Background: Tenofovir (TFV) is widely used to treat patients with hepatitis B virus (HBV) infection. But kidney abnormalities are the main concern using this drug. Few studies have described the renal impairment due t...Background: Tenofovir (TFV) is widely used to treat patients with hepatitis B virus (HBV) infection. But kidney abnormalities are the main concern using this drug. Few studies have described the renal impairment due to the TFV in chronic hepatitis B (CHB) in Sub-Saharan Africa. The objective was to evaluate factors associated with renal impairment observed in patients on TFV for CHB. Method: It was a hospital based cross sectional prospective study carried out from June 2023 to July 2023 in Yaoundé (Cameroon) and included any patient treated with TFV for CHB during at least a period of 6 months. For each participant, we collected in the medical report socio-demographic data, clinical data, baseline creatinine, treatment information (type of TFV which was Disoproxil Fumarate (TDF) or Alafenamide (TAF), duration). Then, we collected blood samples to measure serum creatinine and phosphate levels and urine dipstick analysis. Factors associated with renal impairment were assessed with the Odds Ratio. A p value of Results: A total of 60 participants were included. The median age was 44 years [36-55] and median duration of TFV therapy was 17.5 months [11.7-25.7]. The prevalence of reduced eGFR (Conclusion: Kidney function was impaired in some patients receiving TFV for CHB. It should be monitored, particularly after 36 months and for those receiving TDF prodrug.展开更多
BACKGROUND Townes–Brocks syndrome(TBS)is a rare autosomal dominant syndrome that is characterized by a triad of imperforate anus,dysplastic ears,and thumb malformations.Heterozygous variants of SALL1 are responsible ...BACKGROUND Townes–Brocks syndrome(TBS)is a rare autosomal dominant syndrome that is characterized by a triad of imperforate anus,dysplastic ears,and thumb malformations.Heterozygous variants of SALL1 are responsible for this syndrome.Renal structural abnormalities and functional impairments are often reported in TBS patients.CASE SUMMARY We report a case of TBS in a Chinese family.The index patients showed obvious renal atrophy and renal failure.TBS was suggested after a physical examination and pedigree analysis.Whole exome sequencing revealed a heterozygous variant of SALL1.The variant(NM_001127892 c.1289_c.1290 insC)led to a read-frame shift of the encoded protein,which was confirmed by Sanger sequencing.The variant cosegregated with the phenotype among affected members.CONCLUSION A novel variant in SALL1 gene may be the molecular pathogenic basis of this disorder.展开更多
Objective： To investigate the efficacy and safety of the treatment of the newly diagnosed multiple myeloma （MM） with or without renal impairment receiving the therapy of bortezomib, dexamethasone plus thalidomide ...Objective： To investigate the efficacy and safety of the treatment of the newly diagnosed multiple myeloma （MM） with or without renal impairment receiving the therapy of bortezomib, dexamethasone plus thalidomide （BTD） regimen in order to analyze the effects of BTD regimen on the prognosis of the MM patients with renal impairment compared with the patients without renal impairment. Methods： Seventy-two newly diagnosed MM patients entered into our study and all the patients belonged to International Stage System （ISS） 3 in which transplantation patients were excluded or the patients refused receiving transplantation therapy. According to the level of serum creatinine （Scr）, the patients were divided into two groups including group 1 （n=42） （Scr 〈2 mg/dL） and group 2 （n=30） （Scr ≥2 mg/dL）. All the patients received the therapy of BTD regimen as induction therapy, and the median treatment time was 5 （range, 2-8） cycles. The outcome was analyzed retrospectively. Results： The overall remission （OR） rates were 81.0% （group 1） and 80.0% （group 2）. There was no statistical difference between the two groups （P〉0.05）. In group 2, 10 patients （33.3%） got renal function reversal, 14 patients （46.7%） got improved renal function and the median time to renal function reversal was 1.4 （range, 0.7-3.0） months. Among 12 patients with hemodialysis at diagnosis, 8 patients got rid of hemodialysis after median 4 cycles of therapy （range, 3-6 cycles）. After a median follow-up period of 16 （range, 2-31） months, 5 patients （11.9%） in group 1 died and 9 patients （30.0%） in group 2 died （P=0.056）. The 2-year estimate of overall survival was 77.3% in group 1 and 63.8% in group 2, respectively （P=0.188）. During a median follow-up time of 13.0 months （range, 2-25 months）, 15 patients （35.7%） in group 1 progressed and 13 patients （43.3%） in group 2 progressed （P=0.513）. The 2-year estimate of response duration was 50.6% in group 1 and 42.1% in group 2, respectively （P=1）. The main toxicities in the two groups included thrombocytopenia, peripheral neuropathy （PN）, infection, herpes zoster and so on. The incidence of grade 3 and 4 adverse events was low. Conclusions： BTD regimen may become the front-line therapy for the newly diagnosed MM patients with renal impairment because BTD regimen can improve the prognosis of the patients with renal impairment as good as the patients without renal impairment.展开更多
Objective: To evaluate the efficacy of Breviscapine on essential hypertension (EH) patients complicated with micro-albuminuria of renal impairment. Methods: Seventy-six EH patients were randomly assigned to the contro...Objective: To evaluate the efficacy of Breviscapine on essential hypertension (EH) patients complicated with micro-albuminuria of renal impairment. Methods: Seventy-six EH patients were randomly assigned to the control group and the treated group, the former was given amlodipine, captopril/uropidil and the latter was given in addition Breviscapine intravenously dripped for 2 treatment courses. The indexes of serum creatinine (Cr), blood urea nitrogen (BUN), blood and urinary β 2-microglobulin (β 2-MG), and quantitative determination of 24 hrs urinary protein were evaluated before and after treatment. Results: In the control group, compared with before treatment, the quantitative determination of 24 hrs urinary protein got reduced significantly ( P <0.05), while in the treated group, both urinary β 2-MG and quantitative determination of 24 hrs urinary protein got lowered significantly ( P <0.05 and P <0.01). But after treatment, compared with the control group, urinary β 2-MG and quantitative determination of 24 hrs urinary protein in the treated group were obviously reduced ( P <0.05). Conclusion: Besides lowering blood pressure effectively, Breviscapine could improve the renal function significantly and reduce the urinary micro-albuminuria, hence showing promising effect on renal protection.展开更多
