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Redonnet-Vernhet I, Mercié P, Lebreton L, Blouin JM, Bronnimann D, Mesli S, Guibet C, Ribeiro E, Gensous N, Duffau P, Gouya L, Richard E. Preventing hyperhomocysteinemia using vitamin B 6 supplementation in Givosiran-treated acute intermittent porphyria: Highlights from a case report and brief literature review. Mol Genet Metab Rep 2024; 39:101076. [PMID: 38601120 PMCID: PMC11004984 DOI: 10.1016/j.ymgmr.2024.101076] [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: 12/20/2023] [Revised: 03/19/2024] [Accepted: 03/19/2024] [Indexed: 04/12/2024] Open
Abstract
Acute hepatic porphyrias are inherited metabolic disorders of heme biosynthesis characterized by the accumulation of toxic intermediate metabolites responsible for disabling acute neurovisceral attacks. Givosiran is a newly approved siRNA-based treatment of acute hepatic porphyria targeting the first and rate-limiting δ-aminolevulinic acid synthase 1 (ALAS1) enzyme of heme biosynthetic pathway. We described a 72-year old patient who presented with severe inaugural neurological form of acute intermittent porphyria evolving for several years which made her eligible for givosiran administration. On initiation of treatment, the patient developed a major hyperhomocysteinemia (>400 μmol/L) which necessitated to discontinue the siRNA-based therapy. A thorough metabolic analysis in the patient suggests that hyperhomocysteinemia could be attributed to a functional deficiency of cystathionine β-synthase (CBS) enzyme induced by givosiran. Long-term treatment with vitamin B6, a cofactor of CBS, allowed to normalize homocysteinemia while givosiran treatment was maintained. We review the recently published cases of hyperhomocysteinemia in acute hepatic porphyria and its exacerbation under givosiran therapy. We also discuss the benefits of vitamin B6 supplementation in the light of hypothetic pathophysiological mechanisms responsible for hyperhomocysteinemia in these patients. Our results confirmed the importance of monitoring homocysteine metabolism and vitamin status in patients with acute intermittent porphyria in order to improve management by appropriate vitamin supplementation during givosiran treatment.
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Affiliation(s)
- Isabelle Redonnet-Vernhet
- Univ. Bordeaux, INSERM, MRGM, U1211, F-33076 Bordeaux, France
- Service de Biochimie, Laboratoire de Biologie Médicale de Référence (LBMR) Métabolisme des acides Aminés et Métabolisme de l'hème, Groupe hospitalier Pellegrin, CHU de Bordeaux, France
| | - Patrick Mercié
- Service de Médecine Interne et Immunologie Clinique, Groupe Hospitalier Saint-André, CHU de Bordeaux, F-33075 Bordeaux, France
- Centre de Compétence Maladies Rares Porphyries et Anémies rares du Métabolisme du fer, CHU de Bordeaux, France
- Univ. Bordeaux, INSERM, BRIC, UMR1312, F-33076 Bordeaux, France
- Laboratory of Excellence Gr-Ex, F-75015 Paris, France
| | - Louis Lebreton
- Service de Biochimie, Laboratoire de Biologie Médicale de Référence (LBMR) Métabolisme des acides Aminés et Métabolisme de l'hème, Groupe hospitalier Pellegrin, CHU de Bordeaux, France
| | - Jean-Marc Blouin
- Service de Biochimie, Laboratoire de Biologie Médicale de Référence (LBMR) Métabolisme des acides Aminés et Métabolisme de l'hème, Groupe hospitalier Pellegrin, CHU de Bordeaux, France
- Centre de Compétence Maladies Rares Porphyries et Anémies rares du Métabolisme du fer, CHU de Bordeaux, France
- Univ. Bordeaux, INSERM, BRIC, UMR1312, F-33076 Bordeaux, France
- Laboratory of Excellence Gr-Ex, F-75015 Paris, France
| | - Didier Bronnimann
- Service de Médecine Interne et Maladies Infectieuses, Groupe Hospitalier Saint-André, CHU de Bordeaux, F-33075, France
