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Li Y, Yang Y, Wang J. Skeletal muscle mass and kidney function among Chinese older adults: a cross-sectional study. Ren Fail 2024; 46:2377776. [PMID: 38994793 PMCID: PMC11249167 DOI: 10.1080/0886022x.2024.2377776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Accepted: 07/03/2024] [Indexed: 07/13/2024] Open
Abstract
OBJECTIVES To assess the association between kidney function and odds of having low skeletal muscle mass (LSMM) in Chinese adults on the basis of a community study. DATA AND METHODS In this cross-sectional study, we included 3726 Chinese older persons who participated in an ongoing prospective study, the China Health and Retirement Longitudinal Study(CHARLS). Fasting blood samples were collected in 2012 and analyzed for serum creatinine. Estimated glomerular filtration rate(eGFR) was computed using serum creatinine, gender, and age, according to the 2021 race-free Chronic Kidney Disease Epidemiology Collaboration equation (CKD-EPI). We classified the target population into three categories according to eGFR (normal eGFR;90mL/min/1.73m2, mildly-impaired eGFR;60 to < 90 mL/min/1.73 m2, moderate to severve impaired eGFR;<60 mL/min/1.73 m2). BMI-adjusted muscle mass was used to measure skeletal muscle mass.The association between eGFR(per interquartile range(IQR) increment) and the risk of low skeletal muscle mass was assessed using logistic regression model. RESULTS Worsening renal function was associated with being high risk for LSMM after adjusting for potential confounders:the odds ratios (ORs) 95% confidence intervals (CIs) were 0.76 (95% CI = 0.63 - 0.88) for male, and [0.71, (0.61-0.82)]in female, p < 0.001. Specifically, male participants with mildly renal impairment were more prone to develop LSMM (multiadjusted OR, 1.43, 95% CI(0.92 to 2.09), p = 0.1) than femal(multiadjusted OR, 1.32, 95% CI(0.85 to 2.00), p = 0.2), the gender difference was not significant in severe renal dysfunction.However, there was a non-linear relationship between eGFR(per IQR increment) and risk of LSMM(eGFR/IQR =5.42, knot = 4 OR =1, p for non-linear <0.001). CONCLUSIONS Lower levels of eGFR had a high likelihood of being high risk for LSMM. Older male patients with mildly renal insufficiency are more likely to experience a decrease in skeletal muscle mass compared to female.
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Affiliation(s)
- Yu Li
- Department of Nephropathy, Shenzhen Luohu Hospital of Traditional Chinese Medicine, Guangdong, P.R. China
| | - Yan Yang
- Department of Nephropathy, Peking University Shenzhen Hospital, Guangdong, P.R. China
| | - Jing Wang
- Department of Nephropathy, Shenzhen Luohu Hospital of Traditional Chinese Medicine, Guangdong, P.R. China
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Wang T, Zhou Z, Ren L, Shen Z, Li J, Zhang L. Prediction of the risk of 3-year chronic kidney disease among elderly people: a community-based cohort study. Ren Fail 2024; 46:2303205. [PMID: 38284171 PMCID: PMC10826789 DOI: 10.1080/0886022x.2024.2303205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 01/01/2024] [Indexed: 01/30/2024] Open
Abstract
OBJECTIVE We conducted a community-based cohort study to predict the 3-year occurrence of chronic kidney disease (CKD) among population aged ≥60 years. METHOD Participants were selected from two communities through randomized cluster sampling in Jiading District of Shanghai, China. The two communities were randomly divided into a development cohort (n = 12012) and a validation cohort (n = 6248) with a 3-year follow-up. Logistic regression analysis was used to determine the independent predictors. A nomogram was established to predict the occurrence of CKD within 3 years. The area under the curve (AUC), the calibration curve and decision curve analysis (DCA) curve were used to evaluate the model. RESULT At baseline, participants in development cohort and validation cohort were with the mean age of 68.24 ± 5.87 and 67.68 ± 5.26 years old, respectively. During 3 years, 1516 (12.6%) and 544 (8.9%) new cases developed CKD in the development and validation cohorts, respectively. Nine variables (age, systolic blood pressure, body mass index, exercise, previous hypertension, triglycerides, fasting plasma glucose, glycated hemoglobin and serum creatinine) were included in the prediction model. The AUC value was 0.742 [95% confidence interval (CI), 0.728-0.756] in the development cohort and 0.881(95%CI, 0.867-0.895) in the validation cohort, respectively. The calibration curves and DCA curves demonstrate an effective predictive model. CONCLUSION Our nomogram model is a simple, reasonable and reliable tool for predicting the risk of 3-year CKD in community-dwelling elderly people, which is helpful for timely intervention and reducing the incidence of CKD.
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Affiliation(s)
- Tao Wang
- Clinical Center for Intelligent Rehabilitation Research, Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), Tongji University School of Medicine, Tongji University, Shanghai, China
| | - Zhitong Zhou
- Clinical Center for Intelligent Rehabilitation Research, Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), Tongji University School of Medicine, Tongji University, Shanghai, China
| | - Longbing Ren
- Clinical Center for Intelligent Rehabilitation Research, Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), Tongji University School of Medicine, Tongji University, Shanghai, China
| | - Zhiping Shen
- Community Health Service Center of Anting Town Affiliated to Tongji University School of Medicine, Tongji University, Shanghai, China
| | - Jue Li
- Clinical Center for Intelligent Rehabilitation Research, Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), Tongji University School of Medicine, Tongji University, Shanghai, China
- Department of Epidemiology, Tongji Hospital Affiliated to Tongji University School of Medicine, Shanghai, China
| | - Lijuan Zhang
- Clinical Center for Intelligent Rehabilitation Research, Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), Tongji University School of Medicine, Tongji University, Shanghai, China
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Chen Z, Zheng Z, Jiang B, Xu Y. Genetic association between celiac disease and chronic kidney disease: a two-sample Mendelian randomization study. Ren Fail 2024; 46:2357246. [PMID: 38832490 DOI: 10.1080/0886022x.2024.2357246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 05/14/2024] [Indexed: 06/05/2024] Open
Abstract
OBJECTIVE A two-sample Mendelian randomization (MR) analysis was performed to elucidate the causal impact of celiac disease on the risk of chronic kidney disease (CKD). METHODS The study comprised data from three genome-wide association studies involving individuals of European ancestry. The study groups included participants with celiac disease (n = 24,269), CKD (n = 117,165), and estimated glomerular filtration rate levels based on serum creatinine (eGFRcrea, n = 133,413). We employed four widely recognized causal inference algorithms: MR-Egger, inverse variance weighted (IVW), weighted median, and weighted mode. To address potential issues related to pleiotropy and overall effects, MR-Egger regression and the MR-PRESSO global test were performed. Heterogeneity was assessed using Cochran's Q test. RESULTS We identified 14 genetic variants with genome-wide significance. The MR analysis provided consistent evidence across the various methodologies, supporting a causal relationship between celiac disease and an elevated risk of CKD (odds ratio (OR)IVW = 1.027, p = 0.025; ORweighted median = 1.028, P = 0.049; ORweighted mode = 1.030, p = 0.044). Furthermore, we observed a causal link between celiac disease and a decreased eGFRcrea (ORIVW = 0.997, P = 2.94E-06; ORweighted median = 0.996, P = 1.68E-05; ORweighted mode = 0.996, P = 3.11E-04; ORMR Egger = 0.996, P = 5.00E-03). We found no significant evidence of horizontal pleiotropy, heterogeneity, or bias based on MR-Egger regression, MR-PRESSO, and Cochran's Q test. CONCLUSION The results of this study indicate a causal relationship between celiac disease and an increased risk of CKD.
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Affiliation(s)
- Zhimin Chen
- Department of Nephrology, Blood Purification Research Center, the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Research Center for Metabolic Chronic Kidney Disease, the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Department of Nephrology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Zigui Zheng
- Department of Nephrology, Blood Purification Research Center, the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Research Center for Metabolic Chronic Kidney Disease, the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Department of Nephrology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Bingjing Jiang
- Department of Nephrology, Blood Purification Research Center, the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Research Center for Metabolic Chronic Kidney Disease, the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Department of Nephrology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Yanfang Xu
- Department of Nephrology, Blood Purification Research Center, the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Research Center for Metabolic Chronic Kidney Disease, the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Department of Nephrology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
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Yang F, Li T, Zhang XQ, Gong Y, Su H, Fan J, Wang L, Hu QD, Tan RZ. Screening of active components in Astragalus mongholicus Bunge and Panax notoginseng formula for anti-fibrosis in CKD: nobiletin inhibits Lgals1/PI3K/AKT signaling to improve renal fibrosis. Ren Fail 2024; 46:2375033. [PMID: 38967135 PMCID: PMC11229745 DOI: 10.1080/0886022x.2024.2375033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Accepted: 06/26/2024] [Indexed: 07/06/2024] Open
Abstract
The Astragalus mongholicus Bunge and Panax notoginseng formula (A&P) has been clinically shown to effectively slow down the progression of chronic kidney disease (CKD) and has demonstrated significant anti-fibrosis effects in experimental CKD model. However, the specific active ingredients and underlying mechanism are still unclear. The active ingredients of A&P were analyzed by Ultra-high performance liquid chromatography-tandem mass spectrometry (UPLC-HR-MS). A mouse model of CKD was constructed by 5/6 nephrectomy. Renal function was assessed by creatinine and urea nitrogen. Real-time PCR and Western Blot were performed to detect the mRNA and protein changes in kidney and cells. An in vitro fibrotic cell model was constructed by TGF-β induction in TCMK-1 cells. The results showed that thirteen active ingredients of A&P were identified by UPLC-HR-MS, nine of which were identified by analysis with standards, among which the relative percentage of NOB was high. We found that NOB treatment significantly improved renal function, pathological damage and reduced the expression level of fibrotic factors in CKD mice. The results also demonstrated that Lgals1 was overexpressed in the interstitial kidney of CKD mice, and NOB treatment significantly reduced its expression level, while inhibiting PI3K and AKT phosphorylation. Interestingly, overexpression of Lgals1 significantly increased fibrosis in TCMK1 cells and upregulated the activity of PI3K and AKT, which were strongly inhibited by NOB treatment. NOB is one of the main active components of A&P. The molecular mechanism by which NOB ameliorates renal fibrosis in CKD may be through the inhibition of Lgals1/PI3K/AKT signaling pathway.
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Affiliation(s)
- Fang Yang
- Department of Nephrology, the Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou, China
- Research Center of Integrated Traditional Chinese and Western Medicine, the Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou, China
- Department of Nephrology, Sichuan Integrative Medicine Hospital, Chengdu, China
| | - Tong Li
- Research Center of Integrated Traditional Chinese and Western Medicine, the Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou, China
| | - Xiao-qian Zhang
- Department of Nephrology, the Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou, China
- Research Center of Integrated Traditional Chinese and Western Medicine, the Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou, China
| | - Yi Gong
- Department of Nephrology, the Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou, China
- Research Center of Integrated Traditional Chinese and Western Medicine, the Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou, China
| | - Hongwei Su
- Department of Urology, the Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou, China
| | - Junming Fan
- Department of Nephrology, the First Affiliated Hospital of Chengdu Medical College, Chengdu, China
| | - Li Wang
- Research Center of Integrated Traditional Chinese and Western Medicine, the Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou, China
| | - Qiong-dan Hu
- Department of Nephrology, the Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou, China
- Research Center of Integrated Traditional Chinese and Western Medicine, the Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou, China
| | - Rui-zhi Tan
- Research Center of Integrated Traditional Chinese and Western Medicine, the Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou, China
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Zhang L, Guan X, Liu L, Huang Y, Xiong J, Zhao J. Risk factors and outcomes in patients who switched from peritoneal dialysis to physician-oriented or patient-oriented kidney replacement therapy. Ren Fail 2024; 46:2337286. [PMID: 38604972 PMCID: PMC11011228 DOI: 10.1080/0886022x.2024.2337286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 03/27/2024] [Indexed: 04/13/2024] Open
Abstract
BACKGROUND We aimed to compare the cardiovascular events and mortality in patients who underwent either physician-oriented or patient-oriented kidney replacement therapy (KRT) conversion due to discontinuation of peritoneal dialysis (PD). METHODS Patients with end-stage kidney disease who were receiving PD and required a switch to an alternative KRT were included. They were divided into physician-oriented group or patient-oriented group based on the decision-making process. Logistic regression analysis was used to explore the influencing factors related to KRT conversion in PD patients. The association of physician-oriented or patient-oriented KRT conversion with outcomes after the conversion was assessed by using Cox proportional hazards models. RESULTS A total of 257 PD patients were included in the study. The median age at catheterization was 35 years. 69.6% of the participants were male. The median duration of PD was 20 months. 162 participants had patient-oriented KRT conversion, while 95 had physician-oriented KRT conversion. Younger patients, those with higher education levels, higher income, and no diabetes were more likely to have patient-oriented KRT conversion. Over a median follow-up of 39 months, 40 patients experienced cardiovascular events and 16 patients died. Physician-oriented KRT conversion increased nearly 3.8-fold and 4.0-fold risk of cardiovascular events and death, respectively. After adjusting for confounders, physician-oriented KRT conversion remained about a 3-fold risk of cardiovascular events. CONCLUSION Compared to patient-oriented KRT conversion, PD patients who underwent physician-oriented conversion had higher risks of cardiovascular events and all-cause mortality. Factors included age at catheterization, education level, annual household income, and history of diabetes mellitus.
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Affiliation(s)
- Liu Zhang
- Department of Nephrology, the Key Laboratory for the Prevention and Treatment of Chronic Kidney Disease of Chongqing, Kidney Center of PLA, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, P.R. China
| | - Xu Guan
- Department of Nephrology, the Key Laboratory for the Prevention and Treatment of Chronic Kidney Disease of Chongqing, Kidney Center of PLA, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, P.R. China
| | - Liang Liu
- Department of Nephrology, the Key Laboratory for the Prevention and Treatment of Chronic Kidney Disease of Chongqing, Kidney Center of PLA, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, P.R. China
| | - Yinghui Huang
- Department of Nephrology, the Key Laboratory for the Prevention and Treatment of Chronic Kidney Disease of Chongqing, Kidney Center of PLA, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, P.R. China
| | - Jiachuan Xiong
- Department of Nephrology, the Key Laboratory for the Prevention and Treatment of Chronic Kidney Disease of Chongqing, Kidney Center of PLA, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, P.R. China
| | - Jinghong Zhao
- Department of Nephrology, the Key Laboratory for the Prevention and Treatment of Chronic Kidney Disease of Chongqing, Kidney Center of PLA, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, P.R. China
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Huang J, Li H, Yang X, Qian C, Wei Y, Sun M. The relationship between dietary inflammatory index (DII) and early renal injury in population with/without hypertension: analysis of the National health and nutrition examination survey 2001-2002. Ren Fail 2024; 46:2294155. [PMID: 38178375 PMCID: PMC10773634 DOI: 10.1080/0886022x.2023.2294155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 12/07/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND Inflammation plays a crucial role in occurrence of kidney injury, and specific dietary patterns can influence systemic inflammation levels. However, the relationship between dietary inflammatory potential and early-stage kidney damage remains unclear. METHOD 2,108 participants was recruited from 2001-2002 National Health and Nutrition Examination Survey (NHANES). Dietary Inflammatory Index (DII) is utilized to assess dietary inflammatory potential, calculated through a 24-h dietary recall questionnaire. Early renal injury was evaluated using urinary albumin to creatinine (UACR), cystatin C (CysC), β-2 microglobulin (β2M), and estimated glomerular filtration rate (eGFR) based on serum creatinine (eGFRs), cystatin C (eGFRc), and both Scr and CysC (eGFRs&c). Participant characteristics were analyzed, and association between DII, hypertension, and early renal injury markers was explored using multiple linear and logistic regression models. RESULTS The average age of participants was 53.9 years. DII exhibited a positive correlation with UACR (β = -0.048[0.017,0.078]), β2M (β = 0.019[0.010,0.027]), CysC (β = 0.012 [0.004,0.021]). Conversely, a negative correlation was observed between DII and eGFRc (β = -1.126[-1.554, -0.699]), eGFRs&c (β=-1.101[-1.653, -0.549]). A significant association was observed between hypertension and abnormality of early kidney damage markers. Subgroup analysis reveals that the positive correlation between DII and the occurrence of abnormal markers of early kidney damage is only observed in individuals with hypertension. Furthermore, an interaction between DII and hypertension was detected in eGFRs&c (OR:1.250[1.042, 1.499], p for interaction = 0.03). CONCLUSION Higher levels of DII may be associated with occurrence of early kidney damage. For individuals with hypertension, avoiding excessive consumption of pro-inflammatory foods may reduce the risk of renal injury.
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Affiliation(s)
- Jingda Huang
- Department of Nephrology, First Hospital of Jilin University, Changchun, China
| | - Huimin Li
- Department of Nephrology, First Hospital of Jilin University, Changchun, China
| | - Xu Yang
- Department of Neurology, People’s hospital of Jilin province, Changchun, China
| | - Chuyue Qian
- Department of Nephrology, First Hospital of Jilin University, Changchun, China
| | - Yihui Wei
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China
| | - Mindan Sun
- Department of Nephrology, First Hospital of Jilin University, Changchun, China
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Xu L, Li D, Song Z, Liu J, Zhou Y, Yang J, Wen P. The association between monocyte to high-density lipoprotein cholesterol ratio and chronic kidney disease in a Chinese adult population: a cross-sectional study. Ren Fail 2024; 46:2331614. [PMID: 38522954 PMCID: PMC10962299 DOI: 10.1080/0886022x.2024.2331614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 03/12/2024] [Indexed: 03/26/2024] Open
Abstract
BACKGROUND Monocyte to high-density lipoprotein cholesterol ratio (MHR) was confirmed as a novel inflammatory marker and strongly associated with the risk of several diseases. This study aimed to investigate the relationship between MHR and chronic kidney disease (CKD) in a Chinese adult population. METHODS In this cross-sectional study, 232,775 community-dwelling adults in Binhai who completed health checkups in 2021 were enrolled. Participants were categorized based on the MHR quartiles. Clinical characteristics of participants across different groups were compared using one-way ANOVA, Kruskal-Wallis h-test, and Chi-squared test as appropriate. Univariate and multivariable logistic regression analyses were taken to assess the relationship between MHR and the presence of CKD, as well as its association with low estimated glomerular filtration rate (eGFR) and proteinuria. Subgroup analyses were further executed to confirm the reliability of this relationship. RESULTS A total of 21,014 (9.0%) individuals were diagnosed with CKD. Characteristic indicators including waist circumference, body mass index (BMI), blood pressure (BP), serum uric acid (SUA), triglyceride, and fasting blood glucose (FBG) showed a gradual increase with higher MHR quartiles, whereas parameters such as age, total cholesterol, high-density lipoprotein cholesterol (HDL-C), and eGFR decreased (p < .001). In the multivariable logistic regression analysis, we observed independent associations between MHR (per 1 SD increase) and CKD, as well as low eGFR and proteinuria, with odds ratio (ORs) and 95% confidence intervals (95%CIs) of 1.206 (1.186-1.225), 1.289 (1.260-1.319), and 1.150 (1.129-1.171), respectively (p < .001). Similar conclusions were confirmed in subgroup analysis stratified by gender, age, BMI, central obesity, hypertension, and diabetes mellitus, after justification for confounding factors. CONCLUSION Elevated MHR level was independently associated with the presence of CKD, suggesting that it might serve as a useful clinical tool for risk stratification, offering valuable insights to inform preventive and therapeutic approaches for clinicians in their routine medical practice.
