5851
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Chan TC, Luk JKH, Chu LW, Chan FHW. Association between body mass index and cause-specific mortality as well as hospitalization in frail Chinese older adults. Geriatr Gerontol Int 2014; 15:72-9. [PMID: 24418288 DOI: 10.1111/ggi.12230] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/25/2013] [Indexed: 12/29/2022]
Abstract
AIM A U-shaped relationship between body mass index (BMI) and all-cause mortality has been reported, but there are few studies examining the association between BMI and cause-specific mortality and hospitalization. We carried out a longitudinal study to examine these associations in Chinese older adults with multiple comorbidities, which could provide a reference for the recommended BMI in this population. METHODS From 2004 to 2013, a retrospective cohort of Chinese older adults was selected from a geriatric day hospital in Hong Kong. They were divided into groups according to their BMI: BMI <16; BMI 16-18; BMI 18.1-20; BMI 20.1-22; BMI 22.1-24; BMI 24.1-26; BMI 26.1-28; BMI 28.1-30 and BMI >30. Other assessments included medical, functional, cognitive, social and nutritional assessment. RESULTS A total of 1747 older adults (mean age 80.8 ± 7.1 years, 44.1% male, 46.1% living in nursing homes, Charlson Comorbidity Index 2.0 ± 1.6) with a median follow up of 3.5 years were included. Older adults with BMI 24-28 had the lowest all-cause, infection-related and cardiovascular mortality (P < 0.001). Multivariate analysis showed that there was an inverted J-shaped association between BMI and hazard ratio for all-cause and infection-related mortality in both nursing home and community-dwelling older adults. The rate of all-cause hospitalization was lower in older adults with BMI 22-28 (P = 0.002). Multivariate analysis showed that there was an inverted J-shaped association between the odds ratio of recurrent hospitalization and BMI. CONCLUSION Chinese older adults with BMI 24-28 had lower all-cause mortality, infection-related mortality, cardiovascular-related mortality and all-cause hospitalization. This study provides a reference for the recommended BMI in this population.
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Affiliation(s)
- Tuen-Ching Chan
- Department of Medicine and Geriatrics, Fung Yiu King Hospital, Hong Kong; Division of Geriatric Medicine, Department of Medicine, Queen Mary Hospital, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
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5852
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Lamb EJ, Brettell EA, Cockwell P, Dalton N, Deeks JJ, Harris K, Higgins T, Kalra PA, Khunti K, Loud F, Ottridge RS, Sharpe CC, Sitch AJ, Stevens PE, Sutton AJ, Taal MW. The eGFR-C study: accuracy of glomerular filtration rate (GFR) estimation using creatinine and cystatin C and albuminuria for monitoring disease progression in patients with stage 3 chronic kidney disease--prospective longitudinal study in a multiethnic population. BMC Nephrol 2014; 15:13. [PMID: 24423077 PMCID: PMC3898236 DOI: 10.1186/1471-2369-15-13] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Accepted: 01/09/2014] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Uncertainty exists regarding the optimal method to estimate glomerular filtration rate (GFR) for disease detection and monitoring. Widely used GFR estimates have not been validated in British ethnic minority populations. METHODS/DESIGN Iohexol measured GFR will be the reference against which each estimating equation will be compared. The estimating equations will be based upon serum creatinine and/or cystatin C. The eGFR-C study has 5 components: 1) A prospective longitudinal cohort study of 1300 adults with stage 3 chronic kidney disease followed for 3 years with reference (measured) GFR and test (estimated GFR [eGFR] and urinary albumin-to-creatinine ratio) measurements at baseline and 3 years. Test measurements will also be undertaken every 6 months. The study population will include a representative sample of South-Asians and African-Caribbeans. People with diabetes and proteinuria (ACR ≥30 mg/mmol) will comprise 20-30% of the study cohort.2) A sub-study of patterns of disease progression of 375 people (125 each of Caucasian, Asian and African-Caribbean origin; in each case containing subjects at high and low risk of renal progression). Additional reference GFR measurements will be undertaken after 1 and 2 years to enable a model of disease progression and error to be built.3) A biological variability study to establish reference change values for reference and test measures.4) A modelling study of the performance of monitoring strategies on detecting progression, utilising estimates of accuracy, patterns of disease progression and estimates of measurement error from studies 1), 2) and 3).5) A comprehensive cost database for each diagnostic approach will be developed to enable cost-effectiveness modelling of the optimal strategy.The performance of the estimating equations will be evaluated by assessing bias, precision and accuracy. Data will be modelled as a linear function of time utilising all available (maximum 7) time points compared with the difference between baseline and final reference values. The percentage of participants demonstrating large error with the respective estimating equations will be compared. Predictive value of GFR estimates and albumin-to-creatinine ratio will be compared amongst subjects that do or do not show progressive kidney function decline. DISCUSSION The eGFR-C study will provide evidence to inform the optimal GFR estimate to be used in clinical practice. TRIAL REGISTRATION ISRCTN42955626.
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Affiliation(s)
- Edmund J Lamb
- Clinical Biochemistry, East Kent Hospitals University NHS Foundation Trust, Canterbury, Kent CT1 3NG, UK
| | - Elizabeth A Brettell
- Birmingham Clinical Trials Unit, School of Cancer Sciences, Robert Aitken Institute, University of Birmingham, Birmingham B15 2TT, UK
| | - Paul Cockwell
- University Hospitals Birmingham NHS Foundation Trust, Birmingham B15 2TT, UK
| | | | - Jon J Deeks
- Birmingham Clinical Trials Unit, School of Cancer Sciences, Robert Aitken Institute, University of Birmingham, Birmingham B15 2TT, UK
- Test Evaluation Research Group, School of Health and Population Sciences, Public Health Building, University of Birmingham, Birmingham, B15 2TT, UK
| | - Kevin Harris
- University Hospitals of Leicester, Leicester, UK
| | - Tracy Higgins
- Centre for Health Services Studies, University of Kent, Canterbury CT2 7NF, UK
| | | | | | - Fiona Loud
- British Kidney Patient Association, Hampshire, UK
| | - Ryan S Ottridge
- Birmingham Clinical Trials Unit, School of Cancer Sciences, Robert Aitken Institute, University of Birmingham, Birmingham B15 2TT, UK
| | - Claire C Sharpe
- King’s College London & King’s College Hospital NHS Foundation Trust SE5 9RJ, London, UK
| | - Alice J Sitch
- Test Evaluation Research Group, School of Health and Population Sciences, Public Health Building, University of Birmingham, Birmingham, B15 2TT, UK
| | - Paul E Stevens
- Kent Kidney Care Centre, East Kent Hospitals University NHS Foundation Trust, Canterbury, Kent CT1 3NG, UK
| | - Andrew J Sutton
- Health Economics Unit, School of Health and Population Sciences, Occupational Health Building, University of Birmingham, Birmingham B15 2TT, UK
| | - Maarten W Taal
- Royal Derby Hospital, Uttoxeter Road, Derby DE22 3NE, UK
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5853
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Liang Y. Analysis of the prevalence rate and correlative risk factors of chronic kidney disease in physical checkups of adults in Henan area. Asia Pac J Public Health 2014; 25:15S-21S. [PMID: 23966600 DOI: 10.1177/1010539513495270] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This paper reports the results of physical examination data of a population aged 19 years and above in the Henan area. The prevalence of Chronic Kidney Disease (CKD) in adults in a healthy population and associations with potential risk factors are described. There were 556 cases with albuminuria, a prevalence rate of 5.09% (95% CI: 3.19-6.88). The prevalence rate of males (5.87%) was higher than that of females (3.81%). There were 278 cases with eGFR <60 mL/min·(1.73 m(2))(-1), suggesting a high rate of unreported CKD in this community.
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Affiliation(s)
- Yan Liang
- Henan Provincial People's Hospital, Weiwu Road No. 7, Zhengzhou, Henan Province, China.
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5854
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Comparisons between the 2012 new CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) equations and other four approved equations. PLoS One 2014; 9:e84688. [PMID: 24454737 PMCID: PMC3890277 DOI: 10.1371/journal.pone.0084688] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2013] [Accepted: 11/25/2013] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) reported two equations in 2012: one based on cystatin C concentration (CKD-EPI2012cys) and the other using both serum creatinine and cystatin C concentrations (CKD-EPI2012Scr-cys). We compared the adaptability of new formulae with other four equations. METHODS Participants (n = 788; median age, 54 [range, 19-94] years) were recruited from the First Affiliated Hospital of Nanjing Medical University. The reference glomerular filtration rate (rGFR) was measured by a (99)mTc-DTPA renal dynamic imaging method, and the estimated glomerular filtration rate (eGFR) was calculated separately by the Chinese adapted Modification of Diet in Renal Disease equation (C-MDRD), MacIsaac, Ma, serum creatinine-based CKD-EPI equation (CKD-EPI2009Scr), CKD-EPI2012cys and CKD-EPI2012Scr-cys equations. We compared the performance of six equations with rGFR. RESULTS Median rGFR was 76.35 (interquartile range, 59.03-92.50) mL/min/1.73 m(2). Compared with CKD-EPI2009Scr, CKD-EPI2012Scr-cys formula had better diagnostic value with larger area under the receiver operating characteristic curve (ROC(AUC), 0.879, p = 0.006), especially in young participants (ROC(AUC), 0.883, p = 0.005). CKD-EPI2012cys equation did not perform better than other available equations. Accuracy (the proportion of eGFR within 30% of rGFR [P30]) of the CKD-EPI2012Scr-cys equation (77.03%) was inferior only to MacIsaac equation (80.2%) in the entire participants, but performed best in young participants with normal or mildly-injured GFR. Neither of the two new CKD-EPI equations achieved any ideal P30 in the elderly participants with moderately-severely injured GFR. Linear regression analysis demonstrated a consistent result. In this study, CKD-EPI2012Scr-cys had a relatively better diagnosis consistency of GFR stage between the eGFR and rGFR in the whole cohort. CONCLUSION CKD-EPI2012Scr-cys appeared less biased and more accurate in overall participants. Neither of the new CKD-EPI equations achieved ideal accuracy in senior participants with moderately-severely injured GFR. A large-scale study with more subjects and cooperating centers to develop new formulae for the elderly is assumed to be necessary.
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5855
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Barraclough KA, Hawley CM, Playford EG, Johnson DW. Prevention of access-related infection in dialysis. Expert Rev Anti Infect Ther 2014; 7:1185-200. [DOI: 10.1586/eri.09.100] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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5856
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Annaloro C, Airaghi L, Saporiti G, Onida F, Cortelezzi A, Deliliers GL. Metabolic syndrome in patients with hematological diseases. Expert Rev Hematol 2014; 5:439-58. [DOI: 10.1586/ehm.12.35] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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5857
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de Goeij MCM, Halbesma N, Dekker FW, Wijsman CA, van Heemst D, Maier AB, Mooijaart SP, Slagboom PE, Westendorp RGJ, de Craen AJM. Renal function in familial longevity: the Leiden Longevity Study. Exp Gerontol 2014; 51:65-70. [PMID: 24389060 DOI: 10.1016/j.exger.2013.12.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Revised: 12/18/2013] [Accepted: 12/23/2013] [Indexed: 10/25/2022]
Abstract
Studying renal function in subjects with a familial propensity for longevity may provide insight in (un)known mechanisms that determine the age-related decline in renal function of normal subjects. In the Leiden Longevity Study, middle-aged offspring of non-agenarian siblings and their partners as environmentally matched controls were included. Information was collected on lifestyle, medical history, medication use, and a non-fasting blood sample was drawn. Renal function (estimated glomerular filtration rate, eGFR) was assessed with the Chronic Kidney Disease epidemiology collaboration (CKD-EPI) formula. Linear mixed models were used to account for familial dependencies within the offspring and all analyses were stratified by sex. eGFR was similar between female offspring and female controls (0.44ml/min/1.73m(2) (SE 0.72) difference, p=0.54, age-adjusted). Male offspring had a higher eGFR compared to male controls (1.78ml/min/1.73m(2) (SE 0.78) difference, p=0.022, age-adjusted), and further adjustments for various characteristics did not materially change this difference. Among men with a history of hypertension, or myocardial infarction and/or stroke, offspring had a higher eGFR compared to controls (4.74ml/min/1.73m(2) (SE 1.53) difference, p=0.002, age-adjusted, and 6.21ml/min/1.73m(2) (SE 2.85) difference, p=0.033, age-adjusted, respectively). Middle-aged men, but not women, with a propensity for longevity have better renal function compared to environmentally matched controls, especially among those with a history of cardiovascular disease.