Diabetes mellitus(DM)is defined as a chronic disease of disordered metabolism with an ongoing increase in prevalence and incidence rates.Renal disease in patients with diabetes is associated with increased morbidity a...Diabetes mellitus(DM)is defined as a chronic disease of disordered metabolism with an ongoing increase in prevalence and incidence rates.Renal disease in patients with diabetes is associated with increased morbidity and premature mortality,particularly attributed to their very high cardiovascular risk.Since this group of patients frequently lacks specific symptomatology prior to the adverse events,a screening tool for the identification of high-risk patients is necessary.The epicardial adipose tissue(EAT)is a biologically active organ having properties similar to visceral adipose tissue and has been associated with metabolic diseases and coronary artery disease.Superior to conventional cardiovascular risk factors and anthropometric measures,including body mass index and waist circumference,the EAT can early predict the development of coronary artery disease.Assessment of EAT can be performed by twodimensional echocardiography,magnetic resonance imaging or computer tomography.However,its role and significance in patients with DM and nephropathy has not been thoroughly evaluated.The aim of the current editorial is to evaluate all available evidence regarding EAT in patients with DM and renal impairment.Systematic search of the literature revealed that patients with DM and nephropathy have increased EAT measurements,uncontrolled underlying disease,high body mass index and raised cardiovascular risk markers.Acknowledging the practical implications of this test,EAT assessment could serve as a novel and non-invasive biomarker to identify high-risk patients for cardiovascular adverse events.展开更多
Objective: The aim of the study was to investigate the clinic manifestation, diagnosis and treatment on multiple myeloma (MM) with the onset of renal impairment. Methods: The 27 cases of multiple myeloma with the onse...Objective: The aim of the study was to investigate the clinic manifestation, diagnosis and treatment on multiple myeloma (MM) with the onset of renal impairment. Methods: The 27 cases of multiple myeloma with the onset of renal impair-ment were collected in Department of Nephrology, Wuhan General Hospital of Guangzhou Command, China, from January 2007 to January 2011. All cases were divided into the groups with renal dysfunction (n = 16) and normal renal function (n = 11). The clinic manifestations, treatments and prognosis of all patients were analyzed. Results: Of all the patients in normal renal function group, 5 suffered nephrotic syndrome, 4 had abnormal results of routine urinalysis (hematuria or proteinuria) which were not caused by nephrotic syndrome, and 1 suffered urinary tract infection. Five pathological specimens of renal biopsy revealed that light chain protein, immunoglobulin and complement C3 were deposited mainly in the glomerular base-ment membrane and mesangia, tubular basement membrane and arteriolar walls. Two pathological specimens were proved to be renal amyloidosis. Patients with renal dysfunction had poorer prognosis, severer anemia, higher values of serum lactate dehydrogenase (LDH) and β2-microglobulin (β2-MG), worse responses to chemotherapy. Of 16 patients with renal dysfunc-tion, 14 (87.5%) were stage III, which were significantly higher than that in the group of normal renal function [63.6% (7/11)]. Of 16 cases with renal dysfunction, 9 were treated with blood purification, and 5 of 9 cases were treated with plasma exchange. Conclusion: Multiple myeloma with the onset of renal impairment was easily misdiagnosed. Hemodialysis concomitant with chemotherapy could contribute to recovery of renal function.展开更多
Objective:To explore the main factors of renal function injury caused by the combination of elemene emulsion injection in the real world.Methods:Based on the hospital information system medical database constructed by...Objective:To explore the main factors of renal function injury caused by the combination of elemene emulsion injection in the real world.Methods:Based on the hospital information system medical database constructed by the Institute of Clinical Basic Medicine of Chinese Academy of Traditional Chinese Medicine,taking the patient information of elemene emulsion injection used in 21 top three hospitals in China as the research object,the nested case control study method was used to compare the combined medication of patients with renal function injury group and control group,The main factors that may lead to renal function injury were screened by MCP variable selection method,and the above main factors were further analyzed by classical logistic regression and propensity score logistic regression method.Results:The analysis found that the combined use of potassium chloride within 7 d before the use of elemene emulsion injection or the combined use of furosemide during the use of elemene emulsion injection may be the main factor leading to renal function injury.Conclusion:The combination of elemene emulsion injection and the above main factors that may lead to renal injury should be avoided.If it must be used,clinical monitoring should be strengthened,and abnormal reactions should be treated immediately.The results of this study have certain clinical significance,and the clinical mechanism can be further studied and explored in the future.展开更多
Background:Nonalcoholic fatty liver disease(NAFLD)is associated with impaired renal function,and both diseases often occur alongside other metabolic disorders.However,the prevalence and risk factors for impaired renal...Background:Nonalcoholic fatty liver disease(NAFLD)is associated with impaired renal function,and both diseases often occur alongside other metabolic disorders.However,the prevalence and risk factors for impaired renal function in patients with NAFLD remain unclear.The objective of this study was to identify the prevalence and risk factors for renal impairment in NAFLD patients.Methods:All adults aged 18-70 years with ultrasound-diagnosed NAFLD and transient elastography examination from eight Asian centers were enrolled in this prospective study.Liver fibrosis and cirrhosis were assessed by FibroScan-aspartate aminotransferase(FAST),Agile 3+and Agile 4 scores.Impaired renal function and chronic kidney disease(CKD)were defined by an estimated glomerular filtration rate(eGFR)with value of<90 mL/min/1.73 m^(2) and<60 mL/min/1.73 m^(2),respectively,as estimated by the CKD-Epidemiology Collaboration(CKD-EPI)equation.Results:Among 529 included NAFLD patients,the prevalence rates of impaired renal function and CKD were 37.4%and 4.9%,respectively.In multivariate analysis,a moderate-high risk of advanced liver fibrosis and cirrhosis according to Agile 3+and Agile 4 scores were independent risk factors for CKD(P<0.05).Furthermore,increased fasting plasma glucose(FPG)and blood pressure were significantly associated with impaired renal function after controlling for the other components of metabolic syndrome(P<0.05).Compared with patients with normoglycemia,those with prediabetes[FPG≥5.6 mmol/L or hemoglobin A1c(HbA1c)≥5.7%]were more likely to have impaired renal function(P<0.05).Conclusions:Agile 3+and Agile 4 are reliable for identifying NAFLD patients with high risk of CKD.Early glycemic control in the prediabetic stage might have a potential renoprotective role in these patients.展开更多
