Chinese Medicine, No. 16369, Jingshi Road, Jinan City, Shandong Province, China
| | - Xin Zhang
- Shandong University of Traditional Chinese Medicine, No. 16369, Jingshi Road, Jinan City, Shandong Province, China.
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Zahra S, Saleem MK, Ejaz KF, Akbar A, Jadoon SK, Hussain S, Ali AI, Ifty M, Jannati SZ, Armin F, Sarker D, Islam DZ, Khandker SS, Khan MS, Alvi S. Prevalence of nephropathy among diabetic patients in North American region: A systematic review and meta-analysis. Medicine (Baltimore) 2024; 103:e39759. [PMID: 39312314 PMCID: PMC11419527 DOI: 10.1097/md.0000000000039759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2024] [Accepted: 08/29/2024] [Indexed: 09/25/2024] Open
Abstract
BACKGROUND Nephropathy is one of the most common microvascular impediments of diabetes mellitus. In this study, we aimed to estimate the prevalence of nephropathy in diabetic patients across the North American region. METHODS Eligible studies were screened out from 3 electronic databases, for example, PubMed, Google Scholar, and ScienceDirect using specific search keywords based on the eligibility criteria. Extracting the data from the included studies publication bias, quality assessment, outlier investigation, and meta-analysis was done followed by the subgroup analysis. A total of 11 studies met the study inclusion criteria. Meta-analysis was performed with the extracted data. RESULTS Pooled prevalence of 28.2% (95% confidence interval [CI]: 19.7-36.7) with a high rate of heterogeneity (I2 = 100%) was identified. The pooled prevalence of nephropathy among diabetic patients in the United States of America, Canada, and Mexico was 24.2% (95% CI: 13.8-34.5), 31.2% (95% CI: 25.8-36.5), and 31.1% (95% CI: 20.8-41.5), respectively. CONCLUSION The prevalence of nephropathy among diabetic patients was found lower in the United States of America as compared to Canada and Mexico. Besides, the pooled prevalence of the North American region was found to be lower as compared to the African, European, and Asian regions. Minimizing the pathogenic factors, sufficient diagnostic, healthcare facilities, and awareness are recommended to improve the situation.
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Affiliation(s)
- Sabahat Zahra
- Queen Elizabeth Hospital Birmingham, Birmingham, United Kingdom
| | - Muhammad Khurram Saleem
- General Internal Medicine, University Hospital, Bristol and Weston NHS Foundation Trust, Royal College of Physicians and Surgeons of Glasgow, Glasgow, United Kingdom
| | | | - Amna Akbar
- District Headquarter Hospital Jhelum Valley, Muzaffarabad, AJK, Pakistan
| | | | - Shoukat Hussain
- Medicine (AJKMC), Fellow Endocrinology Capital Hospital Islamabad, Islamabad, Pakistan
| | - Amir Iqbal Ali
- Consultant Surgeon, Combined Military Hospital/SKBZ, Muzaffarabad, AJK, Pakistan
| | | | | | - Fariza Armin
- School of Pharmacy, Brac University, Dhaka, Bangladesh
| | | | | | - Shahad Saif Khandker
- Department of Microbiology, Gonoshasthaya Samaj Vittik Medical College, Dhaka, Bangladesh
| | | | - Sarosh Alvi
- Teaching Faculty, University of Khartoum, Khartoum, Sudan
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Wang F, Suo XG, Wang JN, Liu CY, Liu CC, Wang C, Li J, Duan ZH, Zhang FS, Xia YM, Jiang JJ, Hao YW, Li GY, Meng XM, Shao YX, Wang FC. SFN promotes renal fibrosis via binding with MYH9 in chronic kidney disease. Eur J Pharmacol 2024; 979:176806. [PMID: 38986830 DOI: 10.1016/j.ejphar.2024.176806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 05/19/2024] [Accepted: 07/08/2024] [Indexed: 07/12/2024]
Abstract
Chronic kidney disease (CKD) is a clinical syndrome characterized by persistent renal function decline. Renal fibrosis is the main pathological process in CKD, but an effective treatment does not exist. Stratifin (SFN) is a highly-conserved, multi-function soluble acidic protein. Therefore, this study explored the effects of SFN on renal fibrosis. First, we found that SFN was highly expressed in patients with CKD, as well as in renal fibrosis animal and cell models. Next, transforming growth factor-beta 1 (TGF-β1) induced injury and fibrosis in human renal tubule epithelial cells, and SFN knockdown reversed these effects. Furthermore, SFN knockdown mitigated unilateral ureteral obstruction (UUO)-induced renal tubular dilatation and renal interstitial fibrosis in mice. Liquid chromatography-tandem mass spectrometry/mass spectrometry (LC-MS/MS), co-immunoprecipitation (Co-IP), and immunofluorescence co-localization assays demonstrated that SFN bound the non-muscle myosin-encoding gene, myosin heavy chain 9 (MYH9), in the cytoplasm of renal tubular epithelial cells. MYH9 knockdown also reduced Col-1 and α-SMA expression, which are fibrosis markers. Finally, silencing SFN decreased MYH9 expression, alleviating renal fibrosis. These results suggest that SFN promotes renal fibrosis in CKD by interacting with MYH9. This study may provide potential strategies for the treatment of CKD.