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Affiliation(s)
- Moniek C M de Goeij
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Nynke Halbesma
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Friedo W Dekker
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Carolien A Wijsman
- Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands; Netherlands Consortium for Healthy Ageing, Leiden University Medical Center, Leiden, The Netherlands
| | - Diana van Heemst
- Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands; Netherlands Consortium for Healthy Ageing, Leiden University Medical Center, Leiden, The Netherlands
| | - Andrea B Maier
- Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands; Department of Internal Medicine, Section of Gerontology and Geriatrics, VU University Medical Center, Amsterdam, The Netherlands
| | - Simon P Mooijaart
- Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands; Institute for Evidence-Based Medicine in Old Age, Leiden, The Netherlands
| | - P Eline Slagboom
- Netherlands Consortium for Healthy Ageing, Leiden University Medical Center, Leiden, The Netherlands; Department of Molecular Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Rudi G J Westendorp
- Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands; Leyden Academy on Vitality and Ageing, Leiden, The Netherlands
| | - Anton J M de Craen
- Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands; Netherlands Consortium for Healthy Ageing, Leiden University Medical Center, Leiden, The Netherlands.
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5858
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Li J, Wang H, Xie H, Mei G, Cai W, Ye J, Zhang J, Ye G, Zhai H. Effects of post-discharge nurse-led telephone supportive care for patients with chronic kidney disease undergoing peritoneal dialysis in China: a randomized controlled trial. Perit Dial Int 2014; 34:278-88. [PMID: 24385331 DOI: 10.3747/pdi.2012.00268] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Patients with end-stage renal failure (ESRF) need integrated health care to maintain a desirable quality of life. Studies suggest that post-discharge nurseled telephone support has a positive effect for patients suffering from chronic diseases. But the post-discharge care is under-developed in mainland China and the effects of post-discharge care on patients with peritoneal dialysis have not been conclusive. AIM The purpose of this study is to test the effectiveness of postdischarge nurse-led telephone support on patients with peritoneal dialysis in mainland China. METHODS A randomized controlled trial was conducted in the medical department of a regional hospital in Guangzhou. 135 patients were recruited, 69 in the study group and 66 in the control group. The control group received routine hospital discharge care. The study group received post-discharge nurse-led telephone support. The quality of life (Kidney Disease Quality of Life Short Form, KDQOL-SF), blood chemistry, complication control, readmission and clinic visit rates were observed at three time intervals: baseline before discharge (T1), 6 (T2) and 12 (T3) weeks after discharge. RESULTS Statistically significant effects were found for symptom/problem, work status, staff encouragement, patient satisfaction and energy/fatigue in KDQOL-SF and 84-day (12-week) clinic visit rates between the two groups. The study group had more significant improvement than the control group for sleep, staff encouragement at both T2 and T3, and pain at T2 and patient satisfaction at T3. No significant differences were observed between the two groups for the baseline measures, other dimensions in KDQOL-SF, blood chemistry, complication control, readmission rates at all time intervals and clinic visit rates at the first two time intervals. CONCLUSIONS Post-discharge nurse-led telephone support for patients undergoing peritoneal dialysis is effective to enhance patients' well-being in the transition from hospital to home in mainland China.
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Affiliation(s)
- Juan Li
- School of nursing, Southern Medical University, Guangzhou, Guangdong 510515, China; Department of Nursing, General Hospital of Guangzhou Military Command of PLA, Guangzhou, Guangdong 510010, China; Department of Organ Transplantation, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, China; and Department of Nephrology, General Hospital of Guangzhou Military Command of PLA, Guangzhou, Guangdong 510010, China
| | - Huizhen Wang
- School of nursing, Southern Medical University, Guangzhou, Guangdong 510515, China; Department of Nursing, General Hospital of Guangzhou Military Command of PLA, Guangzhou, Guangdong 510010, China; Department of Organ Transplantation, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, China; and Department of Nephrology, General Hospital of Guangzhou Military Command of PLA, Guangzhou, Guangdong 510010, China
| | - Hongzhen Xie
- School of nursing, Southern Medical University, Guangzhou, Guangdong 510515, China; Department of Nursing, General Hospital of Guangzhou Military Command of PLA, Guangzhou, Guangdong 510010, China; Department of Organ Transplantation, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, China; and Department of Nephrology, General Hospital of Guangzhou Military Command of PLA, Guangzhou, Guangdong 510010, China
| | - Guiping Mei
- School of nursing, Southern Medical University, Guangzhou, Guangdong 510515, China; Department of Nursing, General Hospital of Guangzhou Military Command of PLA, Guangzhou, Guangdong 510010, China; Department of Organ Transplantation, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, China; and Department of Nephrology, General Hospital of Guangzhou Military Command of PLA, Guangzhou, Guangdong 510010, China
| | - Wenzhi Cai
- School of nursing, Southern Medical University, Guangzhou, Guangdong 510515, China; Department of Nursing, General Hospital of Guangzhou Military Command of PLA, Guangzhou, Guangdong 510010, China; Department of Organ Transplantation, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, China; and Department of Nephrology, General Hospital of Guangzhou Military Command of PLA, Guangzhou, Guangdong 510010, China
| | - Junsheng Ye
- School of nursing, Southern Medical University, Guangzhou, Guangdong 510515, China; Department of Nursing, General Hospital of Guangzhou Military Command of PLA, Guangzhou, Guangdong 510010, China; Department of Organ Transplantation, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, China; and Department of Nephrology, General Hospital of Guangzhou Military Command of PLA, Guangzhou, Guangdong 510010, China
| | - Jianlin Zhang
- School of nursing, Southern Medical University, Guangzhou, Guangdong 510515, China; Department of Nursing, General Hospital of Guangzhou Military Command of PLA, Guangzhou, Guangdong 510010, China; Department of Organ Transplantation, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, China; and Department of Nephrology, General Hospital of Guangzhou Military Command of PLA, Guangzhou, Guangdong 510010, China
| | - Guirong Ye
- School of nursing, Southern Medical University, Guangzhou, Guangdong 510515, China; Department of Nursing, General Hospital of Guangzhou Military Command of PLA, Guangzhou, Guangdong 510010, China; Department of Organ Transplantation, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, China; and Department of Nephrology, General Hospital of Guangzhou Military Command of PLA, Guangzhou, Guangdong 510010, China
| | - Huimin Zhai
- School of nursing, Southern Medical University, Guangzhou, Guangdong 510515, China; Department of Nursing, General Hospital of Guangzhou Military Command of PLA, Guangzhou, Guangdong 510010, China; Department of Organ Transplantation, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, China; and Department of Nephrology, General Hospital of Guangzhou Military Command of PLA, Guangzhou, Guangdong 510010, China
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5859
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Yang T, Chou YC, Chu CH, Lin SH, Hsieh PC, Hsu CH, Bai CH, You SL, Sun CA. Metabolic syndrome and C-reactive protein concentration as independent correlates of chronic kidney disease. Endocr Res 2014; 39:94-8. [PMID: 24152229 DOI: 10.3109/07435800.2013.840652] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Inflammation is a common phenotype for cardiometabolic disorders. In this study, we attempted to investigate inter-relationships between metabolic syndrome (MetS), C-reactive protein (an inflammatory biomarker) and chronic kidney disease (CKD). We performed a cross-sectional analysis of data from a representative sample of 4425 Chinese adults in Taiwan. The MetS was defined by a unified criteria set by several major organizations. A CKD event was defined as an estimated glomerular filtration rate (eGFR) <60 mL/min per 1.73 m(2). Additionly, a CRP cutpoint of 3 mg/L was used to differentiate high and low CRP levels. Overall, 1000 participants had MetS, resulting in a prevalence rate of 22.6%. High CRP level was noted in 782 (17.6%) subjects. In addition, a total of 508 (11.5%) persons qualified as having CKD. Subjects with the MetS had 1.55-fold [95% confidence interval (CI), 1.03-2.32] increased odds of CKD compared with their counterparts without the MetS after multiple adjustments. In addition, there was a significantly graded relationship between increasing levels of serum CRP and prevalent CKD (p for trend = 0.001). Participants in the highest category of serum CRP had a significantly elevated odds of CKD as compared with those in the lowest category [odds ratio (OR), 1.60; 95% CI, 1.21-2.12]. However, there was no interaction in excess of additive scale between the presence of MetS and high CRP level (p = 0.83). These findings suggest that MetS and high CRP were independently associated with increased prevalence of CKD in Chinese adults.
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Affiliation(s)
- Tsan Yang
- Department of Health Business Administration, Meiho University , Pingtung County , Taiwan
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5860
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Yang X, Kong APS, Luk AOY, Ozaki R, Ko GTC, Ma RCW, Chan JCN, So WY. Validation of Methods to Control for Immortal Time Bias in a Pharmacoepidemiologic Analysis of Renin^|^ndash;Angiotensin System Inhibitors in Type 2 Diabetes. J Epidemiol 2014; 24:267-73. [PMID: 24747198 PMCID: PMC4074630 DOI: 10.2188/jea.je20130164] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background Pharmacoepidemiologic analysis can confirm whether drug efficacy in a randomized controlled trial (RCT) translates to effectiveness in real settings. We examined methods used to control for immortal time bias in an analysis of renin–angiotensin system (RAS) inhibitors as the reference cardioprotective drug. Methods We analyzed data from 3928 patients with type 2 diabetes who were recruited into the Hong Kong Diabetes Registry between 1996 and 2005 and followed up to July 30, 2005. Different Cox models were used to obtain hazard ratios (HRs) for cardiovascular disease (CVD) associated with RAS inhibitors. These HRs were then compared to the HR of 0.92 reported in a recent meta-analysis of RCTs. Results During a median follow-up period of 5.45 years, 7.23% (n = 284) patients developed CVD and 38.7% (n = 1519) were started on RAS inhibitors, with 39.1% of immortal time among the users. In multivariable analysis, time-dependent drug-exposure Cox models and Cox models that moved immortal time from users to nonusers both severely inflated the HR, and time-fixed models that included immortal time deflated the HR. Use of time-fixed Cox models that excluded immortal time resulted in a HR of only 0.89 (95% CI, 0.68–1.17) for CVD associated with RAS inhibitors, which is closer to the values reported in RCTs. Conclusions In pharmacoepidemiologic analysis, time-dependent drug exposure models and models that move immortal time from users to nonusers may introduce substantial bias in investigations of the effects of RAS inhibitors on CVD in type 2 diabetes.
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Affiliation(s)
- Xilin Yang
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR, China
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Alice PS Kong
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR, China
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR, China
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR, China
| | - Andrea OY Luk
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR, China
| | - Risa Ozaki
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR, China
| | - Gary TC Ko
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR, China
| | - Ronald CW Ma
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR, China
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR, China
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR, China
| | - Juliana CN Chan
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR, China
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR, China
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR, China
| | - Wing Yee So
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR, China
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5861
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Zhou Y, Ye L, Wang T, Hong J, Bi Y, Zhang J, Xu B, Sun J, Huang X, Xu M. Free triiodothyronine concentrations are inversely associated with microalbuminuria. Int J Endocrinol 2014; 2014:959781. [PMID: 25484900 PMCID: PMC4248482 DOI: 10.1155/2014/959781] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2014] [Revised: 10/27/2014] [Accepted: 10/28/2014] [Indexed: 01/03/2023] Open
Abstract
Thyroid function and microalbuminuria are both associated with vascular disease and endothelial damage. However, whether thyroid function is associated with microalbuminuria is not well established. The objective was to explore the relationship between thyroid hormones and microalbuminuria in Chinese population. A community-based cross-sectional study was performed among 3,346 Chinese adults (aged ≥ 40 years). Serum free triiodothyronine (FT3), free thyroxine (FT4), and TSH (thyroid stimulating hormone) were determined by chemiluminescent microparticle immunoassay. A single-void first morning urine sample was obtained for urinary albumin-creatinine ratio measurement. The prevalence of microalbuminuria decreased according to FT3 quartiles (13.2, 9.5, 8.6, and 8.2%, P for trend = 0.0005). A fully adjusted logistic regression analysis showed that high FT3 levels were associated with low prevalent microalbuminuria. The adjusted odds ratios for microalbuminuria were 0.61 (95% CI, 0.43-0.87, P = 0.007) when comparing the highest with the lowest quartile of FT3. The exclusion of participants with abnormal FT3 did not appreciably change the results (OR = 0.69, 95% CI, 0.49-0.98, P = 0.02). We concluded that serum FT3 levels, even within the normal range, were inversely associated with microalbuminuria in middle-aged and elderly Chinese adults. FT3 concentrations might play a role in the pathogenesis of microalbuminuria.