Objective：To observe the effect of Chinese medical regimen and integrative medical regimen on quality of life and early renal impairment in elderly patients with isolated systolic hypertension（EISH）.Methods： A mul...Objective：To observe the effect of Chinese medical regimen and integrative medical regimen on quality of life and early renal impairment in elderly patients with isolated systolic hypertension（EISH）.Methods： A multi-center,randomized,double-blinded controlled trail was adopted.A total of 270 cases of EISH were randomly divided into 3 groups：Chinese medicine group（CM）,combination group and Western medicine group （WM）.The course of treatment was 4 weeks.The clinical blood pressure,integral of quality of life（SF-36 scale）, immunoglubin G（IgG）,microalbumin（mALB）,β_2-microglobulin（β_2-MG）,transferrin（TRF）and N-acetyl-β＇- D-glucosa-minidase（NAG）in urine were determined before and after the treatment.Results：After treatment, systolic blood pressure depressed significantly in each group（P〈0.05）,and the combination group was superior to CM or WM group in depressing SBP（P〈0.05）; in each group,integral of quality of life improved in different degree,and combination group was superior to WM group in all 8 dimensions（P〈0.05）.The level of mALB andβ_2-MG in urine decreased in all groups（P〈0.05）,and the combination group was superior to CM group or WM group in decreasing mALB（P〈0.05）.Conclusions：Chinese medical regimen has affirmative effect in treating EISH patients,and could lower the systolic blood pressure,improve quality of life and early renal impairment of the patients,and integrative medical regimen has superiority on account of cooperation,and deserves further study.展开更多
AIMTo investigate the role of contrast enhanced ultrasound (CEUS) in evaluating patients with renal function impairment (RFI) showing: (1) acute renal failure (ARF) of suspicious vascular origin; or (2) suspicious ren...AIMTo investigate the role of contrast enhanced ultrasound (CEUS) in evaluating patients with renal function impairment (RFI) showing: (1) acute renal failure (ARF) of suspicious vascular origin; or (2) suspicious renal lesions.METHODSWe retrospectively evaluated patients addressed to CEUS over an eight years period to rule-out vascular causes of ARF (first group of 50 subjects) or assess previously found suspicious renal lesions (second group of 41 subjects with acute or chronic RFI). After preliminary grey-scale and color Doppler investigation, each kidney was investigated individually with CEUS, using 1.2-2.4 mL of a sulfur hexafluoride-filled microbubble contrast agent. Image analysis was performed in consensus by two readers who reviewed digital clips of CEUS. We calculated the detection rate of vascular abnormalities in the first group and performed descriptive statistics of imaging findings for the second group.RESULTSIn the first group, CEUS detected renal infarction or cortical ischemia in 18/50 patients (36%; 95%CI: 23.3-50.9) and 1/50 patients (2%; 95%CI: 0.1-12), respectively. The detection rate of infarction was significantly higher (P = 0.0002; McNemar test) compared to color Doppler ultrasonography (10%). No vascular causes of ARF were identified in the remaining 31/50 patients (62%). In the second group, CEUS detected 41 lesions on 39 patients, allowing differentiation between solid lesions (21/41; 51.2%) vs complex cysts (20/41; 48.8%), and properly addressing 15/39 patients to intervention when feasible based on clinical conditions (surgery and cryoablation in 13 and 2 cases, respectively). Cysts were categorized Bosniak II, IIF, III and IV in 8, 5, 4 and 3 cases, respectively. In the remaining two patients, CEUS found 1 pseudolesion and 1 subcapsular hematoma.CONCLUSIONCEUS showed high detection rate of renal perfusion abnormalities in patients with ARF, influencing the management of patients with acute or chronic RFI and renal masses throughout their proper characterization.展开更多
Background Hyperuricemia is frequently present in patients with heart failure. Many pathological conditions, such as tissue ischemia, renal function impairment, cardiac function impairment, metabolic syndrome, and inf...Background Hyperuricemia is frequently present in patients with heart failure. Many pathological conditions, such as tissue ischemia, renal function impairment, cardiac function impairment, metabolic syndrome, and inflammatory status, may impact uric acid （UA） metabolism. This study was to assess their potential relations to UA metabolism in heart failure. Methods We retrospectively assessed clinical charac- teristics, echocardiological, renal, metabolic and inflammatory variables selected on the basis of previous evidence of their involvement in cardiovascular diseases and UA metabolism in a large cohort of randomly selected adults with congestive heart failure （n = 553）. By clustering of indices, those variables were explored using factor analysis. Results In factor analysis, serum uric acid （SUA） formed part of a principal cluster of renal functional variables which included serum creatinine （SCr） and blood urea nitrogen （BUN）. Univariate correlation coefficients between variables of patients with congestive heart failure showed that the strongest correlations for SUA were with BUN （r = 0.48, P 〈 0.001） and SCr （r = 0.47, P 〈 0.001）. Conclusions There was an inverse relationship between SUA levels and measures of renal function in patients with congestive heart failure. The strong correlation between SUA and SCr and BUN levels suggests that elevated SUA concentrations reflect an impairment of renal function in heart failure.展开更多
Anti-B cell maturation antigen(BCMA)chimeric antigen receptor(CAR)T-cell therapyis effective and well-tolerated for refractory or relapsed multiple myeloma(RRMM).The purposcof the present study was to analyze efficacy...Anti-B cell maturation antigen(BCMA)chimeric antigen receptor(CAR)T-cell therapyis effective and well-tolerated for refractory or relapsed multiple myeloma(RRMM).The purposcof the present study was to analyze efficacy in RRMM patients with renal impairment treated byanti-BCMA CAR-T cell therapy.A total of 59 RRMM patients were selected,and divided intoimpaired renal function(lRF)group[basclinc cstimated giomerular filtration rate(eSFR)<90 m/min/1.73 m^2(n=18)]and normal renal function(NRF)group(baseline eGFR≥90 mL/min/1.73 m,n=41).For patients with IRF,eGFR at the 6th month post-CAR-T cells infusion was significantlyhigher than the baseline(P<0.05).The multivariate analysis showed that light chain type and beta-2 micro-globulin(bcta-2M)were associated factors with the decrease of serum creatinine.Medianprogression-free survival(PFS)in the NRF group and IRF group was 266 days and 181 daysrespectively.Overall survival(OS)in the NRF group and lRF group was 877 days and 238 daysrespectively.There was no significant difference in the objective response rate(ORR)between thelRF group and the NRF group.It is suggested that CAR-T cells therapy could improve the renalfunction during the treatment of RRMM.The renal function could be more significantly improvedin RRMM patients with light chain type than with other types.展开更多