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Affiliation(s)
- Fang Wang
- Department of Pharmacy, Lu'an Hospital of Anhui Medical University, Lu'an People's Hospital of Anhui Province, Lu'an, 237006, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Institute of Innovative Drugs, School of Pharmacy, Anhui Medical University, The Key Laboratory of Anti-inflammatory of Immune Medicines, Ministry of Education, Hefei, 230032, China
| | - Xiao-Guo Suo
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Institute of Innovative Drugs, School of Pharmacy, Anhui Medical University, The Key Laboratory of Anti-inflammatory of Immune Medicines, Ministry of Education, Hefei, 230032, China
| | - Jia-Nan Wang
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Institute of Innovative Drugs, School of Pharmacy, Anhui Medical University, The Key Laboratory of Anti-inflammatory of Immune Medicines, Ministry of Education, Hefei, 230032, China
| | - Cheng-Yi Liu
- Department of Urology, Lu'an Hospital of Anhui Medical University, Lu'an People's Hospital of Anhui Province, Lu'an, 237006, China
| | - Cheng-Cheng Liu
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Institute of Innovative Drugs, School of Pharmacy, Anhui Medical University, The Key Laboratory of Anti-inflammatory of Immune Medicines, Ministry of Education, Hefei, 230032, China
| | - Cong Wang
- Department of Pharmacy, Lu'an Hospital of Anhui Medical University, Lu'an People's Hospital of Anhui Province, Lu'an, 237006, China
| | - Jing Li
- Department of Pharmacy, Lu'an Hospital of Anhui Medical University, Lu'an People's Hospital of Anhui Province, Lu'an, 237006, China
| | - Zi-Hao Duan
- Department of Pharmacy, Lu'an Hospital of Anhui Medical University, Lu'an People's Hospital of Anhui Province, Lu'an, 237006, China
| | - Feng-Sen Zhang
- Department of Pharmacy, Lu'an Hospital of Anhui Medical University, Lu'an People's Hospital of Anhui Province, Lu'an, 237006, China
| | - Yi-Miao Xia
- Department of Pharmacy, Lu'an Hospital of Anhui Medical University, Lu'an People's Hospital of Anhui Province, Lu'an, 237006, China
| | - Jun-Jie Jiang
- Department of Pharmacy, Lu'an Hospital of Anhui Medical University, Lu'an People's Hospital of Anhui Province, Lu'an, 237006, China
| | - Yun-Wu Hao
- Department of Urology, Lu'an Hospital of Anhui Medical University, Lu'an People's Hospital of Anhui Province, Lu'an, 237006, China
| | - Guang-Yuan Li
- Department of Urology, Lu'an Hospital of Anhui Medical University, Lu'an People's Hospital of Anhui Province, Lu'an, 237006, China
| | - Xiao-Ming Meng
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Institute of Innovative Drugs, School of Pharmacy, Anhui Medical University, The Key Laboratory of Anti-inflammatory of Immune Medicines, Ministry of Education, Hefei, 230032, China
| | - Yun-Xia Shao
- College of Life Sciences, Anhui Normal University, Wuhu, 241000, China; Wuhu Hospital, East China Normal University (The Second People's Hospital of Wuhu), Wuhu, 241000, China.
| | - Fa-Cai Wang
- Department of Pharmacy, Lu'an Hospital of Anhui Medical University, Lu'an People's Hospital of Anhui Province, Lu'an, 237006, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Institute of Innovative Drugs, School of Pharmacy, Anhui Medical University, The Key Laboratory of Anti-inflammatory of Immune Medicines, Ministry of Education, Hefei, 230032, China.
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Song SH, Oh TR, Suh SH, Choi HS, Kim CS, Ma SK, Kim SW, Bae EH. Obesity is associated with incident chronic kidney disease in individuals with normal renal function. Korean J Intern Med 2024; 39:813-822. [PMID: 39135524 PMCID: PMC11384258 DOI: 10.3904/kjim.2023.491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 03/17/2024] [Accepted: 05/02/2024] [Indexed: 09/11/2024] Open
Abstract
BACKGROUND/AIMS Obesity has known to be a modifiable risk factor associated with worse outcomes in chronic kidney disease (CKD), but few studies have examined the impact of obesity on CKD incidence in the general population. The purpose of this study was to investigate the role of body mass index (BMI) and waist-to-hip ratio (WHR) as predictors of incident CKD and to evaluate the impact of weight reduction on CKD prevention. METHODS A total of 2,711 participants from a community-based cohort with normal renal function were prospectively analyzed. Among participants with obesity, we analyzed the change in WHR to evaluate the association of obesity reduction with CKD development. RESULTS During a mean follow-up of 11.03 ± 4.22 years, incident CKD occurred in 190 (7.0%) participants. In the fully adjusted multivariable Cox proportional hazard models, the risk of incident CKD increased with higher BMI (hazard ratio, 1.06; 95% confidence interval, 1.00-1.11; p = 0.033) and higher WHR (hazard ratio, 1.33; 95% confidence interval, 1.07-1.66; p = 0.009). In the Kaplan-Meier analysis, cumulative adverse renal events were significantly more common in the maintained obesity group than in the reduced obesity group (p = 0.001). CONCLUSION Both higher BMI and WHR were associated with development of CKD, but the magnitude of the effect of WHR was higher than that of BMI. Moreover, reducing obesity would be beneficial for renal prognosis.