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Affiliation(s)
- Yulin Zhou
- Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrinology and Metabolism, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, 197 Rui-Jin 2nd Road, Shanghai 200025, China
| | - Lei Ye
- Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrinology and Metabolism, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, 197 Rui-Jin 2nd Road, Shanghai 200025, China
- Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, E-Institute of Shanghai Universities, Shanghai 200025, China
| | - Tiange Wang
- Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrinology and Metabolism, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, 197 Rui-Jin 2nd Road, Shanghai 200025, China
- Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, E-Institute of Shanghai Universities, Shanghai 200025, China
| | - Jie Hong
- Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrinology and Metabolism, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, 197 Rui-Jin 2nd Road, Shanghai 200025, China
| | - Yufang Bi
- Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrinology and Metabolism, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, 197 Rui-Jin 2nd Road, Shanghai 200025, China
- Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, E-Institute of Shanghai Universities, Shanghai 200025, China
| | - Jie Zhang
- Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrinology and Metabolism, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, 197 Rui-Jin 2nd Road, Shanghai 200025, China
- Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, E-Institute of Shanghai Universities, Shanghai 200025, China
| | - Baihui Xu
- Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrinology and Metabolism, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, 197 Rui-Jin 2nd Road, Shanghai 200025, China
- Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, E-Institute of Shanghai Universities, Shanghai 200025, China
| | - Jichao Sun
- Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrinology and Metabolism, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, 197 Rui-Jin 2nd Road, Shanghai 200025, China
- Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, E-Institute of Shanghai Universities, Shanghai 200025, China
| | - Xiaolin Huang
- Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrinology and Metabolism, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, 197 Rui-Jin 2nd Road, Shanghai 200025, China
- Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, E-Institute of Shanghai Universities, Shanghai 200025, China
| | - Min Xu
- Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrinology and Metabolism, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, 197 Rui-Jin 2nd Road, Shanghai 200025, China
- Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, E-Institute of Shanghai Universities, Shanghai 200025, China
- *Min Xu:
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5862
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Liu X, Qiu X, Shi C, Huang H, Huang J, Li M, Lou T. Modified glomerular filtration rate-estimating equations developed in asiatic population for chinese patients with type 2 diabetes. Int J Endocrinol 2014; 2014:521071. [PMID: 24734043 PMCID: PMC3966408 DOI: 10.1155/2014/521071] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Revised: 01/13/2014] [Accepted: 01/21/2014] [Indexed: 12/02/2022] Open
Abstract
Objectives. To evaluate eight modified equations developed in Asiatic populations in type 2 diabetic patients in China. Methods. A total of 209 Chinese patients with type 2 diabetes were recruited. Using the technetium-99m diethylenetriaminepentaacetic acid-glomerular filtration rate (GFR) to act as the reference, comparisons of their efficiency to estimate GFR in the subjects were made between various equations. Results. Median of difference of the Chinese equation 1 was the lowest (median of difference, 0.51 mL/min/1.73 m(2)). Median percent of absolute difference of the Chinese equation 2 was less than those of the other equations (26.97 versus ranged from 32.54 to 37.61 mL/min/1.73 m(2), [P < 0.001 for all]). Precision of the simplified reexpressed MDRD equation was the best (92.9 mL/min/1.73 m(2)). Accuracies of the Chinese equation 2 were greater (P < 0.05 for all). There was also an improvement in chronic kidney disease (CKD) stage misclassification of the Chinese equation 2 (55.0 versus ranged from 61.2 to 64.6%, [P < 0.001 for all]). However, the 30% accuracies of all the equations were less than 70%. Conclusions. Our study highlighted a limitation in the use of the above equations in the majority of Chinese diabetic subjects. A better equation is needed in order to give an accurate estimation of GFR in type 2 diabetic patients in China.
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Affiliation(s)
- Xun Liu
- Division of Nephrology, Department of Internal Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
- College of Biology Engineering, South China University of Technology, Guangzhou, China
| | - Xilian Qiu
- Department of Laboratory Medicine, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Chenggang Shi
- Division of Nephrology, Department of Internal Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
| | - Hui Huang
- Department of Cardiology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China
| | - Jianhua Huang
- Department of Laboratory Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
| | - Ming Li
- Division of Nephrology, Department of Internal Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
| | - Tanqi Lou
- Division of Nephrology, Department of Internal Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
- *Tanqi Lou:
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5863
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Nyman U, Grubb A, Larsson A, Hansson LO, Flodin M, Nordin G, Lindström V, Björk J. The revised Lund-Malmö GFR estimating equation outperforms MDRD and CKD-EPI across GFR, age and BMI intervals in a large Swedish population. ACTA ACUST UNITED AC 2014; 52:815-24. [DOI: 10.1515/cclm-2013-0741] [Citation(s) in RCA: 108] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Accepted: 11/18/2013] [Indexed: 11/15/2022]
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5864
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Wang X, Luo Y, Wang Y, Wang C, Zhao X, Wang D, Liu L, Liu G, Wang Y. Comparison of Associations of Outcomes After Stroke With Estimated GFR Using Chinese Modifications of the MDRD Study and CKD-EPI Creatinine Equations: Results From the China National Stroke Registry. Am J Kidney Dis 2014; 63:59-67. [DOI: 10.1053/j.ajkd.2013.08.008] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2013] [Accepted: 08/06/2013] [Indexed: 11/11/2022]
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5865
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Kawarada O, Yasuda S, Huang J, Honda Y, Fitzgerald PJ, Ishihara M, Ogawa H. Contemporary Infrapopliteal Intervention for Limb Salvage and Wound Healing. Circ J 2014. [DOI: 10.1253/circj.cj-14-0060] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Osami Kawarada
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
- Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University
| | - Satoshi Yasuda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
- Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University
| | - Janice Huang
- Division of Cardiovascular Medicine, Stanford University Medical Center
| | - Yasuhiro Honda
- Division of Cardiovascular Medicine, Stanford University Medical Center
| | | | - Masaharu Ishihara
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
- Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University
| | - Hisao Ogawa
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University
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5866
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Luk AOY, Lau ESH, So WY, Ma RCW, Kong APS, Ozaki R, Chow FCC, Chan JCN. Prospective study on the incidences of cardiovascular-renal complications in Chinese patients with young-onset type 1 and type 2 diabetes. Diabetes Care 2014; 37:149-57. [PMID: 24356598 DOI: 10.2337/dc13-1336] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE We examined metabolic profiles and cardiovascular-renal outcomes in a prospective cohort of Chinese patients with young-onset diabetes defined by diagnosis age <40 years. Patients with type 1 diabetes and normal-weight (BMI <23 kg/m(2)) and overweight (BMI ≥23 kg/m(2)) patients with type 2 diabetes were compared. RESEARCH DESIGN AND METHODS Between 1995 and 2004, 2,323 patients (type 1 diabetes, n = 209; normal-weight type 2 diabetes, n = 636; and overweight type 2 diabetes, n = 1,478) underwent detailed clinical assessment. Incident cardiovascular disease (CVD) including coronary heart disease, stroke, and peripheral vascular disease were identified using hospital discharge diagnoses. End-stage renal disease (ESRD) was defined by glomerular filtration rate <15 mL/min/1.73 m(2) or dialysis. RESULTS Overweight patients with type 2 diabetes had the worst metabolic profile and highest prevalence of microvascular complications. Over a median follow-up of 9.3 years, incidences of CVD were 0.6, 5.1, and 9.6 per 1,000 person-years in patients with type 1 diabetes, normal-weight patients with type 2 diabetes, and overweight patients with type 2 diabetes. The respective figures for ESRD were 2.2, 6.4, and 8.4 per 1,000 person-years. Compared with type 1 diabetes, the overweight type 2 diabetes group had a greater hazard of progression to CVD (hazard ratio [HR] 15.3 [95% CI 2.1-112.4]) and ESRD (HR 5.4 [95% CI 1.8-15.9]), adjusted for age, sex, and disease duration. The association became nonsignificant upon additional adjustment for BMI, blood pressure, and lipid. CONCLUSIONS Young patients with type 2 diabetes had greater risks of developing cardiovascular-renal complications compared with patients with type 1 diabetes. The increased risk was driven primarily by accompanying metabolic risk factors.
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5867
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Hu BC, Li Y, Liu M, Li LH, Sheng CS, Zhang Y, Wang JG. Blood pressure and urinary sodium excretion in relation to 16 genetic polymorphisms in the natriuretic peptide system in Chinese. Endocr J 2014; 61:861-74. [PMID: 24954621 DOI: 10.1507/endocrj.ej14-0104] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
We systematically investigated the association between single nucleotide polymorphisms (SNPs) in the natriuretic peptide system (NPPA, NPPB, NPPC, NPRA, NPRC, and Corin genes) and blood pressure in a Chinese population. The study population was recruited from a mountainous area 500 km south of Shanghai from 2003 to 2009. Using the ABI SNapShot method, we first genotyped 951 subjects enrolled in 2005 for 16 SNPs and then the remaining 1355 subjects as validation for 5 SNPs selected from the primary study. Overall, the association of the studied genetic polymorphisms with blood pressure and urinary excretion of cations was weak or non-significant. However, in the primary study, there was significant (Pint = 0.003) interaction between the rs198358 polymorphism and age in relation to diastolic blood pressure. After adjustment for covariates, diastolic blood pressure was significantly higher in the G allele carriers than AA homozygotes in 176 subjects aged 60 years or older (77.8 ± 1.72 vs 73.9 ± 1.54 mmHg, P = 0.001). In the primary combined with validation studies, this interaction remained statistically significant (Pint = 0.02). The odds ratio of hypertension for carrying the G allele versus AA homozygotes was 1.25 (95% CI: 1.03-1.52; P = 0.03) in all subjects, and 0.85 (0.51-1.41; P = 0.53), 1.30 (0.98-1.73; P = 0.06), and 1.45 (0.95-2.22; P = 0.08) in the subjects younger than 40 years, 40-59 years, and 60 years or older, respectively. Some of the genetic polymorphisms in the natriuretic peptide system might be associated with blood pressure. However, not only the size, but also the direction of the association may change with age.
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Affiliation(s)
- Bang-Chuan Hu
- Centre for Epidemiological Studies and Clinical Trials, The Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
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5868
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Soltysiak J, Skowronska B, Fichna P, Ostalska-Nowicka D, Stankiewicz W, Lewandowska-Stachowiak M, Lipkowska K, Zachwieja J. Urinary angiotensinogen and urinary sodium are associated with blood pressure in normoalbuminuric children with diabetes. Pediatr Nephrol 2014; 29:2373-8. [PMID: 24880819 PMCID: PMC4212134 DOI: 10.1007/s00467-014-2861-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2014] [Revised: 05/02/2014] [Accepted: 05/14/2014] [Indexed: 12/12/2022]
Abstract
BACKGROUND The aim of this study was to evaluate the association between blood pressure (BP) and urinary angiotensinogen excretion (uAGT) and renal sodium excretion (uNa) in children with type 1 diabetes mellitus (DM1). METHODS The study group consisted of 52 children with DM1 (28 males and 24 females) with albumin/creatinine ratio (ACR) below 30 mg/g and glomerular filtration rate (eGFR) above 90 ml/min/1.73 m(2). BP was assessed by 24-h ambulatory blood pressure monitoring (ABPM). RESULTS The patients showed significantly increased uAGT values with respect to controls (median 0.00 and range 1.76 vs. 0.00 and 0.00 ng/mg, respectively). The significant increase of uAGT was observed even in prehypertensive patients. uAGT concentrations showed positive correlation with systolic and diastolic 24-h BP and with mean arterial pressure (MAP) (r = 0.594). uNa values were negatively correlated with BP parameters, uAGT, ACR and eGFR. CONCLUSIONS An increase in uAGT precedes hypertension (HTN) in normoalbuminuric children with DM1 and may be considered as a new marker of HTN. Decreased sodium excretion seems to be involved in the development of HTN and early renal injury. Both uAGT and uNa are associated with BP in normoalbuminuric diabetic children.