Objective: We aim to detect over-time variations in mortality of liver transplant recipients stratified by the period of transplant. Since this is a retrospective investigation, bias reduction caused by possible confo...Objective: We aim to detect over-time variations in mortality of liver transplant recipients stratified by the period of transplant. Since this is a retrospective investigation, bias reduction caused by possible confounding effects can be achieved by using propensity score weighting in a multivariate logistic regression model. Methods: Medical charts of all adult liver transplant recipients (n = 250) who were transplanted in three periods 2005-2009, 2010-2014 and 2015-2019 were retrospectively reviewed. The following recipient factors were analyzed: recipients and donors’ ages, sex, renal impairment, body mass index (BMI), presence of bacterial or viral infections, MELD (Model for end-stage diseases). Multivariate logistic model adjusted by Propensity Scores (PS) was used to identify the effect of the risk factors on mortality, and death within five years, in the targeted time frame. Patient outcomes are recorded as;(patient status = 1 if dead, or patient status = 0 if alive). Results: Meld score, recipient age, and renal impairments were shown to be predictors of mortality in transplanted patients. Multivariate regression model was used to identify the significance of the specified risk factors, followed by pairwise comparisons between periods. Pairwise comparisons between periods using logistic regression weighted by the inverse propensity score, correcting for the possible confounding effect of measured covariates showed that the death rate is significantly reduced in subsequent periods as compared to the initial period. Conclusions: The clinical implications of these findings are the ability to stratify patients at high risk of posttransplant death by planning more intensive and accurate management for them.展开更多
Objective:This paper aims to study the clinical characteristics of patients with different types of primary hyperuricemia(HUA).Methods:Using a retrospective research method,200 patients with primary HUA in the hospita...Objective:This paper aims to study the clinical characteristics of patients with different types of primary hyperuricemia(HUA).Methods:Using a retrospective research method,200 patients with primary HUA in the hospital from June 2020 to January 2023 were selected as the research objects.Patients were grouped according to the detection results of 24-hour urinary uric acid excretion(UUE)and fractional excretion of uric acid(FEUA)(renal insufficiency type,renal overload type,mixed type,and other types).The general information of patients in the four groups(gender,age,body mass index,living habits,etc.),underlying diseases(hypertension,diabetes),blood test results[uric acid(UA),creatinine(Cre)],urine test results(24-hour urine UA,24-hour urine Cre)were summarized and the differences between the groups were analyzed.Results:The 200 cases of HUA patients were divided into 54.00%with renal insufficiency type,38.50%with mixed type,6.00%with renal overload type,and 1.50%with other types.The age of patients with mixed HUA was younger than that of patients with other types,renal overload type,and renal insufficiency type,and the difference was statistically significant(P<0.05).The UA level of patients with other types of HUA was lower than that of patients with mixed type HUA,and there was statistical significance(P<0.05).The Cre level of patients with mixed type HUA was lower than that of patients with renal insufficiency type and renal overload type,and the difference was statistically significant(P<0.05).The 24-hour urinary UA level in patients with renal insufficiency type HUA was lower than that in patients with renal overload type and mixed type HUA,and the difference was statistically significant(P<0.05).The 24-hour urinary Cre level of patients with other types of HUA was lower than that of patients with renal overload type and mixed HUA,the difference was statistically significant(P<0.05).The estimated glomerular filtration rate(eGFR)level of patients with other types of HUA was lower than that of patients with mixed type HUA,and the difference was statistically significant(P<0.05).There was no significant difference in the proportions of hypertension,diabetes,coronary heart disease,and urinary calculi among patients with renal insufficiency type,renal overload type,mixed type,and other types of HUA(P>0.05).Conclusion:The primary HUA patients are mainly of renal insufficiency type,followed by mixed type.There are significant differences in the clinical characteristics of patients with different types of HUA.Among them,patients with other types of HUA are the oldest and have the lowest uric acid levels.Patients with mixed HUA had the best renal function but the highest 24-hour urine creatinine level.This study can be used as a basis for rational selection of urate-lowering drugs for different HUA patients.展开更多
BACKGROUND Once daily tacrolimus regimen was found to exhibits similar bioavailability,safety and efficacy properties compared to twice-daily tacrolimus in kidney transplantation patients.AIM To compare the efficacy a...BACKGROUND Once daily tacrolimus regimen was found to exhibits similar bioavailability,safety and efficacy properties compared to twice-daily tacrolimus in kidney transplantation patients.AIM To compare the efficacy and safety of once-daily prolonged release tacrolimus compared to twice-daily tacrolimus in liver transplantation patients.METHODS MEDLINE,EMBASE,CENTRAL databases were searched for clinical trials until December 2020.Efficacy outcome measured as the rate of treatment failure indicated by biopsy-proven acute rejection,Serum creatinine,graft loss,or death.Two reviewers independently selected studies,collected data and assessed risk of bias.The results are reported as risk ratio with 95%confidence interval(CI)for dichotomous data.RESULTS Seven studies included with 965 patients.All the included studies were of moderate quality according to the risk of bias assessment using Cochrane Risk of Bias tool.Biopsy-proven acute rejection was reported in four studies,and pooled analysis of those studies indicated similar rejections in both twice daily and once daily tacrolimus groups(risk ratio:1.06,95%CI:0.84-1.34,n=758,I2=0%)and also we found no significant difference between both groups for renal outcome(serum creatinine;mean difference,0.001 mg/dL,95%CI:-0.042 to 0.043,n=846,I2=18.6%).Similarly,there was similar number of adverse events such as hypertension,headache,back pain,blood related disorders,infections and nausea observed in both groups.CONCLUSION The analysis findings confirm that both once daily and twice daily tacrolimus formulations are comparable in terms of efficacy and safety outcomes.展开更多
This study investigated the putative protective effects of supplemental 2-aminoethane sulfonic acid（taurine） and reduced housing density on renal function in laying hens. We randomly assigned fifteen thousand green-...This study investigated the putative protective effects of supplemental 2-aminoethane sulfonic acid（taurine） and reduced housing density on renal function in laying hens. We randomly assigned fifteen thousand green-shell laying hens into three groups： a free range group, a low-density caged group, and a high-density caged group. Each group was further divided equally into a control group（C） and a taurine treatment group（T）. After 15 d, we analyzed histological changes in kidney cells, inflammatory mediator levels, oxidation and anti-oxidation levels. Experimental data revealed taurine supplementation, and rearing free range or in low-density housing can lessen morphological renal damage, inflammatory mediator levels, and oxidation levels and increase anti-oxidation levels. Our data demonstrate that taurine supplementation and a reduction in housing density can ameliorate renal impairment, increase productivity, enhance health, and promote welfare in laying hens.展开更多