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Affiliation(s)
- Lingling Xu
- Center for Kidney Disease, Second Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Dongling Li
- Department of Nephrology, People’s Hospital of Binhai County, Yancheng, Jiangsu, China
| | - Zongwei Song
- Center for Kidney Disease, Second Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Jin Liu
- Center for Kidney Disease, Second Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yang Zhou
- Center for Kidney Disease, Second Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Junwei Yang
- Center for Kidney Disease, Second Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Ping Wen
- Center for Kidney Disease, Second Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
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Yu Y, Wang D, Guo Z, Gao B, Zhou J, Xu Y, Chen Y, Geng N, Qi X, Wu S, Li J. The effect of different levels of systolic blood pressure control on new-onset chronic kidney disease in hypertension multimorbidity. Sci Rep 2024; 14:19858. [PMID: 39191891 DOI: 10.1038/s41598-024-71019-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Accepted: 08/23/2024] [Indexed: 08/29/2024] Open
Abstract
To explore the effect of different levels of systolic blood pressure (SBP) control on new-onset chronic kidney disease in hypertension multimorbidity. The hypertensive patients with multimorbidity information were enrolled from the Kailuan Study. The isolated hypertension patients undergoing physical examination during the same period were selected in a 1:1 ratio as control. Finally, 12,897 participants were divided into six groups: Group SBP < 110 mmHg, Group 110 ≤ SBP < 120 mmHg, Group 120 ≤ SBP < 130 mmHg, Group 130 ≤ SBP < 140 mmHg, Group 140 ≤ SBP < 160 mmHg and Group SBP ≥ 160 mmHg. The outcomes were new-onset CKD, new onset proteinuria, decline in eGFR and high or very high risk of CKD. Cox proportional hazards regression was used to examine the hazard ratios (HRs) of the outcomes among SBP levels. When 110 ≤ SBP < 120 mmHg, the incidence density of new-onset CKD, new onset proteinuria and decline in eGFR were 59.54, 20.23 and 29.96 per 1000 person-years, respectively. Compared to this group, the HR (95% CI) values for the risk of new-onset CKD from Group SBP < 110 mmHg to Group SBP ≥ 160 mmHg were 1.03 (0.81-1.32), 1.04 (0.91-1.19), 1.09 (0.95-1.16), 1.16 (1.02-1.21) and 1.18 (1.04-1.24), respectively. For patients over 65 years old, the risks of outcomes were increased when SBP < 120 mmHg. The lowest HR of high or very high risk of CKD for participants with or without multimorbidity occurred when 120 ≤ SBP < 130 mmHg. The HR of new-onset CKD in hypertension multimorbidity was lowest at 110-120 mmHg. The optimal SBP level was between 120 and 130 mmHg for individuals with high or very high risk of CKD. For patients over 65 years old, the low limit of target BP is advised to be not lower than 120 mmHg.
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Affiliation(s)
- Yue Yu
- School of Clinical Medicine, North China University of Science and Technology, Tangshan, Hebei, China
| | - Dan Wang
- Department of Neurology, Kailuan General Hospital, Tangshan, Hebei, China
| | - Zhizhen Guo
- Department of Nephrology, Kailuan General Hospital, Tangshan, Hebei, China
| | - Bixia Gao
- Renal Division, Department of Medicine, Peking University Institute of Nephrology, Key Laboratory of Renal Disease, Ministry of Health of China, and Key Laboratory of Chronic Kidney Disease Prevention and Treatment (Peking University), Ministry of Education, Beijing, China
| | - Jing Zhou
- Department of Nephrology, Kailuan General Hospital, Tangshan, Hebei, China
| | - Yan Xu
- School of Clinical Medicine, Hebei North University, Zhangjiakou, Hebei, China
| | - Yujie Chen
- Department of Nephrology, Kailuan General Hospital, Tangshan, Hebei, China
| | - Nan Geng
- Department of Nephrology, Kailuan General Hospital, Tangshan, Hebei, China
| | - Xiujuan Qi
- Department of Nephrology, Kailuan General Hospital, Tangshan, Hebei, China
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, Tangshan, Hebei, China.
| | - Junjuan Li
- Department of Nephrology, Kailuan General Hospital, Tangshan, Hebei, China.
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Xu W, Hou L. Knockdown of nicotinamide N-methyltransferase ameliorates renal fibrosis caused by ischemia-reperfusion injury and remodels sphingosine metabolism. Clin Exp Nephrol 2024:10.1007/s10157-024-02545-z. [PMID: 39168882 DOI: 10.1007/s10157-024-02545-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Accepted: 07/29/2024] [Indexed: 08/23/2024]
Abstract
BACKGROUND CKD currently affects 8.2% to 9.1% of the global population and the CKD mortality rate has increased during recent decades, making it necessary to identify new therapeutic targets. This study investigated the role of nicotinamide N-methyltransferase (NNMT) in renal fibrosis following ischemia-reperfusion injury (IRI), a key factor in chronic kidney disease (CKD) progression. METHODS We established a mouse model with a knockdown of NNMT to investigate the impact of this enzyme on renal fibrosis after unilateral IRI. We then utilized histology, immunohistochemistry, and metabolomic analyses to investigate fibrosis markers and sphingolipid metabolism in NNMT-deficient mice. We also utilized an Nnmt lentivirus interference vector or an Nnmt overexpression plasmid to transfect mouse kidney proximal tubule cells, stimulated these cells with TGF-β1, and then measured the pro-fibrotic response and the expression of the methylated and unmethylated forms of Sphk1. RESULTS The results demonstrated that reducing NNMT expression mitigated fibrosis, inflammation, and lipid deposition, potentially through the modulation of sphingolipid metabolism. Histology, immunohistochemistry, and metabolomic analyses provided evidence of decreased fibrosis and enhanced sphingolipid metabolism in NNMT-deficient mice. NNMT mediated the TGF-β1-induced pro-fibrotic response, knockdown of Nnmt decreased the level of unmethylated Sphk1 and increased the level of methylated Sphk1 in renal tubular epithelial cells. CONCLUSIONS Our findings suggest that NNMT functions in sphingolipid metabolism and has potential as a therapeutic target for CKD. Further research is needed to elucidate the mechanisms linking NNMT to sphingolipid metabolism and renal fibrosis.
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Affiliation(s)
- Wanfeng Xu
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Ling Hou
- Department of Pediatrics, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Heping District, Shenyang, China.
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Wei D, Shi J, Xu H, Guo Y, Wu X, Chen Z, Chen T, Lou H, Han E, Han G, Yan Y, Liu X, Zeng X, Fan C, Hou J, Huo W, Li L, Jing T, Wang C, Mao Z. Prospective study on the joint effect of persistent organic pollutants and glucose metabolism on chronic kidney disease: Modifying effects of lifestyle interventions. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 951:175694. [PMID: 39173765 DOI: 10.1016/j.scitotenv.2024.175694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2024] [Revised: 07/24/2024] [Accepted: 08/20/2024] [Indexed: 08/24/2024]
Abstract
There is no evidence on the associations between persistent organic pollutants (POPs) and the incidence of chronic kidney disease (CKD) in the Chinese rural population. We aimed to investigate the individual and mixed effects of 22 POPs on the prevalence and incidence of CKD, and the joint effects of POPs and abnormal glucose metabolism as well as the modification effects of healthy lifestyle on these associations. A total of 2775 subjects, including 925 subjects with normal plasma glucose (NPG) and 925 subjects with prediabetes (PDM) and type 2 diabetes mellitus (T2DM), were enrolled from the Henan Rural Cohort Study. Logistic regression and quantile g-computation were performed to assess the individual and mixed effects of POPs on the risk of CKD. Joint effects of POPs and abnormal glucose metabolism status, as well as the modification effects of lifestyle on CKD were assessed. After 3-year follow-up, an increment of ln-o,p'-DDT was related to an elevated risk of CKD prevalence. Positive associations of p,p'-DDE and β-BHC with CKD incidence were observed (P < 0.05). In addition, participants with high levels of ∑POPs were associated elevated incidence risk of CKD (OR: 1.217, 95%CI: 1.008-1.469). One quartile increase in POPs mixture was associated with the increased incidence of CKD among T2DM patients (P < 0.05). Further, a higher risk of CKD was observed among PDM and T2DM patients with high levels of o,p'-DDT, p,p'-DDE, β-BHC, and ∑POPs than NPG subjects with low levels of pollutants. In addition, interactive effects of ∑POPs and lifestyle score on CKD incidence were found. Individual and mixed exposure to POPs increased the prevalence and incidence of CKD, and glucose metabolic status exacerbated the risk of CKD resulting from such exposures. Further, the modifying effects of lifestyle were observed, highlighting the importance of precision prevention for high-risk CKD population and healthy lifestyle intervention measures.
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Affiliation(s)
- Dandan Wei
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Jiayu Shi
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Haoran Xu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Yao Guo
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Xueyan Wu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Zhiwei Chen
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Taimeng Chen
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Huilin Lou
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Erbao Han
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Guozhen Han
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Yumeng Yan
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Xiaotian Liu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Xin Zeng
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Caini Fan
- Department of Hypertension, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, Henan, PR China
| | - Jian Hou
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Wenqian Huo
- Department of Occupational and Environmental Health Sciences, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Linlin Li
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Tao Jing
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Zhenxing Mao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China.
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Zhang XY, Yang Y. The value of multi-modal ultrasound in the assessment of sarcopenia in maintenance hemodialysis patients. Rev Clin Esp 2024; 224:437-444. [PMID: 38849074 DOI: 10.1016/j.rceng.2024.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Accepted: 05/05/2024] [Indexed: 06/09/2024]
Abstract
INTRODUCTION Sarcopenia is one of the common complications in maintenance hemodialysis (MHD) patients and is associated with poor prognosis. We aimed to study the validity and reliability of ultrasound in the assessment of sarcopenia in MHD patients. METHODS MHD patients were categorized into the sarcopenia group and the non-sarcopenia group according to the diagnostic criteria of the Asian Working Group on Sarcopenia (AWGS) 2019. Ultrasonography of the left medial head of the gastrocnemius muscle was performed in MHD and healthy controls to obtain muscle thickness (MT), pinnation angle (PA), fascicle length (FL), cross-sectional area (CSA), echo intensity (EI), elastic modulus (E), shear wave velocity (SWV), and microvascular velocity (MV). Compare the differences in ultrasound parameters among different groups, and determine the cut-off values suitable for diagnosing sarcopenia in MHD patients. RESULTS The MT, CSA, PA, and MV in the sarcopenia group were lower than those in the non-sarcopenia group and the control group; while the EI was higher, the FL of the sarcopenia group was lower than that of the non-sarcopenia group, while the E and SWV of the sarcopenia group were higher than those of the control group. Receiver operating characteristic curve analyses indicated that ultrasound combined index had a good diagnostic value, model Y = 13.511-0.121*MT-0.609*CSA-0.172*PA+0.011*EI-2.205*MV(P < 0.05), with a cut-off value of 0.69. CONCLUSIONS Multi-modal ultrasound is a safe, non-invasive, and real-time imaging examination method, and can provide information on muscle structure, stiffness, and perfusion, which is expected to be a promising potential tool for predicting sarcopenia in MHD patients.
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Affiliation(s)
- X Y Zhang
- Chongqing Hospital of Traditional Chinese Medicine, China
| | - Y Yang
- Chongqing Hospital of Traditional Chinese Medicine, China.
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12
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Liu X, Sun J, Ge B, Pan C, Yan H, Sun X, Peng J, Wang W, Lin Y, Zhang D, Ning F. Association between famine exposure during infancy and childhood and the risk of chronic kidney disease in adulthood. Intern Med J 2024; 54:1310-1319. [PMID: 38465389 DOI: 10.1111/imj.16367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Accepted: 02/08/2024] [Indexed: 03/12/2024]
Abstract
BACKGROUND Famine exposure in childhood is proven to be associated with multiple chornic disease in adult but has not been studied with chronic kidney disease (CKD). AIMS This study was conducted to identify the relationship between famine exposure during infancy and childhood - specifically, the Chinese famine of 1959-1961 - and the risk of adult-onset chronic kidney disease (CKD) among Chinese individuals. METHODS This study included 2937 individuals from the Qingdao Diabetes Prevention Program. They were stratified by birth year into infancy-exposed (1956-1958), childhood-exposed (1950-1955) and unexposed (1963-1971) groups. The estimated glomerular filtration rate (eGFR) was calculated using the Chronic Kidney Disease Epidemiology Collaboration equation. CKD was defined as an eGFR of <90 mL/min/1.73 m2. RESULTS The mean eGFR values for the infancy-exposed and childhood-exposed groups were 107.23 ± 12.53 and 103.23 ± 12.44 mL/min/1.73 m2, respectively, both of which were lower than that of the unexposed group (114.82 ± 13.39 mL/min/1.73 m2; P < 0.05). In the crude model, the odds ratio (OR) for CKD was 2.00 (95% confidence interval (CI): 1.39-2.88) in the infancy-exposed group and 2.92 (95% CI: 2.17-3.93) in the childhood-exposed group. Further adjustments for urban/rural residence, body mass index, age, current smoking, type 2 diabetes, systolic blood pressure, diastolic blood pressure and total cholesterol did not significantly alter the association between famine exposure and CKD. The corresponding ORs were 1.71 (95% CI: 1.17-2.50) and 2.48 (95% CI: 1.81-3.40) for the infancy-exposed and childhood-exposed groups respectively. CONCLUSIONS Famine exposure during infancy and childhood is associated with a long-term decline in eGFR and an increased adult-onset CKD risk. Early intervention for high-risk individuals may mitigate the risk of adult-onset CKD.
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Affiliation(s)
- Xiao Liu
- Department of Epidemiology and Health Statistics, Public Health College, Qingdao University, Qingdao, Shandong, China
| | - Junhui Sun
- The Second People's Hospital of Jimo, Qingdao, Shandong, China
| | - Bing Ge
- Qingdao Centers for Disease Control and Prevention, Qingdao, Shandong, China
| | - Chi Pan
- Huangdao District Centers for Disease Control and Prevention, Qingdao, Shandong, China
| | - Hongxuan Yan
- Department of Epidemiology and Health Statistics, Public Health College, Qingdao University, Qingdao, Shandong, China
| | - Xiaohui Sun
- Qingdao Centers for Disease Control and Prevention, Qingdao, Shandong, China
| | - Jiahui Peng
- Qingdao Centers for Disease Control and Prevention, Qingdao, Shandong, China
| | - Weijing Wang
- Department of Epidemiology and Health Statistics, Public Health College, Qingdao University, Qingdao, Shandong, China
| | - Yongfeng Lin
- Qingdao Centers for Disease Control and Prevention, Qingdao, Shandong, China
| | - Dongfeng Zhang
- Department of Epidemiology and Health Statistics, Public Health College, Qingdao University, Qingdao, Shandong, China
| | - Feng Ning
- Qingdao Centers for Disease Control and Prevention, Qingdao, Shandong, China
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Zhu L, Liu Y, Li S, Liao R, Fu P, Yuan H. Factors related to the disaster preparedness of patients on haemodialysis from Sichuan, China, during COVID-19: A cross-sectional study. Nurs Open 2024; 11:e70005. [PMID: 39180141 PMCID: PMC11343723 DOI: 10.1002/nop2.70005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 05/31/2024] [Accepted: 08/05/2024] [Indexed: 08/26/2024] Open
Abstract
AIM This study aimed to investigate personal preparedness among patients on haemodialysis (HD) and to examine the relationship among sociodemographic characteristics, attitudes toward disaster preparedness and personal preparedness behaviours during natural disaster incidents. DESIGN A cross-sectional survey was conducted. METHODS A convenience sampling method was used. A total of 446 participants from six areas of Sichuan province completed the online questionnaire study from February 27 to March 13, 2022. Sociodemographic characteristics, attitudes toward disaster preparedness and personal preparedness behaviours were measured. Descriptive statistics were used to analyse sociodemographic characteristics and attitudes toward disaster preparedness. The relationship among sociodemographic characteristics, attitudes toward disaster preparedness and personal preparedness behaviours were assessed using ordinal regression. Statistical significance was defined as p < 0.05. RESULTS A total of 446 participants completed the survey. Of these, 42.15% (N = 188) were poorly prepared, 26.23% (N = 117) were moderately prepared and 31.61% (N = 141) were highly prepared. Ordinal regression showed that knowing about disaster preparedness (Odds Ratio (OR) = 1.691, 95% Confidence Interval (CI) = 1.081-2.644, p = 0.021), participating in disaster evacuation exercises (OR = 2.519, 95% CI = 1.595-3.977, p < 0.001) and learning about disaster preparedness (OR = 2.421, 95% CI = 1.542-3.802, p < 0.001) were associated with high preparedness. Compared to patients with a university degree or higher, patients with a junior high school education or lower (OR = 3.491, 95% CI = 1.760-6.925, p < 0.001) and senior high school degree (OR = 2.052, 95% CI = 1.038-4.057, p = 0.039) were associated with high preparedness. Patients who felt very confident and could deal with all their needs (OR = 3.878, 95% CI = 2.904-7.181, p < 0.001) or patients who felt confident and could meet some of their needs (OR = 1.949, 95% CI = 1.124-3.379, p = 0.017) had higher preparedness than those who felt less confident and were not well prepared to take care of their needs. PATIENT OR PUBLIC CONTRIBUTION After obtaining each participant's consent, they filled out the online questionnaire using their own or a relative's cell phone while undergoing HD. IMPLICATION FOR PRACTICE It is essential that patients should be educated not only on medical specialty topics, but also on general disaster preparedness. Medical institutions should improve and reinforce preparation training among targeted populations. The low level of preparedness is partly due to the lack of participation of patients in disaster preparedness programs. Dialysis center managers should be urged to implement such programs at their centers.