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Affiliation(s)
- Jolanta Soltysiak
- Department of Pediatric Cardiology and Nephrology, Poznan University of Medical Sciences, 27/33 Szpitalna St., 60-572, Poznan, Poland,
| | - Bogda Skowronska
- Department of Pediatric Diabetes and Obesity, Poznan University of Medical Sciences, Poznan, Poland
| | - Piotr Fichna
- Department of Pediatric Diabetes and Obesity, Poznan University of Medical Sciences, Poznan, Poland
| | - Danuta Ostalska-Nowicka
- Department of Pediatric Cardiology and Nephrology, Poznan University of Medical Sciences, 27/33 Szpitalna St., 60-572 Poznan, Poland
| | - Witold Stankiewicz
- Department of Pediatric Diabetes and Obesity, Poznan University of Medical Sciences, Poznan, Poland
| | - Maria Lewandowska-Stachowiak
- Department of Pediatric Cardiology and Nephrology, Poznan University of Medical Sciences, 27/33 Szpitalna St., 60-572 Poznan, Poland
| | - Katarzyna Lipkowska
- Department of Pediatric Cardiology and Nephrology, Poznan University of Medical Sciences, 27/33 Szpitalna St., 60-572 Poznan, Poland
| | - Jacek Zachwieja
- Department of Pediatric Cardiology and Nephrology, Poznan University of Medical Sciences, 27/33 Szpitalna St., 60-572 Poznan, Poland
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5869
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Prevalence of and factors associated with albuminuria in the Korean adult population: the 2011 Korea National Health and Nutrition Examination Survey. PLoS One 2013; 8:e83273. [PMID: 24386169 PMCID: PMC3873941 DOI: 10.1371/journal.pone.0083273] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Accepted: 11/12/2013] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Microalbuminuria is associated with increased risk of renal disease and cardiovascular diseases even in non-diabetic subjects. High incidence rates of microalbuminuria have been found in a number of population-based studies. However, the prevalence and risk factors associated with microalbuminuria in the general population in Korea are unclear. OBJECTIVES The present study was performed to estimate the prevalence of microalbuminuria and investigate the associated risk factors in the general adult population using the Fifth Korea National Health and Nutrition Examination Survey (KNHANES V-2) data from 2011. METHODS A total of 5,202 participants (mean age, 45.6 years; men, 2,337; women, 2,865) were included in the analysis. Microalbuminuria was evaluated in participants of KNHANES V-2 based on the urine albumin-creatinine ratio. Estimated glomerular filtration rate was calculated using the Modification of Diet in Renal Disease study equation. RESULTS The weighted prevalence of microalbuminuria was 5.2% (95% CI, 4.4-6.1) in the general population. The prevalence of albuminuria is increased with age. After adjustment for age and sex, the presence of albuminuria was associated with increased waist circumference, systolic and diastolic blood pressure, aspartate aminotransferase, triglyceride, fasting plasma glucose, and the presence of hypertension and diabetes. In logistic regression analyses, older age, female sex, diabetes, hypertension, and serum aspartate aminotransferase were independently associated with the presence of albuminuria. CONCLUSION The prevalence of microalbuminuria was found to be 5.2%, and conventional risk factors for cardiovascular diseases are closely related to the presence of microalbuminuria in Korea. Microalbuminuria may be a useful marker to identify individuals with increased risk of cardiovascular disease.
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5870
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Use of net reclassification improvement (NRI) method confirms the utility of combined genetic risk score to predict type 2 diabetes. PLoS One 2013; 8:e83093. [PMID: 24376643 PMCID: PMC3869744 DOI: 10.1371/journal.pone.0083093] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Accepted: 11/03/2013] [Indexed: 11/28/2022] Open
Abstract
Background Recent genome-wide association studies (GWAS) identified more than 70 novel loci for type 2 diabetes (T2D), some of which have been widely replicated in Asian populations. In this study, we investigated their individual and combined effects on T2D in a Chinese population. Methodology We selected 14 single nucleotide polymorphisms (SNPs) in T2D genes relating to beta-cell function validated in Asian populations and genotyped them in 5882 Chinese T2D patients and 2569 healthy controls. A combined genetic score (CGS) was calculated by summing up the number of risk alleles or weighted by the effect size for each SNP under an additive genetic model. We tested for associations by either logistic or linear regression analysis for T2D and quantitative traits, respectively. The contribution of the CGS for predicting T2D risk was evaluated by receiver operating characteristic (ROC) analysis and net reclassification improvement (NRI). Results We observed consistent and significant associations of IGF2BP2, WFS1, CDKAL1, SLC30A8, CDKN2A/B, HHEX, TCF7L2 and KCNQ1 (8.5×10−18<P<8.5×10−3), as well as nominal associations of NOTCH2, JAZF1, KCNJ11 and HNF1B (0.05<P<0.1) with T2D risk, which yielded odds ratios ranging from 1.07 to 2.09. The 8 significant SNPs exhibited joint effect on increasing T2D risk, fasting plasma glucose and use of insulin therapy as well as reducing HOMA-β, BMI, waist circumference and younger age of diagnosis of T2D. The addition of CGS marginally increased AUC (2%) but significantly improved the predictive ability on T2D risk by 11.2% and 11.3% for unweighted and weighted CGS, respectively using the NRI approach (P<0.001). Conclusion In a Chinese population, the use of a CGS of 8 SNPs modestly but significantly improved its discriminative ability to predict T2D above and beyond that attributed to clinical risk factors (sex, age and BMI).
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5871
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Pattern and risk factors of intravesical recurrence after nephroureterectomy for upper tract urothelial carcinoma: a large Chinese center experience. J Formos Med Assoc 2013; 113:820-7. [PMID: 24360737 DOI: 10.1016/j.jfma.2013.11.004] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2013] [Revised: 11/06/2013] [Accepted: 11/13/2013] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND/PURPOSE There is currently no consensus about the pattern and risk factors of bladder recurrence after nephroureterectomy, especially in the Chinese population. We evaluated the pattern and risk factors based on data from a large Chinese center. METHODS The clinical and pathological data of 438 patients with upper tract urothelial carcinoma (UTUC), who underwent nephroureterectomy at Peking University First Hospital, Beijing, China between 2000 and 2010, was retrospectively analyzed. Univariate analysis by log-rank test and multivariate analysis by Cox proportional hazards regression model were used to determine the independent risk factors. RESULTS A total of 135 patients (30.8%) developed intravesical recurrence within a median follow-up of 45 months (range: 12-144 months). The median interval of bladder recurrence was 15 months (range: 2.0-98.0 months), and the two peaks for recurrence were 4-6 months and 17-19 months. Lower tumor grade, tumor multifocality, concomitant carcinoma in situ (CIS) and tumors located in the lower ureter were significant risk factors by univariate and multivariate analysis. A risk-scoring system was developed and a significant difference was found between different risk evaluations. Patients with concomitant CIS tended to develop a late bladder recurrence. One hundred and eighteen patients (87.4%) received transurethral resection after bladder tumor recurrence. CONCLUSION Lower tumor grade, tumor multifocality, concomitant CIS and tumors located in the lower ureter tend to be predictive for bladder recurrence after nephroureterectomy, although the underlying mechanism is not fully elucidated, and the scoring system could help risk stratification. Most recurrent tumors could be treated by transurethral resection and there were two peaks for recurrence, which is probably related to the mechanisms and may be unique to the Chinese population.
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5872
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Inflammation but not dietary macronutrients insufficiency associated with the malnutrition-inflammation score in hemodialysis population. PLoS One 2013; 8:e83233. [PMID: 24349471 PMCID: PMC3859660 DOI: 10.1371/journal.pone.0083233] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2013] [Accepted: 11/01/2013] [Indexed: 12/11/2022] Open
Abstract
Malnutrition is associated with increased risk of mortality in hemodialysis patients. And insufficient dietary intake is the common cause for malnutrition. So, in order to survey the dietary intake of hemodialysis patients and study the relationship between the dietary feature and nutritional status, a cross-sectional study was performed. 75 hemodialysis patients from South China participated in the dietary intake survey and nutrition assessment. A three-day diet diary record was used to estimate the major dietary macronutrients. Nutritional status was assessed by malnutrition-inflammation score (MIS) in addition to several related anthropometric measurements. Serum albumin, transferrin, and high-sensitivity C-reactive protein (CRP) were measured. Receiver operating characteristic (ROC) curve analysis was used to quantify the assessing value of independent parameters for nutritional status. The results showed that 48% patients were malnourished according to the MIS. The malnourished patients had a lower body mass index (BMI), fat mass (FM), albumin and a higher level of CRP, compared with normal nourished patients (P < 0.05). However, no significant differences of macronutrients (calories, protein, fat, carbohydrates, etc) were found between the two nutrition groups (P > 0.05). The multivariate regression analysis showed that the major macronutrients had no significant association with MIS (P > 0.05). In conclusion, malnutrition is very common in South China hemodialysis population and these data indicated that inflammation but not dietary macronutrients insufficiency might be the candidate cause for malnutrition in hemodialysis population.
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5873
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Kidney and eye diseases: common risk factors, etiological mechanisms, and pathways. Kidney Int 2013; 85:1290-302. [PMID: 24336029 DOI: 10.1038/ki.2013.491] [Citation(s) in RCA: 163] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2013] [Revised: 09/09/2013] [Accepted: 09/19/2013] [Indexed: 12/14/2022]
Abstract
Chronic kidney disease is an emerging health problem worldwide. The eye shares striking structural, developmental, and genetic pathways with the kidney, suggesting that kidney disease and ocular disease may be closely linked. A growing number of studies have found associations of chronic kidney disease with age-related macular degeneration, diabetic retinopathy, glaucoma, and cataract. In addition, retinal microvascular parameters have been shown to be predictive of chronic kidney disease. Chronic kidney disease shares common vascular risk factors including diabetes, hypertension, smoking, and obesity, and pathogenetic mechanisms including inflammation, oxidative stress, endothelial dysfunction, and microvascular dysfunction, with ocular diseases supporting the 'Common Soil Hypothesis.' In this review, we present major epidemiological evidence for these associations and explore underlying pathogenic mechanisms and common risk factors for kidney and ocular disease. Understanding the link between kidney and ocular disease can lead to the development of new treatment and screening strategies for both diseases.
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5874
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Zinc, iron and vitamins A, C and e are associated with obesity, inflammation, lipid profile and insulin resistance in Mexican school-aged children. Nutrients 2013; 5:5012-30. [PMID: 24335710 PMCID: PMC3875915 DOI: 10.3390/nu5125012] [Citation(s) in RCA: 92] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2013] [Revised: 11/20/2013] [Accepted: 11/26/2013] [Indexed: 01/05/2023] Open
Abstract
The objective of this cross-sectional study was to evaluate the relationship between micronutrient status and obesity, lipids, insulin resistance and chronic inflammation in children. Weight, height, waist circumference and body composition (dual-energy X-ray absorptiometry (DEXA)) were determined in 197 school-aged children. Lipids, glucose, insulin, C-reactive protein (CRP), zinc, iron and vitamins A, C and E were analyzed in blood. Vitamin C and vitamin E:lipids were negatively associated with Body Mass Index (BMI), waist-to-height ratio (WHR) and body and abdominal fat (p < 0.05). Vitamin A was positively associated with BMI, BMI-for-age, WHR and abdominal fat (p < 0.05). Iron and vitamin E:lipids were negatively associated with insulin (p < 0.05). Vitamins A, C and E and iron were negatively associated with CRP (p < 0.05). Interaction analysis showed that children who were overweight and obese who also had low concentrations of vitamin A had higher CRP and lower triglycerides (p < 0.1), children with low vitamin E had significantly lower glucose and triglycerides (p < 0.1) and higher low-density lipoprotein (LDL) concentrations (p < 0.05), and children with low zinc concentrations had higher insulin resistance compared with children with adequate weight (p < 0.05). In conclusion, low vitamin C concentration and vitamin E:lipids were associated with obesity. Furthermore, low concentrations of zinc, vitamins A and E in children who were overweight and obese were associated with lipids, inflammation and insulin resistance.
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5875
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May JM, Harrison FE. Role of vitamin C in the function of the vascular endothelium. Antioxid Redox Signal 2013; 19:2068-83. [PMID: 23581713 PMCID: PMC3869438 DOI: 10.1089/ars.2013.5205] [Citation(s) in RCA: 212] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2013] [Revised: 03/26/2013] [Accepted: 04/14/2013] [Indexed: 12/28/2022]
Abstract
SIGNIFICANCE Vitamin C, or ascorbic acid, has long been known to participate in several important functions in the vascular bed in support of endothelial cells. These functions include increasing the synthesis and deposition of type IV collagen in the basement membrane, stimulating endothelial proliferation, inhibiting apoptosis, scavenging radical species, and sparing endothelial cell-derived nitric oxide to help modulate blood flow. Although ascorbate may not be able to reverse inflammatory vascular diseases such as atherosclerosis, it may well play a role in preventing the endothelial dysfunction that is the earliest sign of many such diseases. RECENT ADVANCES Beyond simply preventing scurvy, evidence is mounting that ascorbate is required for optimal function of many dioxygenase enzymes in addition to those involved in collagen synthesis. Several of these enzymes regulate the transcription of proteins involved in endothelial function, proliferation, and survival, including hypoxia-inducible factor-1α and histone and DNA demethylases. More recently, ascorbate has been found to acutely tighten the endothelial permeability barrier and, thus, may modulate access of ascorbate and other molecules into tissues and organs. CRITICAL ISSUES The issue of the optimal cellular content of ascorbate remains unresolved, but it appears that low millimolar ascorbate concentrations are normal in most animal tissues, in human leukocytes, and probably in the endothelium. Although there may be little benefit of increasing near maximal cellular ascorbate concentrations in normal people, many diseases and conditions have either systemic or localized cellular ascorbate deficiency as a cause for endothelial dysfunction, including early atherosclerosis, sepsis, smoking, and diabetes. FUTURE DIRECTIONS A key focus for future studies of ascorbate and the vascular endothelium will likely be to determine the mechanisms and clinical relevance of ascorbate effects on endothelial function, permeability, and survival in diseases that cause endothelial dysfunction.