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Affiliation(s)
- Su Hyun Song
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Tae Ryom Oh
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Sang Heon Suh
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Hong Sang Choi
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Chang Seong Kim
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Seong Kwon Ma
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Soo Wan Kim
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Eun Hui Bae
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
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Kheirandish M, Eftekhar E, Azarbad A, Salarpour E, Shahmoradi M, Ghazizadeh S, Malektojari A, Nikeghbali Z, karimi Lengeh S, Dehghani A. Prevalence of Chronic Kidney Disease and Associated Factors among the Diabetic and Prediabetic Population in the Bandare-Kong Cohort Study; A Population-Based Study. ARCHIVES OF IRANIAN MEDICINE 2024; 27:470-478. [PMID: 39465521 PMCID: PMC11496602 DOI: 10.34172/aim.31194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Accepted: 08/20/2024] [Indexed: 10/29/2024]
Abstract
BACKGROUND This investigation aims to examine the relationship between diabetes and prediabetes with chronic kidney disease (CKD) while taking into account key risk factors such as gender, age, lifestyle, smoking habits, and blood pressure. METHODS Between November 17, 2016, and November 22, 2018, 4063 subjects aged 35 to 70 years were enrolled in the first phase of the Bandare-Kong Non-Communicable Disease (BKNCD) Cohort Study, which is part of the PERSIAN (Prospective Epidemiological Research Studies in IrAN) cohort and was conducted in a coastal region of the Hormozgan province in southern Iran. CKD was calculated using the Modification of Diet in Renal Disease (MDRD) formula based on glomerular filtration rate (GFR)<60 mL/min per 1.73 m2 , or albumin/Cr>30 mg/g in random urine, self-reported kidney failure, or dialysis. Urine albumin and creatinine were determined by standard kits (Pars Azmoon, Tehran, Iran) and the BT1500 automatic chemistry analyzer (Biotecnica Instruments, Rome, Italy). RESULTS The prevalence of CKD was found to be 15.3%, with 29.6% identified in diabetic individuals and 16.5% in prediabetic patients. So, the prevalence of CKD in diabetics was higher than prediabetics and normal people. Increased age, dysglycemia (diabetes or prediabetes), hypertension, and use of angiotensin receptor blockers were markedly associated with an elevated risk of CKD in adults. CONCLUSION The study emphasizes the importance of early detection and management of CKD risk factors, particularly among high-risk individuals, to mitigate CKD progression and associated complications. By addressing modifiable risk factors, proactive screening, and enhanced awareness, significant strides can be made in reducing CKD burden and improving patient outcomes.
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Affiliation(s)
- Masoumeh Kheirandish
- Endocrinology and Metabolism Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Ebrahim Eftekhar
- Molecular Medicine Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Abnoos Azarbad
- Endocrinology and Metabolism Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Elaheh Salarpour
- Endocrinology and Metabolism Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Mehdi Shahmoradi
- Endocrinology and Metabolism Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Sara Ghazizadeh
- Evidence Based Medicine Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
- Cardiovascular Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Alireza Malektojari
- Evidence Based Medicine Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
- Cardiovascular Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Zohre Nikeghbali
- Student Research Committee, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Soheil karimi Lengeh
- Student Research Committee, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Aghdas Dehghani
- Endocrinology and Metabolism Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
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Hustrini NM, Susalit E, Widjaja FF, Khumaedi AI, Dekkers OM, van Diepen M, Rotmans JI. The Etiology of Advanced Chronic Kidney Disease in Southeast Asia: A Meta-analysis. J Epidemiol Glob Health 2024; 14:740-764. [PMID: 38587764 PMCID: PMC11442843 DOI: 10.1007/s44197-024-00209-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 02/14/2024] [Indexed: 04/09/2024] Open
Abstract
INTRODUCTION Chronic kidney disease (CKD) etiology varies greatly between developed and developing countries. In addition, differences in underlying pathogenesis and therapeutic options affect the progression towards advanced-CKD. This meta-analysis aims to identify the etiology of advanced-CKD in Southeast Asia. METHODS A systematic search in four electronic-databases and complementary search on national kidney registries and repository libraries was conducted until July 20, 2023. The risk of bias was assessed using Newcastle-Ottawa Scale for observational studies and Version-2 of Cochrane for intervention studies. A random-effects model was used to estimate pooled prevalence. The protocol is registered in the International Prospective Register of Systematic Reviews PROSPERO; Registration ID:CRD42022300786. RESULTS We analyzed 81 studies involving 32,834 subjects. The pooled prevalence of advanced-CKD etiologies are diabetic kidney disease (DKD) 29.2% (95%CI 23.88-34.78), glomerulonephritis 20.0% (95%CI 16.84-23.38), hypertension 16.8% (95%CI 14.05-19.70), other 8.6% (95%CI 6.97-10.47), unknown 7.5% (95%CI 4.32-11.50), and polycystic kidney disease 0.7% (95%CI 0.40-1.16). We found a significant increase in DKD prevalence from 21% (9.2%, 95%CI 0.00-33.01) to 30% (95%CI 24.59-35.97) before and after the year 2000. Among upper-middle-income and high-income countries, DKD is the most prevalent (26.8%, 95%CI 21.42-32.60 and 38.9%, 95%CI 29.33-48.79, respectively), while glomerulonephritis is common in lower-middle-income countries (33.8%, 95%CI 15.62-54.81). CONCLUSION The leading cause of advanced-CKD in Southeast Asia is DKD, with a substantial proportion of glomerulonephritis. An efficient screening program targeting high-risk populations (diabetes mellitus and glomerulonephritis) is needed, with the aim to delay CKD progression.
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Affiliation(s)
- Ni Made Hustrini
- Division of Nephrology and Hypertension, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia
- Department of Internal Medicine, Leiden University Medical Center, Albinusdreef 2, Leiden, The Netherlands
| | - Endang Susalit
- Division of Nephrology and Hypertension, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia
| | | | - Anandhara Indriani Khumaedi
- Division of Nephrology and Hypertension, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia
| | - Olaf M Dekkers
- Department of Internal Medicine, Leiden University Medical Center, Albinusdreef 2, Leiden, The Netherlands
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Merel van Diepen
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Joris I Rotmans
- Department of Internal Medicine, Leiden University Medical Center, Albinusdreef 2, Leiden, The Netherlands.