Diabetic kidney disease （DKD） is one of the primary causes of end-stage renal disease （ESRD）. Early diagnosis is very important in preventing the development of DKD. Urinary albumin excretion rate （UAER） and glo...Diabetic kidney disease （DKD） is one of the primary causes of end-stage renal disease （ESRD）. Early diagnosis is very important in preventing the development of DKD. Urinary albumin excretion rate （UAER） and glomerular filtration rate （GFR） are widely accepted as criteria for the diagnosis and clinical grading of DKD, and microalbuminuria has been recommended as the first clinical sign of DKD. The natural history of DKD has been divided into three stages： normoalbuminuria, microalbuminuria, and macroalbuminuria. However, this clinical paradigm has been questioned recently, as studies have shown that a portion of diabetes mellitus （DM） patients with normoalbuminuria have progressive renal insufficiency, referred to as normoalbuminuric diabetic kidney disease （NADKD） or nonalbuminuric diabetic nephropathy. Epidemiologic research has demonstrated that normoalbuminuric diabetic kidney disease is common, and the large number of NADKD patients suggests that the traditional paradigm needs to be shifted. Currently, the pathogenesis of NADKD remains unclear, but many clinical studies have identified some clinical and pathological features of NADKD. In addition, the long-term outcomes of NADKD patients remain controversial. In this article, we reviewed the latest studies addressing the pathogenesis, pathology, treatment and prevention of NADKD.展开更多
文摘Background: Tenofovir (TFV) is widely used to treat patients with hepatitis B virus (HBV) infection. But kidney abnormalities are the main concern using this drug. Few studies have described the renal impairment due to the TFV in chronic hepatitis B (CHB) in Sub-Saharan Africa. The objective was to evaluate factors associated with renal impairment observed in patients on TFV for CHB. Method: It was a hospital based cross sectional prospective study carried out from June 2023 to July 2023 in Yaoundé (Cameroon) and included any patient treated with TFV for CHB during at least a period of 6 months. For each participant, we collected in the medical report socio-demographic data, clinical data, baseline creatinine, treatment information (type of TFV which was Disoproxil Fumarate (TDF) or Alafenamide (TAF), duration). Then, we collected blood samples to measure serum creatinine and phosphate levels and urine dipstick analysis. Factors associated with renal impairment were assessed with the Odds Ratio. A p value of Results: A total of 60 participants were included. The median age was 44 years [36-55] and median duration of TFV therapy was 17.5 months [11.7-25.7]. The prevalence of reduced eGFR (Conclusion: Kidney function was impaired in some patients receiving TFV for CHB. It should be monitored, particularly after 36 months and for those receiving TDF prodrug.
基金Supported by Joint Medical Project of Science and Technology Commission of Chongqing,No.2021MSXM164.
文摘BACKGROUND Townes–Brocks syndrome(TBS)is a rare autosomal dominant syndrome that is characterized by a triad of imperforate anus,dysplastic ears,and thumb malformations.Heterozygous variants of SALL1 are responsible for this syndrome.Renal structural abnormalities and functional impairments are often reported in TBS patients.CASE SUMMARY We report a case of TBS in a Chinese family.The index patients showed obvious renal atrophy and renal failure.TBS was suggested after a physical examination and pedigree analysis.Whole exome sequencing revealed a heterozygous variant of SALL1.The variant(NM_001127892 c.1289_c.1290 insC)led to a read-frame shift of the encoded protein,which was confirmed by Sanger sequencing.The variant cosegregated with the phenotype among affected members.CONCLUSION A novel variant in SALL1 gene may be the molecular pathogenic basis of this disorder.
文摘Objective： To investigate the efficacy and safety of the treatment of the newly diagnosed multiple myeloma （MM） with or without renal impairment receiving the therapy of bortezomib, dexamethasone plus thalidomide （BTD） regimen in order to analyze the effects of BTD regimen on the prognosis of the MM patients with renal impairment compared with the patients without renal impairment. Methods： Seventy-two newly diagnosed MM patients entered into our study and all the patients belonged to International Stage System （ISS） 3 in which transplantation patients were excluded or the patients refused receiving transplantation therapy. According to the level of serum creatinine （Scr）, the patients were divided into two groups including group 1 （n=42） （Scr 〈2 mg/dL） and group 2 （n=30） （Scr ≥2 mg/dL）. All the patients received the therapy of BTD regimen as induction therapy, and the median treatment time was 5 （range, 2-8） cycles. The outcome was analyzed retrospectively. Results： The overall remission （OR） rates were 81.0% （group 1） and 80.0% （group 2）. There was no statistical difference between the two groups （P〉0.05）. In group 2, 10 patients （33.3%） got renal function reversal, 14 patients （46.7%） got improved renal function and the median time to renal function reversal was 1.4 （range, 0.7-3.0） months. Among 12 patients with hemodialysis at diagnosis, 8 patients got rid of hemodialysis after median 4 cycles of therapy （range, 3-6 cycles）. After a median follow-up period of 16 （range, 2-31） months, 5 patients （11.9%） in group 1 died and 9 patients （30.0%） in group 2 died （P=0.056）. The 2-year estimate of overall survival was 77.3% in group 1 and 63.8% in group 2, respectively （P=0.188）. During a median follow-up time of 13.0 months （range, 2-25 months）, 15 patients （35.7%） in group 1 progressed and 13 patients （43.3%） in group 2 progressed （P=0.513）. The 2-year estimate of response duration was 50.6% in group 1 and 42.1% in group 2, respectively （P=1）. The main toxicities in the two groups included thrombocytopenia, peripheral neuropathy （PN）, infection, herpes zoster and so on. The incidence of grade 3 and 4 adverse events was low. Conclusions： BTD regimen may become the front-line therapy for the newly diagnosed MM patients with renal impairment because BTD regimen can improve the prognosis of the patients with renal impairment as good as the patients without renal impairment.
文摘Objective: To evaluate the efficacy of Breviscapine on essential hypertension (EH) patients complicated with micro-albuminuria of renal impairment. Methods: Seventy-six EH patients were randomly assigned to the control group and the treated group, the former was given amlodipine, captopril/uropidil and the latter was given in addition Breviscapine intravenously dripped for 2 treatment courses. The indexes of serum creatinine (Cr), blood urea nitrogen (BUN), blood and urinary β 2-microglobulin (β 2-MG), and quantitative determination of 24 hrs urinary protein were evaluated before and after treatment. Results: In the control group, compared with before treatment, the quantitative determination of 24 hrs urinary protein got reduced significantly ( P <0.05), while in the treated group, both urinary β 2-MG and quantitative determination of 24 hrs urinary protein got lowered significantly ( P <0.05 and P <0.01). But after treatment, compared with the control group, urinary β 2-MG and quantitative determination of 24 hrs urinary protein in the treated group were obviously reduced ( P <0.05). Conclusion: Besides lowering blood pressure effectively, Breviscapine could improve the renal function significantly and reduce the urinary micro-albuminuria, hence showing promising effect on renal protection.