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Affiliation(s)
- Linfang Zhu
- Department of Nephrology, Institute of Kidney DiseasesWest China Hospital of Sichuan UniversityChengduChina
- West China School of NursingSichuan UniversityChengduChina
| | - Yang Liu
- Department of Nephrology, Institute of Kidney DiseasesWest China Hospital of Sichuan UniversityChengduChina
- West China School of NursingSichuan UniversityChengduChina
| | - Sijian Li
- School of NursingThe Hong Kong Polytechnic UniversityKowloonChina
| | - Ruoxi Liao
- Department of Nephrology, Institute of Kidney DiseasesWest China Hospital of Sichuan UniversityChengduChina
| | - Ping Fu
- Department of Nephrology, Institute of Kidney DiseasesWest China Hospital of Sichuan UniversityChengduChina
| | - Huaihong Yuan
- Department of Nephrology, Institute of Kidney DiseasesWest China Hospital of Sichuan UniversityChengduChina
- West China School of NursingSichuan UniversityChengduChina
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14
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Wu YL, Wu YC, Akhmetzhanov AR, Wu MY, Lin YF, Lin CC. Urban-rural health disparity among patients with chronic kidney disease: a cross-sectional community-based study from 2012 to 2019. BMJ Open 2024; 14:e082959. [PMID: 39079922 PMCID: PMC11293390 DOI: 10.1136/bmjopen-2023-082959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 06/27/2024] [Indexed: 08/03/2024] Open
Abstract
OBJECTIVES The incidence of chronic kidney disease (CKD) is increasing owing to the ageing population, resulting in an increased demand for dialysis and kidney transplantation, which can be costly. Current research lacks clarity regarding the relationship between residence setting and CKD prevalence or its related risk factors. This study explored the urban-rural disparities in CKD prevalence and risk factors in Taiwan. Our findings will aid the understanding of the distribution of CKD and the design of more effective prevention programmes. DESIGN This cross-sectional community-based study used the Renal Value Evaluation Awareness and Lift programme, which involves early screening and health education for CKD diagnosis and treatment. CKD prevalence and risk factors including alcohol consumption, smoking and betel nut chewing were compared between urban and rural areas. SETTING Urbanisation levels were determined based on population density, education, age, agricultural population and medical resources. PARTICIPANTS A total of 7786 participants from 26 urban and 15 rural townships were included. RESULTS The prevalence of CKD was significantly higher in rural (29.2%) than urban (10.8%) areas, representing a 2.7-fold difference (p<0.0001). Risk factors including diabetes (rural vs urban: 21.7% and 11.0%), hypertension (59.0% vs 39.9%), hyperuricaemia (36.7% vs 18.6%), alcohol consumption (29.0% vs 19.5%), smoking (15.9% vs 12.0%), betel nut chewing (12.6% vs 2.8%) and obesity (33.6% vs 19.4%) were significantly higher (p<0.0001) in rural areas. CONCLUSIONS The prevalence of CKD is three times higher in rural versus urban areas. Despite >99% National Health Insurance coverage, disparities in CKD prevalence persist between residential areas. Targeted interventions and further studies are crucial for addressing these disparities and enhancing CKD management across different settings.
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Affiliation(s)
- Yi-Lien Wu
- Taiwan Kidney Foundation, New Taipei City, Taiwan
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Yun-Chun Wu
- Institute of Epidemiology and Preventive Medicine, National Taiwan University College of Public Health, Taipei, Taiwan
| | - Andrei R Akhmetzhanov
- Institute of Epidemiology and Preventive Medicine, National Taiwan University College of Public Health, Taipei, Taiwan
- Global Health Program, National Taiwan University College of Public Health, Taipei, Taiwan
| | - Mei-Yi Wu
- Department of Nephrology, Department of Internal Medicine, Taipei Medical University Shuang Ho Hospital Ministry of Health and Welfare, New Taipei City, Taiwan
- Division of Nephrology, Department of Internal Medicine, School of Medicine, Taipei Medical University College of Medicine, Taipei, Taiwan
| | - Yuh-Feng Lin
- Graduate Institute of Clinical Medicine, Taipei Medical University, Taipei, Taiwan
- Division of Nephrology, Department of Internal Medicine, Taipei Medical University Shuang Ho Hospital Ministry of Health and Welfare, New Taipei City, Taiwan
| | - Chia-Chin Lin
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
- The University of Hong Kong, Hong Kong, Hong Kong
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15
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Chen XY, Lu F, Zhang J, Xu CX, Du XF, Liang MB, Chen LJ, Zhong JM. The effect of hyperuricemia and its interaction with hypertension towards chronic kidney disease in patients with type 2 diabetes: evidence from a cross- sectional study in Eastern China. Front Endocrinol (Lausanne) 2024; 15:1415459. [PMID: 39135624 PMCID: PMC11317236 DOI: 10.3389/fendo.2024.1415459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Accepted: 07/16/2024] [Indexed: 08/15/2024] Open
Abstract
Objectives This study aimed to explore the synergistic interaction effect between hyperuricemia and hypertension towards chronic kidney disease in patients with type 2 diabetes. Methods This research originates from a cross-sectional study performed in Zhejiang Province, Eastern China, between March and November 2018. The correlation between serum uric acid levels and the risk of chronic kidney disease was assessed using a restricted cubic spline model. An unconditional multivariable logistic regression model, along with an interaction table, was utilized to explore the potential interaction effect of hyperuricemia and hypertension towards chronic kidney disease. Results 1,756 patients with type 2 diabetes were included in this study, the prevalence of chronic kidney disease (CKD) was 27.62% in this population. A U-shaped non-linear pattern emerged correlating serum uric acid (SUA) levels and CKD risk, indicating that both low and high SUA levels were linked to an increased CKD risk. This risk achieved its lowest point (nadir) at SUA approximately equals to 285μmol/L (p for trend <0.05). Once adjustments for age, gender, education level, abnormal fasting plasma glucose (FPG), abnormal hemoglobin A1c (HbA1c), abnormal total cholesterol (TC), abnormal high-density lipoprotein cholesterol (HDL-C), alcohol consumption and duration of diabetes were factored in, it was found that patients with both hyperuricemia and hypertension demonstrated a 5.42-fold (95% CI: 3.72-7.90) increased CKD risk compared to the reference group. The additive interaction between hyperuricemia and hypertension was statistically significant, as manifested by the following values: a relative excess risk due to interaction (RERI) of 2.57 (95% CI: 0.71-4.71), an attributable proportion due to interaction (AP) of 0.47 (95% CI: 0.14-0.64), and a synergy index (SI) of 2.39 (95% CI: 1.24-4.58). In contrast, there was no significant interaction effect in multiplicative scale. Conclusion Hyperuricemia and hypertension may contribute additively to CKD, beyond their isolated impacts. Evaluating the risk of CKD in type 2 diabetes patients necessitates considering this potential interaction.
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Affiliation(s)
| | | | | | | | | | | | | | - Jie-ming Zhong
- Department of Non-Communicable Disease Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
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16
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Liu X, Shi J, Jiao Y, An J, Tian J, Yang Y, Zhuo L. Integrated multi-omics with machine learning to uncover the intricacies of kidney disease. Brief Bioinform 2024; 25:bbae364. [PMID: 39082652 PMCID: PMC11289682 DOI: 10.1093/bib/bbae364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 06/20/2024] [Accepted: 07/17/2024] [Indexed: 08/03/2024] Open
Abstract
The development of omics technologies has driven a profound expansion in the scale of biological data and the increased complexity in internal dimensions, prompting the utilization of machine learning (ML) as a powerful toolkit for extracting knowledge and understanding underlying biological patterns. Kidney disease represents one of the major growing global health threats with intricate pathogenic mechanisms and a lack of precise molecular pathology-based therapeutic modalities. Accordingly, there is a need for advanced high-throughput approaches to capture implicit molecular features and complement current experiments and statistics. This review aims to delineate strategies for integrating multi-omics data with appropriate ML methods, highlighting key clinical translational scenarios, including predicting disease progression risks to improve medical decision-making, comprehensively understanding disease molecular mechanisms, and practical applications of image recognition in renal digital pathology. Examining the benefits and challenges of current integration efforts is expected to shed light on the complexity of kidney disease and advance clinical practice.
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Affiliation(s)
| | | | | | | | | | | | - Li Zhuo
- Corresponding author. Department of Nephrology, China-Japan Friendship Hospital, Beijing 100029, China; China-Japan Friendship Clinic Medical College, Beijing University of Chinese Medicine, 100029 Beijing, China. E-mail:
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17
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Qian G, Qin H, Deng D, Feng Y, Zhang C, Qu X, Zhang Z. Prognostic value of angiographic microvascular resistance in patients with ST-segment elevation myocardial infarction. Clinics (Sao Paulo) 2024; 79:100429. [PMID: 39053030 PMCID: PMC11327545 DOI: 10.1016/j.clinsp.2024.100429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 05/24/2024] [Accepted: 06/10/2024] [Indexed: 07/27/2024] Open
Abstract
BACKGROUND The Angiographic Microvascular Resistance (AMR), derived from a solitary angiographic view, has emerged as a viable substitute for the Index of Microcirculatory Resistance (IMR). However, the prognostic significance in ST-Segment Elevation Myocardial Infarction (STEMI) patients is yet to be established. This research endeavors to explore the prognostic capabilities of AMR in patients diagnosed with STEMI. METHODS In this single-center, retrospective study, 232 patients diagnosed with STEMI who received primary Percutaneous Coronary Intervention (PCI) were recruited from January 1, 2018, to June 30, 2022. Utilizing the maximally selected log-rank statistics analysis, participants were divided into two cohorts according to an AMR threshold of 2.55 mmHg*s/cm. The endpoint evaluated was a composite of all-cause mortality or hospital readmission due to heart failure. RESULTS At a median follow-up of 1.74 (1.07, 3.65) years, the composite endpoint event was observed in 28 patients within the higher AMR group and 8 patients within the lower AMR group. The higher AMR group showed a significantly higher risk for composite outcome compared to those within the low-AMR group (HRadj: 3.33; 95% CI 1.30‒8.52; p = 0.03). AMR ≥ 2.55 mmHg*s/cm was an independent predictor of the composite endpoint (HR = 2.33; 95% CI 1.04‒5.21; p = 0.04). Furthermore, a nomogram containing age, sex, left ventricle ejection fraction, post-PCI Quantitative Flow Ratio (QFR), and AMR was developed and indicated a poorer prognosis in the high-risk group for STEMI patients at 3 years. (HR=4.60; 95% CI 1.91‒11.07; p < 0.01). CONCLUSIONS AMR measured after PCI can predict the risk of all-cause death or readmission for heart failure in patients with STEMI. AMR-involved nomograms improved predictive performance over variables alone.
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Affiliation(s)
- Gangzhen Qian
- Department of Cardiovascular Medicine, Center for Circadian Metabolism and Cardiovascular Disease, Southwest Hospital, Army Medical University, Chongqing, China
| | - Haoran Qin
- Department of Cardiovascular Medicine, Center for Circadian Metabolism and Cardiovascular Disease, Southwest Hospital, Army Medical University, Chongqing, China
| | - Dan Deng
- Department of Cardiovascular Medicine, Center for Circadian Metabolism and Cardiovascular Disease, Southwest Hospital, Army Medical University, Chongqing, China
| | - Yue Feng
- Department of Cardiovascular Medicine, Center for Circadian Metabolism and Cardiovascular Disease, Southwest Hospital, Army Medical University, Chongqing, China
| | - Chao Zhang
- Department of Cardiovascular Medicine, Center for Circadian Metabolism and Cardiovascular Disease, Southwest Hospital, Army Medical University, Chongqing, China
| | - Xiaolong Qu
- Department of Cardiovascular Medicine, Center for Circadian Metabolism and Cardiovascular Disease, Southwest Hospital, Army Medical University, Chongqing, China
| | - Zhihui Zhang
- Department of Cardiovascular Medicine, Center for Circadian Metabolism and Cardiovascular Disease, Southwest Hospital, Army Medical University, Chongqing, China.
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18
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Liu H, Chen Y, Feng T, Liu X, Han Y, Wu X, Shi A, Zhou S, Lin Y, Yu P. The association between physical activity and cardiovascular events, tumors and all-cause mortality in patients with maintenance hemodialysis with different nutritional status. Sci Rep 2024; 14:16924. [PMID: 39043841 PMCID: PMC11266654 DOI: 10.1038/s41598-024-67707-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Accepted: 07/15/2024] [Indexed: 07/25/2024] Open
Abstract
The current research focuses on the effects of nutritional supplementation and exercise on dialysis patients, but whether physical activity (PA) can reduce the risk of adverse outcomes for patients with different nutritional status is not clear. The maintenance hemodialysis (MHD) patients were recruited from April 2021 to April 2022. The information of PA was obtained from the international physical activity questionnaire (IPAQ). The outcomes were cardiovascular death, myocardial infarction, stroke, heart failure, atrial fibrillation, tumor and all-cause death. We used COX proportional risk model to estimate the association between PA and the outcomes of MHD patients. Patients are classified into two groups based on geriatric nutritional risk index (GNRI) and classified by age, and we used COX proportional risk model to estimate the association of PA and outcomes in subgroups. The isotemporal substitution model (ISM) was used to estimate the effects of replacing light physical activity (LPA) with moderate physical activity (MPA) or vigorous physical activity (VPA) on risk of cardiovascular events, tumors, and all-cause death in different subgroups. The effects of PA on ankle-brachial index (ABI) and body fat content were analyzed in different IPAQ groups. A total of 241 maintenance hemodialysis patients were included, 105 peoples developed cardiovascular death, myocardial infarction, stroke, heart failure, atrial fibrillation, tumor and all-cause death (43.6%). The median follow-up time was 12 months. MPA reduced the risk of outcome in MHD patients or high GNRI patients (40% vs 39%).In MHD patients who was under 65 years with high GNRI, MPA reduced cardiovascular death, myocardial infarction, stroke, heart failure, atrial fibrillation, tumor and all-cause death by 55%.PA reduced the risk of cardiovascular event by 65%, but did not reduce the risk of tumor or all-cause death. Replacing LPA with VPA did not improve clinical outcomes. It actually increases the risk of heart failure 0.4%. MPA reduced the risk of cardiovascular death, myocardial infarction, stroke, heart failure, atrial fibrillation, tumor, all-cause death in MHD patients under 65 years, while VPA had no health benefit.Trial registration: ChiCTR210050998.
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Affiliation(s)
- Hongyan Liu
- NHC Key Laboratory of Hormones and Development, Chu Hsien-lMemorial Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, 300134, China
- Tianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University, Tianjin, 300134, China
| | - Yuyang Chen
- Tianjin Dongli Hospital, Tianjin, 300300, China
| | - Tao Feng
- Kidney Internal Medicine, The Second Affiliated Hospital of Baotou Medical College, Inner Mongolia University of Science and Technology, Baotou, 014030, China
| | - Xiangyang Liu
- NHC Key Laboratory of Hormones and Development, Chu Hsien-lMemorial Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, 300134, China
- Tianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University, Tianjin, 300134, China
| | - Yujie Han
- NHC Key Laboratory of Hormones and Development, Chu Hsien-lMemorial Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, 300134, China
- Tianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University, Tianjin, 300134, China
| | - Xuerong Wu
- NHC Key Laboratory of Hormones and Development, Chu Hsien-lMemorial Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, 300134, China
- Tianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University, Tianjin, 300134, China
| | - Aijie Shi
- Tianjin Dongli Hospital, Tianjin, 300300, China
| | - Saijun Zhou
- NHC Key Laboratory of Hormones and Development, Chu Hsien-lMemorial Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, 300134, China
- Tianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University, Tianjin, 300134, China
| | - Yao Lin
- NHC Key Laboratory of Hormones and Development, Chu Hsien-lMemorial Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, 300134, China
- Tianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University, Tianjin, 300134, China
| | - Pei Yu
- NHC Key Laboratory of Hormones and Development, Chu Hsien-lMemorial Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, 300134, China.
- Tianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University, Tianjin, 300134, China.
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Shen R, Lin L, Bin Z, Qiao X. The U-shape relationship between insulin resistance-related indexes and chronic kidney disease: a retrospective cohort study from National Health and Nutrition Examination Survey 2007-2016. Diabetol Metab Syndr 2024; 16:168. [PMID: 39014458 PMCID: PMC11253359 DOI: 10.1186/s13098-024-01408-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Accepted: 07/08/2024] [Indexed: 07/18/2024] Open
Abstract
BACKGROUND There is ongoing debate on the correlation between chronic kidney disease (CKD) and insulin resistance (IR)-related indices. Our objective was to explore the prognostic ability of IR-related indexes for the prevalence of CKD, as well as the mortality from all causes and cardiovascular disease (CVD) in CKD patients. METHODS The data used in this study came from the National Health and Nutrition Examination Survey (NHANES). Binary logistic regression analysis, Cox proportional hazards model, and restricted cubic spline (RCS) were used to analyze the relationship between IR-related indexes, including metabolic score of IR (METS-IR), homeostatic model assessment for IR (HOMA-IR), triglyceride glucose index (TyG), triglyceride glucose-waist-to-height ratio (TyG-WHtR), triglyceride glucose-body mass index (TyG-BMI), with CKD and its all-cause mortality and CVD mortality. Subgroup analysis was performed to test the stability of the results. Finally, the predictive power of IR-related indexes for CKD was tested by the receiver operating characteristic (ROC) curve. RESULTS Among the recruited 10,660 participants, 15.42% were CKD patients. All IR-related indexes were found to be nonlinearly correlated to the prevalence of CKD in the study. When the TyG index was higher than 9.05, it was positively associated with CKD (OR: 1.77, 95% CI 1.44-2.18). Moreover, increased TyG-WHtR level was correlated with a greater prevalence of CKD when it was higher than 4.3 (OR: 1.31, 95% CI 1.19-1.45). Other IR-related indexes (METS-IR, HOMA-IR, and TyG-BMI) showed fewer notable correlations with CKD. The association of IR-related indexes and the prevalence of CKD remained consistent in most subgroups (P for interactions > 0.05). TyG-WHtR was also the predictor of all-cause mortality in CKD patients (HR: 1.34, 95% CI 1.14-1.58), while other IR-related indexes were not correlated with the all-cause mortality or CVD mortality in CKD patients (P > 0.05). Otherwise, ROC curves showed that TyG-WHtR had more robust diagnostic efficacy than other IR-related indexes (METS-IR, HOMA-IR, TyG, and TyG-BMI) in predicting CKD (area under the curve: 0.630, 95% CI 0.615-0.644). CONCLUSIONS IR-related biomarkers (METS-IR, HOMA-IR, TyG, and TyG-BMI) were positively correlated with the prevalence of CKD. Moreover, TyG-WHtR enhanced CKD and its all-cause mortality prediction. In patients with elevated levels of IR-related indexes, the early detection and intervention of IR may reduce the occurrence of CKD and the prognosis of CKD patients.