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Iwamoto W, Ikeda T, Nishikawa H, Hirano M, Kinoshita H, Ono M, Kurogi K, Sakakibara Y, Suiko M, Yasuda S. Regulatory effects of antioxidants on indoxyl sulfate-enhanced intracellular oxidation and impaired phagocytic activity in differentiated U937 human macrophage cells. Biosci Biotechnol Biochem 2024; 88:1081-1089. [PMID: 38849302 DOI: 10.1093/bbb/zbae077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Accepted: 05/28/2024] [Indexed: 06/09/2024]
Abstract
Indoxyl sulfate (IS), a uremic toxin, is a physiologically active sulfated metabolite, specifically in kidney failure patients. Our previous studies have shown that IS downregulates phagocytic immune function in a differentiated HL-60 human macrophage cell model. However, it remains unclear whether IS exerts similar effects on macrophage function in other cell types or in lipopolysaccharide (LPS)-sensitive immune cell models. Therefore, this study aimed to investigate the effects of IS on intracellular oxidation levels and phagocytic activity in a differentiated U937 human macrophage cell model, both in the absence and presence of LPS. Our results demonstrated that IS significantly increases intracellular oxidation levels and decreases phagocytic activity, particularly in cells activated by LPS. Furthermore, we found that 2-acetylphenothiazine, an NADH oxidase inhibitor, attenuates the effects of IS in LPS-activated macrophage cells. Representative antioxidants, trolox, α-tocopherol, and ascorbic acid, significantly mitigated the effects of IS on the macrophages responding to LPS.
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Affiliation(s)
- Wakana Iwamoto
- Graduate School of Agriculture, Tokai University, Mashiki-Cho, Kamimashiki-Gun, Kumamoto, Japan
| | - Tomohiro Ikeda
- Graduate School of Agriculture, Tokai University, Mashiki-Cho, Kamimashiki-Gun, Kumamoto, Japan
| | - Hirotaka Nishikawa
- Graduate School of Agriculture, Tokai University, Mashiki-Cho, Kamimashiki-Gun, Kumamoto, Japan
| | - Masashi Hirano
- Graduate School of Agriculture, Tokai University, Mashiki-Cho, Kamimashiki-Gun, Kumamoto, Japan
- Department of Food and Life Sciences, School of Agriculture, Tokai University, Mashiki-Cho, Kamimashiki-Gun, Kumamoto, Japan
| | - Hideki Kinoshita
- Graduate School of Agriculture, Tokai University, Mashiki-Cho, Kamimashiki-Gun, Kumamoto, Japan
- Department of Food and Life Sciences, School of Agriculture, Tokai University, Mashiki-Cho, Kamimashiki-Gun, Kumamoto, Japan
| | - Masateru Ono
- Graduate School of Agriculture, Tokai University, Mashiki-Cho, Kamimashiki-Gun, Kumamoto, Japan
- Department of Food and Life Sciences, School of Agriculture, Tokai University, Mashiki-Cho, Kamimashiki-Gun, Kumamoto, Japan
| | - Katsuhisa Kurogi
- Department of Biochemistry and Applied Biosciences, Faculty of Agriculture, University of Miyazaki, Miyazaki, Japan
| | - Yoichi Sakakibara
- Department of Biochemistry and Applied Biosciences, Faculty of Agriculture, University of Miyazaki, Miyazaki, Japan
| | - Masahito Suiko
- Support Office for the Next Generation Researcher, University of Miyazaki, Miyazaki, Japan
| | - Shin Yasuda
- Graduate School of Agriculture, Tokai University, Mashiki-Cho, Kamimashiki-Gun, Kumamoto, Japan
- Department of Food and Life Sciences, School of Agriculture, Tokai University, Mashiki-Cho, Kamimashiki-Gun, Kumamoto, Japan
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Yuan Y, Zhao Y, Li F, Ling C, Wu Y, Ma W, Wang Z, Yuan Y, Hao H, Zhang W. Inflammatory cytokine expression in Fabry disease: impact of disease phenotype and alterations under enzyme replacement therapy. Front Immunol 2024; 15:1367252. [PMID: 39234251 PMCID: PMC11371600 DOI: 10.3389/fimmu.2024.1367252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 08/05/2024] [Indexed: 09/06/2024] Open
Abstract
Objectives The aim of this study is to explore the expression of inflammatory cytokines (ICs) in Fabry disease (FD), the correlation between ICs and FD phenotypes, and the impact of enzyme replacement therapy (ERT) on IC expression. Methods We recruited 67 FD patients and 44 healthy controls (HCs) and detected concentrations of the following ICs: interferon-γ, interleukin (IL)-1β, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12P70, IL-17A, IL-17F, IL-22, tumor necrosis factor (TNF)-α, and TNF-β. We also analyzed the impact of ERT on IC expression in FD patients and the relationship between IC expression and sex, genotype, phenotype, disease burden, and biomarkers. Results Most ICs were significantly higher in FD patients than in HCs. A number of ICs were positively correlated with clinical aspects, including disease burden (Mainz Severity Score Index [MSSI]) and cardiac and renal markers. IL-8 was higher in the high MSSI (P-adj=0.026*) than in the low MSSI. Conclusions ICs were upregulated in FD patients, indicating the role of the innate immune process in FD etiology. ERT ameliorated FD-related inflammatory activation, at least to some extent. IC expression was positively correlated with disease burden and clinical markers in FD. Our findings indicated that the inflammatory pathway may be a promising therapeutic target for FD.