| | - Samir Mesli
- Service de Biochimie, Laboratoire de Biologie Médicale de Référence (LBMR) Métabolisme des acides Aminés et Métabolisme de l'hème, Groupe hospitalier Pellegrin, CHU de Bordeaux, France
| | - Claire Guibet
- Service de Biochimie, Laboratoire de Biologie Médicale de Référence (LBMR) Métabolisme des acides Aminés et Métabolisme de l'hème, Groupe hospitalier Pellegrin, CHU de Bordeaux, France
- Centre de Compétence Maladies Rares Porphyries et Anémies rares du Métabolisme du fer, CHU de Bordeaux, France
- Univ. Bordeaux, INSERM, BRIC, UMR1312, F-33076 Bordeaux, France
- Laboratory of Excellence Gr-Ex, F-75015 Paris, France
| | - Emmanuel Ribeiro
- Service de Médecine Interne et Immunologie Clinique, Groupe Hospitalier Saint-André, CHU de Bordeaux, F-33075 Bordeaux, France
| | - Noémie Gensous
- Service de Médecine Interne et Immunologie Clinique, Groupe Hospitalier Saint-André, CHU de Bordeaux, F-33075 Bordeaux, France
- Univ-Bordeaux, CNRS UMR5164 Immunoconcept, Bordeaux, France
| | - Pierre Duffau
- Service de Médecine Interne et Immunologie Clinique, Groupe Hospitalier Saint-André, CHU de Bordeaux, F-33075 Bordeaux, France
- Univ-Bordeaux, CNRS UMR5164 Immunoconcept, Bordeaux, France
| | - Laurent Gouya
- Laboratory of Excellence Gr-Ex, F-75015 Paris, France
- Centre de Référence Maladies Rares Porphyries et anémies rares du métabolisme du fer, Centre Français des Porphyries, Hôpital Louis Mourier, AP-HP, Paris, France
| | - Emmanuel Richard
- Service de Biochimie, Laboratoire de Biologie Médicale de Référence (LBMR) Métabolisme des acides Aminés et Métabolisme de l'hème, Groupe hospitalier Pellegrin, CHU de Bordeaux, France
- Centre de Compétence Maladies Rares Porphyries et Anémies rares du Métabolisme du fer, CHU de Bordeaux, France
- Univ. Bordeaux, INSERM, BRIC, UMR1312, F-33076 Bordeaux, France
- Laboratory of Excellence Gr-Ex, F-75015 Paris, France
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Chen W, Feng J, Ji P, Liu Y, Wan H, Zhang J. Association of hyperhomocysteinemia and chronic kidney disease in the general population: a systematic review and meta-analysis. BMC Nephrol 2023; 24:247. [PMID: 37612681 PMCID: PMC10463317 DOI: 10.1186/s12882-023-03295-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 08/11/2023] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND Increasing evidence shows that an elevated homocysteine(Hcy) level is associated with an increased risk of chronic kidney disease (CKD). This study systematically evaluated the correlation between homocysteine level and the incidence of CKD reported in cohort and cross-sectional studies. METHODS We searched electronic databases and reference lists for relevant articles. 4 cohort studies and 7 cross-sectional studies including 79,416 patients were analyzed in a meta-analysis. Hyperhomocysteinemia was defined as a Hcy level > 15 µmol/L, which was the criterium used in previous studies. Meta-analyses were conducted of literature searches from online databases such as PubMed, Embase, Cochrane and Scopus. Computed pooled adjusted odds ratios with corresponding 95% confidence intervals (95% CI) were used to estimate the risk of new-onset CKD according to Hcy levels in the general population. RESULTS People with high Hcy levels were more likely to suffer from CKD than people with normal Hcy levels (pooled OR, 2.09; 95% CI, 1.72-2.55). This positive relationship persisted across different study types such as cohort studies (summary OR, 2.2; 95% CI, 1.55-3.13) and cross-sectional studies (summary OR, 2.07; 95% CI, 1.63-2.63). CONCLUSIONS People with hyperhomocysteinemia have a higher incidence of CKD, Hyperhomocysteinemia may also be an independent risk factor for CKD in the general population.