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Affiliation(s)
- Ruihua Shen
- Department of Nephrology, Second Hospital of Shanxi Medical University, Taiyuan, People's Republic of China
- Shanxi Kidney Disease Institute, Taiyuan, People's Republic of China
- Kidney Research Center of Shanxi Medical University, Taiyuan, People's Republic of China
| | - Ling Lin
- Department of Nephrology, Second Hospital of Shanxi Medical University, Taiyuan, People's Republic of China
- Shanxi Kidney Disease Institute, Taiyuan, People's Republic of China
- Kidney Research Center of Shanxi Medical University, Taiyuan, People's Republic of China
| | - Zexuan Bin
- Department of Rheumatology, Second Hospital of Shanxi Medical University, Taiyuan, People's Republic of China
| | - Xi Qiao
- Department of Nephrology, Second Hospital of Shanxi Medical University, Taiyuan, People's Republic of China.
- Shanxi Kidney Disease Institute, Taiyuan, People's Republic of China.
- Kidney Research Center of Shanxi Medical University, Taiyuan, People's Republic of China.
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20
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An Q, Wang Q, Liu R, Zhang J, Li S, Shen W, Zhou H, Liang Y, Li Y, Mu L, Lei L. Analysis of relationship between mixed heavy metal exposure and early renal damage based on a weighted quantile sum regression and Bayesian kernel machine regression model. J Trace Elem Med Biol 2024; 84:127438. [PMID: 38520795 DOI: 10.1016/j.jtemb.2024.127438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 03/18/2024] [Accepted: 03/18/2024] [Indexed: 03/25/2024]
Abstract
BACKGROUND Occupation, environmental heavy metal exposure, and renal function impairment are closely related. The relationship between mixed metal exposure and chronic renal injury is inadequately described, and the interaction between each metal is poorly explored. OBJECTIVE This cross-sectional study assessed mixed heavy metal exposure in the general population and their relationship with early renal impairment, as well as possible interactions between metals. METHODS The study was conducted in two communities in Taiyuan City in northern China. Multiple linear regression, weighted quantile sum (WQS) and bayesian kernel machine regression (BKMR) regression were used to explore the relationship of mixed heavy metal exposure with indicators of early kidney injury (N-acetyl-β-D- glucosidase (UNAG), urinary albumin (UALB)). Meanwhile, BKMR was used to explore the possible interactions between mixed heavy metal and indicators of early kidney injury. RESULTS Based on the WQS regression results, we observed adjusted WQS coefficient β (β-WQS) of 0.711 (95% CI: 0.543, 0.879). Notably, this change was primarily driven by As (35.6%) and Cd (22.5%). In the UALB model, the adjusted β-WQS was 0.657 (95% CI: 0.567, 0.747), with Ni (30.5%), Mn (22.1%), Cd (21.2%), and As (18.6%) exhibiting higher weights in the overall effect. The BKMR results showed a negative interaction between As and other metals in the UNAG and UALB models, a positive interaction between Mn and Ni and other metals. No significant pairwise interaction was observed in the association of metals with indicators of early kidney injury. CONCLUSION Through multiple linear regression, WQS regression, and BKMR analyses, we found that exposure to mixed heavy metals such as Cd, Cr, Pb, Mn, As, Co and Ni was positively correlated with UNAG and UALB. Moreover, there are complex interactions between two or more heavy metals in more than one direction.
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Affiliation(s)
- Qi An
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan 030001, China; Key Laboratory of Coal Environmental Pathogenicity and Prevention (Shanxi Medical University), Ministry of Education, Taiyuan 030001, China
| | - Qingyao Wang
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan 030001, China; Key Laboratory of Coal Environmental Pathogenicity and Prevention (Shanxi Medical University), Ministry of Education, Taiyuan 030001, China
| | - Rujie Liu
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan 030001, China
| | - Jiachen Zhang
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan 030001, China
| | - Shuangjing Li
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan 030001, China
| | - Weitong Shen
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan 030001, China
| | - Han Zhou
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan 030001, China
| | - Yufen Liang
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan 030001, China
| | - Yang Li
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan 030001, China; Key Laboratory of Coal Environmental Pathogenicity and Prevention (Shanxi Medical University), Ministry of Education, Taiyuan 030001, China
| | - Lina Mu
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, The State University of New York at Buffalo, Buffalo, NY 14214, USA
| | - Lijian Lei
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan 030001, China; Key Laboratory of Coal Environmental Pathogenicity and Prevention (Shanxi Medical University), Ministry of Education, Taiyuan 030001, China.
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21
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Chinese expert consensus on the clinical application of sodium-glucose cotransporter 2 inhibitors in patients with chronic kidney disease. Chin Med J (Engl) 2024; 137:1264-1266. [PMID: 38738698 PMCID: PMC11191031 DOI: 10.1097/cm9.0000000000003145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Indexed: 05/14/2024] Open
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22
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Zhou L, Wu B, Tang M, Li G, Chan W, Song L, Wang J, Zhu L, Lin L, Lian Y. Association between exposure to metalworking fluid aerosols, occupational noise and chronic kidney disease: a cross-sectional study in China. BMC Public Health 2024; 24:1495. [PMID: 38835007 DOI: 10.1186/s12889-024-19006-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 05/30/2024] [Indexed: 06/06/2024] Open
Abstract
BACKGROUND Chronic kidney disease (CKD) carries a high public health burden yet little is known about the relationship between metalworking fluid (MWF) aerosols, occupational noise and CKD. We aimed to explore the relationship between occupational MWF aerosols, occupational noise and CKD. METHODS A total of 2,738 machinists were sampled from three machining companies in Wuxi, China, in 2022. We used the National Institute for Occupational Safety and Health (NIOSH) method 5524 to collect individual samples for MWF aerosols exposure, and the Chinese national standard (GBZ/T 189.8-2007) method to test individual occupational noise exposure. The diagnostic criteria for CKD were urinary albumin/creatinine ratio (UACR) of ≥ 30 mg/g and reduced renal function (eGFR < 60 mL.min- 1. 1.73 m- 2) lasting longer than 3 months. Smooth curve fitting was conducted to analyze the associations of MWF aerosols and occupational noise with CKD. A segmented regression model was used to analyze the threshold effects. RESULTS Workers exposed to MWF aerosols (odds ratio [OR] = 2.03, 95% confidence interval [CI]: 1.21-3.41) and occupational noise (OR = 1.77, 95%CI: 1.06-2.96) had higher prevalence of CKD than nonexposed workers. A nonlinear and positive association was found between increasing MWF aerosols and occupational noise dose and the risk of CKD. When daily cumulative exposure dose of MWF aerosols exceeded 8.03 mg/m3, the OR was 1.24 (95%CI: 1.03-1.58), and when occupational noise exceeded 87.22 dB(A), the OR was 1.16 (95%CI: 1.04-1.20). In the interactive analysis between MWF aerosols and occupational noise, the workers exposed to both MWF aerosols (cumulative exposure ≥ 8.03 mg/m3-day) and occupational noise (LEX,8 h ≥ 87.22 dB(A)) had an increased prevalence of CKD (OR = 2.71, 95%CI: 1.48-4.96). MWF aerosols and occupational noise had a positive interaction in prevalence of CKD. CONCLUSIONS Occupational MWF aerosols and noise were positively and nonlinearly associated with CKD, and cumulative MWF aerosols and noise exposure showed a positive interaction with CKD. These findings emphasize the importance of assessing kidney function of workers exposed to MWF aerosols and occupational noise. Prospective and longitudinal cohort studies are necessary to elucidate the causality of these associations.
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Affiliation(s)
- Li Zhou
- Department of Epidemiology and Medical Statistics, School of Public Health, Nantong University, Se Yuan Road, No. 9, Nantong, Jiangsu, 226001, China
| | - Beining Wu
- Department of Epidemiology and Medical Statistics, School of Public Health, Nantong University, Se Yuan Road, No. 9, Nantong, Jiangsu, 226001, China
| | - Minzhu Tang
- Wuxi Eighth People's Hospital, Wuxi, Jiangsu, China
| | - Geyang Li
- Department of Epidemiology and Medical Statistics, School of Public Health, Nantong University, Se Yuan Road, No. 9, Nantong, Jiangsu, 226001, China
| | - Weiling Chan
- Department of Epidemiology and Medical Statistics, School of Public Health, Nantong University, Se Yuan Road, No. 9, Nantong, Jiangsu, 226001, China
| | - Lin Song
- Department of Epidemiology and Medical Statistics, School of Public Health, Nantong University, Se Yuan Road, No. 9, Nantong, Jiangsu, 226001, China
| | - Jin Wang
- Department of Epidemiology and Medical Statistics, School of Public Health, Nantong University, Se Yuan Road, No. 9, Nantong, Jiangsu, 226001, China
| | - Lejia Zhu
- Department of Epidemiology and Medical Statistics, School of Public Health, Nantong University, Se Yuan Road, No. 9, Nantong, Jiangsu, 226001, China
| | - Lan Lin
- Department of Epidemiology and Medical Statistics, School of Public Health, Nantong University, Se Yuan Road, No. 9, Nantong, Jiangsu, 226001, China
| | - Yulong Lian
- Department of Epidemiology and Medical Statistics, School of Public Health, Nantong University, Se Yuan Road, No. 9, Nantong, Jiangsu, 226001, China.
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23
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Liu P, Liu Y, Liu H, Xiong L, Mei C, Yuan L. A Random Forest Algorithm for Assessing Risk Factors Associated With Chronic Kidney Disease: Observational Study. Asian Pac Isl Nurs J 2024; 8:e48378. [PMID: 38830204 PMCID: PMC11184270 DOI: 10.2196/48378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 02/02/2024] [Accepted: 04/16/2024] [Indexed: 06/05/2024] Open
Abstract
BACKGROUND The prevalence and mortality rate of chronic kidney disease (CKD) are increasing year by year, and it has become a global public health issue. The economic burden caused by CKD is increasing at a rate of 1% per year. CKD is highly prevalent and its treatment cost is high but unfortunately remains unknown. Therefore, early detection and intervention are vital means to mitigate the treatment burden on patients and decrease disease progression. OBJECTIVE In this study, we investigated the advantages of using the random forest (RF) algorithm for assessing risk factors associated with CKD. METHODS We included 40,686 people with complete screening records who underwent screening between January 1, 2015, and December 22, 2020, in Jing'an District, Shanghai, China. We grouped the participants into those with and those without CKD by staging based on the glomerular filtration rate staging and grouping based on albuminuria. Using a logistic regression model, we determined the relationship between CKD and risk factors. The RF machine learning algorithm was used to score the predictive variables and rank them based on their importance to construct a prediction model. RESULTS The logistic regression model revealed that gender, older age, obesity, abnormal index estimated glomerular filtration rate, retirement status, and participation in urban employee medical insurance were significantly associated with the risk of CKD. On RF algorithm-based screening, the top 4 factors influencing CKD were age, albuminuria, working status, and urinary albumin-creatinine ratio. The RF model predicted an area under the receiver operating characteristic curve of 93.15%. CONCLUSIONS Our findings reveal that the RF algorithm has significant predictive value for assessing risk factors associated with CKD and allows the screening of individuals with risk factors. This has crucial implications for early intervention and prevention of CKD.
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Affiliation(s)
- Pei Liu
- Department of Mathematics and Physics, Second Military Medical University, Shanghai, China
| | - Yijun Liu
- Department of Health Management, Second Military Medical University, Shanghai, China
| | - Hao Liu
- Faculty of Health Service, Second Military Medical University, Shanghai, China
| | - Linping Xiong
- Department of Health Management, Second Military Medical University, Shanghai, China
| | - Changlin Mei
- Nephrology Department, Shanghai Changzheng Hospital, Shanghai, China
| | - Lei Yuan
- Department of Health Management, Second Military Medical University, Shanghai, China
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Zhang M, Cai Y, Zhong X, Liu W, Lin Y, Qiu Z, Liang R, Wei H, Wu K, Liu Q. Effects of cell-free DNA on kidney disease and intervention strategies. Front Pharmacol 2024; 15:1377874. [PMID: 38835660 PMCID: PMC11148383 DOI: 10.3389/fphar.2024.1377874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Accepted: 04/23/2024] [Indexed: 06/06/2024] Open
Abstract
Kidney disease has become a global public health problem. Patients with end-stage kidney disease must rely on dialysis or undergo renal transplantation, placing heavy burdens on their families and society. Therefore, it is important to develop new therapeutic targets and intervention strategies during early stages of chronic kidney disease. The widespread application of liquid biopsy has led to an increasing number of studies concerning the roles of cell-free DNA (cfDNA) in kidney disease. In this review, we summarize relevant studies concerning the roles of cfDNA in kidney disease and describe various strategies for targeted removal of cfDNA, with the goal of establishing novel therapeutic approaches for kidney disease.
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Affiliation(s)
- Mingying Zhang
- Department of Nephrology, Jieyang People's Hospital, Jieyang, China
| | - Yubin Cai
- Department of Nephrology, Jieyang People's Hospital, Jieyang, China
| | - Xiaoze Zhong
- Department of Nephrology, Jieyang People's Hospital, Jieyang, China
| | - Weijun Liu
- Department of Nephrology, Jieyang People's Hospital, Jieyang, China
| | - Yuan Lin
- Department of Nephrology, Jieyang People's Hospital, Jieyang, China
| | - Zhanyi Qiu
- Department of Nephrology, Jieyang People's Hospital, Jieyang, China
| | - Ruihuang Liang
- Department of Nephrology, Jieyang People's Hospital, Jieyang, China
| | - Huibo Wei
- Department of Nephrology, Jieyang People's Hospital, Jieyang, China
| | - Kefei Wu
- Department of Nephrology, Jieyang People's Hospital, Jieyang, China
| | - Qinghua Liu
- Department of Nephrology, Jieyang People's Hospital, Jieyang, China
- Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- NHC Key Laboratory of Clinical Nephrology (Sun Yat-sen University) and Guangdong Provincial Key Laboratory of Nephrology, Guangzhou, China
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25
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Xu P, Zhao N, Wang J. Knowledge, attitude, and practice toward osteoporosis among patients with chronic kidney disease in Zhejiang. Medicine (Baltimore) 2024; 103:e38153. [PMID: 38758880 PMCID: PMC11098230 DOI: 10.1097/md.0000000000038153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Accepted: 04/16/2024] [Indexed: 05/19/2024] Open
Abstract
Patients with chronic kidney disease (CKD) are considered high-risk group for osteoporosis. However, the current understanding of their knowledge, attitude, and practice toward osteoporosis remains unclear. CKD patients were recruited from Li Huili Hospital, Ningbo Medical Center between March 2023 and June 2023. A self-designed questionnaire was used to collect the participant's demographic characteristics and knowledge, attitude, and practice toward osteoporosis. A total of 500 valid questionnaires were included in the analysis, with participants aged 51.08 ± 14.76 years. The mean scores for knowledge, attitude, and practice were 6.67 ± 3.04 (range: 0-11), 33.99 ± 3.37 (range: 10-50), and 35.29 ± 5.54 (range: 9-45), respectively. Pearson correlation analysis revealed significant positive associations between knowledge and attitude scores (r = 0.440, P < .001), knowledge and practice scores (r = 0.376, P < .001), as well as attitude and practice scores (r = 0.403, P < .001). Structural equation modeling revealed direct associations between knowledge and attitude (path coefficient = 0.488, P < .001), and between attitude and practice (path coefficient = 0.485, P < .001). The knowledge also exhibited a directly positive effect on practice (path coefficient = 0.449, P < .001). Undergoing glucocorticoid therapy (odd ratio [OR] = 2.353, 95% confidence interval [CI]: 1.022-5.418, P = .044) and osteoporosis osteoporosis (OR = 1.565, 95% CI: 1.011-2.421, P = .044) were positively associated with knowledge. Moreover, disease duration >1 year was positively associated with practice (OR = 3.643, 95% CI: 1.754-7.565, P < .001). CKD patients demonstrated moderate knowledge, neutral attitude, and moderate practice toward osteoporosis. To address the practice gaps of CKD patients toward osteoporosis, targeted educational interventions and attitude support programs can be developed.
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Affiliation(s)
- Pengjie Xu
- Department of Nephrology, Ningbo Medical Center Lihuili Hospital, Ningbo University, Ningbo, China
| | - Nadan Zhao
- Department of Radiology, Ningbo Medical Center Lihuili Hospital, Ningbo University, Ningbo, China
| | - Jiangdong Wang
- Department of Nephrology, Ningbo Medical Center Lihuili Hospital, Ningbo University, Ningbo, China
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26
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Zhang Y, Kong X, Liang L, Xu D. Regulation of vascular remodeling by immune microenvironment after the establishment of autologous arteriovenous fistula in ESRD patients. Front Immunol 2024; 15:1365422. [PMID: 38807593 PMCID: PMC11130379 DOI: 10.3389/fimmu.2024.1365422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 04/30/2024] [Indexed: 05/30/2024] Open
Abstract
Autogenous arteriovenous fistula (AVF) is the preferred dialysis access for receiving hemodialysis treatment in end-stage renal disease patients. After AVF is established, vascular remodeling occurs in order to adapt to hemodynamic changes. Uremia toxins, surgical injury, blood flow changes and other factors can induce inflammatory response, immune microenvironment changes, and play an important role in the maintenance of AVF vascular remodeling. This process involves the infiltration of pro-inflammatory and anti-inflammatory immune cells and the secretion of cytokines. Pro-inflammatory and anti-inflammatory immune cells include neutrophil (NEUT), dendritic cell (DC), T lymphocyte, macrophage (Mφ), etc. This article reviews the latest research progress and focuses on the role of immune microenvironment changes in vascular remodeling of AVF, in order to provide a new theoretical basis for the prevention and treatment of AVF failure.