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Affiliation(s)
- James M May
- Department of Medicine, Vanderbilt University School of Medicine , Nashville, Tennessee
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5876
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Hu Y, Lu GM, Li K, Zhang LJ, Zhu H. Collecting duct carcinoma of the kidney: Imaging observations of a rare tumor. Oncol Lett 2013; 7:519-524. [PMID: 24396480 PMCID: PMC3881913 DOI: 10.3892/ol.2013.1739] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2013] [Accepted: 11/26/2013] [Indexed: 11/24/2022] Open
Abstract
Collecting duct carcinoma (CDC) is a rare type of renal neoplasm. Early diagnosis is possibly the only factor leading to a prolonged survival for patients with CDC. The purpose of the present study was to characterize the imaging features of CDC and improve its diagnosis. Radiological data of six patients were retrospectively reviewed by three experienced radiologists, including six cases examined with non-contrast computed tomography (CT) scans, five with contrast-enhanced CT scans, one with magnetic resonance urography, one with renal dynamic imaging and two with conventional whole-body 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT scans. All patients were pathologically confirmed with CDC. In total, seven tumors were detected in the six cases, with a mean size of 5.3 cm. Of the tumors, two were solid and the rest were complex solid and cystic. In addition, six tumors were located in medullary areas and only one tumor was found in the cortical location. Cystic components were observed in five tumors. Weak enhancements were observed in all six tumors examined with contrast-enhanced CT, and heterogeneous enhancements were also observed in the majority of these tumors with the exception of one tumor. Infiltrative growth and expansible growth were found in five and two tumors, respectively. Metastatic lesions were detected in all six patients. On MR urography, the involved kidney exhibited similar imaging observations to the CT scan. Renal dynamic imaging revealed a decreased renal function in the involved kidney and an increased renal function in the contralateral kidney. On PET/CT imaging, a marked uptake of 18F-FDG was found in primary and metastatic lesions. The results of the present study indicated that medullary location, weak and heterogeneous enhancement, infiltrative growth, damage of renal function in the involved kidney and a marked uptake of 18F-FDG are imaging observations commonly identified in patients with CDC. When a renal tumor exhibits these imaging features, CDC may be suggested as a valuable differential diagnosis.
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Affiliation(s)
- Yuxiao Hu
- Department of Nuclear Medicine, Jinling Hospital, Clinical School of Medical College, Nanjing University, Nanjing, Jiangsu 210002, P.R. China
| | - Guang-Ming Lu
- Department of Medical Imaging, Jinling Hospital, Clinical School of Medical College, Nanjing University, Nanjing, Jiangsu 210002, P.R. China
| | - Kai Li
- Department of Pharmacology, Soochow University, Suzhou, Jiangsu 215123, P.R. China
| | - Long-Jiang Zhang
- Department of Medical Imaging, Jinling Hospital, Clinical School of Medical College, Nanjing University, Nanjing, Jiangsu 210002, P.R. China
| | - Hong Zhu
- Department of Nuclear Medicine, Jinling Hospital, Clinical School of Medical College, Nanjing University, Nanjing, Jiangsu 210002, P.R. China
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5877
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Wang X, Du Y, Fan L, Ye P, Yuan Y, Lu X, Wang F, Zeng Q. Relationships between HDL-C, hs-CRP, with central arterial stiffness in apparently healthy people undergoing a general health examination. PLoS One 2013; 8:e81778. [PMID: 24312587 PMCID: PMC3849294 DOI: 10.1371/journal.pone.0081778] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2013] [Accepted: 10/16/2013] [Indexed: 11/18/2022] Open
Abstract
Background Some cardiovascular risk factors have been confirmed to be positively correlated with arterial stiffness. However, it is unclear whether HDL-C, a well-established anti-risk factor, has an independent association with arterial stiffness. The aim of this study was to evaluate the relationship between HDL-C levels and arterial stiffness and the possible role of high-sensitivity C-reactive protein (hs-CRP) in this potential correlation in apparently healthy adults undergoing a general health examination in China. Materials and Methods This was a cross-sectional survey. In total, 15,302 participants (age range, 18–82 years; mean, 43.88±8.44 years) were recruited during routine health status examinations. A questionnaire was used and we measured the body mass index, systolic and diastolic blood pressure, and fasting glucose, and serum lipid, uric acid, hs-CRP, and serum creatinine levels of each participant. Central arterial stiffness was assessed by carotid–femoral pulse wave velocity (cf-PWV). Results HDL-C levels decreased as cf-PWV increased. Pearson’s correlation analysis revealed that HDL-C levels were associated with cf-PWV (r=−0.18, P<0.001). hs-CRP levels were positively associated with cf-PWV (r=0.13). After adjustment for all confounders, HDL-C was inversely independently associated with all quartiles of cf-PWV. Furthermore, HDL-C was associated with cf-PWV in different quartiles of hs-CRP, and the correlation coefficients (r) gradually decreased with increasing hs-CRP levels (quartiles 1–4). Conclusions HDL-C is inversely independently associated with central arterial stiffness. The anti-inflammatory activity of HDL-C may mediate its relationship with cf-PWV. Further, long-term follow-up studies are needed to evaluate whether high HDL-C levels are protective against central artery stiffening through the anti-inflammatory activity of HDL-C.
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Affiliation(s)
- Xi Wang
- Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, China
| | - YingZhen Du
- Department of Geriatric Respiratory, Chinese PLA General Hospital, Beijing, China
| | - Li Fan
- Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, China
- * E-mail:
| | - Ping Ye
- Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, China
| | - Ying Yuan
- Second Department of Internal Medicine, Affiliated Hospital of Institute of Aviation Medicine, Air Force, Beijing, China
| | - XueChun Lu
- Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, China
| | - Fan Wang
- Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, China
| | - Qiang Zeng
- International Medical Centre, Chinese PLA General Hospital, Beijing, China
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5878
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He L, Peng Y, Liu H, Yin W, Chen X, Peng X, Shao J, Liu Y, Liu F. Th1/Th2 polarization in tonsillar lymphocyte form patients with IgA nephropathy. Ren Fail 2013; 36:407-12. [PMID: 24295274 DOI: 10.3109/0886022x.2013.862809] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Imbalance of Th1/Th2 pro-inflammatory cytokines plays an important role in the development and progression of IgA nephropathy (IgAN). Clinical development and exacerbation of IgAN are frequently preceded by episodes of upper respiratory tract infection, and palatine tonsils represent the predominant immunocompetent tissue of the upper respiratory tract. This study examined tonsillar lymphocytes of IgAN who suffered from tonsillitis (n = 22), and using tonsils derived from patients with chronic tonsillitis (n = 24) but without renal disease as a control. We identified a polarization toward Th2 response in tonsils of IgAN patients. TH0 cells are differentially mobilized during contact sensitization and by adjuvants such as lipopolysaccharide (LPS) that induce T-helper type 1 (Th1) responses, or α-hemolytic streptococcus (HS) that induces T-helper type 2 (Th2) responses. Th1:Th2 ratio is correlated with proteinuria and renal pathologic changes in IgAN group. Our study suggests that IgAN is associated with the change in Th1/Th2 balance in favor of Th2 lymphocytes.
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Affiliation(s)
- Liyu He
- Key Lab of Kidney Disease and Blood Purification, Nephrology Department, 2nd Xiangya Hospital, Central South University , Changsha, Hunan , People's Republic of China
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5879
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Sengul S, Erdem Y, Batuman V, Erturk S. Hypertension and chronic kidney disease in Turkey. Kidney Int Suppl (2011) 2013; 3:308-311. [PMID: 25019009 PMCID: PMC4089601 DOI: 10.1038/kisup.2013.64] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Worldwide, both hypertension and chronic kidney disease are major public health problems, due to their epidemic proportions and their association with high cardiovascular mortality. In 2003, the first Prevalence, awareness, treatment, and control of hypertension in Turkey (the PatenT) study was conducted in a nationally representative population (n=4910) by the Turkish Society of Hypertension and Renal Diseases, and showed that overall age- and sex-adjusted prevalence of hypertension in Turkey was 31.8%. The PatenT study also reported that overall awareness (40.7%), treatment (31.1%), and control rates (8.1%) of hypertension were strikingly low. Only 20.7% of the patients who were aware of their hypertension and receiving treatment had their blood pressure controlled to <140/90 mm Hg. In the Chronic Renal Disease in Turkey (CREDIT) study (n=10,748), the overall prevalence of chronic kidney (including all stages) disease was 15.7% and increased with advancing age. In the same population, the prevalence of hypertension, diabetes mellitus, dyslipidemia, obesity, and metabolic syndrome were reported as 32.7%, 12.7%, 76.3%, 20.1%, and 31.3%, respectively. The prevalence and awareness of hypertension in CREDIT population was 32.7% and 48.6%, respectively. According to the data obtained from national surveys, the prevalence of hypertension and chronic kidney disease in Turkey is alarmingly high. To improve prevention, early diagnosis, and treatment of these major public health problems, appropriate health strategies should be implemented by the government, together with medical societies, non-governmental organizations, industry, health-care providers, and academia.
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Affiliation(s)
- Sule Sengul
- Department of Nephrology, Ankara University School of Medicine, Ankara, Turkey
| | - Yunus Erdem
- Department of Nephrology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Vecihi Batuman
- Division of Nephrology, Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - Sehsuvar Erturk
- Department of Nephrology, Ankara University School of Medicine, Ankara, Turkey
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5880
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Chan TC, Fan-Ngai Hung I, Ka-Hay Luk J, Chiu-Yat Woo P, Chu LW, Hon-Wai Chan F. Efficacy of Trivalent Seasonal Influenza Vaccination in Reducing Mortality and Hospitalization in Chinese Nursing Home Older Adults. J Am Med Dir Assoc 2013; 14:889-94. [DOI: 10.1016/j.jamda.2013.04.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Revised: 04/11/2013] [Accepted: 04/12/2013] [Indexed: 11/29/2022]
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5881
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Liu M, Li Y, Citterio L, Huang QF, Zeng WF, Sheng CS, Wei FF, Dong Q, Li GL, Kang YY, Zhang L, Xu TY, Li JJ, Song J, Manunta P, Wang JG. A functional common polymorphism of the ABCB1 gene is associated with chronic kidney disease and hypertension in Chinese. Am J Hypertens 2013; 26:1428-36. [PMID: 23926124 DOI: 10.1093/ajh/hpt126] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Permeability glycoprotein is encoded by the ATP-binding cassette B1 gene (ABCB1) and is an extruder of toxic metabolites in the kidney. A functional common polymorphism (C3435T, rs1045642) in the human ABCB1 gene has been found to be associated with allograft outcome in kidney transplant patients. In this study, we investigated the association of the C3435T polymorphism with renal function and blood pressure (BP) in 2 Chinese populations. METHODS The discovery and replication populations were recruited from a mountainous area (Zhejiang Province) and a newly urbanized suburban area (Shanghai), respectively. We genotyped all subjects using the ABI SNapShot method. Chronic kidney disease (CKD) was defined as an estimated glomerular filtration rate <60 ml/min × 1.73 m(2) or 24-hour urinary albumin excretion ≥30 mg. RESULTS In the discovery population of 1,987 subjects, after adjustment for covariables, TT homozygosity (n = 217) was associated with a higher risk of CKD (n = 369; odds ratio (OR) = 1.73; P = 0.003) and with higher systolic BP (+3.1 mm Hg; P = 0.03) and pulse pressure (+3.4 mm Hg; P = 0.001). These associations were dependent on age (Pint ≤ 0.05). In subjects aged ≥60 years (n = 374), the corresponding OR or difference was 2.40 for CKD, 15.1 mm Hg for systolic BP, and 12.4 mm Hg for pulse pressure (P < 0.001). In similar adjusted analyses in the replication population of 2,427 elderly (≥60 years) subjects, TT homozygosity was also associated with a higher risk of CKD (OR = 1.39; P = 0.02) and an enhanced association of hypertension with CKD (OR = 1.50; P = 0.04). CONCLUSIONS The ABCB1 C3435T polymorphism might predict CKD, especially in the elderly.