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Affiliation(s)
- Wei Chen
- Guangxi Health Commission key Laboratory of Emergency and Critical Medicine, The Second Affiliated Hospital of Guangxi, Medical University, Nanning, China
| | - Jihua Feng
- Guangxi Health Commission key Laboratory of Emergency and Critical Medicine, The Second Affiliated Hospital of Guangxi, Medical University, Nanning, China
| | - Pan Ji
- Guangxi Health Commission key Laboratory of Emergency and Critical Medicine, The Second Affiliated Hospital of Guangxi, Medical University, Nanning, China
| | - Yani Liu
- Guangxi Health Commission key Laboratory of Emergency and Critical Medicine, The Second Affiliated Hospital of Guangxi, Medical University, Nanning, China
| | - Huan Wan
- Guangxi Health Commission key Laboratory of Emergency and Critical Medicine, The Second Affiliated Hospital of Guangxi, Medical University, Nanning, China
| | - Jianfeng Zhang
- Guangxi Health Commission key Laboratory of Emergency and Critical Medicine, The Second Affiliated Hospital of Guangxi, Medical University, Nanning, China.
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Xue XL, Wang Y, Zhang H, Chen S, Niu SY, Cui L, Wang KP, Hu ZQ. A coumarin-based fluorescent probe: single-wavelength excitation, discrimination of Cys/Hcy and GSH by naked eyes. SPECTROCHIMICA ACTA. PART A, MOLECULAR AND BIOMOLECULAR SPECTROSCOPY 2023; 292:122410. [PMID: 36736049 DOI: 10.1016/j.saa.2023.122410] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 01/19/2023] [Accepted: 01/23/2023] [Indexed: 06/18/2023]
Abstract
Biothiols mainly include cysteine (Cys), homocysteine (Hcy) and glutathione (GSH), which play an important role in life activities and abnormal changes in their concentrations are closely related to certain diseases. Therefore, the quantitative tracking and analysis of biothiols in living organisms has become a hot research topic in recent years. In this work, a coumarin-based fluorescent probe COUN was designed and synthesized for the comparable color recognition of Cys/Hcy and GSH by introducing the phenylethynyl group as the recognition site of biothiols, which showed significant fluorescence enhancement and green fluorescence under the UV light at 365 nm. The probe specifically recognized Hcy, showing 40-fold fluorescence enhancement and strong green fluorescence at 492 nm. Moreover, there was a good linear relationship between the fluorescence intensity of the probe and certain concentrations of Cys/Hcy and GSH, with detection limits of 36.6 nM, 86.4 nM, and 174 nM, respectively. The recognition mechanism of COUN to distinguish Cys/Hcy and GSH was studied by TDDFT calculations. More importantly, COUN was successfully used for imaging biothiols in living cells. The results showed that this probe could provide an effective contribution to the understanding of the role of biothiols, especially Hcy.
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Affiliation(s)
- Xiao-Lei Xue
- Key Laboratory of Optic-electric Sensing and Analytical Chemistry for Life Science, MOE, College of Chemistry and Molecular Engineering, Qingdao University of Science and Technology, Qingdao 266042, PR China
| | - Yang Wang
- Key Laboratory of Optic-electric Sensing and Analytical Chemistry for Life Science, MOE, College of Chemistry and Molecular Engineering, Qingdao University of Science and Technology, Qingdao 266042, PR China
| | - Hao Zhang
- Key Laboratory of Optic-electric Sensing and Analytical Chemistry for Life Science, MOE, College of Chemistry and Molecular Engineering, Qingdao University of Science and Technology, Qingdao 266042, PR China
| | - Shaojin Chen
- Key Laboratory of Optic-electric Sensing and Analytical Chemistry for Life Science, MOE, College of Chemistry and Molecular Engineering, Qingdao University of Science and Technology, Qingdao 266042, PR China
| | - Shu-Yan Niu
- Key Laboratory of Optic-electric Sensing and Analytical Chemistry for Life Science, MOE, College of Chemistry and Molecular Engineering, Qingdao University of Science and Technology, Qingdao 266042, PR China
| | - Lingyun Cui
- Beijing City University, Beijing 100083, China.
| | - Kun-Peng Wang
- Key Laboratory of Optic-electric Sensing and Analytical Chemistry for Life Science, MOE, College of Chemistry and Molecular Engineering, Qingdao University of Science and Technology, Qingdao 266042, PR China.
| | - Zhi-Qiang Hu
- Key Laboratory of Optic-electric Sensing and Analytical Chemistry for Life Science, MOE, College of Chemistry and Molecular Engineering, Qingdao University of Science and Technology, Qingdao 266042, PR China.