文摘Diabetes mellitus(DM)is defined as a chronic disease of disordered metabolism with an ongoing increase in prevalence and incidence rates.Renal disease in patients with diabetes is associated with increased morbidity and premature mortality,particularly attributed to their very high cardiovascular risk.Since this group of patients frequently lacks specific symptomatology prior to the adverse events,a screening tool for the identification of high-risk patients is necessary.The epicardial adipose tissue(EAT)is a biologically active organ having properties similar to visceral adipose tissue and has been associated with metabolic diseases and coronary artery disease.Superior to conventional cardiovascular risk factors and anthropometric measures,including body mass index and waist circumference,the EAT can early predict the development of coronary artery disease.Assessment of EAT can be performed by twodimensional echocardiography,magnetic resonance imaging or computer tomography.However,its role and significance in patients with DM and nephropathy has not been thoroughly evaluated.The aim of the current editorial is to evaluate all available evidence regarding EAT in patients with DM and renal impairment.Systematic search of the literature revealed that patients with DM and nephropathy have increased EAT measurements,uncontrolled underlying disease,high body mass index and raised cardiovascular risk markers.Acknowledging the practical implications of this test,EAT assessment could serve as a novel and non-invasive biomarker to identify high-risk patients for cardiovascular adverse events.
文摘Objective: The aim of the study was to investigate the clinic manifestation, diagnosis and treatment on multiple myeloma (MM) with the onset of renal impairment. Methods: The 27 cases of multiple myeloma with the onset of renal impair-ment were collected in Department of Nephrology, Wuhan General Hospital of Guangzhou Command, China, from January 2007 to January 2011. All cases were divided into the groups with renal dysfunction (n = 16) and normal renal function (n = 11). The clinic manifestations, treatments and prognosis of all patients were analyzed. Results: Of all the patients in normal renal function group, 5 suffered nephrotic syndrome, 4 had abnormal results of routine urinalysis (hematuria or proteinuria) which were not caused by nephrotic syndrome, and 1 suffered urinary tract infection. Five pathological specimens of renal biopsy revealed that light chain protein, immunoglobulin and complement C3 were deposited mainly in the glomerular base-ment membrane and mesangia, tubular basement membrane and arteriolar walls. Two pathological specimens were proved to be renal amyloidosis. Patients with renal dysfunction had poorer prognosis, severer anemia, higher values of serum lactate dehydrogenase (LDH) and β2-microglobulin (β2-MG), worse responses to chemotherapy. Of 16 patients with renal dysfunc-tion, 14 (87.5%) were stage III, which were significantly higher than that in the group of normal renal function [63.6% (7/11)]. Of 16 cases with renal dysfunction, 9 were treated with blood purification, and 5 of 9 cases were treated with plasma exchange. Conclusion: Multiple myeloma with the onset of renal impairment was easily misdiagnosed. Hemodialysis concomitant with chemotherapy could contribute to recovery of renal function.
基金Key project of Science and Technology Innovation Project of China Academy of Chinese Medical Sciences(NO.CI2021A00702)the National Key Research and Development Program(NO.2018YFC1707410)。
文摘Objective:To explore the main factors of renal function injury caused by the combination of elemene emulsion injection in the real world.Methods:Based on the hospital information system medical database constructed by the Institute of Clinical Basic Medicine of Chinese Academy of Traditional Chinese Medicine,taking the patient information of elemene emulsion injection used in 21 top three hospitals in China as the research object,the nested case control study method was used to compare the combined medication of patients with renal function injury group and control group,The main factors that may lead to renal function injury were screened by MCP variable selection method,and the above main factors were further analyzed by classical logistic regression and propensity score logistic regression method.Results:The analysis found that the combined use of potassium chloride within 7 d before the use of elemene emulsion injection or the combined use of furosemide during the use of elemene emulsion injection may be the main factor leading to renal function injury.Conclusion:The combination of elemene emulsion injection and the above main factors that may lead to renal injury should be avoided.If it must be used,clinical monitoring should be strengthened,and abnormal reactions should be treated immediately.The results of this study have certain clinical significance,and the clinical mechanism can be further studied and explored in the future.
基金This study was partially supported by an unrestricted grant from Gilead Sciences(CAP-Asia Study-IN-US-989-5334).
文摘Background:Nonalcoholic fatty liver disease(NAFLD)is associated with impaired renal function,and both diseases often occur alongside other metabolic disorders.However,the prevalence and risk factors for impaired renal function in patients with NAFLD remain unclear.The objective of this study was to identify the prevalence and risk factors for renal impairment in NAFLD patients.Methods:All adults aged 18-70 years with ultrasound-diagnosed NAFLD and transient elastography examination from eight Asian centers were enrolled in this prospective study.Liver fibrosis and cirrhosis were assessed by FibroScan-aspartate aminotransferase(FAST),Agile 3+and Agile 4 scores.Impaired renal function and chronic kidney disease(CKD)were defined by an estimated glomerular filtration rate(eGFR)with value of<90 mL/min/1.73 m^(2) and<60 mL/min/1.73 m^(2),respectively,as estimated by the CKD-Epidemiology Collaboration(CKD-EPI)equation.Results:Among 529 included NAFLD patients,the prevalence rates of impaired renal function and CKD were 37.4%and 4.9%,respectively.In multivariate analysis,a moderate-high risk of advanced liver fibrosis and cirrhosis according to Agile 3+and Agile 4 scores were independent risk factors for CKD(P<0.05).Furthermore,increased fasting plasma glucose(FPG)and blood pressure were significantly associated with impaired renal function after controlling for the other components of metabolic syndrome(P<0.05).Compared with patients with normoglycemia,those with prediabetes[FPG≥5.6 mmol/L or hemoglobin A1c(HbA1c)≥5.7%]were more likely to have impaired renal function(P<0.05).Conclusions:Agile 3+and Agile 4 are reliable for identifying NAFLD patients with high risk of CKD.Early glycemic control in the prediabetic stage might have a potential renoprotective role in these patients.