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Affiliation(s)
- Yujing Yuan
- Department of Neurology, Peking University First Hospital, Beijing, China
| | - Yawen Zhao
- Department of Neurology, Peking University First Hospital, Beijing, China
| | - Fan Li
- Department of Neurology, Peking University First Hospital, Beijing, China
| | - Chen Ling
- Department of Neurology, Peking University First Hospital, Beijing, China
| | - Yuan Wu
- Department of Ophthalmology, Peking University First Hospital, Beijing, China
| | - Wei Ma
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Zhaoxia Wang
- Department of Neurology, Peking University First Hospital, Beijing, China
- Beijing Key Laboratory of Neurovascular Diseases, Beijing, China
| | - Yun Yuan
- Department of Neurology, Peking University First Hospital, Beijing, China
- Beijing Key Laboratory of Neurovascular Diseases, Beijing, China
| | - Hongjun Hao
- Department of Neurology, Peking University First Hospital, Beijing, China
- Department of Neuroimmunity, Peking University First Hospital, Beijing, China
| | - Wei Zhang
- Department of Neurology, Peking University First Hospital, Beijing, China
- Beijing Key Laboratory of Neurovascular Diseases, Beijing, China
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Regmi P, Aryal N, Bhattarai S, Sedhain A, K. C. RK, van Teijlingen E. Exploring lifestyles, work environment and health care experience of Nepalese returnee labour migrants diagnosed with kidney-related problems. PLoS One 2024; 19:e0309203. [PMID: 39163385 PMCID: PMC11335114 DOI: 10.1371/journal.pone.0309203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Accepted: 07/24/2024] [Indexed: 08/22/2024] Open
Abstract
In recent years, international media and the scientific community have expressed concerns regarding rising kidney health-related risks among Nepalese labour migrants in Gulf countries and Malaysia. Previous studies have highlighted poor lifestyles and work conditions among Nepalese migrants, which could potentially impact their kidney health. This qualitative study aims to explore the lifestyles and work environment of returnee Nepalese migrants who were diagnosed with kidney health problems. In-depth interviews were carried out with twelve returnee migrants, all males, with half having worked abroad for at least a decade. Our analysis yielded seven themes: (a) living and lifestyles; (b) work environment; (c) exposure to pollutants; (d) Chronic Kidney Disease (CKD) experience; (e) use of painkillers and healthcare; (f) medical expenses for CKD patients; and (g) pre-departure training. This study indicates that Nepalese migrants face numerous challenges, including limited access to clean water and sanitation facilities, poor diets, exposure to occupational hazards, and overuse of pain medication, all of which may contribute to an increased risk of kidney disease. An enhanced pre-departure and on-arrival orientation programme focusing on kidney health-related topics, including the necessary advocacy at the country of destination to provide access to basic services, may encourage migrants to adopt healthy lifestyles and safe working environments, as well as help sensitise migrants to their kidney health risks.
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Affiliation(s)
- Pramod Regmi
- Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, United Kingdom
| | - Nirmal Aryal
- Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, United Kingdom
| | | | - Arun Sedhain
- Department of Nephrology, National Academy of Medical Sciences, Kathmandu, Nepal
| | | | - Edwin van Teijlingen
- Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, United Kingdom
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45
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Chen T, Liu Y, Wu S, Long S, Feng L, Lu W, Chen W, Hong G, Zhou L, Wang F, Luo Y, Zou H, Liu W. Comparison of TyG and Newly TyG Related Indicators for Chronic Kidney Diseases Estimation in a Chinese Population. Diabetes Metab Syndr Obes 2024; 17:3063-3075. [PMID: 39184550 PMCID: PMC11342947 DOI: 10.2147/dmso.s469260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Accepted: 08/07/2024] [Indexed: 08/27/2024] Open
Abstract
Background Obesity and insulin resistance (IR) are positively associated with chronic kidney disease (CKD). Previous studies have identified triglyceride-glucose index (TyG) as a valuable surrogate of insulin resistance. Recently, new indicators combining TyG and simple anthropometric indices have emerged, The objective of this study was to assess the diagnostic accuracy of TyG and newly TyG related indicators in detecting CKD and explore which indices were superior in associating with CKD in Chinese population. Methods Correlation test, logistic regression analysis, and receiver operating characteristic (ROC) analyses were used to evaluate the optimal cut-off and value of TyG, TyG-body mass index (TyG-BMI), TyG-waist circumference (TyG-WC), TyG-waist to height ratio (TyG-WHtR) for predicting CKD. Results TyG-WHtR, TyG-WC, and TyG-BMI correlated with several risk factors for CKD. After adjusting for confounders, TyG-WHtR and TyG-WC remained significantly associated with CKD, while TyG-BMI did not. The highest quartiles of TyG-WHtR and TyG-WC had 1.95- and 1.91-fold increased risk of CKD than the lowest quartiles (P<0.05). TyG-WHtR had the largest AUC (0.687) for CKD detection, followed by TyG-WC (0.669), TyG (0.652), and TyG-BMI (0.648). A united model that involved TyG-WHtR and other risk variables had higher predictive performance (AUC=0.791) than a single TyG related indicator. However, TyG had the highest OR (2.713, 95% CI, 1.446-5.090) for reduced eGFR in the fully adjusted model. A united model that involved TyG and WHtR separately had stronger predictive ability (AUC: 0.794) than the model that involved TyG-WHtR individually (AUC:0.791). Conclusion This study found that TyG-WHtR had a better diagnostic value in the diagnosis of CKD, compared to other TyG related indicators, but none of the TyG related indicators showed a stronger association with CKD than TyG. Further research and more refined algorithms are needed to verify these new indicators.