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Ventura P, Sardh E, Longo N, Balwani M, Plutzky J, Gouya L, Phillips J, Rhyee S, Fanelli MJ, Sweetser MT, Petrides PE. Hyperhomocysteinemia in acute hepatic porphyria (AHP) and implications for treatment with givosiran. Expert Rev Gastroenterol Hepatol 2022; 16:879-894. [PMID: 35929959 DOI: 10.1080/17474124.2022.2110469] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Homocysteine is a sulfur-containing amino acid formed in the intermediary metabolism of methionine. Amino acid metabolism and heme biosynthesis pathways are complexly intertwined. Plasma homocysteine elevation, hyperhomocysteinemia (HHcy), has been reported in patients with acute hepatic porphyria (AHP), a family of rare genetic disorders caused by defects in hepatic heme biosynthesis. AREAS COVERED This article summarizes published case series in which givosiran, a subcutaneously administered small interfering RNA approved for AHP treatment, appeared to exacerbate dysregulated homocysteine metabolism in patients with AHP. A comprehensive exploratory analysis of ENVISION trial data demonstrated that on a population level, givosiran increased homocysteine but with wide interpatient variations, and there is no proof of correlations between HHcy and changes in efficacy or safety of givosiran. EXPERT OPINION The strong correlation and co-increase of homocysteine and methionine suggest that HHcy associated with givosiran is likely attributable to the impaired trans-sulfuration pathway catalyzed by cystathionine β-synthase, which uses vitamin B6 as a cofactor. Data-based consensus supports monitoring total plasma homocysteine and vitamin B6, B12, and folate levels before and during givosiran treatment; supplementing with pyridoxine/vitamin B6 in patients with homocysteine levels >100 μmol/L; and involving patients with homocysteine levels >30 μmol/L in decisions to supplement.
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Affiliation(s)
- Paolo Ventura
- Department of Surgical and Medical Sciences for Children and Adults, Internal Medicine Unit, University of Modena and Reggio Emilia, Modena, Italy
| | - Eliane Sardh
- Porphyria Centre Sweden, Centre for Inherited Metabolic Diseases, Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Nicola Longo
- Division of Medical Genetics, Departments of Pediatrics and Pathology, University of Utah, Salt Lake City, UT, USA
| | - Manisha Balwani
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jorge Plutzky
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | | | - John Phillips
- Division of Hematology and Hematologic Malignancies, Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | - Sean Rhyee
- Alnylam Pharmaceuticals, Cambridge, MA, USA
| | | | | | - Petro E Petrides
- EPNET Center Munich, Hematology Oncology Center, Ludwig Maximilians University (LMU) of Munich Medical School, Munich, Germany
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Zhao X, Hui QC, Xu R, Gao N, Cao P. Resveratrol: A new approach to ameliorate hyperhomocysteinaemia-induced renal dysfunction. Exp Ther Med 2022; 24:510. [PMID: 35837032 DOI: 10.3892/etm.2022.11437] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 05/16/2022] [Indexed: 11/05/2022] Open
Affiliation(s)
- Xuan Zhao
- Department of Cardiology, Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan, Shandong 250014, P.R. China
| | - Qing-Chen Hui
- Department of Cardiology, Jimo District Qingdao Hospital of Traditional Chinese Medicine, Qingdao, Shandong 266200, P.R. China
| | - Rui Xu
- Department of Cardiology, Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan, Shandong 250014, P.R. China
| | - Ning Gao
- Department of Cardiology, The First Affiliated Hospital of Shandong First Medical University, Jinan, Shandong 250014, P.R. China
| | - Ping Cao
- Department of Geriatric Medicine, Tai'an City Central Hospital, Tai'an, Shandong 271000, P.R. China
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Liu Q, Liu X, Zhang X, Zhou C. Diagnostic Value of Hcy Combined with Blood Pressure Variability Index in the Severity of Hypertension Complicated with CSVD and Its Correlation with Cognitive Function and CysC Expression. JOURNAL OF HEALTHCARE ENGINEERING 2022; 2022:9003537. [PMID: 35463682 PMCID: PMC9023186 DOI: 10.1155/2022/9003537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/13/2022] [Accepted: 03/16/2022] [Indexed: 11/27/2022]
Abstract
This paper explores the diagnostic value of Hcy combined with the blood pressure variability index in the severity of hypertension complicated with CSVD and its correlation with cognitive function and CysC expression. 200 patients with ischemic small cerebral vessels are selected as the research object. According to the MRI findings, they are divided into 48 cases of white matter lesions (WML), 44 cases of lacunar infarction (LI), 44 cases of enlarged perivascular spaces (EPVs), and 46 cases in the mixed group (referring to two or more types of ischemic cerebrovascular disease on imaging). Different cognitive domains of different types of ischemic cerebrovascular diseases are analyzed. The risk factors of cognitive decline in patients with ischemic cerebrovascular disease are analyzed by univariate analysis and multivariate logistic regression analysis. There is an ancestral correlation between serum Hcy and CSVD, which is an independent risk factor for CSVD.