基金Supported by"Eleventh Five-Year"National Science and Technology Support Program of Chinese Medicine Treatment of Common Diseases Project(No.2007BAI20B07)Science and Technology Research Projects of Capital Medical Development Fund,(No.03Ⅱ01)
文摘Objective：To observe the effect of Chinese medical regimen and integrative medical regimen on quality of life and early renal impairment in elderly patients with isolated systolic hypertension（EISH）.Methods： A multi-center,randomized,double-blinded controlled trail was adopted.A total of 270 cases of EISH were randomly divided into 3 groups：Chinese medicine group（CM）,combination group and Western medicine group （WM）.The course of treatment was 4 weeks.The clinical blood pressure,integral of quality of life（SF-36 scale）, immunoglubin G（IgG）,microalbumin（mALB）,β_2-microglobulin（β_2-MG）,transferrin（TRF）and N-acetyl-β＇- D-glucosa-minidase（NAG）in urine were determined before and after the treatment.Results：After treatment, systolic blood pressure depressed significantly in each group（P〈0.05）,and the combination group was superior to CM or WM group in depressing SBP（P〈0.05）; in each group,integral of quality of life improved in different degree,and combination group was superior to WM group in all 8 dimensions（P〈0.05）.The level of mALB andβ_2-MG in urine decreased in all groups（P〈0.05）,and the combination group was superior to CM group or WM group in decreasing mALB（P〈0.05）.Conclusions：Chinese medical regimen has affirmative effect in treating EISH patients,and could lower the systolic blood pressure,improve quality of life and early renal impairment of the patients,and integrative medical regimen has superiority on account of cooperation,and deserves further study.
文摘AIMTo investigate the role of contrast enhanced ultrasound (CEUS) in evaluating patients with renal function impairment (RFI) showing: (1) acute renal failure (ARF) of suspicious vascular origin; or (2) suspicious renal lesions.METHODSWe retrospectively evaluated patients addressed to CEUS over an eight years period to rule-out vascular causes of ARF (first group of 50 subjects) or assess previously found suspicious renal lesions (second group of 41 subjects with acute or chronic RFI). After preliminary grey-scale and color Doppler investigation, each kidney was investigated individually with CEUS, using 1.2-2.4 mL of a sulfur hexafluoride-filled microbubble contrast agent. Image analysis was performed in consensus by two readers who reviewed digital clips of CEUS. We calculated the detection rate of vascular abnormalities in the first group and performed descriptive statistics of imaging findings for the second group.RESULTSIn the first group, CEUS detected renal infarction or cortical ischemia in 18/50 patients (36%; 95%CI: 23.3-50.9) and 1/50 patients (2%; 95%CI: 0.1-12), respectively. The detection rate of infarction was significantly higher (P = 0.0002; McNemar test) compared to color Doppler ultrasonography (10%). No vascular causes of ARF were identified in the remaining 31/50 patients (62%). In the second group, CEUS detected 41 lesions on 39 patients, allowing differentiation between solid lesions (21/41; 51.2%) vs complex cysts (20/41; 48.8%), and properly addressing 15/39 patients to intervention when feasible based on clinical conditions (surgery and cryoablation in 13 and 2 cases, respectively). Cysts were categorized Bosniak II, IIF, III and IV in 8, 5, 4 and 3 cases, respectively. In the remaining two patients, CEUS found 1 pseudolesion and 1 subcapsular hematoma.CONCLUSIONCEUS showed high detection rate of renal perfusion abnormalities in patients with ARF, influencing the management of patients with acute or chronic RFI and renal masses throughout their proper characterization.
文摘Background Hyperuricemia is frequently present in patients with heart failure. Many pathological conditions, such as tissue ischemia, renal function impairment, cardiac function impairment, metabolic syndrome, and inflammatory status, may impact uric acid （UA） metabolism. This study was to assess their potential relations to UA metabolism in heart failure. Methods We retrospectively assessed clinical charac- teristics, echocardiological, renal, metabolic and inflammatory variables selected on the basis of previous evidence of their involvement in cardiovascular diseases and UA metabolism in a large cohort of randomly selected adults with congestive heart failure （n = 553）. By clustering of indices, those variables were explored using factor analysis. Results In factor analysis, serum uric acid （SUA） formed part of a principal cluster of renal functional variables which included serum creatinine （SCr） and blood urea nitrogen （BUN）. Univariate correlation coefficients between variables of patients with congestive heart failure showed that the strongest correlations for SUA were with BUN （r = 0.48, P 〈 0.001） and SCr （r = 0.47, P 〈 0.001）. Conclusions There was an inverse relationship between SUA levels and measures of renal function in patients with congestive heart failure. The strong correlation between SUA and SCr and BUN levels suggests that elevated SUA concentrations reflect an impairment of renal function in heart failure.
基金the National Natural Science Foundation of China(No.81873452)the Clinical Research Program of Huazhong University of Science and Technology Affiliated Tongji Hospital(No.2020003).
文摘Anti-B cell maturation antigen(BCMA)chimeric antigen receptor(CAR)T-cell therapyis effective and well-tolerated for refractory or relapsed multiple myeloma(RRMM).The purposcof the present study was to analyze efficacy in RRMM patients with renal impairment treated byanti-BCMA CAR-T cell therapy.A total of 59 RRMM patients were selected,and divided intoimpaired renal function(lRF)group[basclinc cstimated giomerular filtration rate(eSFR)<90 m/min/1.73 m^2(n=18)]and normal renal function(NRF)group(baseline eGFR≥90 mL/min/1.73 m,n=41).For patients with IRF,eGFR at the 6th month post-CAR-T cells infusion was significantlyhigher than the baseline(P<0.05).The multivariate analysis showed that light chain type and beta-2 micro-globulin(bcta-2M)were associated factors with the decrease of serum creatinine.Medianprogression-free survival(PFS)in the NRF group and IRF group was 266 days and 181 daysrespectively.Overall survival(OS)in the NRF group and lRF group was 877 days and 238 daysrespectively.There was no significant difference in the objective response rate(ORR)between thelRF group and the NRF group.It is suggested that CAR-T cells therapy could improve the renalfunction during the treatment of RRMM.The renal function could be more significantly improvedin RRMM patients with light chain type than with other types.
文摘Objective: We aim to detect over-time variations in mortality of liver transplant recipients stratified by the period of transplant. Since this is a retrospective investigation, bias reduction caused by possible confounding effects can be achieved by using propensity score weighting in a multivariate logistic regression model. Methods: Medical charts of all adult liver transplant recipients (n = 250) who were transplanted in three periods 2005-2009, 2010-2014 and 2015-2019 were retrospectively reviewed. The following recipient factors were analyzed: recipients and donors’ ages, sex, renal impairment, body mass index (BMI), presence of bacterial or viral infections, MELD (Model for end-stage diseases). Multivariate logistic model adjusted by Propensity Scores (PS) was used to identify the effect of the risk factors on mortality, and death within five years, in the targeted time frame. Patient outcomes are recorded as;(patient status = 1 if dead, or patient status = 0 if alive). Results: Meld score, recipient age, and renal impairments were shown to be predictors of mortality in transplanted patients. Multivariate regression model was used to identify the significance of the specified risk factors, followed by pairwise comparisons between periods. Pairwise comparisons between periods using logistic regression weighted by the inverse propensity score, correcting for the possible confounding effect of measured covariates showed that the death rate is significantly reduced in subsequent periods as compared to the initial period. Conclusions: The clinical implications of these findings are the ability to stratify patients at high risk of posttransplant death by planning more intensive and accurate management for them.