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Affiliation(s)
- Tong Chen
- Department of Nephrology, Chongqing Key Laboratory of Prevention and Treatment of Kidney Disease, Chongqing Clinical Research Center of Kidney and Urology Diseases, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, 400037, People’s Republic of China
- South China Hospital of Shenzhen University, Shenzhen, 518116, People’s Republic of China
- Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging, National Regional Key Technology Engineering Laboratory for Medical Ultrasound School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen, 518060, People’s Republic of China
- Department of Nephrology, The Third Affiliated Hospital, Southern Medical University, Guangzhou, People’s Republic of China
| | - Yu Liu
- South China Hospital of Shenzhen University, Shenzhen, 518116, People’s Republic of China
- Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging, National Regional Key Technology Engineering Laboratory for Medical Ultrasound School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen, 518060, People’s Republic of China
| | - Shiquan Wu
- South China Hospital of Shenzhen University, Shenzhen, 518116, People’s Republic of China
| | - Siyu Long
- South China Hospital of Shenzhen University, Shenzhen, 518116, People’s Republic of China
| | - Ling Feng
- Department of Nephrology, The Third Affiliated Hospital, Southern Medical University, Guangzhou, People’s Republic of China
- Department of Nephrology, Shenzhen Hospital, Southern Medical University, Shenzhen, People’s Republic of China
| | - Wenqian Lu
- School of Medicine, The Chinese University of Hong Kong, Shenzhen, People’s Republic of China
| | - Wenya Chen
- South China Hospital of Shenzhen University, Shenzhen, 518116, People’s Republic of China
| | - Guoai Hong
- South China Hospital of Shenzhen University, Shenzhen, 518116, People’s Republic of China
| | - Li Zhou
- South China Hospital of Shenzhen University, Shenzhen, 518116, People’s Republic of China
| | - Fang Wang
- South China Hospital of Shenzhen University, Shenzhen, 518116, People’s Republic of China
| | - Yuechan Luo
- South China Hospital of Shenzhen University, Shenzhen, 518116, People’s Republic of China
| | - Hequn Zou
- South China Hospital of Shenzhen University, Shenzhen, 518116, People’s Republic of China
- Department of Nephrology, The Third Affiliated Hospital, Southern Medical University, Guangzhou, People’s Republic of China
- School of Medicine, The Chinese University of Hong Kong, Shenzhen, People’s Republic of China
| | - Weihua Liu
- Department Nephrology of Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fujian, 350001, People’s Republic of China
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Mishina S, Ito Y, Lee T, Murofushi T, Uetake Y, Akizawa T. Physician and Patient Preferences for Treatment of Anemia Associated with Chronic Kidney Disease in Japan: A Survey Including Best-Worst Scaling. Patient Prefer Adherence 2024; 18:1563-1575. [PMID: 39100430 PMCID: PMC11298171 DOI: 10.2147/ppa.s450464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 06/03/2024] [Indexed: 08/06/2024] Open
Abstract
Background Several treatment options are available for anemia associated with chronic kidney disease (CKD); however, there remains a lack of awareness of physician and patient preferences regarding these treatments. We aimed to explore physicians' and patients' perceptions and preferences regarding the management of anemia of CKD in Japan. Methods A web-based survey, including best-worst scaling (BWS), was conducted with physicians who had treated ≥1 patient with anemia of CKD in the preceding year, and with patients with CKD who self-reported a clinical diagnosis of anemia of CKD or low hemoglobin levels. A three-step approach was used comprising cognitive interviews, a pilot survey, and a main survey. The BWS survey results were analyzed using multinomial logit and hierarchical Bayesian models. Results The survey was completed by 906 participants: 103 patients (average age 60.6 years; 77.7% male) and 803 physicians (166 nephrologists, 214 cardiologists, 137 diabetologists, and 286 general internists). Almost all (96.0%) physicians surveyed considered anemia of CKD to be an important condition to treat. Hypoxia-inducible factor prolyl hydroxylase (HIF-PH) inhibitors had the highest treatment satisfaction among physicians, whereas patients had the highest satisfaction with both erythropoietin-stimulating agent therapy and HIF-PH inhibitors. Approximately one-third (35.9%) of patients surveyed indicated that they were receiving treatment. When comparing the relative importance of attributes and levels, physicians favored efficacy (particularly improvement in hemoglobin levels), whereas patients favored safety (particularly a lower rate of severe adverse events). Conclusion Although a majority of physicians consider treatment of CKD-related anemia important, differences in the perceptions and usage of medications exist between medical specialties. Preferences for the management of anemia of CKD vary between physicians and patients; therefore, patient involvement in treatment decisions may help optimize outcomes.
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Affiliation(s)
| | | | | | | | | | - Tadao Akizawa
- Division of Nephrology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
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47
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Toyama M, Satoh M, Nakayama S, Hashimoto H, Muroya T, Murakami T, Hirose T, Obara T, Nakaya N, Mori T, Ohkubo T, Imai Y, Hozawa A, Metoki H. Combined effects of blood pressure and glucose status on the risk of chronic kidney disease. Hypertens Res 2024; 47:1831-1841. [PMID: 38671217 PMCID: PMC11224015 DOI: 10.1038/s41440-024-01683-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 03/24/2024] [Accepted: 03/31/2024] [Indexed: 04/28/2024]
Abstract
This study aimed to assess the combined effects of blood pressure (BP) and glucose status on chronic kidney disease (CKD) incidence in young and middle-aged adults. We examined data from 1,297,341 Japanese individuals aged <60 years (60.1% men; mean age 41.4 ± 9.3 years) with no history of CKD at baseline. The interval-censored Cox proportional hazards model with covariates was used. During a median follow-up period of 2.1 years, new onset CKD (estimated glomerular filtration rate <60 ml/min/1.73 m2 and/or proteinuria) occurred in 80,187 participants. In participants without antihypertensive treatment (AHT), the adjusted hazard ratios (95% confidence interval) per 1-standard deviation, that is, 15 mmHg increase in systolic BP for CKD incidence, were 1.08 (1.07-1.09), 1.12 (1.10-1.13), and 1.15 (1.12-1.18) in normoglycemia, borderline glycemia, and diabetes groups, respectively. These ratios were significantly higher in the borderline glycemia and diabetes groups compared with those in the normoglycemia group (interaction p < 0.0001). The interaction between BP and borderline glycemia was evident when the outcome definition was restricted to proteinuria. In participants under AHT, systolic BP was most strongly associated with CKD risk in the diabetes group, although no significant interaction was observed. High BP and high glucose status may synergistically increase the incidence of CKD. Strict BP management may play an important role in the early prevention of CKD in individuals with worse glucose status within the young and middle-aged population. This large-scale longitudinal cohort study showed high BP and diabetes synergistically increased the risk of CKD in individuals without AHT. Strict BP management may play an important role in the early prevention of CKD in individuals with worse glucose status within the young and middle-aged population.
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Affiliation(s)
- Maya Toyama
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Division of Public Health, Hygiene and Epidemiology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
- Department of Nephrology, Self-Defense Forces Sendai Hospital, Sendai, Japan
| | - Michihiro Satoh
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan.