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Affiliation(s)
- Ming Liu
- Centre for Epidemiological Studies and Clinical Trials, Shanghai Key Lab of Hypertension, Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
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5882
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Mayer G. Chronic kidney disease: who is affected, who is at risk and who cares? Nephrol Dial Transplant 2013; 29:937-41. [DOI: 10.1093/ndt/gft475] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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5883
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Biniaz V, Sadeghi Shermeh M, Ebadi A, Tayebi A, Einollahi B. Effect of Vitamin C Supplementation on C-reactive Protein Levels in Patients Undergoing Hemodialysis: A Randomized, Double Blind, Placebo-Controlled Study. Nephrourol Mon 2013; 6:e13351. [PMID: 24719806 PMCID: PMC3968960 DOI: 10.5812/numonthly.13351] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2013] [Revised: 07/14/2013] [Accepted: 08/03/2013] [Indexed: 02/07/2023] Open
Abstract
Background: Chronic inflammation is the most important cause of cardiovascular disease in patients undergoing hemodialysis, and vitamin C as a major antioxidant which could be effective to suppress inflammation. Objectives: This study was performed to evaluate the effect of vitamin C supplementation on C-reactive protein levels in patients undergoing hemodialysis. Patients and Methods: This randomized, placebo-controlled and double-blind trial was conducted on 151 patients on hemodialysis who were divided randomly by lottery method to three identical groups. In the intervention group, 250 mg of vitamin C was injected intravenously immediately at the end of each hemodialysis session three times a week for 8 weeks in a row. In the control group 1, same term of placebo saline was injected, and in the control group 2, no intervention was performed. Results: A total of 86 (61%) male and 55 female patients with mean hemodialysis duration of 39.74 ± 45.5 months, and a mean age of 61.36 ± 11.46 years-old, participated in this study. Hypertension and diabetes were the most common underlying diseases (79.4%). Median baseline CRP in the intervention, control 1 and control 2 groups were 16.8, 17.8, and 19.4 mg/L respectively. After 2 months, median CRP reduced significantly in the vitamin C group to 10.7 (P = 0.04) vs. 22.6, and 30.6 mg/L in control groups. Conclusions: Our findings demonstrated that vitamin C supplementation modifies the levels of CRP in patients on hemodialysis.
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Affiliation(s)
- Vajihe Biniaz
- Nephrology and Urology Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Mehdi Sadeghi Shermeh
- Department of Medical Surgical Nursing, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Abbas Ebadi
- Department of Medical Surgical Nursing, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Ali Tayebi
- Department of Medical Surgical Nursing, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
- Corresponding author: Ali Tayebi, Department of Medical Surgical Nursing, Baqiyatallah University of Medical Sciences, Tehran, IR Iran. Tel: +98-9121058516, Fax: +98-2126127253, E-mail:
| | - Behzad Einollahi
- Nephrology and Urology Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
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5884
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Du TY, Luo HM, Qin HC, Wang F, Wang Q, Xiang Y, Zhang Y. Circulating serum trefoil factor 3 (TFF3) is dramatically increased in chronic kidney disease. PLoS One 2013; 8:e80271. [PMID: 24282531 PMCID: PMC3840008 DOI: 10.1371/journal.pone.0080271] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Accepted: 10/11/2013] [Indexed: 01/10/2023] Open
Abstract
Objectives Trefoil factor 3 (TFF3) is a small peptide that plays an important role in mucosal protection, cell proliferation, and cell migration. The aberrant expression of TFF3 is correlated with gastrointestinal inflammation, solid tumors, and other clinical diseases. The objective of this study was to identify the distribution characteristics of serum TFF3 in common clinical diseases. Materials and Methods A large prospective randomized study of 1,072 Chinese patients was performed using an enzyme-linked immunosorbent assay (ELISA) to examine the serum TFF3 concentrations in patients with different diseases. A matched case-control study was conducted on patients with chronic kidney disease (CKD) stages 1–5. Immunohistochemistry (IHC) was performed using renal tissues to determine the relationship between the severity of CKD and the serum and urine concentrations of TFF3 peptides. Results The mean serum concentrations of TFF3 in patients with CKD, metastatic and secondary carcinoma (MC) and acute gastroenteritis (AG) (200.9 ng/ml, 95.7 ng/ml and 71.7 ng/ml, respectively) were significantly higher than those in patients with other common clinical diseases. A positive correlation tendency was observed between the serum TFF3 concentrations and the severity of CKD. The mean serum TFF3 values for CKD stages 1–5 were 23.6 ng/ml, 29.9 ng/ml, 54.9 ng/ml, 85.0 ng/ml and 176.6 ng/ml, respectively. The same trend was observed in the urine TFF3 concentrations and the CKD stages. The creatinine(Cr)-corrected concentrations of TFF3 in urine were 367.1 ng/mg·Cr, 910.6 ng/mg·Cr, 1,149.0 ng/mg·Cr, 1,610.0 ng/mg·Cr and 3,475.0 ng/mg·Cr for CKD stages 1–5, respectively. IHC revealed that TFF3 expression was concentrated in tubular epithelial cells. Conclusions The influence of kidney injuries must be fully considered when performing clinical TFF3 research. Further studies on TFF3 in CKD will contribute to our understanding of its pathological roles and mechanisms in other diseases.
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Affiliation(s)
- Ting-yi Du
- Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences and Yunnan Province, Kunming Institute of Zoology, The Chinese Academy of Sciences, Kunming, Yunnan Province, China
- University of the Chinese Academy of Sciences, Beijing, China
- Department of Clinical Laboratory Medicine, the First People’s Hospital of Yunnan Province, Kunming, Yunnan Province, China
| | - Hui-ming Luo
- Department of Nephrology, The First People’s Hospital of Yunnan Province, Kunming, Yunnan Province, China
| | - Hai-chun Qin
- Department of Gastroenterology, The First People’s Hospital of Yunnan Province, Kunming, Yunnan Province, China
| | - Fang Wang
- Department of Clinical Laboratory Medicine, the First People’s Hospital of Yunnan Province, Kunming, Yunnan Province, China
| | - Qing Wang
- Department of Gynecology, The First People’s Hospital of Yunnan Province,Kunming, Yunnan Province, China
| | - Yang Xiang
- Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences and Yunnan Province, Kunming Institute of Zoology, The Chinese Academy of Sciences, Kunming, Yunnan Province, China
| | - Yun Zhang
- Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences and Yunnan Province, Kunming Institute of Zoology, The Chinese Academy of Sciences, Kunming, Yunnan Province, China
- * E-mail:
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5885
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Cai G, Zheng Y, Sun X, Chen X. Prevalence, Awareness, Treatment, and Control of Hypertension in Elderly Adults with Chronic Kidney Disease: Results from the Survey of Prevalence, Awareness, and Treatment Rates in Chronic Kidney Disease Patients with Hypertension in China. J Am Geriatr Soc 2013; 61:2160-2167. [PMID: 24479145 DOI: 10.1111/jgs.12551] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Guangyan Cai
- Department of Nephrology State Key Laboratory of Kidney Disease (2011DAV00088) National Clinical Research Center for Kidney Disease, General Hospital of Chinese People's Liberation Army Beijing China
| | - Ying Zheng
- Department of Nephrology State Key Laboratory of Kidney Disease (2011DAV00088) National Clinical Research Center for Kidney Disease, General Hospital of Chinese People's Liberation Army Beijing China
| | - Xuefeng Sun
- Department of Nephrology State Key Laboratory of Kidney Disease (2011DAV00088) National Clinical Research Center for Kidney Disease, General Hospital of Chinese People's Liberation Army Beijing China
| | - Xiangmei Chen
- Department of Nephrology State Key Laboratory of Kidney Disease (2011DAV00088) National Clinical Research Center for Kidney Disease, General Hospital of Chinese People's Liberation Army Beijing China
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5886
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Yang J, Arima H, Zhou J, Zhao Y, Li Q, Wu G, Zhang Y. Effects of low estimated glomerular filtration rate on outcomes after stroke: a hospital-based stroke registry in China. Eur J Neurol 2013; 21:1143-1145. [PMID: 24261457 DOI: 10.1111/ene.12311] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2013] [Accepted: 10/21/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND PURPOSE As uncertainty persists over the prognostic significance of low estimated glomerular filtration rate (eGFR) in acute stroke, the effects of low eGFR on death/disability amongst participants with acute stroke in China were determined. METHODS Nanjing First Hospital stroke registry was a prospective cohort study of stroke patients. Patients with acute stroke (brain infarction, intracerebral hemorrhage or subarachnoid hemorrhage) within 7 days of onset were recruited consecutively from 2004 to 2008. Baseline eGFR was estimated using the Chronic Kidney Disease Epidemiology Collaboration equation. Outcomes were death/disability, defined by scores 3-6 on the modified Rankin Scale at 90 days. RESULTS A total of 1909 participants were included in the present analyses. Of them, 112 (5.9%) had baseline moderate to severe decrease in eGFR (G3b-4) and increasing risk of higher National Institutes of Health Stroke Scale (NIHSS) scores. Low eGFR was associated with increasing risk of death/disability at 90 days [G3b-4, odds ratio 2.58 (95% confidence interval 1.71-3.91); G3a, 1.86 (1.35-2.56); G2, 1.21 (0.96-1.52); P trend <0.001). However, the association was not statistically significant after adjustment for demographic and clinical factors including NIHSS scores. CONCLUSIONS There were no appreciable effects of low eGFR on death/disability at 90 days independent of other prognostic factors in Chinese patients with acute stroke.
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Affiliation(s)
- J Yang
- Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - H Arima
- George Institute for Global Health, Royal Prince Alfred Hospital and University of Sydney, Sydney, NSW, Australia
| | - J Zhou
- Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Y Zhao
- Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Q Li
- George Institute for Global Health, Royal Prince Alfred Hospital and University of Sydney, Sydney, NSW, Australia
| | - G Wu
- Department of Neurology, Hebei Yutian Hospital, Tangshan, China
| | - Y Zhang
- Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
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5887
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Vega A, García de Vinuesa S, Goicoechea M, Verdalles U, Martínez-Pueyo ML, Chacón A, Quiroga B, Luño J. Evaluation of methods based on creatinine and cystatin C to estimate glomerular filtration rate in chronic kidney disease. Int Urol Nephrol 2013; 46:1161-7. [PMID: 24265040 DOI: 10.1007/s11255-013-0607-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Accepted: 11/08/2013] [Indexed: 02/02/2023]
Abstract
PURPOSE Estimated glomerular filtration rate (GFR) is a useful tool for the detection of chronic kidney disease (CKD). Several methods have been proposed, but findings can vary in specific groups such as patients with diabetes, elderly and high and low body mass index and, also, with the stage of CKD. The objective of this study was comparing the accuracy of the currently used equations for estimating GFR with that of the gold standard technetium-(99m)-diethylene triamine pentaacetic acid (99mTc-DTPA). METHODS We performed a cross-sectional study of 129 patients with all five CKD stages. GFR was estimated using the following: 24-h urine creatinine clearance, Cockcroft-Gault equation, MDRD equation, CKD-EPI equation, Hoek's cystatin C equation, and isotopic 99mTc-DTPA (as gold standard). We evaluated agreement in the whole study population and according to age, sex, weight, and diabetes. RESULTS All methods had good agreement. The best agreement was observed with the cystatin C [intraclass coefficient correlation (ICC) 95 % confidence interval (95 % CI), 0.87 (0.82-0.91)], followed by CKD-EPI [ICC 0.83 (0.77-0.88)]. Twenty-four-hour urine creatinine clearance showed the worst agreement in patients older than 65 years [ICC 0.70 (0.56-0.79)]. The Cockcroft-Gault equation showed the worst agreement in younger than 65 years [ICC 0.64 (0.42-0.79)]. The best agreement for classification in the correct CKD stage was with the cystatin C equation [κ = 0.80 (0.74-0.87)]. GFR was overestimated with all methods in CKD stages 4 and 5. CONCLUSIONS The methods used in clinical practice are adequate for classification of CKD. Cystatin C is the most accurate method, followed by CKD-EPI. The Cockcroft-Gault equation is not accurate in young patients. Twenty-four-hour urine creatinine clearance loses accuracy in patients aged older than 65 years.
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Affiliation(s)
- Almudena Vega
- Nephrology Department, Hospital Gregorio Marañón, C/Doctor Esquerdo, 46, 28007, Madrid, Spain
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5888
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Wang C, Zhang J, Li CC, Gong WY, Liu X, Ye ZC, Peng H, Lou TQ. The ambulatory arterial stiffness index and target-organ damage in Chinese patients with chronic kidney disease. BMC Nephrol 2013; 14:257. [PMID: 24245955 PMCID: PMC3840650 DOI: 10.1186/1471-2369-14-257] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2012] [Accepted: 11/07/2013] [Indexed: 01/23/2023] Open
Abstract
Background The ambulatory arterial stiffness index (AASI) can be used to predict cardiovascular morbidity and mortality in hypertensive patients. However, data on AASI in Chinese patients with chronic kidney disease (CKD) is not available. Methods This cross-sectional study enrolled 583 CKD patients. Univariate and multivariate analyses were used to evaluate the relationship between AASI and renal function and parameters of cardiovascular injury. Results Patients with a higher AASI had a higher systolic blood pressure, a lower estimated glomerular filtration rate (eGFR), a higher serum cystatin C, a higher left ventricular mass index (LVMI) and carotid intima-media thickness (cIMT). Univariate analyses showed that AASI was positively correlated with serum cystatin C (r=0.296, P < 0.001), serum creatinine (r=0.182, P < 0.001), and LVMI (r = 0.205, P < 0.001) and negatively correlated with the eGFR (r = –0.200, P < 0.001). Multivariate analyses revealed that serum cystatin C, eGFR, serum creatinine and LVMI were independently correlated with AASI. Conclusions These data suggest that AASI was closely correlated with renal function and parameters of cardiovascular injury in Chinese CKD patients. Good quality, long-term, large longitudinal trials to validate the role of AASI in clinical practice for Chinese CKD patients.