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Affiliation(s)
- Qiaoling Liu
- Department of Geriatrics, The First People's Hospital of Lianyungang, Lianyungang, China
- Xuzhou Medical University Affiliated the Hospital of Lianyungang, The First Affiliated the Hospital of Kangda College of Nangjing Medical University, Jiangsu 222000, China
| | - Xia Liu
- Department of Geriatrics, The First People's Hospital of Lianyungang, Lianyungang, China
- Xuzhou Medical University Affiliated the Hospital of Lianyungang, The First Affiliated the Hospital of Kangda College of Nangjing Medical University, Jiangsu 222000, China
| | - Xuelian Zhang
- Department of Geriatrics, The First People's Hospital of Lianyungang, Lianyungang, China
- Xuzhou Medical University Affiliated the Hospital of Lianyungang, The First Affiliated the Hospital of Kangda College of Nangjing Medical University, Jiangsu 222000, China
| | - Chen Zhou
- Drug Clinical Experimental Center, The First Affiliated Hospital of Nanjing Medical University (Jiangsu Province Hospital), Nanjing, Jiangsu 210029, China
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Zhao W, Gao F, Lv L, Chen X. The interaction of hypertension and homocysteine increases the risk of mortality among middle-aged and older population in the United States. J Hypertens 2022; 40:254-263. [PMID: 34475348 DOI: 10.1097/hjh.0000000000003002] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To investigate the interaction of hypertension and total plasma homocysteine (tHcy) levels on risk of all-cause and cardiovascular disease (CVD) mortality among middle-aged and older population. METHODS This observational cohort study analyzed data from the National Health and Nutrition Examination Survey database (1999-2002 survey cycle). A generalized additive model (GAM) based on Cox proportional hazards models was applied to estimate the relationship of tHcy level with all-cause and CVD mortality. Stratification analyses by sex and renal function were performed. RESULTS Among 5724 individuals aged 40-85, 704 (12.3%) died, with 339 CVD deaths after a median follow-up period of 5.58 years. Mean age was 60.7 ± 13.4 years (49.6% men). In the fully adjusted model, we found that per 1 μmol/l increment of plasma tHcy was associated with 8% increased risk of all-cause mortality and 7% increased risk of CVD mortality in hypertensive participants. The adjusted hazard ratio (95% CIs) for all-cause and CVD mortality were 1.08 (1.06-1.10) and 1.07 (1.04-1.10), respectively. There were pronounced interactive effects between hypertension and tHcy levels on risk of all-cause mortality (P for interaction = 0.031). CONCLUSION Hypertension and tHcy levels can interactively affect the risk of all-cause mortality among middle-aged and older population. Conceivably, hypertension may further enhance the ability of elevated tHcy to provoke the risk of all-cause mortality.