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Affiliation(s)
| | | | - Liming Liang
- Department of Nephrology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Institute of Nephrology, Jinan, Shandong, China
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27
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Lin Y, Xie C, Zhang Y, Luo F, Gao Q, Li Y, Su L, Xu R, Zhang X, Chen R, Zhou S, Li P, Liu J, Liang M, Nie S. Association of serum 25-hydroxyvitamin D with cardiovascular mortality and kidney outcome in patients with early stages of CKD. J Endocrinol Invest 2024:10.1007/s40618-024-02383-6. [PMID: 38733429 DOI: 10.1007/s40618-024-02383-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Accepted: 04/18/2024] [Indexed: 05/13/2024]
Abstract
PURPOSE While serum 25-hydroxyvitamin D (25[OH]D) deficiency is prevalent in chronic kidney disease (CKD), the effects of 25(OH)D deficiency on cardiovascular mortality and kidney outcomes in patients with early-stage CKD remain incompletely understood. METHODS This multicenter retrospective cohort study included adult patients with stages 1-3 CKD from 19 medical centers across China between January 2000 and May 2021. The primary outcome was cardiovascular mortality. The secondary study outcome included CKD progression (defined as a sustained > 40% eGFR decrease from baseline or progress to end-stage kidney disease), and annual percentage change of eGFR. RESULTS Of 9229 adults with stages 1-3 CKD, 27.0% and 38.9% had severe (< 10 ng/mL) and moderate (10 to < 20 ng/mL) serum 25(OH)D deficiency, respectively. Compared with patients having 25(OH)D ≥ 20 ng/mL, a significantly higher risk of cardiovascular mortality (hazard ratio [HR] 1.90, 95% CI 1.37-2.63), CKD progression (HR 2.20, 95% CI 1.68-2.88), and a steeper annual decline in eGFR (estimate - 7.87%; 95% CI - 10.24% to - 5.51% per year) was found in those with serum 25(OH)D < 10 ng/mL. Similar results were obtained in subgroups and by sensitivity analyses. CONCLUSIONS 25(OH)D deficiency is associated with increased risks of cardiovascular mortality and CKD progression in patients with early-stage CKD. Studies are needed to determine whether early intervention for 25(OH)D deficiency could improve the prognosis of patients with early-stage CKD.
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Affiliation(s)
- Y Lin
- Division of Nephrology, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, 1838 North Guangzhou Ave, Guangzhou, 510515, China
| | - C Xie
- Department of Nephrology, The First People's Hospital of Foshan, Foshan, Guangdong, China
| | - Y Zhang
- Division of Nephrology, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, 1838 North Guangzhou Ave, Guangzhou, 510515, China
| | - F Luo
- Division of Nephrology, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, 1838 North Guangzhou Ave, Guangzhou, 510515, China
| | - Q Gao
- Division of Nephrology, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, 1838 North Guangzhou Ave, Guangzhou, 510515, China
| | - Y Li
- Division of Nephrology, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, 1838 North Guangzhou Ave, Guangzhou, 510515, China
| | - L Su
- Division of Nephrology, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, 1838 North Guangzhou Ave, Guangzhou, 510515, China
| | - R Xu
- Division of Nephrology, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, 1838 North Guangzhou Ave, Guangzhou, 510515, China
| | - X Zhang
- Division of Nephrology, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, 1838 North Guangzhou Ave, Guangzhou, 510515, China
| | - R Chen
- Division of Nephrology, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, 1838 North Guangzhou Ave, Guangzhou, 510515, China
| | - S Zhou
- Division of Nephrology, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, 1838 North Guangzhou Ave, Guangzhou, 510515, China
| | - P Li
- Division of Nephrology, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, 1838 North Guangzhou Ave, Guangzhou, 510515, China
| | - J Liu
- Division of Nephrology, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, 1838 North Guangzhou Ave, Guangzhou, 510515, China
| | - M Liang
- Division of Nephrology, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, 1838 North Guangzhou Ave, Guangzhou, 510515, China.
| | - S Nie
- Division of Nephrology, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, 1838 North Guangzhou Ave, Guangzhou, 510515, China.
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Wong TS, Chen Q, Liu T, Yu J, Gao Y, He Y, Zhong Q, Tan Z, Liu T, Lu J, Huang J, Zhang CJP, Yin L, Hu B, Ming WK. Patients, healthcare providers, and general population preferences for hemodialysis vascular access: a discrete choice experiment. Front Public Health 2024; 12:1047769. [PMID: 38784588 PMCID: PMC11112084 DOI: 10.3389/fpubh.2024.1047769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Accepted: 04/16/2024] [Indexed: 05/25/2024] Open
Abstract
Background A patient-centered dialysis treatment option requires an understanding of patient preferences for alternative vascular accesses and nephrologists often face difficulties when recommending vascular access to end-stage kidney disease (ESKD) patients. We aimed to quantify the relative importance of various vascular access characteristics to patients, healthcare providers and general population, and how they affect acceptability for patients and healthcare providers. Methods In a discrete choice experiment, patients with maintenance hemodialysis (MHD), healthcare providers, and individuals from the general population were invited to respond to a series of hypothetical vascular access scenarios that differed in five attributes: cumulative patency, infection rate, thrombosis rate, cost, and time to maturation. We estimated the respondents' preference heterogeneity and relative importance of the attributes with a mixed logit model (MXL) and predicted the willingness to pay (WTP) of respondents via a multinomial logit model (MNL). Results Healthcare providers (n = 316) and the general population (n = 268) exhibited a favorable inclination toward longer cumulative patency, lower access infection rate and lower access thrombosis rate. In contrast, the patients (n = 253) showed a preference for a 3-year cumulative patency, 8% access infection rate, 35% access thrombosis rate and 1.5 access maturity time, with only the 3-year cumulative patency reaching statistical significance. Among the three respondent groups, the general population found cumulative patency less important than healthcare providers and patients did. Patients demonstrated the highest WTP for cumulative patency, indicating a willingness to pay an extra RMB$24,720(US$3,708) for each additional year of patency time. Conclusion Patients and healthcare providers had a strong preference for vascular access with superior patency. While the general population preferred vascular access with lower thrombosis rates. These results indicate that most patients prefer autogenous arteriovenous fistula (AVF) as an appropriate choice for vascular access due to its superior patency and lower complications than other vascular access types.
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Affiliation(s)
- Tak-Sui Wong
- Division of Nephrology, Department of Medicine, The First Affiliated Hospital, Jinan University, Guangzhou, China
- Department of Infectious Diseases and Public Health, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Kowloon, Hong Kong SAR, China
| | - Qian Chen
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Taoran Liu
- Department of Infectious Diseases and Public Health, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Kowloon, Hong Kong SAR, China
| | - Jing Yu
- Department of Infectious Diseases and Public Health, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Kowloon, Hong Kong SAR, China
| | - Yangyang Gao
- Department of Infectious Diseases and Public Health, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Kowloon, Hong Kong SAR, China
| | - Yan He
- Department of Infectious Diseases and Public Health, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Kowloon, Hong Kong SAR, China
| | - Qiongqiong Zhong
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Zijian Tan
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Tinlun Liu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
- International School, Jinan University, Guangzhou, China
| | - Jian Lu
- Division of Nephrology, Department of Medicine, The First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Jian Huang
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
- Bioinformatics Institute, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, Norfolk Place, London, United Kingdom
| | - Casper J. P. Zhang
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Lianghong Yin
- Division of Nephrology, Department of Medicine, The First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Bo Hu
- Division of Nephrology, Department of Medicine, The First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Wai-Kit Ming
- Department of Infectious Diseases and Public Health, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Kowloon, Hong Kong SAR, China
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Yuan S, Cao Y, Jiang J, Chen J, Huang X, Li X, Zhou J, Zhou Y, Zhou J. Xuebijing injection and its bioactive components alleviate nephrotic syndrome by inhibiting podocyte inflammatory injury. Eur J Pharm Sci 2024; 196:106759. [PMID: 38570053 DOI: 10.1016/j.ejps.2024.106759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 03/31/2024] [Accepted: 03/31/2024] [Indexed: 04/05/2024]
Abstract
Xuebijing injection (XBJ) is widely used to treat nephrotic syndrome (NS) in clinic, but its bioactive components and therapeutic mechanism are still unclear. In this study, the bioactive components of XBJ were determined by ultra-performance liquid chromatography quadrupole time-of-flight tandem mass spectrometry (UPLC-Q-TOF/MS). The therapeutic effect of XBJ on NS was evaluated in BALB/c mice induced by adriamycin (ADR, 10 mg/kg) via a single tail vein. The protective effect of XBJ and its bioactive components on podocytes was demonstrated using mouse podocytes (MPC-5) induced by lipopolysaccharide (LPS, 4 μg/mL). The results show that 33 components of XBJ were identified. Furthermore, 12 bioactive components were detected in blood, including protocatechuic acid, salvianolic acid C, benzoyloxypaeoniflorin, danshensu, salvianolic acid A, salvianolic acid B, catechin, caffeic acid, galloylpaeoniflorin, oxypaeoniflorin, hydroxysafflor yellow A, rosmarinic acid. The relative content (%) of the bioactive components were 59.32, 16.01, 9.97, 9.73, 8.72, 8.31, 7.92, 6.54, 1.54, 1.30, 0.68 and 0.59 in this order. After XBJ treatment, the renal function, hyperlipidemia and renal pathological damage were improved in NS model mice. Moreover, the levels of nephrin and desmin which are functional proteins in podocytes were reversed, and the levels of pro-inflammatory factors were reduced by XBJ. Interestingly, protocatechuic acid and salvianolic acid C also showed good protective effects on podocyte function and reduced the level of inflammation in LPS-induced MPC-5. The study is the first time to elucidate the bioactive components of XBJ and its potential therapeutic mechanism for treating NS by protecting podocyte function.
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Affiliation(s)
- Shengliang Yuan
- School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong 510006, China; Affiliated Gaozhou People's Hospital, Guangdong Medical University, Gaozhou 525200, China
| | - Yiwen Cao
- School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong 510006, China
| | - Jiaying Jiang
- School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong 510006, China
| | - Junqi Chen
- School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong 510006, China
| | - Xiuye Huang
- School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong 510006, China
| | - Xiaojie Li
- School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong 510006, China; The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Jie Zhou
- School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong 510006, China
| | - Yuan Zhou
- School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong 510006, China
| | - Jiuyao Zhou
- School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong 510006, China.
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Liu X, Liu Z, Niu Y, Zhang K, Zhang X, Yu C. The Relationship Between Fracture and Mortality in a Chinese Maintenance Hemodialysis Patients Cohort. J Multidiscip Healthc 2024; 17:2031-2038. [PMID: 38706503 PMCID: PMC11070156 DOI: 10.2147/jmdh.s457193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 04/17/2024] [Indexed: 05/07/2024] Open
Abstract
Background Patients on maintenance hemodialysis have an increased risk of fracture. However, the relationship between fracture and poor prognosis is not clear. Methods A total of 182 maintenance hemodialysis patients were enrolled in the study. The relationship between fracture and poor prognosis (cardiovascular events, stroke, malignancy and 5-year all-cause mortality) were analyzed. Results 21 of 182 patients had a history of fracture at the time of enrollment. 26 patients had a new fracture after enrollment. A total of 57 fractures occurred in 47 patients, the most common fracture site was the rib. Patients with fracture group had a higher proportion of elderly and female, higher serum phosphorus and B-type natriuretic peptide and lower hemoglobin, albumin, and potassium compared with those without fracture. Age (OR=3.809, 95% CI: 1.064-8.966, p=0.038), hemoglobin (OR=0.961, 95% CI: 0.925-0.997, p=0.035), and serum phosphorus (OR=3.325, 95% CI:1.104-10.019, p=0.033) were the independent risk factors of new fractures in MHD patients. The incidence of malignancy and 5-year all-cause mortality in patients with fracture was higher than those without fracture (p<0.05). But there was no significant difference in the incidence of acute myocardial infarction or stroke. Conclusion 25.8% of maintenance hemodialysis patients had at least one fracture, with rib fractures accounting for the highest proportion. Age, hemoglobin and serum phosphorus were the independent risk factors of new fractures. The incidence of malignancy and 5-year all-cause mortality in patients with fracture was higher than those without fracture, but there was no significant difference in the incidence of acute myocardial infarction and stroke.
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Affiliation(s)
- Xi Liu
- Department of Nephrology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, 200092, People’s Republic of China
| | - Zhonghan Liu
- Department of Spinal Surgery, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, 200092, People’s Republic of China
| | - Yangyang Niu
- Department of Nephrology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, 200092, People’s Republic of China
| | - Kun Zhang
- Department of Nephrology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, 200092, People’s Republic of China
| | - Xiaoqin Zhang
- Department of Nephrology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, 200092, People’s Republic of China
| | - Chen Yu
- Department of Nephrology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, 200092, People’s Republic of China
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Hu N, Yang Z, Wang A. Early Post-Transplant Adaptation Experience in Young and Middle-Aged People With Kidney Transplant in China: A Qualitative Study. West J Nurs Res 2024; 46:356-365. [PMID: 38500353 DOI: 10.1177/01939459241238683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2024]
Abstract
BACKGROUND Successful adaptation to post-transplantation life in patients who have undergone kidney transplants is crucial. The psychosocial needs of people with kidney transplants are closely related to the health of the transplanted kidney. If transplant recipients cannot adapt to the effects of the transplant, their physical and mental health will be seriously impaired. OBJECTIVE The purpose of this study was to explore the early post-transplant adaptation experience of young and middle-aged persons with kidney transplants in China based on the Roy adaptation model. METHODS A qualitative descriptive study was conducted using semi-structured interviews. Fifteen young and middle-aged persons with kidney transplant were recruited from a tertiary hospital in China between September 2022 and March 2023 through purposive sampling. Data were analyzed using a thematic analysis approach. RESULTS This study identified 4 themes: (1) "two-sided" changes in physiological functioning, (2) "dawn and darkness" (conflicting perceived emotions about the future), (3) role functioning adaptation conflict and impairment, and (4) social isolation and the challenges of coping. CONCLUSIONS This study found that early post-transplant adaptation in young and middle-aged people with kidney transplant included both positive and negative experiences, and these findings can provide new insights into research related to successful post-operative adaptation.
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Affiliation(s)
- Na Hu
- Department of Transplantation, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Zhen Yang
- Department of Public Service, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Aiping Wang
- Department of Public Service, The First Affiliated Hospital of China Medical University, Shenyang, China
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Zhang LP, Li MT, Pan MJ, Ou YT, Gao M, Wu M. The association between vascular access satisfaction and all-cause mortality in maintenance hemodialysis patients. J Vasc Access 2024:11297298241244483. [PMID: 38682422 DOI: 10.1177/11297298241244483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2024] Open
Abstract
BACKGROUND The mortality is significantly higher in patients undergoing maintenance hemodialysis (MHD) than in the general population. It is well-known that vascular access (VA) is critical for MHD patients. But the association between VA satisfaction and all-cause mortality in MHD patients is still not clear. The aim of this study was to explore the relationship between VA satisfaction and all-cause mortality in MHD patients with a 30-month follow-up. METHODS Two hundred twenty-nine MHD patients in two dialysis centers were enrolled in this observational prospective study. VA satisfaction was assessed using the Short Form Vascular Access Questionnaire (VAQ). Health-related quality of life (HRQoL) score was calculated with Short Form 36 (SF-36) questionnaire. Multiple logistic regression analysis was used to evaluate the influencing factors of all-cause mortality. RESULTS During the 30-month follow-up period, 35 patients dropped out of the study. Among them, 31 patients died, and 4 patients stopped MHD treatment after renal transplantation. Multivariable analyses showed that the age, VAQ total score, social functioning score and dialysis-related complication score of the VAQ, the total score and MCS of the SF-36 were factors influencing all-cause mortality in MHD patients. The Kaplan-Meier curve further showed that the cumulative survival probability was significantly higher in the MHD patients with VAQ scores <7 at baseline than in patients with VAQ scores ⩾7 (p = 0.031). INCLUSION The present study showed that VA satisfaction was significantly associated with all-cause mortality in MHD patients. These findings suggest that a holistic approach is required for VA choice.
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Affiliation(s)
- Liu-Ping Zhang
- Institute of Nephrology, Zhongda Hospital, Southeast University School of Medicine, Nanjing City, Jiangsu, China
| | - Meng-Ting Li
- Institute of Nephrology, Zhongda Hospital, Southeast University School of Medicine, Nanjing City, Jiangsu, China
| | - Meng-Jiao Pan
- Institute of Nephrology, Zhongda Hospital, Southeast University School of Medicine, Nanjing City, Jiangsu, China
| | - Yu-Tong Ou
- Institute of Nephrology, Zhongda Hospital, Southeast University School of Medicine, Nanjing City, Jiangsu, China
| | - Min Gao
- Institute of Nephrology, Zhongda Hospital, Southeast University School of Medicine, Nanjing City, Jiangsu, China
| | - Min Wu
- Institute of Nephrology, Zhongda Hospital, Southeast University School of Medicine, Nanjing City, Jiangsu, China
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Yang K, Li T, Geng Y, Zou X, Peng F, Gao W. The role of mitophagy in the development of chronic kidney disease. PeerJ 2024; 12:e17260. [PMID: 38680884 PMCID: PMC11056108 DOI: 10.7717/peerj.17260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 03/28/2024] [Indexed: 05/01/2024] Open
Abstract
Chronic kidney disease (CKD) represents a significant global health concern, with renal fibrosis emerging as a prevalent and ultimate manifestation of this condition. The absence of targeted therapies presents an ongoing and substantial challenge. Accumulating evidence suggests that the integrity and functionality of mitochondria within renal tubular epithelial cells (RTECs) often become compromised during CKD development, playing a pivotal role in the progression of renal fibrosis. Mitophagy, a specific form of autophagy, assumes responsibility for eliminating damaged mitochondria to uphold mitochondrial equilibrium. Dysregulated mitophagy not only correlates with disrupted mitochondrial dynamics but also contributes to the advancement of renal fibrosis in CKD. While numerous studies have examined mitochondrial metabolism, ROS (reactive oxygen species) production, inflammation, and apoptosis in kidney diseases, the precise pathogenic mechanisms underlying mitophagy in CKD remain elusive. The exact mechanisms through which modulating mitophagy mitigates renal fibrosis, as well as its influence on CKD progression and prognosis, have not undergone systematic investigation. The role of mitophagy in AKI has been relatively clear, but the role of mitophagy in CKD is still rare. This article presents a comprehensive review of the current state of research on regulating mitophagy as a potential treatment for CKD. The objective is to provide fresh perspectives, viable strategies, and practical insights into CKD therapy, thereby contributing to the enhancement of human living conditions and patient well-being.