- Division of Public Health, Hygiene and Epidemiology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan.
- Department of Pharmacy, Tohoku Medical and Pharmaceutical University Hospital, Sendai, Japan.
| | - Shingo Nakayama
- Division of Public Health, Hygiene and Epidemiology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
- Division of Nephrology and Endocrinology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Hideaki Hashimoto
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Division of Public Health, Hygiene and Epidemiology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
- Division of Nephrology and Endocrinology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Tomoko Muroya
- Division of Public Health, Hygiene and Epidemiology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
- Division of Internal Medicine, Izumi Hospital, Sendai, Japan
| | - Takahisa Murakami
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Division of Public Health, Hygiene and Epidemiology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
- Division of Aging and Geriatric Dentistry, Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Takuo Hirose
- Division of Nephrology and Endocrinology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
- Department of Endocrinology and Applied Medical Science, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Taku Obara
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Department of Pharmaceutical Sciences, Tohoku University Hospital, Sendai, Japan
| | - Naoki Nakaya
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Takefumi Mori
- Division of Nephrology and Endocrinology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Takayoshi Ohkubo
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan
- Tohoku Institute for Management of Blood Pressure, Sendai, Japan
| | - Yutaka Imai
- Tohoku Institute for Management of Blood Pressure, Sendai, Japan
| | - Atsushi Hozawa
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Hirohito Metoki
- Division of Public Health, Hygiene and Epidemiology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
- Tohoku Institute for Management of Blood Pressure, Sendai, Japan
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Ma Y, Ma M, Ye S, Liu Y, Zhao X, Wang Y. Risk factors for preeclampsia in patients with chronic kidney disease primarily focused on stage 1 CKD. Are referred and registered patients alike? Hypertens Res 2024; 47:1842-1851. [PMID: 38750217 DOI: 10.1038/s41440-024-01698-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 03/23/2024] [Accepted: 03/31/2024] [Indexed: 07/06/2024]
Abstract
Limited research exists on identifying risk factors for preeclampsia (PE) in the chronic kidney disease (CKD) population, especially across different patient sources. This study aimed to address this gap by analyzing clinical data from CKD pregnant women admitted to Peking University Third Hospital from January 2012 to December 2022. Logistic regression analysis identified independent risk factors for PE in the CKD population and assessed variations among patients from different sources. Additionally, a predictive model for PE was established using data from the registered group. The study included 524 CKD patients. Hypertension, proteinuria, fibrinogen >4 g/L, serum albumin ≤30 g/L, and uric acid >260 μmol/L were independent risk factors for PE in the overall CKD population. Subgroup analysis revealed that hypertension, serum albumin ≤30 g/L, and uric acid >260 μmol/L were independent risk factors in the referred group, while hypertension, uric acid >260 μmol/L, and fibrinogen >4 g/L were independent risk factors in the registered group. The prediction model based on registered group risk factors showed good predictive efficiency, with the area under the curve of 0.774 in the training set and 0.714 in the validation set. In conclusion, this study revealed that hypertension and elevated uric acid are independent risk factors for PE in CKD patients regardless of patient source, while serum albumin and fibrinogen levels are associated with PE risk in specific patient subgroups. Our predictive model enables clinicians to quickly identify the risk of PE in CKD patients, and early intervention treatment to improve pregnancy outcomes.
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Affiliation(s)
- Yue Ma
- Department of Obstetrics and Gynecology, Peking University Third Hospital, National Clinical Research Center for Obstetrics and Gynecology, Beijing, 100191, China
| | - Mingyue Ma
- Department of Public Health, Johns Hopkins University, Baltimore, MD, 21218, USA
| | - Shenglong Ye
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing, 100044, China
| | - Yuanying Liu
- Department of Obstetrics and Gynecology, Peking University Third Hospital, National Clinical Research Center for Obstetrics and Gynecology, Beijing, 100191, China
| | - Xueqing Zhao
- Department of Obstetrics and Gynecology, Peking University Third Hospital, National Clinical Research Center for Obstetrics and Gynecology, Beijing, 100191, China
| | - Yongqing Wang
- Department of Obstetrics and Gynecology, Peking University Third Hospital, National Clinical Research Center for Obstetrics and Gynecology, Beijing, 100191, China.
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Xiao X, Wang W, Guo C, Wu J, Zhang S, Shi H, Kwon S, Chen J, Dong Z. Hypermethylation leads to the loss of HOXA5, resulting in JAG1 expression and NOTCH signaling contributing to kidney fibrosis. Kidney Int 2024; 106:98-114. [PMID: 38521405 DOI: 10.1016/j.kint.2024.02.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 02/19/2024] [Accepted: 02/28/2024] [Indexed: 03/25/2024]
Abstract
Epigenetic regulations, including DNA methylation, are critical to the development and progression of kidney fibrosis, but the underlying mechanisms remain elusive. Here, we show that fibrosis of the mouse kidney was associated with the induction of DNA methyltransferases and increases in global DNA methylation and was alleviated by the DNA methyltransferase inhibitor 5-Aza-2'-deoxycytidine (5-Aza). Genome-wide analysis demonstrated the hypermethylation of 94 genes in mouse unilateral ureteral obstruction kidneys, which was markedly reduced by 5-Aza. Among these genes, Hoxa5 was hypermethylated at its gene promoter, and this hypermethylation was associated with reduced HOXA5 expression in fibrotic mouse kidneys after ureteral obstruction or unilateral ischemia-reperfusion injury. 5-Aza prevented Hoxa5 hypermethylation, restored HOXA5 expression, and suppressed kidney fibrosis. Downregulation of HOXA5 was verified in human kidney biopsies from patients with chronic kidney disease and correlated with the increased kidney fibrosis and DNA methylation. Kidney fibrosis was aggravated by conditional knockout of Hoxa5 and alleviated by conditional knockin of Hoxa5 in kidney proximal tubules of mice. Mechanistically, we found that HOXA5 repressed Jag1 transcription by directly binding to its gene promoter, resulting in the suppression of JAG1-NOTCH signaling during kidney fibrosis. Thus, our results indicate that loss of HOXA5 via DNA methylation contributes to fibrogenesis in kidney diseases by inducing JAG1 and consequent activation of the NOTCH signaling pathway.