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Affiliation(s)
| | | | | | | | | | | | | | - Tan-Qi Lou
- Division of Nephrology, Department of medicine, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong 510630, China.
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5889
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Hephzibah J, Shanthly N, Oommen R. Comparison of glomerular filtration rate measured by plasma sample technique, Cockroft Gault method and Gates' method in voluntary kidney donors and renal transplant recipients. Indian J Nucl Med 2013; 28:144-51. [PMID: 24250022 PMCID: PMC3822413 DOI: 10.4103/0972-3919.119544] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Background: There are numerous methods for calculation of glomerular filtration rate (GFR), which is a crucial measurement to identify patients with renal disease. Aims: The aim of this study is to compare four different methods of GFR calculation. Settings and Design: Clinical setup, prospective study. Materials and Methods: Data was collected from routine renal scans done for voluntary kidney donors (VKD) or renal transplant recipients 6 months after transplantation. Following technetium-99m diethylene triamine penta acetic acid injection, venous blood samples were collected from contralateral arm at 120, 180, and 240 min through an indwelling venous cannula and direct collection by syringe. A total volume of 1 ml of plasma from each sample and standards were counted in an automatic gamma counter for 1 min. Blood samples taken at 120 min and 240 min were used for double plasma sample method (DPSM) and a sample taken at 180 min for single plasma sample method (SPSM). Russell's formulae for SPSM and DPSM were used for GFR estimation. Gates’ method GFR was calculated by vendor provided software. Correlation analysis was performed using Pearson's correlation test. Results: SPSM correlated well with DPSM. GFR value in healthy potential kidney donors has a significant role in the selection of donors. The mean GFR ± (standard deviation) in VKD using SPSM, DPSM, camera depth method and Cockroft Gault method was 134.6 (25.9), 137.5 (42.4), 98.6 (15.9), 83.5 (21.1) respectively. Gates’ GFR calculation did not correlate well with plasma sampling method. Conclusions: Calculation of GFR plays a vital role in the management of renal patients, hence it was noted that Gates GFR may not be a reliable method of calculation. SPSM was more reliable. DPSM is reliable but cumbersome. It is difficult to accurately calculate GFR without a gold standard.
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Affiliation(s)
- Julie Hephzibah
- Department of Nuclear Medicine, Christian Medical College, Vellore, Tamil Nadu, India
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5890
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Zhou Y, Echouffo-Tcheugui JB, Gu JJ, Ruan XN, Zhao GM, Xu WH, Yang LM, Zhang H, Qiu H, Narayan KMV, Sun Q. Prevalence of chronic kidney disease across levels of glycemia among adults in Pudong New Area, Shanghai, China. BMC Nephrol 2013; 14:253. [PMID: 24238578 PMCID: PMC4225706 DOI: 10.1186/1471-2369-14-253] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2013] [Accepted: 11/12/2013] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Few population-based studies have examined the relationship between glycemic status and chronic kidney disease (CKD) in China. We examined the prevalence of CKD across categories of glycemia [diagnosed diabetes, undiagnosed diabetes (fasting plasma glucose [FPG] ≥ 126 mg/dL), prediabetes (FPG 100-126 mg/dL) and normal glycemia (FPG <100 mg/dL)] among Chinese adults and assessed the relative contribution of dysglycemia (prediabetes and/or diabetes) to the burden of CKD. METHODS 5,584 Chinese adults aged 20-79 years were selected from the Pudong New Area of Shanghai through a multistage random sampling. Demographic and lifestyle characteristics, anthropometry and blood pressure were measured. Biochemical assays included FPG, serum creatinine and lipids, urinary creatinine and albumin. Prevalence of albuminuria [urine albumin-to-creatinine ratio (ACR) ≥ 30 mg/g], decreased kidney function and CKD (either decreased kidney function or albuminuria) across levels of glycemia were estimated. RESULTS The prevalence of albuminuria, decreased kidney function and CKD each increased with higher glycemic levels (P < 0.001). Based on the MDRD Study equation, the unadjusted CKD prevalence was 30.9%, 28.5%, 14.1% and 9.2% in those with diagnosed diabetes, undiagnosed diabetes, prediabetes and normoglycemia, respectively. The corresponding age-, gender- and hypertension-adjusted CKD prevalence were 25.8%, 25.0%, 12.3% and 9.1%, respectively. In a multivariable analysis, the factors associated with CKD were hypertension (Odds ratio [OR] 1.70, 95% confidence interval [CI]: 1.42-2.03), dysglycemia (OR 1.65, 95% CI: 1.39-1.95), female gender (OR 1.48, 95% CI: 1.25-1.75), higher triglycerides (OR 1.14, 95% CI: 1.08-1.20 per mmol/L), higher body mass index (OR 1.08, 95% CI: 1.05-1.10 per kg/m2), and older age (OR 1.02, 95% CI: 1.01 -1.03 per year). The population attributable risks (PARs) associated with diabetes, prediabetes, dysglycemia (diabetes and prediabetes) and hypertension were 18.4%, 19.7%, 30.3% and 44.5% for CKD as defined by the MDRD study equation, and 15.8%, 24.4%, 29.2% and 10.0% with the CKD-EPI equation. Estimates of prevalence and ORs of the relative contribution of various risk factors to CKD obtained with the CKD-EPI equation were similar. CONCLUSIONS As much as 30% of the CKD burden may be associated with dysglycemia among Chinese adults, independent of age, gender and hypertension status. Prevention and control of diabetes and prediabetes should be a high priority in reducing the CKD burden in China.
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Affiliation(s)
- Yi Zhou
- Pudong New Area Center for Disease Control and Prevention, 3039 Zhang Yang Road, Shanghai 200136, China.
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5891
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Zhang K, Li Y, Cheng X, Liu L, Bai W, Guo W, Wu L, Zuo L. Cross-over study of influence of oral vitamin C supplementation on inflammatory status in maintenance hemodialysis patients. BMC Nephrol 2013; 14:252. [PMID: 24228847 PMCID: PMC3840610 DOI: 10.1186/1471-2369-14-252] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2012] [Accepted: 11/05/2013] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Both vitamin C deficiency and inflammation are prevalent in maintenance hemodialysis (MHD) patients. In this study, we aimed to elucidate the effect of oral vitamin C supplementation on inflammatory status in MHD patients with low vitamin C level and high hypersensitive C-reactive protein (hs-CRP) level. METHODS A total of 128 patients were recruited in our present study. Patients were divided into two groups. In group 1 (n = 67), patients were orally administered with 200 mg/day vitamin C in the first 3 months, and then the vitamin C supplementation was withdrawn in the next 3 months. In group 2 (n = 61), patients were not given vitamin C in the first 3 months, and then they were orally administered with 200 mg/day in the next 3 months. Levels of hs-CRP, prealbumin, albumin and hemoglobin as well as the EPO resistance index (ERI) were determined at the baseline and every 3 months throughout the study. Plasma vitamin C level was determined by high-performance liquid chromatography with UV detection. RESULTS Among the 128 patients, 28 of them dropped out of the study before completion. Consequently, a total of 100 patients (group 1: n = 48; group 2: n = 52) were included in the final analysis. At the baseline, the plasma vitamin C level of all patients was less than 4 μg/mL. However, this proportion was decreased to 20% after the vitamin C supplementation for 3 months. Compared with patients without the vitamin C supplementation, a decreased level of hs-CRP and an increased level of prealbumin were induced by the vitamin C supplementation for 3 months in both groups. However, levels of these biomarkers returned to their original state after the supplementation was withdrawn. Same beneficial effects on plasma albumin, hemoglobin and ERI response to vitamin C supplementation were observed in the two groups without statistical significance. CONCLUSIONS The inflammatory status in MHD patients with plasma vitamin C deficiency and high levels of inflammatory markers could be partially improved by long-term oral administration of small doses of vitamin C. TRIAL REGISTRATION The clinical trial number: NCT01356433.
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Affiliation(s)
| | | | | | | | | | | | | | - Li Zuo
- Department of Medicine, Renal Division, Peking University First Hospital, Beijing, P, R, China.
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5892
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van Hasselt TJ, Pickles O, Midgley-Hunt A, Jiang CQ, Zhang WS, Cheng KK, Thomas GN, Lam TH. Effects of tea consumption on renal function in a metropolitan Chinese population: the Guangzhou biobank cohort study. J Ren Nutr 2013; 24:26-31. [PMID: 24216256 DOI: 10.1053/j.jrn.2013.08.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2013] [Revised: 08/11/2013] [Accepted: 08/14/2013] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE Green tea consumption has been associated with many prophylactic health benefits. This study examined for the first time associations between tea consumption and renal function in a Chinese population. DESIGN AND METHODS Cross-sectional baseline data including demographics, and lifestyle and weekly consumption of green, black, and oolong tea were analyzed from 12,428 ambulatory subjects aged 50 to 85 years (67.3% female) that were randomly selected from the membership list of a community social and welfare association in Guangzhou, China. INTERVENTION Associations between tea consumption and renal function were assessed using regression analyses to adjust for potential confounding factors. MAIN OUTCOME MEASURE Renal function was assessed using the estimated glomerular filtration rate (eGFR) and in a subcohort of 1,910 participants using a spot urinary albumin-to-creatinine ratio. RESULTS Six thousand eight hundred and seventy-two participants drank at least 1 type of tea. Oolong tea consumption was negatively associated with eGFR (β-coefficient -0.019, P = .025), but in a gender-stratified analysis this was not the case. In men, black tea was positively associated with eGFR (β-coefficient 0.037, P = .013), but not in women (β-coefficient -0.002, P = .856). Otherwise, no statistically significant consistent associations between the measures of renal function and consumption of green tea, black tea, or oolong tea individually or total tea consumption were identified. CONCLUSION Overall there was no clear evidence to suggest any consistent association between renal function and tea consumption in this large population-based study of older Chinese individuals.
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Affiliation(s)
| | - Oliver Pickles
- Worcestershire Royal Hospital, Worcester, United Kingdom; Queen Elizabeth Hospital, Birmingham, United Kingdom
| | | | - Chao Quiang Jiang
- Guangzhou Occupational Disease Prevention and Treatment Centre, Guangzhou No.12 Hospital, Guangzhou, People's Republic of China
| | - Wei Sen Zhang
- School of Public Health, University of Hong Kong, Hong Kong, Hong Kong
| | - Kar Keung Cheng
- Public Health, Epidemiology and Biostatistics, University of Birmingham, Birmingham, United Kingdom
| | - Graham Neil Thomas
- Public Health, Epidemiology and Biostatistics, University of Birmingham, Birmingham, United Kingdom
| | - Tai Hing Lam
- School of Public Health, University of Hong Kong, Hong Kong, Hong Kong
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5893
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Sedaghat S, Hoorn EJ, van Rooij FJA, Hofman A, Franco OH, Witteman JCM, Dehghan A. Serum uric acid and chronic kidney disease: the role of hypertension. PLoS One 2013; 8:e76827. [PMID: 24265674 PMCID: PMC3827035 DOI: 10.1371/journal.pone.0076827] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2013] [Accepted: 08/29/2013] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND There are inconsistent findings on the role of hyperuricemia as an independent risk factor for chronic kidney disease (CKD). Hypertension has been implicated as a factor influencing the association between serum uric acid and CKD. In this population-based study we investigated the association between serum uric acid and decline in renal function and tested whether hypertension moderates this association. METHODS We included 2601 subjects aged 55 years and over from the Rotterdam Study. Serum uric acid and estimated glomerular filtration rate (eGFR) were assessed at baseline. After average 6.5 years of follow-up, second eGFR was assessed. CKD was defined as eGFR<60 ml/min/1.73 m(2). All associations were corrected for socio-demographic and cardiovascular factors. RESULTS Each unit (mg/dL) increase in serum uric acid was associated with 0.19 ml/min per 1.73 m(2) faster annual decline in eGFR. While the association between serum uric acid and incidence of CKD was not significant in our study population (Hazard Ratio: 1.12, 95% confidence interval [CI]: 0.98-1.28), incorporating our results in a meta-analysis with eleven published studies revealed a significant association (Relative Risk: 1.18, 95%CI: 1.15-1.22). In the stratified analyses, we observed that the associations of serum uric acid with eGFR decline and incident CKD were stronger in hypertensive subjects (P for interaction = 0.046 and 0.024, respectively). CONCLUSIONS Our findings suggest that hyperuricemia is independently associated with a decline in renal function. Stronger association in hypertensive individuals may indicate that hypertension mediates the association between serum uric acid and CKD.