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Affiliation(s)
- Kexin Yang
- Department of Pathophysiology, School of Basic Medical Sciences, Shandong Second Medical University, Weifang, Shandong, China
| | - Ting Li
- Department of Pathophysiology, School of Basic Medical Sciences, Shandong Second Medical University, Weifang, Shandong, China
| | - Yingpu Geng
- School of Clinical Medicine, Shandong Second Medical University, Weifang, Shandong, China
| | - Xiangyu Zou
- Department of Pathophysiology, School of Basic Medical Sciences, Shandong Second Medical University, Weifang, Shandong, China
| | - Fujun Peng
- Department of Pathophysiology, School of Basic Medical Sciences, Shandong Second Medical University, Weifang, Shandong, China
| | - Wei Gao
- Department of Pathophysiology, School of Basic Medical Sciences, Shandong Second Medical University, Weifang, Shandong, China
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Fu R, He P, Hong W, Liang Y, Wang W, Yuan S, Liu L. Male sexual dysfunction in patients with chronic kidney disease: a cross-sectional study. Sci Rep 2024; 14:9207. [PMID: 38649741 PMCID: PMC11035701 DOI: 10.1038/s41598-024-59844-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 04/16/2024] [Indexed: 04/25/2024] Open
Abstract
Sexual dysfunction is common in males with chronic kidney disease (CKD), but yet the prevalence and specific relationship between CKD and sexual dysfunction, especially premature ejaculation (PE), remain to be investigated in China; This study aims to examine the prevalence and association between CKD and sexual dysfunction in male patients in China; In this cross-sectional, non-interventional, observational study conducted at a single center. 72 male patients with CKD were enrolled. Data collection included socio-demographic information, assessments via the 5-item version of the International Index of Erectile Function (IIEF-5), the Chinese version of the Premature Ejaculation Diagnostic Tool, the Patient Health Quentionnnaire-9 and the General Anxiety Disorder-7. Data analysis was performed using R version 3.5.2 and SPSS software version 25.0; Among the 72 CKD patients, 56.9% experienced erectile dysfunction and 29.2% had PE. Various factors including estimated Glomerular Filtration Rate, Albumin-to-Creatinine Ratio, psychological aspects, medication use were found to be associated with sexual dysfunction in these CKD patients; Sexual dysfunction is prevalent in males with CKD and is, influenced by multiple factors. It is important for clinicians to focus on sexual dysfunction in this patient group and further investigate its underlying mechanisms.
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Affiliation(s)
- Ruijie Fu
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, 510006, China
| | - Peihua He
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, 510006, China
| | - Weihong Hong
- Department of Nephrology, Zhuhai Hospital of Guangdong Provincial Hospital of Chinese Medicine, Zhuhai, 519015, China
| | - Yichun Liang
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, 510006, China
| | - Wen Wang
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, 510006, China
| | - Shaoying Yuan
- Department of Andrology, Zhuhai Hospital of Guangdong Provincial Hospital of Chinese Medicine, Zhuhai, 519015, China.
| | - Lichang Liu
- Department of Nephrology, Zhuhai Hospital of Guangdong Provincial Hospital of Chinese Medicine, Zhuhai, 519015, China.
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Chen Q, Deng Q, Liao Q, Liu Y, Zhang Z, Wu D, Lv Y, Qin J, Liu Q, Li S, Long Z, Xing X, Wang Q, Zeng X, Dong G, Hou M, Xiao Y. 8-OHdG mediates the association of co-exposure to fifty-five typical endocrine-disrupting chemicals with renal function: a cross-section investigation in Southern Chinese adults. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2024:10.1007/s11356-024-33266-1. [PMID: 38613763 DOI: 10.1007/s11356-024-33266-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 04/05/2024] [Indexed: 04/15/2024]
Abstract
Individual typical endocrine-disrupting chemicals (EDCs), including organophosphate triesters (OPEs), parabens, triclosan (TCS), bisphenols, benzophenones (BPs), phthalates (PAEs), and synthetic phenolic antioxidants (SPAs), are associated with renal dysfunction. However, the combined effects and underlying mechanisms of mixed EDC exposure on renal function remain unclear. Two hundred ninety-nine adult participants were enrolled in the cross-sectional survey conducted in Guangzhou, China. Urinary levels of 7 OPEs, 6 parabens, TCS, 14 bisphenols, 8 BPs, 15 PAEs, 4 SPAs, and 8-hydroxy-2'-deoxyguanosine (8-OHdG) were determined, and estimated glomerular filtration rate (eGFR) was served as the outcome index. We found elevated levels of diphenyl phosphate (DPP), bisphenol A (BPA), mono-(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP), and mono-butyl phthalate (MBP) showed dose-responsive associations with eGFR decline, However, nonlinear associations were observed for bis(2-butoxyethyl) hydrogen phosphate (BBOEP), TCS, 4-hydroxybenzophenone (HBP), mono-n-pentyl phthalate (MnPP), and mono-benzyl phthalate (MBzP). The quantile-based g-computation model demonstrated that a quartile increase in the EDC mixture corresponded to a 0.383-SD decrease (95% CI - 0.658 ~ - 0.108, P = 0.007) in eGFR. Notably, BPA was identified as the primary contributor to this effect. Moreover, 8-OHdG mediated the eGFR decline associated with EDC mixtures with a mediation proportion of 25.49%. A sex-modified effect was also observed (P = 0.004), indicating that exposure to the mixture of EDC was linked to more pronounced renal dysfunction in females. Our novel findings suggest that exposure to a typical mixture of EDCs is associated with renal dysfunction in the general adult population of Southern China. Furthermore, 8-OHdG may play a role in the pathogenesis of EDC mixture-related renal dysfunction.
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Affiliation(s)
- Qingfei Chen
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, No. 74 Zhongshan Road 2, Yuexiu District, Guangzhou, 510080, Guangdong, China
- Joint International Research Laboratory of Environment and Health, Ministry of Education, School of Public Health, Sun Yat-Sen University, No. 74 Zhongshan Road 2, Guangzhou, 510080, Guangdong, China
| | - Qifei Deng
- School of Public Health, Guangzhou Medical University, Xinzao Town, Panyu District, Guangzhou, 511436, Guangdong, China
| | - Qilong Liao
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, No. 74 Zhongshan Road 2, Yuexiu District, Guangzhou, 510080, Guangdong, China
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Ecology and Environment, Guangzhou, 510530, People's Republic of China
| | - Yan Liu
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, No. 74 Zhongshan Road 2, Yuexiu District, Guangzhou, 510080, Guangdong, China
| | - Zhaorui Zhang
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, No. 74 Zhongshan Road 2, Yuexiu District, Guangzhou, 510080, Guangdong, China
- School of Public Health, Guangzhou Medical University, Xinzao Town, Panyu District, Guangzhou, 511436, Guangdong, China
| | - Dehua Wu
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, No. 74 Zhongshan Road 2, Yuexiu District, Guangzhou, 510080, Guangdong, China
| | - Yanrong Lv
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, No. 74 Zhongshan Road 2, Yuexiu District, Guangzhou, 510080, Guangdong, China
| | - Jingyao Qin
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, No. 74 Zhongshan Road 2, Yuexiu District, Guangzhou, 510080, Guangdong, China
| | - Qing Liu
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, No. 74 Zhongshan Road 2, Yuexiu District, Guangzhou, 510080, Guangdong, China
| | - Shuangqi Li
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, No. 74 Zhongshan Road 2, Yuexiu District, Guangzhou, 510080, Guangdong, China
| | - Zihao Long
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, No. 74 Zhongshan Road 2, Yuexiu District, Guangzhou, 510080, Guangdong, China
| | - Xiumei Xing
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, No. 74 Zhongshan Road 2, Yuexiu District, Guangzhou, 510080, Guangdong, China
- Joint International Research Laboratory of Environment and Health, Ministry of Education, School of Public Health, Sun Yat-Sen University, No. 74 Zhongshan Road 2, Guangzhou, 510080, Guangdong, China
| | - Qing Wang
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, No. 74 Zhongshan Road 2, Yuexiu District, Guangzhou, 510080, Guangdong, China
- Guangdong Provincial Key Laboratory of Food, Nutrition, and Health, School of Public Health, Sun Yat-Sen University, No. 74 Zhongshan Road 2, Guangzhou, 510080, Guangdong, China
| | - Xiaowen Zeng
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, No. 74 Zhongshan Road 2, Yuexiu District, Guangzhou, 510080, Guangdong, China
- Joint International Research Laboratory of Environment and Health, Ministry of Education, School of Public Health, Sun Yat-Sen University, No. 74 Zhongshan Road 2, Guangzhou, 510080, Guangdong, China
| | - Guanghui Dong
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, No. 74 Zhongshan Road 2, Yuexiu District, Guangzhou, 510080, Guangdong, China
- Joint International Research Laboratory of Environment and Health, Ministry of Education, School of Public Health, Sun Yat-Sen University, No. 74 Zhongshan Road 2, Guangzhou, 510080, Guangdong, China
| | - Mengjun Hou
- Joint International Research Laboratory of Environment and Health, Ministry of Education, School of Public Health, Sun Yat-Sen University, No. 74 Zhongshan Road 2, Guangzhou, 510080, Guangdong, China
- Guangdong Provincial Key Laboratory of Food, Nutrition, and Health, School of Public Health, Sun Yat-Sen University, No. 74 Zhongshan Road 2, Guangzhou, 510080, Guangdong, China
| | - Yongmei Xiao
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, No. 74 Zhongshan Road 2, Yuexiu District, Guangzhou, 510080, Guangdong, China.
- Joint International Research Laboratory of Environment and Health, Ministry of Education, School of Public Health, Sun Yat-Sen University, No. 74 Zhongshan Road 2, Guangzhou, 510080, Guangdong, China.
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Bu Y, Liu Y, Zhou M, Yin P, Liu K, Bai Y, Lu X. The Burden of Hypertension-Related Chronic Kidney Disease - China, 2010-2019. China CDC Wkly 2024; 6:282-288. [PMID: 38634099 PMCID: PMC11018709 DOI: 10.46234/ccdcw2024.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 02/22/2024] [Indexed: 04/19/2024] Open
Abstract
What is already known about this topic? The global burden of chronic kidney disease (CKD) is on the rise. What is added by this report? In 2019, 5.58 million individuals in China were affected by CKD related to hypertension, leading to 70,260 fatalities and 1.69 million disability-adjusted life years (DALYs). The most affected groups were men, older individuals, and residents of western China. Over the period from 2010-2019, the age-standardized prevalence rate (ASPR) remained constant, and the age-standardized mortality rate (ASMR) and age-standardized DALY rate (ASDR) showed a decreasing trend. However, there was an increase in the number of cases, deaths, and DALYs associated with this condition. What are the implications for public health practice? Hypertension significantly contributes to the burden of CKD; therefore, raising awareness and implementing early screening measures are essential.
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Affiliation(s)
- Youyuan Bu
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yueru Liu
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center For Disease Control and Prevention, Beijing, China
| | - Maigeng Zhou
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center For Disease Control and Prevention, Beijing, China
| | - Peng Yin
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center For Disease Control and Prevention, Beijing, China
| | - Kejun Liu
- China National Health Development Research Center, Beijing, China
| | - Yamin Bai
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center For Disease Control and Prevention, Beijing, China
| | - Xuancheng Lu
- Chinese Center for Disease Control and Prevention, Beijing, China
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Tao Y, Luo R, Xiang Y, Lei M, Peng X, Hu Y. Use of bailing capsules (cordyceps sinensis) in the treatment of chronic kidney disease: a meta-analysis and network pharmacology. Front Pharmacol 2024; 15:1342831. [PMID: 38645562 PMCID: PMC11026558 DOI: 10.3389/fphar.2024.1342831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 03/11/2024] [Indexed: 04/23/2024] Open
Abstract
The Bailing Capsule is a commonly used traditional Chinese medicine for the treatment of chronic kidney disease (CKD). However, its therapeutic effects and pharmacological mechanisms have not been fully explored. In this study, we integrated meta-analysis and network pharmacology to provide scientific evidence for the efficacy and pharmacological mechanism of Bailing Capsule in treating CKD. We conducted searches for randomized controlled studies matching the topic in PubMed, the Cochrane Library, Embase, Web of Science, and the Wanfang Database, and screened them according to predefined inclusion and exclusion criteria. Dates from the included studies were extracted for meta-analysis, including renal function indicators, such as 24-h urinary protein (24UP), blood urea nitrogen (BUN), and serum creatinine (Scr), as well as inflammatory indicators like high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α). Network pharmacology was employed to extract biological information, including active drug ingredients and potential targets of the drugs and diseases, for network construction and gene enrichment. Our findings indicated that 24UP, BUN, and Scr in the treatment group containing Bailing Capsule were lower than those in the control group. In terms of inflammatory indicators, hs-CRP, IL-6, and TNF-α, the treatment group containing Bailing Capsule also exhibited lower levels than the control group. Based on network pharmacology analysis, we identified 190 common targets of Bailing Capsule and CKD. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses suggested that the pharmacological mechanism of Bailing Capsule might be related to immune response, inflammatory response, vascular endothelial damage, cell proliferation, and fibrosis. This demonstrates that Bailing Capsule can exert therapeutic effects through multiple targets and pathways, providing a theoretical basis for its use.
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Affiliation(s)
- Yilin Tao
- Department of Medicine Renal Division, Affiliated Hospital & Clinical Medical College of Chengdu University, Chengdu, China
| | - Ruixiang Luo
- The Third Affiliated Hospital of Sun Yat Sen University, Guangzhou, China
| | - Yuanbing Xiang
- Department of Medicine Renal Division, Affiliated Hospital & Clinical Medical College of Chengdu University, Chengdu, China
| | - Min Lei
- Department of Medicine Renal Division, Affiliated Hospital & Clinical Medical College of Chengdu University, Chengdu, China
| | - Xuan Peng
- Department of Medicine Renal Division, Affiliated Hospital & Clinical Medical College of Chengdu University, Chengdu, China
| | - Yao Hu
- Department of Medicine Renal Division, Affiliated Hospital & Clinical Medical College of Chengdu University, Chengdu, China
- Department of Medicine Renal Division, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, China
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Chen DQ, Zhang HJ, Zhang W, Feng K, Liu H, Zhao HL, Li P. Tangshen Formula alleviates inflammatory injury against aged diabetic kidney disease through modulating gut microbiota composition and related amino acid metabolism. Exp Gerontol 2024; 188:112393. [PMID: 38458480 DOI: 10.1016/j.exger.2024.112393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 02/08/2024] [Accepted: 03/03/2024] [Indexed: 03/10/2024]
Abstract
Diabetic kidney disease (DKD) is leading causes and one of the fastest growing causes of chronic kidney disease worldwide, and leads to high morbidity and mortality. Emerging evidences have revealed gut microbiota dysbiosis and related metabolism dysfunction play a dominant role in DKD progression and treatment through modulating inflammation. Our previous studies showed that Tangshen Formula (TSF), a Chinese herbal prescription, exhibited anti-inflammatory effect on DKD, but underlying mechanism that involved gut microbiota and related metabolism in aged model remained obscure. Here, BTBR ob/ob mice were used to establish aged DKD model, and 16S rRNA sequence and untargeted metabolomic analyses were employed to investigate the correlation between colonic microbiota and serum metabolism. The aged ob/ob mice exhibited obvious glomerular and renal tubule injury and kidney function decline in kidney, while TSF treatment significantly attenuated these abnormalities. TSF also exhibited potent anti-inflammatory effect in aged ob/ob mice indicating by reduced proinflammatory factor IL-6 and TNF-α, MCP-1 and COX-2 in serum, kidney and intestine, which suggested the involvement of gut microbiota with TSF effect. The 16S rDNA sequencing of the colonic microbiome and untargeted serum metabolomics analysis revealed significant differences in gut microbiota structure and serum metabolomic profiles between WT and ob/ob mice. Notably, TSF treatment reshaped the structure of gut microbiota and corrected the disorder of metabolism especially tryptophan metabolism and arginine biosynthesis. TSF increased Anaeroplasma and Barnesiella genera and decreased Romboutsia, Akkermansia, and Collinsella genera, and further elevated tryptophan, 5-hydroxyindoleacetate, glutamic acid, aspartate and reduced 4-hydroxy-2-quinolinecarboxylic acid, indole-3-acetic acid, xanthurenic acid, glutamine. Further correlation analysis indicated that disturbed gut microbiota was linked to tryptophan metabolism and arginine biosynthesis to regulate inflammation in aged DKD. Our data revealed that TSF attenuated renal inflammation by modulating gut microbiota and related amino acid metabolism in aged DKD model, highlighting gut microbiota and related metabolism functioned as potential therapeutic target for DKD in elderly patients.
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Affiliation(s)
- Dan-Qian Chen
- Faculty of Life Science & Medicine, Northwest University, 229 Taibai North Road, Xi'an 710069, China; Beijing Key Lab for Immune-Mediated Inflammatory Diseases, Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, 2 Yinghua Dongjie, Beijing 100029, China
| | - Hao-Jun Zhang
- Beijing Key Lab for Immune-Mediated Inflammatory Diseases, Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, 2 Yinghua Dongjie, Beijing 100029, China
| | - Wen Zhang
- Faculty of Life Science & Medicine, Northwest University, 229 Taibai North Road, Xi'an 710069, China
| | - Kai Feng
- Faculty of Life Science & Medicine, Northwest University, 229 Taibai North Road, Xi'an 710069, China
| | - Hui Liu
- Faculty of Life Science & Medicine, Northwest University, 229 Taibai North Road, Xi'an 710069, China
| | - Hai-Ling Zhao
- Beijing Key Lab for Immune-Mediated Inflammatory Diseases, Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, 2 Yinghua Dongjie, Beijing 100029, China
| | - Ping Li
- Beijing Key Lab for Immune-Mediated Inflammatory Diseases, Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, 2 Yinghua Dongjie, Beijing 100029, China.