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MESH Headings
- Animals
- Jagged-1 Protein/genetics
- Jagged-1 Protein/metabolism
- Homeodomain Proteins/genetics
- Homeodomain Proteins/metabolism
- Fibrosis
- DNA Methylation
- Signal Transduction
- Humans
- Mice
- Male
- Ureteral Obstruction/complications
- Ureteral Obstruction/pathology
- Ureteral Obstruction/genetics
- Ureteral Obstruction/metabolism
- Receptors, Notch/metabolism
- Receptors, Notch/genetics
- Promoter Regions, Genetic
- Kidney/pathology
- Kidney/metabolism
- Mice, Knockout
- Mice, Inbred C57BL
- Disease Models, Animal
- Renal Insufficiency, Chronic/pathology
- Renal Insufficiency, Chronic/genetics
- Renal Insufficiency, Chronic/metabolism
- Epigenesis, Genetic
- Kidney Diseases/pathology
- Kidney Diseases/genetics
- Kidney Diseases/metabolism
- Kidney Diseases/etiology
- Transcription Factors
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Affiliation(s)
- Xiao Xiao
- Department of Laboratory Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China; Department of Cellular Biology and Anatomy, Medical College of Georgia at Augusta University, Augusta, Georgia, USA.
| | - Wei Wang
- Department of Urology, Institute of Urology, and Anhui Province Key Laboratory of Genitourinary Diseases, the First Affiliated Hospital of Anhui Medical University, Hefei, China; Department of Cellular Biology and Anatomy, Medical College of Georgia at Augusta University, Augusta, Georgia, USA
| | - Chunyuan Guo
- Department of Dermatology, Shanghai Skin Disease Hospital, and Institute of Psoriasis, Tongji University School of Medicine, Shanghai, China; Department of Cellular Biology and Anatomy, Medical College of Georgia at Augusta University, Augusta, Georgia, USA
| | - Jiazhu Wu
- Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Sheng Zhang
- Department of Spine Surgery and Musculoskeletal Tumor, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Huidong Shi
- Cancer Center, Medical College of Georgia at Augusta University, Augusta, Georgia, USA
| | - Sangho Kwon
- Department of Cellular Biology and Anatomy, Medical College of Georgia at Augusta University, Augusta, Georgia, USA
| | - Jiankang Chen
- Department of Cellular Biology and Anatomy, Medical College of Georgia at Augusta University, Augusta, Georgia, USA
| | - Zheng Dong
- Department of Cellular Biology and Anatomy, Medical College of Georgia at Augusta University and Charlie Norwood VA Medical Center, Augusta, Georgia, USA.
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Sivaprasad M, Shalini T, Sahay M, Sahay R, Satyanarayanan M, Reddy GB. Plasma levels and dietary intake of minerals in patients with type 2 diabetes and chronic kidney disease: A case-control study. J Trace Elem Med Biol 2024; 84:127425. [PMID: 38484635 DOI: 10.1016/j.jtemb.2024.127425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 02/25/2024] [Accepted: 03/03/2024] [Indexed: 05/27/2024]
Abstract
BACKGROUND AND AIM Diabetic kidney disease (DKD) is the primary cause of chronic kidney disease (CKD) worldwide. Altered mineral levels leading to adverse outcomes are widely reported in diabetes but limited in DKD, in the Indian scenario, hence this study was taken up to address this issue. METHODS A hospital-based case-control study was taken up with 54 healthy controls (C) and 140 subjects with type 2 diabetes wherein 74 subjects with diabetes and CKD formed the DKD group, and 66 subjects with diabetes but no CKD formed the diabetic no-chronic kidney disease (DNCKD) group. High-resolution inductively coupled plasma mass spectrometry was used to evaluate the blood levels of minerals (calcium (Ca), vanadium (V), chromium (Cr), manganese (Mn), iron (Fe), cobalt (Co), copper (Cu), zinc (Zn), and selenium (Se)), and a raw food-based food frequency questionnaire for dietary intakes. Estimated glomerular filtration rate (eGFR) was calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation (mL/min/1.73 m2) and albuminuria. Spearman's rank correlation was used to evaluate the relationship between the categorical variables. RESULTS The median values of plasma Ca in the DKD group were significantly lower compared with the DNCKD and C groups (10.5 mg/dL vs. 11.0 mg/dL and 11.7 mg/dL, p<0.001). Furthermore, plasma Ca levels lowered with declining kidney function, as evidenced by the eGFR and albuminuria segregation. Dietary intake of minerals did not correlate with the corresponding plasma levels. However, in the DKD group, eGFR correlated positively with the plasma levels of Ca (r= 0.422, p=0.001), Cr (r= 0.351, p=0.008), Mn (r= 0.338, p=0.011), Fe (r= 0.403, p=0.002), Cu (r= 0.274, p=0.041) and negatively with Se (r= -0.486, p<0.001). CONCLUSION Plasma Ca levels are lower in the DKD group with a strong positive association with eGFR, indicating its role in predicting the onset and progression of kidney function decline.
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Affiliation(s)
- Mudili Sivaprasad
- Biochemistry Division, ICMR-National Institute of Nutrition, Hyderabad, India
| | - Tattari Shalini
- Biochemistry Division, ICMR-National Institute of Nutrition, Hyderabad, India
| | - Manisha Sahay
- Nephrology Division, Osmania General Hospital and Medical College, Hyderabad, India
| | - Rakesh Sahay
- Endocrinology Division, Osmania General Hospital and Medical College, Hyderabad, India
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