文摘Objective:This paper aims to study the clinical characteristics of patients with different types of primary hyperuricemia(HUA).Methods:Using a retrospective research method,200 patients with primary HUA in the hospital from June 2020 to January 2023 were selected as the research objects.Patients were grouped according to the detection results of 24-hour urinary uric acid excretion(UUE)and fractional excretion of uric acid(FEUA)(renal insufficiency type,renal overload type,mixed type,and other types).The general information of patients in the four groups(gender,age,body mass index,living habits,etc.),underlying diseases(hypertension,diabetes),blood test results[uric acid(UA),creatinine(Cre)],urine test results(24-hour urine UA,24-hour urine Cre)were summarized and the differences between the groups were analyzed.Results:The 200 cases of HUA patients were divided into 54.00%with renal insufficiency type,38.50%with mixed type,6.00%with renal overload type,and 1.50%with other types.The age of patients with mixed HUA was younger than that of patients with other types,renal overload type,and renal insufficiency type,and the difference was statistically significant(P<0.05).The UA level of patients with other types of HUA was lower than that of patients with mixed type HUA,and there was statistical significance(P<0.05).The Cre level of patients with mixed type HUA was lower than that of patients with renal insufficiency type and renal overload type,and the difference was statistically significant(P<0.05).The 24-hour urinary UA level in patients with renal insufficiency type HUA was lower than that in patients with renal overload type and mixed type HUA,and the difference was statistically significant(P<0.05).The 24-hour urinary Cre level of patients with other types of HUA was lower than that of patients with renal overload type and mixed HUA,the difference was statistically significant(P<0.05).The estimated glomerular filtration rate(eGFR)level of patients with other types of HUA was lower than that of patients with mixed type HUA,and the difference was statistically significant(P<0.05).There was no significant difference in the proportions of hypertension,diabetes,coronary heart disease,and urinary calculi among patients with renal insufficiency type,renal overload type,mixed type,and other types of HUA(P>0.05).Conclusion:The primary HUA patients are mainly of renal insufficiency type,followed by mixed type.There are significant differences in the clinical characteristics of patients with different types of HUA.Among them,patients with other types of HUA are the oldest and have the lowest uric acid levels.Patients with mixed HUA had the best renal function but the highest 24-hour urine creatinine level.This study can be used as a basis for rational selection of urate-lowering drugs for different HUA patients.
文摘BACKGROUND Once daily tacrolimus regimen was found to exhibits similar bioavailability,safety and efficacy properties compared to twice-daily tacrolimus in kidney transplantation patients.AIM To compare the efficacy and safety of once-daily prolonged release tacrolimus compared to twice-daily tacrolimus in liver transplantation patients.METHODS MEDLINE,EMBASE,CENTRAL databases were searched for clinical trials until December 2020.Efficacy outcome measured as the rate of treatment failure indicated by biopsy-proven acute rejection,Serum creatinine,graft loss,or death.Two reviewers independently selected studies,collected data and assessed risk of bias.The results are reported as risk ratio with 95%confidence interval(CI)for dichotomous data.RESULTS Seven studies included with 965 patients.All the included studies were of moderate quality according to the risk of bias assessment using Cochrane Risk of Bias tool.Biopsy-proven acute rejection was reported in four studies,and pooled analysis of those studies indicated similar rejections in both twice daily and once daily tacrolimus groups(risk ratio:1.06,95%CI:0.84-1.34,n=758,I2=0%)and also we found no significant difference between both groups for renal outcome(serum creatinine;mean difference,0.001 mg/dL,95%CI:-0.042 to 0.043,n=846,I2=18.6%).Similarly,there was similar number of adverse events such as hypertension,headache,back pain,blood related disorders,infections and nausea observed in both groups.CONCLUSION The analysis findings confirm that both once daily and twice daily tacrolimus formulations are comparable in terms of efficacy and safety outcomes.
基金supported by the National Natural Science Foundation of China(Nos.31372421,31530074,and 31672515)the Fundamental Research Funds for the Central Universities(No.KYZ201415)the Priority Academic Program Development of Jiangsu Higher Education Institutions,China
文摘This study investigated the putative protective effects of supplemental 2-aminoethane sulfonic acid（taurine） and reduced housing density on renal function in laying hens. We randomly assigned fifteen thousand green-shell laying hens into three groups： a free range group, a low-density caged group, and a high-density caged group. Each group was further divided equally into a control group（C） and a taurine treatment group（T）. After 15 d, we analyzed histological changes in kidney cells, inflammatory mediator levels, oxidation and anti-oxidation levels. Experimental data revealed taurine supplementation, and rearing free range or in low-density housing can lessen morphological renal damage, inflammatory mediator levels, and oxidation levels and increase anti-oxidation levels. Our data demonstrate that taurine supplementation and a reduction in housing density can ameliorate renal impairment, increase productivity, enhance health, and promote welfare in laying hens.
文摘Diabetic kidney disease （DKD） is one of the primary causes of end-stage renal disease （ESRD）. Early diagnosis is very important in preventing the development of DKD. Urinary albumin excretion rate （UAER） and glomerular filtration rate （GFR） are widely accepted as criteria for the diagnosis and clinical grading of DKD, and microalbuminuria has been recommended as the first clinical sign of DKD. The natural history of DKD has been divided into three stages： normoalbuminuria, microalbuminuria, and macroalbuminuria. However, this clinical paradigm has been questioned recently, as studies have shown that a portion of diabetes mellitus （DM） patients with normoalbuminuria have progressive renal insufficiency, referred to as normoalbuminuric diabetic kidney disease （NADKD） or nonalbuminuric diabetic nephropathy. Epidemiologic research has demonstrated that normoalbuminuric diabetic kidney disease is common, and the large number of NADKD patients suggests that the traditional paradigm needs to be shifted. Currently, the pathogenesis of NADKD remains unclear, but many clinical studies have identified some clinical and pathological features of NADKD. In addition, the long-term outcomes of NADKD patients remain controversial. In this article, we reviewed the latest studies addressing the pathogenesis, pathology, treatment and prevention of NADKD.