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Affiliation(s)
- Sanaz Sedaghat
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Ewout J. Hoorn
- Department of Internal Medicine—Nephrology, Erasmus Medical Center, Rotterdam, The Netherlands
| | | | - Albert Hofman
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Oscar H. Franco
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | | | - Abbas Dehghan
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
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5894
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Liu X, Wang Y, Wang C, Shi C, Cheng C, Chen J, Ma H, Lv L, Li L, Lou T. A new equation to estimate glomerular filtration rate in Chinese elderly population. PLoS One 2013; 8:e79675. [PMID: 24244543 PMCID: PMC3823564 DOI: 10.1371/journal.pone.0079675] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2013] [Accepted: 10/02/2013] [Indexed: 11/18/2022] Open
Abstract
Background We sought to develop a new equation to estimate glomerular filtration rate (GFR) in Chinese elderly population. Methods A total of 668 Chinese elderly participants, including the development cohort (n = 433), the validation cohort (n = 235) were enrolled. The new equation using the generalized additive model, and age, gender, serum creatinine as predictor variables was developed and the performances was compared with the CKD-EPI equation. Results In the validation data set, both bias and precision were improved with the new equation, as compared with the CKD-EPI equation (median difference, −1.5 ml/min/1.73 m2 vs. 7.4 ml/min/1.73 m2 for the new equation and the CKD-EPI equation, [P<0.001]; interquartile range [IQR] for the difference, 16.2 ml/min/1.73 m2 vs. 19.0 ml/min/1.73 m2 [P<0.001]), as were accuracies (15% accuracy, 40.4% vs. 30.6% [P = 0.02]; 30% accuracy, 71.1% vs. 47.2%, [P<0.001]; 50% accuracy, 90.2% vs. 75.7%, [P<0.001]), allowing improvement in GFR categorization (GFR category misclassification rate, 37.4% vs. 53.2% [P = <0.001]). Conclusions A new equation was developed in Chinese elderly population. In the validation data set, the new equation performed better than the original CKD-EPI equation. The new equation needs further external validations. Calibration of the GFR referent standard to a more accurate one should be an useful way to improve the performance of GFR estimating equations.
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Affiliation(s)
- Xun Liu
- Division of Nephrology, Department of Internal Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- College of Biomedical Engineering, South China University of Technology, Guangzhou, China
| | - Yanni Wang
- Division of Nephrology, Department of Internal Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Cheng Wang
- Division of Nephrology, Department of Internal Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Chenggang Shi
- Division of Nephrology, Department of Internal Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Cailian Cheng
- Division of Nephrology, Department of Internal Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Jinxia Chen
- Division of Nephrology, Department of Internal Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Huijuan Ma
- Division of Nephrology, Department of Internal Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Linsheng Lv
- Operating Room, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Lin Li
- Department of Laboratory Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- * E-mail: (TL); (LL)
| | - Tanqi Lou
- Division of Nephrology, Department of Internal Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- * E-mail: (TL); (LL)
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5895
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Stenvinkel P, Johnson RJ. Kidney biomimicry--a rediscovered scientific field that could provide hope to patients with kidney disease. Arch Med Res 2013; 44:584-90. [PMID: 24220764 DOI: 10.1016/j.arcmed.2013.10.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2013] [Accepted: 10/15/2013] [Indexed: 12/18/2022]
Abstract
Most studies on kidney disease have relied on classic experimental studies in mice and rats or clinical studies in humans. From such studies much understanding of the physiology and pathophysiology of kidney disease has been obtained. However, breakthroughs in the prevention and treatment of kidney diseases have been relatively few, and new approaches to fight kidney disease are needed. Here we discuss kidney biomimicry as a new approach to understand kidney disease. Examples are given of how various animals have developed ways to prevent or respond to kidney failure, how to protect themselves from hypoxia or oxidative stress and from the scourge of hyperglycemia. We suggest that investigation of evolutionary biology and comparative physiology might provide new insights for the prevention and treatment of kidney disease.
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Affiliation(s)
- Peter Stenvinkel
- Division of Renal Medicine, Karolinska University Hospital at Huddinge, Karolinska Institutet, Stockholm, Sweden.
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5896
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Shen Y, Lu L, Ding FH, Sun Z, Zhang RY, Zhang Q, Yang ZK, Hu J, Chen QJ, Shen WF. Association of increased serum glycated albumin levels with low coronary collateralization in type 2 diabetic patients with stable angina and chronic total occlusion. Cardiovasc Diabetol 2013; 12:165. [PMID: 24209601 PMCID: PMC4225762 DOI: 10.1186/1475-2840-12-165] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2013] [Accepted: 11/05/2013] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND We investigated whether serum glycated albumin (GA) levels are related to coronary collateralization in type 2 diabetic patients with chronic total occlusion. METHODS Blood levels of GA and glycosylated hemoglobin (HbA1c) were determined in 317 diabetic and 117 non-diabetic patients with stable angina and angiographic total occlusion of at least one major coronary artery. The degree of collaterals supplying the distal aspect of a total occlusion from the contra-lateral vessel was graded as low (Rentrop score of 0 or 1) or high collateralization (Rentrop score of 2 or 3). RESULTS For diabetic patients, GA (21.2 ± 6.5% vs. 18.7 ± 5.6%, P < 0.001) but not HbA1c levels (7.0 ± 1.1% vs. 6.8 ± 1.3%, P = 0.27) was significantly elevated in low collateralization than in high collateralization group, and correlated inversely with Rentrop score (Spearmen's r = -0.28, P < 0.001; Spearmen's r = -0.10, P = 0.09, respectively). There was a trend towards a larger area under the curve of GA compared with that of HbA1c for detecting the presence of low collateralization (0.64 vs. 0.58, P = 0.15). In non-diabetic patients, both GA and HbA1c levels did not significantly differ regardless the status of coronary collateralization. In multivariable analysis, female gender, age > 65 years, smoke, non-hypertension, duration of diabetes > 10 years, metabolic syndrome, eGFR < 90 ml/min/1.73 m2, and GA > 18.3% were independently determinants for low collateralization in diabetic patients. CONCLUSIONS Increased GA levels in serum are associated with impaired collateral growth in type 2 diabetic patients with stable angina and chronic total occlusion.
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Affiliation(s)
- Ying Shen
- Department of Cardiology, Shanghai Rui Jin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, People’s Republic of China
| | - Lin Lu
- Department of Cardiology, Shanghai Rui Jin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, People’s Republic of China
- Institute of Cardiovascular Diseases, Shanghai Jiaotong University School of Medicine, Shanghai 200025, People’s Republic of China
| | - Feng Hua Ding
- Department of Cardiology, Shanghai Rui Jin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, People’s Republic of China
| | - Zhen Sun
- Department of Cardiology, Shanghai Rui Jin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, People’s Republic of China
| | - Rui Yan Zhang
- Department of Cardiology, Shanghai Rui Jin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, People’s Republic of China
| | - Qi Zhang
- Department of Cardiology, Shanghai Rui Jin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, People’s Republic of China
| | - Zheng Kun Yang
- Department of Cardiology, Shanghai Rui Jin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, People’s Republic of China
| | - Jian Hu
- Department of Cardiology, Shanghai Rui Jin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, People’s Republic of China
| | - Qiu Jing Chen
- Institute of Cardiovascular Diseases, Shanghai Jiaotong University School of Medicine, Shanghai 200025, People’s Republic of China
| | - Wei Feng Shen
- Department of Cardiology, Shanghai Rui Jin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, People’s Republic of China
- Institute of Cardiovascular Diseases, Shanghai Jiaotong University School of Medicine, Shanghai 200025, People’s Republic of China
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5897
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Wang F, Zheng J, Ye P, Luo L, Bai Y, Xu R, Sheng L, Xiao T, Wu H. Association of high-density lipoprotein cholesterol with the estimated glomerular filtration rate in a community-based population. PLoS One 2013; 8:e79738. [PMID: 24223189 PMCID: PMC3819240 DOI: 10.1371/journal.pone.0079738] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2013] [Accepted: 09/23/2013] [Indexed: 02/06/2023] Open
Abstract
Background Reduced kidney function is independently associated with low high-density lipoprotein cholesterol (HDL-C) levels in patients with end-stage renal disease (ESRD), those on hemodialysis, and those with stage 3–5 chronic kidney disease (CKD). However, epidemiological data investigating the relationship between HDL-C levels and kidney function in the general population with roughly normal kidney function are limited, and the results are also inconsistent. The aim of this study was to evaluate the relationship between HDL-C levels and the estimated glomerular filtration rate (eGFR) in a community-based population in China. Methods This was a community-based cross-sectional survey. In total, 4925 participants (age range, 18–96 years; mean, 51.30±11.98 years) were recruited during routine health status examinations. A questionnaire was used to ascertain age, smoking status, and the history of hypertension and diabetes mellitus for each participant. We measured the body mass index, waist circumference, systolic and diastolic blood pressure, and fasting glucose, total cholesterol, triglyceride, HDL-C, low-density lipoprotein cholesterol, uric acid, and serum creatinine level of each participant. eGFR was evaluated using the Chinese modified Modification of Diet in Renal Disease equation. Results The HDL-C level was higher in the first quartile (lowest quartile) of eGFR than in the fourth quartile (the highest quartile). Additionally, HDL-C levels decreased as eGFR decreased. Pearson’s correlation analysis revealed that HDL-C levels were associated with eGFR (r=0.16). After adjustment for some confounders, HDL-C was independently associated with all quartiles of eGFR in the participants. Conclusions HDL-C was independently associated with kidney function in a community-dwelling general population. The association between low HDL-C levels and a decreased eGFR gradually strengthened as eGFR declined.
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Affiliation(s)
- Fan Wang
- Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, China
| | - Jin Zheng
- Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, China
| | - Ping Ye
- Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, China
- * E-mail:
| | - Leiming Luo
- Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, China
| | - Yongyi Bai
- Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, China
| | - Ruyi Xu
- Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, China
| | - Li Sheng
- Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, China
| | - Tiehui Xiao
- Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, China
| | - Hongmei Wu
- Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, China
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5898
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Xie F, Wang X, Ding Z, Fan P, Fan L, Chen Z, Ma G. Serum surfactant protein D is associated with the prognosis in patients with chronic kidney disease. J Cardiovasc Med (Hagerstown) 2013; 14:461-5. [PMID: 23314596 DOI: 10.2459/jcm.0b013e32835dbd24] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Circulating surfactant protein D (SP-D) has been proved to be associated with cardiovascular disease and total mortality in European patients with coronary artery disease (CAD). This study was to determine whether serum SP-D levels are associated with 1-year prognosis in patients with chronic kidney disease (CKD) in a Chinese population. METHODS Serum SP-D levels were examined by ELISA kit in 264 patients undergoing coronary angiography. An estimated glomerular filtration rate (eGFR) was used to determine the presence of CKD. Gensini scores were calculated to reflect the severity of coronary lesions. The correlations between SP-D, Gensini scores, white blood cells, high-sensitivity C-reactive protein (hs-CRP) and eGFR were calculated. Patients with eGFR less than 60 ml/min per 1.73 m2 were followed up for an average of 14 months, and major adverse cardiac events (MACEs) were recorded and analyzed. RESULTS Patients with CKD compared with patients without CKD were more often men, with a higher prevalence of hypertension, CAD, average age, levels of fasting glucose, hs-CRP and SP-D (179.73 ± 72.80 versus 131.65 ± 94.29 ng/ml; all P < 0.05). Serum SP-D levels were positively correlated with Gensini scores and eGFR, but not with white blood cells or hs-CRP. CKD patients suffering from MACEs had higher levels of serum SP-D (217.02 ± 102.34 versus 172.26 ± 70.27 ng/ml) and patients with SP-D at least 200 ng/ml had higher risk of MACEs (all P < 0.05). Multivariable analysis showed that smoking, multivessel disease, CKD and SP-D (OR: 1.396, 95% CI: 1.058-2.718, P = 0.028) were associated with 1-year MACEs (all P < 0.05). CONCLUSION SP-D levels are associated with 1-year prognosis in patients with CKD.
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Affiliation(s)
- Fangyi Xie
- Department of Microbiology and Immunology, Nanjing Medical University, Nanjing, PR China
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Zannini E, Kingston W, Arendt EK, Waters DM. Technological challenges and strategies for developing low-protein/protein-free cereal foods for specific dietary management. Food Res Int 2013. [DOI: 10.1016/j.foodres.2013.03.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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5900
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Individuals of Pacific Asian origin with IgA nephropathy have an increased risk of progression to end-stage renal disease. Kidney Int 2013; 84:1017-24. [DOI: 10.1038/ki.2013.210] [Citation(s) in RCA: 87] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2012] [Revised: 03/01/2013] [Accepted: 03/14/2013] [Indexed: 02/05/2023]
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