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Chen Q, Deng Q, Liu Y, Long Z, Li S, Liu Q, Lv Y, Qin J, Yang A, Huang Y, Tan Z, Wang D, Xing X, Xiao Y. Co-exposure of petrochemical workers to noise and mixture of benzene, toluene, ethylbenzene, xylene, and styrene: Impact on mild renal impairment and interaction. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 346:123628. [PMID: 38395129 DOI: 10.1016/j.envpol.2024.123628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 01/30/2024] [Accepted: 02/20/2024] [Indexed: 02/25/2024]
Abstract
Epidemiological evidence concerning effects of simultaneous exposure to noise and benzene, toluene, ethylbenzene, xylene, and styrene (BTEXS) on renal function remains uncertain. In 2020, a cross-sectional study was conducted among 1160 petrochemical workers in southern China to investigate effects of their co-exposure on estimated glomerular filtration rate (eGFR) and mild renal impairment (MRI). Noise levels were assessed using cumulative noise exposure (CNE). Urinary biomarkers for BTEXS were quantified. We found the majority of workers had exposure levels to noise and BTEXS below China's occupational exposure limits. CNE, trans, trans-muconic acid (tt-MA), and the sum of mandelic acid and phenylglyoxylic acid (PGMA) were linearly associated with decreased eGFR and increased MRI risk. We observed U-shaped associations for both N-acetyl-S-phenyl-L-cysteine (SPMA) and o-methylhippuric acid (2-MHA) with MRI. In further assessing the joint effect of BTEXS (β, -0.164 [95% CI, -0.296 to -0.033]) per quartile increase in all BTEXS metabolites on eGFR using quantile g-computation models, we found SPMA, tt-MA, 2-MHA, and PGMA played pivotal roles. Additionally, the risk of MRI associated with tt-MA was more pronounced in workers with lower CNE levels (P = 0.004). Multiplicative interaction analysis revealed antagonisms of CNE and PGMA on MRI risk (P = 0.034). Thus, our findings reveal negative dose-effect associations between noise and BTEXS mixture exposure and renal function in petrochemical workers. With the exception of toluene, benzene, xylene, ethylbenzene, and styrene are all concerning pollutants for renal dysfunction. Effects of benzene, ethylbenzene, and styrene exposure on renal dysfunction were more pronounced in workers with lower CNE.
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Affiliation(s)
- Qingfei Chen
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, No. 74 Zhongshan Road 2, Guangzhou, 510080, Guangdong, China; Joint International Research Laboratory of Environment and Health, Ministry of Education, School of Public Health, Sun Yat-sen University, No. 74 Zhongshan Road 2, Guangzhou, 510080, Guangdong, China
| | - Qifei Deng
- School of Public Health, Guangzhou Medical University, Xinzao Town, Panyu District, Guangzhou, 511436, Guangdong, China
| | - Yan Liu
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, No. 74 Zhongshan Road 2, Guangzhou, 510080, Guangdong, China
| | - Zihao Long
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, No. 74 Zhongshan Road 2, Guangzhou, 510080, Guangdong, China
| | - Shuangqi Li
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, No. 74 Zhongshan Road 2, Guangzhou, 510080, Guangdong, China
| | - Qing Liu
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, No. 74 Zhongshan Road 2, Guangzhou, 510080, Guangdong, China
| | - Yanrong Lv
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, No. 74 Zhongshan Road 2, Guangzhou, 510080, Guangdong, China
| | - Jingyao Qin
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, No. 74 Zhongshan Road 2, Guangzhou, 510080, Guangdong, China
| | - Aichu Yang
- Guangdong Provincial Key Laboratory of Occupational Disease Prevention and Treatment, Guangdong Province Hospital for Occupational Disease Prevention and Treatment, No. 68 Haikang Street, Guangzhou, 510300, Guangdong, China
| | - Yongshun Huang
- Guangdong Provincial Key Laboratory of Occupational Disease Prevention and Treatment, Guangdong Province Hospital for Occupational Disease Prevention and Treatment, No. 68 Haikang Street, Guangzhou, 510300, Guangdong, China
| | - Zhaoqing Tan
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, No. 74 Zhongshan Road 2, Guangzhou, 510080, Guangdong, China
| | - Dongsheng Wang
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, No. 74 Zhongshan Road 2, Guangzhou, 510080, Guangdong, China
| | - Xiumei Xing
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, No. 74 Zhongshan Road 2, Guangzhou, 510080, Guangdong, China; Joint International Research Laboratory of Environment and Health, Ministry of Education, School of Public Health, Sun Yat-sen University, No. 74 Zhongshan Road 2, Guangzhou, 510080, Guangdong, China
| | - Yongmei Xiao
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, No. 74 Zhongshan Road 2, Guangzhou, 510080, Guangdong, China; Joint International Research Laboratory of Environment and Health, Ministry of Education, School of Public Health, Sun Yat-sen University, No. 74 Zhongshan Road 2, Guangzhou, 510080, Guangdong, China.
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Bai F, Wang C, Fan X, Fang L, Li L, Zhang X, Yu K, Liu L, Guo L, Yang X. Novel biomarkers related to oxidative stress and immunity in chronic kidney disease. Heliyon 2024; 10:e27754. [PMID: 38515668 PMCID: PMC10955299 DOI: 10.1016/j.heliyon.2024.e27754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 03/06/2024] [Indexed: 03/23/2024] Open
Abstract
Introduction The incidence of chronic kidney disease (CKD) has been increasing in recent years, gradually becoming a global health crisis. Due to limited treatment options, novel molecular pathways are urgently required to advance the treatment and diagnosis of CKD. Materials and methods The characteristics of differentially expressed genes (DEGs) in CKD patients were analyzed using Gene Expression Omnibus (GEO) database, and genes related to oxidative stress were retrieved from the Genecard database. Subsequently, a comprehensive approach was applied, including immune infiltration analysis, weighted gene co-expression network analysis (WGCNA) and protein-protein interaction (PPI) network analysis, to identify hub genes among differentially expressed immune-related oxidative stress genes (DEIOSGs). Validation of hub genes was performed using an external data set, and diagnostic potential capability was evaluated through receiver operating curve (ROC) analysis. In animal experiments, the expression of hub genes in CKD was confirmed by inducing a CKD model through a 5/6 nephrectomy procedure. Finally, the relationship between these hub genes and clinical characteristics were assessed using the Nephroseq v5 database. Results 29 DEIOSGs were identified by comprehensive bioinformatics analysis. PPI analysis screened the hub genes NCF2, S100A9, and SELL. ROC analysis demonstrated excellent diagnostic efficacy. Further validation from other databases and animal experiments confirmed a substantial upregulation in the expression of hub genes in CKD. Additionally, clinical correlation analysis established a clear link between hub gene expression and renal function deterioration. Conclusions Our study confirms NCF2, S100A9, and SELL as diagnostic biomarkers associated with immune response and oxidative stress in CKD, suggesting their potential as novel targets for CKD diagnosis and treatment.
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Affiliation(s)
- Fang Bai
- Department of Nephrology, Qilu Hospital of Shandong University, Jinan, 250012, Shandong, China
- Laboratory of Basic Medical Sciences, Qilu Hospital of Shandong University, Jinan, 250012, Shandong, China
| | - Chunjie Wang
- Department of Nephrology, Qilu Hospital of Shandong University, Jinan, 250012, Shandong, China
- Laboratory of Basic Medical Sciences, Qilu Hospital of Shandong University, Jinan, 250012, Shandong, China
| | - Xin Fan
- Department of Nephrology, Qilu Hospital of Shandong University, Jinan, 250012, Shandong, China
| | - Lin Fang
- Department of Nephrology, Qilu Hospital of Shandong University, Jinan, 250012, Shandong, China
| | - Luyao Li
- Department of Nephrology, Qilu Hospital of Shandong University, Jinan, 250012, Shandong, China
| | - Xiaoning Zhang
- Department of Nephrology, Shengli Oilfield Central Hospital, Dongying, 257034, Shandong, China
| | - Kuipeng Yu
- Department of Nephrology, Qilu Hospital of Shandong University, Jinan, 250012, Shandong, China
- Department of Blood Purification, Qilu Hospital of Shandong University, Jinan, 250012, Shandong, China
- Laboratory of Basic Medical Sciences, Qilu Hospital of Shandong University, Jinan, 250012, Shandong, China
| | - Lei Liu
- Department of Nephrology, Qilu Hospital of Shandong University, Jinan, 250012, Shandong, China
- Department of Blood Purification, Qilu Hospital of Shandong University, Jinan, 250012, Shandong, China
| | - Ling Guo
- Department of Nephrology, Qilu Hospital of Shandong University, Jinan, 250012, Shandong, China
- Department of Blood Purification, Qilu Hospital of Shandong University, Jinan, 250012, Shandong, China
| | - Xiangdong Yang
- Department of Nephrology, Qilu Hospital of Shandong University, Jinan, 250012, Shandong, China
- Department of Blood Purification, Qilu Hospital of Shandong University, Jinan, 250012, Shandong, China
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He X, Zhang X, Si C, Feng Y, Zhu Q, Li S, Shu L. Ultra-processed food consumption and chronic kidney disease risk: a systematic review and dose-response meta-analysis. Front Nutr 2024; 11:1359229. [PMID: 38606016 PMCID: PMC11007045 DOI: 10.3389/fnut.2024.1359229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 03/19/2024] [Indexed: 04/13/2024] Open
Abstract
BackgroundHigh intake of ultra-processed food (UPF) has been associated with increased risk of chronic kidney disease(CKD), but the results remain inconsistent. We therefore performed this systematic review and dose–response meta-analysis of observational studies that shed light on the association between UPF consumption and the risk of CKD.MethodsA systematic literature search of PubMed, Embase, Web of Science, Scopus and China National Knowledge Infrastructure (CNKI) databases was carried out to find the eligible articles published up to October 31, 2023. Random-effects or fixed-effects models were used to pool the relative risks(RRs) and their 95% confidence intervals (CIs).The potential sources of heterogeneity across studies were examined using the Cochran’s Q test and I-square(I2). Publication bias was examined using the visual inspection of asymmetry in funnel plots and quantified by Begg’s and Egger’s tests.ResultsEight studies (six cohort and two cross-sectional studies) exploring the association between UPF consumption and risk of CKD, were included in the final analysis. The pooled analyses revealed that high consumption of UPF was associated with an increased risk of CKD (RR = 1.25; 95%CI: 1.09–1.42, p < 0.0001). Moreover, a 10% increase of UPF consumption was associated with a 7% higher risk of CKD (RR = 1.07; 95%CI: 1.04–1.10, p < 0.001). Dose–response analysis of all included studies showed a linear association between UPF consumption and the risk of CKD (RR = 1.02; 95%CI:0.99–1.05, Pdose–response = 0.178, Pnonlinearity = 0.843).ConclusionOur findings indicate that high consumption of UPF is significantly associated with an increased risk of CKD. Future research with prospective design is required to confirm this positive association.Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023478483, PROSPERO identifier CRD42023478483.
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Affiliation(s)
- Xingzhen He
- Department of Digestion, Zhejiang Hospital, Hangzhou, Zhejiang, China
| | - Xiaoyan Zhang
- Department of Nutrition, Zhejiang Hospital, Hangzhou, Zhejiang, China
| | - Caijuan Si
- Department of Nutrition, Zhejiang Hospital, Hangzhou, Zhejiang, China
| | - Yuliang Feng
- Department of Digestion, Zhejiang Hospital, Hangzhou, Zhejiang, China
| | - Qin Zhu
- Department of Digestion, Zhejiang Hospital, Hangzhou, Zhejiang, China
- Department of Nutrition, Zhejiang Hospital, Hangzhou, Zhejiang, China
| | - Songtao Li
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Long Shu
- Department of Nutrition, Zhejiang Hospital, Hangzhou, Zhejiang, China
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Zhu W, Han M, Wang Y, Wang G. Trend analysis and prediction of the incidence and mortality of CKD in China and the US. BMC Nephrol 2024; 25:76. [PMID: 38429632 PMCID: PMC10908046 DOI: 10.1186/s12882-024-03518-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 02/21/2024] [Indexed: 03/03/2024] Open
Abstract
BACKGROUND Currently, limited research is available on the comparative analysis of chronic kidney disease (CKD) incidence and mortality rates between China and the United States. This study aimed to explore the trends in CKD incidence and mortality rates in both countries, as well as make some future predictions. METHODS The data on CKD incidence and mortality in China and the US from 1990 to 2019 were derived from the 2019 Global Burden of Disease database. A Joinpoint regression model was used to analyze temporal trends in CKD incidence and mortality. An age-period-cohort model was used to assess the effects of age, period, and birth cohort on CKD risk and forecast the age-standardized incidence rate (ASIR) and age-standardized mortality rate (ASMR) of CKD in China and the US over the next 15 years. RESULTS CKD incidence in China and the US showed an upward trend. Its mortality rate showed a downward trend in China but an upward one in the US. The relative risk (RR) of CKD incidence and mortality increases with age. The RR of CKD incidence in the 0-5 age group exceeds that in the 5-55 age group, and the RR for mortality surpasses that in the 5-35 age group. Over time, the RR of CKD incidence has gradually increased in China and the US. Individuals born in later birth cohorts had a lower RR of CKD incidence and mortality. The ASIR of CKD may increase in both China and the US, whereas its ASMR may decline over the next 15 years. CONCLUSION Screening measures should be strengthened among populations at high risk of CKD; prenatal examinations of pregnant women should be emphasized to reduce CKD incidence in newborns. It is imperative to increase health education and encourage individuals to adopt healthy lifestyles.
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Affiliation(s)
- Wenpeng Zhu
- School of Public Health, Wannan Medical College, Wuhu, Anhui Province, China
| | - Mengqi Han
- School of Public Health, Wannan Medical College, Wuhu, Anhui Province, China
| | - Yuxin Wang
- School of Public Health, Wannan Medical College, Wuhu, Anhui Province, China
| | - Guoping Wang
- School of Public Health, Wannan Medical College, Wuhu, Anhui Province, China.
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Li CR, Deng YL, Miao Y, Zhang M, Zeng JY, Liu XY, Wu Y, Li YJ, Liu AX, Zhu JQ, Liu C, Zeng Q. Exposures to drinking water disinfection byproducts and kidney function in Chinese women. ENVIRONMENTAL RESEARCH 2024; 244:117925. [PMID: 38103773 DOI: 10.1016/j.envres.2023.117925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 12/05/2023] [Accepted: 12/09/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND Disinfection byproducts (DBPs), the ubiquitous contaminants in drinking water, have been shown to impair renal function in experimental studies. However, epidemiological evidence is sparse. OBJECTIVE To investigate exposures to DBPs in associations with renal function among women. METHODS A total of 920 women from December 2018 to January 2020 were abstracted from the Tongji Reproductive and Environmental (TREE) Study, an ongoing cohort study in Wuhan, China. Urine samples were gathered at baseline recruitment and analyzed for dichloroacetic acid (DCAA) and trichloroacetic acid (TCAA) as biomarkers of DBP exposures. Serum uric acid (UA), creatinine, and estimated glomerular filtration rate (eGFR) were measured as indicators of renal function. Multivariate linear regression and restricted cubic spline (RCS) models were conducted to assess urinary DCAA and TCAA concentrations in associations with renal function indicators. Stratified analyses by age and body mass index (BMI) were also performed. RESULTS We found null evidence of urinary TCAA in associations with renal function indicators. However, elevated urinary DCAA tertiles were related to decreased eGFR (β = -1.78%, 95% CI: 3.21%, -0.36%, comparing the upper vs. lower tertile; P for trend = 0.01). This inverse association still existed when urinary DCAA concentration was treated as a continuous variable, and the dose-response relationship was linear based on the RCS model (P for overall association = 0.002 and P for non-linear associations = 0.44). In the stratified analyses, we found an association of urinary DCAA concentration with decreased UA level among women <30 years but an association with increased UA level among women ≥30 years (P for interaction = 0.04). CONCLUSION Urinary DCAA but not TCAA was associated with impaired renal function among women undergoing assisted reproductive technology.
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Affiliation(s)
- Cheng-Ru Li
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Yan-Ling Deng
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Yu Miao
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Min Zhang
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Jia-Yue Zeng
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Xiao-Ying Liu
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Yang Wu
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Yang-Juan Li
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - A-Xue Liu
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Jin-Qin Zhu
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Chong Liu
- Department of Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China.
| | - Qiang Zeng
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China.
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Zhang H, Zhang Y, Gao W, Mu Y. Identification of risk factors and development of a predictive model for chronic kidney disease in patients with obesity: a four-year cohort study. Lipids Health Dis 2024; 23:57. [PMID: 38389088 PMCID: PMC10882765 DOI: 10.1186/s12944-024-02048-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Accepted: 02/16/2024] [Indexed: 02/24/2024] Open
Abstract
OBJECTIVE The sneaky onset and dismal prognosis of chronic kidney disease (CKD) make it an important public health issue. Obesity-related kidney illness has garnered more attention in recent times. Establishing and validating a risk prediction model for chronic renal illness in overweight or obese adults was the goal of this investigation. METHODS Data from the China Health and Retirement Longitudinal Study were used for analysis. The definition of CKD was reduced renal function (eGFR < 60 mL/min/1.73 m²), while overweight and obesity were characterized through a body mass index exceeding 24 kg/m². The dataset was divided into derivation and validation cohorts using a 7:3 ratio. With respect to the derivation cohort, we constructed a prediction model using LASSO analysis and multivariate logistic regression. The model's performance was evaluated using Hosmer-Lemeshow tests, calibration curves, decision curve analysis, and receiver operating characteristic (ROC) curves. The validation cohort's model was subjected to additional assessment. RESULTS The study was based on survey data from 2011 to 2015 and comprised 3246 individuals who were overweight or obese, with 2274 being part of the derivation cohort and 972 being part of the validation cohort. The research constructed a prediction model that included age, sex, fasting blood glucose, glycated hemoglobin, triglyceride, hypertension, and BMI. The validation cohort's area under the ROC curve was 0.812 (95% CI = 0.763, 0.859) while the derivation cohort's was 0.789 (95% CI = 0.754, 0.831). Hosmer-Lemeshow tests were utilized to evaluate the model's accuracy in the validation and derivation cohorts (P = 0.681 and 0.547, respectively). The calibration curve showed a high level of consistency between the actual observations and the projected outcomes. According to decision curve analysis, the model offered significant net advantages. CONCLUSIONS The forecasting model established in this research has predictive value for CKD in patients with overweight or obesity. These findings could help doctors conduct early detection and intervention in clinical practice and further improve patient prognosis.