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Affiliation(s)
| | - Faliang Gao
- Department of Neurosurgery, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College
| | - Laidi Lv
- Department of General Practice, Hangzhou Zhaohui Jiedao Community Healthcare Center, Hangzhou, Zhejiang, China
| | - Xi Chen
- Department of General Practice
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Zhang M, Yuan J, Dong R, Da J, Li Q, Hu Y, Yu F, Ran Y, Zha Y, Long Y. Hyperhomocysteinemia exacerbates ischemia-reperfusion injury-induced acute kidney injury by mediating oxidative stress, DNA damage, JNK pathway, and apoptosis. Open Life Sci 2021; 16:537-543. [PMID: 34124373 PMCID: PMC8165256 DOI: 10.1515/biol-2021-0054] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 04/01/2021] [Accepted: 04/22/2021] [Indexed: 11/15/2022] Open
Abstract
Background Hyperhomocysteinemia (HHcy) plays an important role in the progression of many kidney diseases; however, the relationship between HHcy and ischemia-reperfusion injury (IRI)-induced acute kidney injury (IRI-induced AKI) is far from clear. In this study, we try to investigate the effect and possible mechanisms of HHcy on IRI-induced AKI. Methods Twenty C57/BL6 mice were reared with a regular diet or high methionine diet for 2 weeks (to generate HHcy mice); after that, mice were subgrouped to receive sham operation or ischemia-reperfusion surgery. Twenty four hour after reperfusion, serum creatinine, blood urea nitrogen, and Malondialdehyde (MDA) were measured. H&E staining for tubular injury, western blot for γH2AX, JNK, p-JNK, and cleaved caspase 3, and TUNEL assay for tubular cell apoptosis were also performed. Results Our results showed that HHcy did not influence the renal function and histological structure, as well as the levels of MDA, γH2AX, JNK, p-JNK, and tubular cell apoptosis in control mice. However, in IRI-induced AKI mice, HHcy caused severer renal dysfunction and tubular injury, higher levels of oxidative stress, DNA damage, JNK pathway activation, and tubular cell apoptosis. Conclusion Our results demonstrated that HHcy could exacerbate IRI-induced AKI, which may be achieved through promoting oxidative stress, DNA damage, JNK pathway activation, and consequent apoptosis.
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Affiliation(s)
- Mei Zhang
- Department of Biomedicine, Guizhou University School of Medicine, Guizhou University, Guiyang 550025, Guizhou, People's Republic of China
| | - Jing Yuan
- Division of Nephrology, Guizhou Provincial People's Hospital, Guizhou Provincial Institute of Nephritic & Urinary Disease, No. 83 East ZhongShan Road, Guiyang 550002, Guizhou, People's Republic of China
| | - Rong Dong
- Division of Nephrology, Guizhou Provincial People's Hospital, Guizhou Provincial Institute of Nephritic & Urinary Disease, No. 83 East ZhongShan Road, Guiyang 550002, Guizhou, People's Republic of China
| | - Jingjing Da
- Division of Nephrology, Guizhou Provincial People's Hospital, Guizhou Provincial Institute of Nephritic & Urinary Disease, No. 83 East ZhongShan Road, Guiyang 550002, Guizhou, People's Republic of China
| | - Qian Li
- Division of Nephrology, Guizhou Provincial People's Hospital, Guizhou Provincial Institute of Nephritic & Urinary Disease, No. 83 East ZhongShan Road, Guiyang 550002, Guizhou, People's Republic of China
| | - Ying Hu
- Division of Nephrology, Guizhou Provincial People's Hospital, Guizhou Provincial Institute of Nephritic & Urinary Disease, No. 83 East ZhongShan Road, Guiyang 550002, Guizhou, People's Republic of China
| | - Fangfang Yu
- Division of Nephrology, Guizhou Provincial People's Hospital, Guizhou Provincial Institute of Nephritic & Urinary Disease, No. 83 East ZhongShan Road, Guiyang 550002, Guizhou, People's Republic of China
| | - Yan Ran
- Division of Nephrology, Guizhou Provincial People's Hospital, Guizhou Provincial Institute of Nephritic & Urinary Disease, No. 83 East ZhongShan Road, Guiyang 550002, Guizhou, People's Republic of China
| | - Yan Zha
- Division of Nephrology, Guizhou Provincial People's Hospital, Guizhou Provincial Institute of Nephritic & Urinary Disease, No. 83 East ZhongShan Road, Guiyang 550002, Guizhou, People's Republic of China
| | - Yanjun Long
- Division of Nephrology, Guizhou Provincial People's Hospital, Guizhou Provincial Institute of Nephritic & Urinary Disease, No. 83 East ZhongShan Road, Guiyang 550002, Guizhou, People's Republic of China
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