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Affiliation(s)
- Haixia Zhang
- PLA Medical school, Beijing, China
- Department of Endocrinology, the First Medical Center of People's Liberation Army General Hospital, Beijing, China
| | - Yue Zhang
- PLA Medical school, Beijing, China
- Department of Endocrinology, the First Medical Center of People's Liberation Army General Hospital, Beijing, China
| | | | - Yiming Mu
- Department of Endocrinology, the First Medical Center of People's Liberation Army General Hospital, Beijing, China.
- Department of Endocrinology, Chinese People's Liberation Army General Hospital, No. 28 Fuxing Road, Beijing, 100853, China.
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Lin P, Wan B, Zhong J, Wang M, Tang F, Wang L, Guo J, Ye Y, Liu X, Peng L, Deng L. Risk of fall in patients with chronic kidney disease: results from the China health and retirement longitudinal study (CHARLS). BMC Public Health 2024; 24:499. [PMID: 38365639 PMCID: PMC10873935 DOI: 10.1186/s12889-024-17982-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 02/04/2024] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND Chronic kidney disease (CKD), often coexisting with various systemic disorders, may increase the risk of falls. Our study aimed to assess the prevalence and risk of falls among patients with CKD in China. METHODS We included patients with/without CKD from China Health and Retirement Longitudinal Study (CHARLS). Our primary outcome was the occurrence of fall accidents within the past 2 years. To enhance the robustness of our findings, we employed a multivariable logistic regression model, conducted propensity score analysis, and applied an inverse probability-weighting model. RESULTS A total of 12,658 participants were included, the prevalence of fall accident rates were 17.1% (2,028/11,837) among participants without CKD and 24.7% (203/821) among those with CKD. In the inverse probability-weighting model, participants with CKD exhibited higher fall accident rates (OR = 1.28, 95% CI: 1.08-1.53, p = 0.005 ). Sensitivity and subgroup analysis showed the results still stable. CONCLUSIONS The population in China afflicted with CKD has a significantly heightened risk of experiencing falls, underscoring the crucial importance of intensifying efforts in assessing and preventing fall risks.
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Affiliation(s)
- Pinli Lin
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Biyu Wan
- School of Nursing, Hunan University of Chinese Medicine, Changsha, China
| | - Jintao Zhong
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Mengya Wang
- School of Nursing, Hunan University of Chinese Medicine, Changsha, China
| | - Fang Tang
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Traditional Chinese Medicine), Guangzhou, China
| | - Lingzhen Wang
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Traditional Chinese Medicine), Guangzhou, China
| | - Junjun Guo
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Traditional Chinese Medicine), Guangzhou, China
| | - Yuling Ye
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Traditional Chinese Medicine), Guangzhou, China
| | - Xusheng Liu
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Traditional Chinese Medicine), Guangzhou, China
| | - Lu Peng
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Traditional Chinese Medicine), Guangzhou, China.
| | - Lili Deng
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Traditional Chinese Medicine), Guangzhou, China.
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Wu Q, Chen Q, Xu D, Wang X, Ye H, Li X, Xiong Y, Li J, Zhou S, Miao J, Shen W, Liu Y, Niu H, Tang Y, Zhou L. C-X-C chemokine receptor type 4 promotes tubular cell senescence and renal fibrosis through β-catenin-inhibited fatty acid oxidation. J Cell Mol Med 2024; 28:e18075. [PMID: 38213100 PMCID: PMC10844696 DOI: 10.1111/jcmm.18075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 11/01/2023] [Accepted: 11/24/2023] [Indexed: 01/13/2024] Open
Abstract
The prevalence of chronic kidney disease (CKD) is highly increasing. Renal fibrosis is a common pathological feature in various CKD. Previous studies showed tubular cell senescence is highly involved in the pathogenesis of renal fibrosis. However, the inducers of tubular senescence and the underlying mechanisms have not been fully investigated. C-X-C motif chemokine receptor 4 (CXCR4), a G-protein-coupled seven-span transmembrane receptor, increases renal fibrosis and plays an important role in tubular cell injury. Whereas, whether CXCR4 could induce tubular cell senescence and the detailed mechanisms have not studied yet. In this study, we adopted adriamycin nephropathy and 5/6 nephrectomy models, and cultured tubular cell line. Overexpression or knockdown of CXCR4 was obtained by injection of related plasmids. We identified CXCR4 increased in injury tubular cells. CXCR4 was expressed predominantly in renal tubular epithelial cells and co-localized with adipose differentiation-related protein (ADRP) as well as the senescence-related protein P16INK4A . Furthermore, we found overexpression of CXCR4 greatly induced the activation of β-catenin, while knockdown of CXCR4 inhibited it. We also found that CXCR4 inhibited fatty acid oxidation and triggered lipid deposition in tubular cells. To inhibit β-catenin by ICG-001, an inhibitor of β-catenin, could significantly block CXCR4-suppressed fatty acid oxidation. Taken together, our results indicate that CXCR4 is a key mediator in tubular cell senescence and renal fibrosis. CXCR4 promotes tubular cell senescence and renal fibrosis by inducing β-catenin and inhibiting fatty acid metabolism. Our findings provide a new theory for tubular cell injury in renal fibrosis.
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Affiliation(s)
- Qinyu Wu
- State Key Laboratory of Organ Failure Research, National Clinical Research Center for Kidney Disease, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Division of Nephrology, Nanfang HospitalSouthern Medical UniversityGuangzhouChina
- Department of NephrologyThe Third Affiliated Hospital of Southern Medical UniversityGuangzhouChina
| | - Qiurong Chen
- State Key Laboratory of Organ Failure Research, National Clinical Research Center for Kidney Disease, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Division of Nephrology, Nanfang HospitalSouthern Medical UniversityGuangzhouChina
| | - Dan Xu
- State Key Laboratory of Organ Failure Research, National Clinical Research Center for Kidney Disease, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Division of Nephrology, Nanfang HospitalSouthern Medical UniversityGuangzhouChina
| | - Xiaoxu Wang
- State Key Laboratory of Organ Failure Research, National Clinical Research Center for Kidney Disease, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Division of Nephrology, Nanfang HospitalSouthern Medical UniversityGuangzhouChina
| | - Huiyun Ye
- State Key Laboratory of Organ Failure Research, National Clinical Research Center for Kidney Disease, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Division of Nephrology, Nanfang HospitalSouthern Medical UniversityGuangzhouChina
| | - Xiaolong Li
- State Key Laboratory of Organ Failure Research, National Clinical Research Center for Kidney Disease, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Division of Nephrology, Nanfang HospitalSouthern Medical UniversityGuangzhouChina
| | - Yabing Xiong
- State Key Laboratory of Organ Failure Research, National Clinical Research Center for Kidney Disease, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Division of Nephrology, Nanfang HospitalSouthern Medical UniversityGuangzhouChina
| | - Jiemei Li
- State Key Laboratory of Organ Failure Research, National Clinical Research Center for Kidney Disease, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Division of Nephrology, Nanfang HospitalSouthern Medical UniversityGuangzhouChina
| | - Shan Zhou
- State Key Laboratory of Organ Failure Research, National Clinical Research Center for Kidney Disease, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Division of Nephrology, Nanfang HospitalSouthern Medical UniversityGuangzhouChina
| | - Jinhua Miao
- State Key Laboratory of Organ Failure Research, National Clinical Research Center for Kidney Disease, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Division of Nephrology, Nanfang HospitalSouthern Medical UniversityGuangzhouChina
| | - Weiwei Shen
- State Key Laboratory of Organ Failure Research, National Clinical Research Center for Kidney Disease, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Division of Nephrology, Nanfang HospitalSouthern Medical UniversityGuangzhouChina
| | - Youhua Liu
- State Key Laboratory of Organ Failure Research, National Clinical Research Center for Kidney Disease, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Division of Nephrology, Nanfang HospitalSouthern Medical UniversityGuangzhouChina
| | - Hongxin Niu
- Special Medical Service Center, Zhujiang HospitalSouthern Medical UniversityGuangzhouChina
| | - Ying Tang
- Department of NephrologyThe Third Affiliated Hospital of Southern Medical UniversityGuangzhouChina
| | - Lili Zhou
- State Key Laboratory of Organ Failure Research, National Clinical Research Center for Kidney Disease, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Division of Nephrology, Nanfang HospitalSouthern Medical UniversityGuangzhouChina
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Taber-Hight E, Gilmore A, Friedman AN. Anti-obesity pharmacotherapy in adults with chronic kidney disease. Kidney Int 2024; 105:269-280. [PMID: 37926421 DOI: 10.1016/j.kint.2023.10.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 09/20/2023] [Accepted: 10/02/2023] [Indexed: 11/07/2023]
Abstract
Obesity is a leading risk factor for the development and progression of kidney disease and a major barrier to optimal management of patients with chronic kidney disease. While in the past anti-obesity drugs offered only modest weight loss efficacy in exchange for various safety and tolerability risks, a wave of safer, more tolerable, and more effective treatment options is transforming the management of obesity. This review evaluates current and future pharmacologic anti-obesity therapy in adults through a kidney-oriented lens. It also explores the goals of anti-obesity treatment, describes the underlying putative mechanisms of action, and raises important scientific questions that deserve further exploration in people with chronic kidney disease.
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Affiliation(s)
- Elizabeth Taber-Hight
- Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Ashley Gilmore
- Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Allon N Friedman
- Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA.
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Deng Y, Zhang L, Chen S, Xu D, Wu W, Shen T, Liu Z, Yang L, Wen A, Hou Y, Shao F. Exploring the clinical efficacy and mechanism of high-position colon dialysis combined with Traditional Chinese Medicine retention enema in real-world patients with stage 3-5 chronic kidney disease (non-dialysis) based on the theory of the Gut-Kidney axis. Front Pharmacol 2024; 14:1246852. [PMID: 38328574 PMCID: PMC10847354 DOI: 10.3389/fphar.2023.1246852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 12/31/2023] [Indexed: 02/09/2024] Open
Abstract
Background: With societal and economic development, the annual incidence of chronic kidney disease (CKD) is increasing. Current treatments for CKD are limited, and once patients progress to the uraemic stage, it places a significant economic burden on families and society. Based on the "gut-kidney axis" theory and real-world research, this study aims to evaluate the clinical efficacy, safety, and potential mechanism of high-position colon dialysis combined with traditional Chinese medicine (TCM) retention enema in treating stage 3-5 chronic kidney disease (non-dialysis). Additionally, it seeks to identify new therapeutic targets and approaches for CKD treatment. Methods: The TCM decoction was analyzed using Ultra-Performance Liquid Chromatography-Quadrupole-Orbitrap-High Resolution Mass Spectrometry (UPLC-Q-Orbitrap-HRMS). Participants meeting the inclusion criteria were divided into a control group (n = 153) and a treatment group (n = 159) based on their preferences and physicians' recommendations. Both groups adhered to a high-quality low-protein, low-salt, low-phosphorus, and low-fat diet supplemented with essential amino acids, and were monitored for blood pressure, blood glucose, and blood lipids. The treatment group received high-position colon dialysis combined with TCM retention enemas (administered at least 12 times every other day). Results: Thirteen compounds were identified from the herbs by UPLC-Q-Orbitrap-HRMS. The CKD3-5 treatment group exhibited improvements in blood biochemistry and other laboratory indices, with significant enhancements in renal function-related indices for CKD4 and CKD5 stages (p < 0.05). Following treatment, indoxyl sulfate (IS), endotoxin, and D-lactic acid levels decreased to a certain extent in both groups, with a statistically significant difference observed within the treatment group (p < 0.05). The treatment group displayed a significant reduction in aerobic bacterial colonies, an increase in anaerobic bacterial colonies, a decrease in Escherichia coli colonies, and an increase in Bifidobacterium and Lactobacillus colonies (p < 0.05). No significant changes in colony numbers were observed in the control group. Conclusion: High-position colon dialysis combined with TCM retention enema may serve as an adjuvant treatment for CKD4-5 (non-dialysis), and its mechanism may be related to the reduction of uraemic toxins, improvement of intestinal mucosal barrier function, and regulation of intestinal microecology. Clinical Trial Registration: https://www.chictr.org.cn/, identifier ChiCTR2200062852.
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Affiliation(s)
- Yanli Deng
- Department of Nephrology, Sichuan Second Hospital of Traditional Chinese Medicine, Chengdu, China
| | - Leixiao Zhang
- Division of Internal Medicine, Institute of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Si Chen
- Department of Nephrology, Sichuan Second Hospital of Traditional Chinese Medicine, Chengdu, China
| | - Dongxian Xu
- Department of Nephrology, Sichuan Second Hospital of Traditional Chinese Medicine, Chengdu, China
| | - Wei Wu
- Department of Nephrology, Sichuan Second Hospital of Traditional Chinese Medicine, Chengdu, China
| | - Tao Shen
- Department of Nephrology, Sichuan Second Hospital of Traditional Chinese Medicine, Chengdu, China
| | - Zhen Liu
- Department of Nephrology, Sichuan Second Hospital of Traditional Chinese Medicine, Chengdu, China
| | - Lin Yang
- Department of Nephrology, Sichuan Second Hospital of Traditional Chinese Medicine, Chengdu, China
| | - Aiwei Wen
- Department of Nephrology, Sichuan Second Hospital of Traditional Chinese Medicine, Chengdu, China
| | - Yuhao Hou
- Department of Nephrology, Sichuan Second Hospital of Traditional Chinese Medicine, Chengdu, China
| | - Fanyun Shao
- Chengdu University of Traditional Chinese Medicine, Chengdu, China
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Choi S, Jang SY, Choi E, Park YS. Association between prevalence and severity of chronic kidney disease and employment status: a nationwide study in Korea. BMC Public Health 2024; 24:216. [PMID: 38238668 PMCID: PMC10797861 DOI: 10.1186/s12889-023-17338-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 11/25/2023] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND The prevalence of chronic kidney disease (CKD) is increasing globally, and understanding the association between CKD and employment status is crucial. This cross-sectional study aimed to investigate the association of CKD with employment and occupation type among patients with CKD. METHODS We analyzed data from 36,732 Korean adults aged ≥ 30 years, who participated in the Korean National Health and Nutrition Examination Survey between 2014 and 2021. CKD was detected based on the estimated glomerular filtration rate, and the employment status of the participants was classified into distinct categories: full-time permanent employment, unemployment, self-employment, and precarious employment. We analyzed the data using multiple logistic regression. RESULTS We observed a significant association between CKD and a higher likelihood of unemployment compared to that in individuals without CKD (odds ratio, 1.70; 95% confidence interval, 1.47-1.96). This association was more prominent in patients with severe CKD. In the multivariable logistic analysis, patients with CKD had a higher likelihood for precarious employment (odds ratio, 1.29; 95% confidence interval, 0.92-1.88), self-employment (odds ratio, 1.3; 95% confidence interval, 0.90-1.88), and unemployment (odds ratio, 2.10; 95% confidence interval, 1.51-2.92) compared to individuals without CKD. CONCLUSIONS Our study demonstrated that CKD is associated with a higher likelihood of unemployment and engagement in precarious employment. These findings highlight the challenges faced by patients with CKD in obtaining stable employment and emphasize the need for interventions to improve the employment outcomes of individuals with CKD.
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Affiliation(s)
- Seoyeong Choi
- Department of Public Health, Graduate School, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Suk-Yong Jang
- Institute of Health Services Research, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
- Department of Healthcare Management, Graduate School of Public Health, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
| | - Eunjeong Choi
- Department of Public Health, Graduate School, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Yu Shin Park
- Department of Public Health, Graduate School, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
- Institute of Health Services Research, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
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50
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Zhao D, Wang W, Niu YY, Ren XH, Shen AJ, Xiang YS, Xie HY, Wu LH, Yu C, Zhang YY. Amide Proton Transfer-Weighted Magnetic Resonance Imaging for Application in Renal Fibrosis: A Radiological-Pathological-Based Analysis. Am J Nephrol 2024; 55:334-344. [PMID: 38228096 DOI: 10.1159/000536232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 01/04/2024] [Indexed: 01/18/2024]
Abstract
INTRODUCTION Renal fibrosis (RF), being the most important pathological change in the progression of CKD, is currently assessed by the evaluation of a biopsy. This present study aimed to apply a novel functional MRI (fMRI) protocol named amide proton transfer (APT) weighting to evaluate RF noninvasively. METHODS Male Sprague-Dawley (SD) rats were initially subjected to bilateral kidney ischemia/reperfusion injury (IRI), unilateral ureteral obstruction, and sham operation, respectively. All rats underwent APT mapping on the 7th and 14th days after operation. Besides, 26 patients underwent renal biopsy at the Nephrology Department of Shanghai Tongji Hospital between July 2022 and May 2023. Patients underwent APT and apparent diffusion coefficient (ADC) mappings within 1 week before biopsy. MRI results of both patients and rats were calculated by comparing with gold standard histology for fibrosis assessment. RESULTS In animal models, the cortical APT (cAPT) and medullary APT (mAPT) values were positively correlated with the degree of RF. Compared to the sham group, IRI group showed significantly increased cAPT and mAPT values on the 7th and 14th days after surgery, but no group differences were found in ADC values. Similar results were found in human patients. Cortical/medullary APT values were significantly increased in patients with moderate-to-severe fibrosis than in patients with mild fibrosis. ROC curve analysis indicated that APT value displayed a better diagnostic value for RF. Furthermore, combination of cADC and cAPT improved fibrosis detection by imaging variables alone (p < 0.1). CONCLUSION APT values had better diagnostic capability at early stage of RF compared to ADC values, and the addition of APT imaging to conventional ADC will significantly improve the diagnostic performance for predicting kidney fibrosis.
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Affiliation(s)
- Dan Zhao
- Department of Nephrology, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai, China,
| | - Wei Wang
- Department of Radiology, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yang-Yang Niu
- Department of Nephrology, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xi-Hui Ren
- Department of Radiology, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai, China
| | - Ai-Jun Shen
- Department of Radiology, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yong-Sheng Xiang
- Department of Radiology, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai, China
| | - Hong-Yan Xie
- Department of Nephrology, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai, China
| | - Le-Hao Wu
- Department of Nephrology, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai, China
| | - Chen Yu
- Department of Nephrology, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai, China
| | - Ying-Ying Zhang
- Department of Nephrology, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai, China
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