Kidney and Blood Pressure Research最新文献

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Identification of Key Genes and Candidated Pathways in Human Autosomal Dominant Polycystic Kidney Disease by Bioinformatics Analysis 用生物信息学分析鉴定人类常染色体显性多囊肾病关键基因和候选通路
Kidney and Blood Pressure Research Pub Date : 2019-07-22 DOI: 10.1159/000500458
Dongmei Liu, Yongbao Huo, Sixiu Chen, Dechao Xu, Bo Yang, C. Xue, Lili Fu, L. Bu, Shuwei Song, C. Mei
{"title":"Identification of Key Genes and Candidated Pathways in Human Autosomal Dominant Polycystic Kidney Disease by Bioinformatics Analysis","authors":"Dongmei Liu, Yongbao Huo, Sixiu Chen, Dechao Xu, Bo Yang, C. Xue, Lili Fu, L. Bu, Shuwei Song, C. Mei","doi":"10.1159/000500458","DOIUrl":"https://doi.org/10.1159/000500458","url":null,"abstract":"Background/Aims: Autosomal dominant polycystic kidney disease (ADPKD) is the most common genetic form of kidney disease. High-throughput microarray analysis has been applied for elucidating key genes and pathways associated with ADPKD. Most genetic profiling data from ADPKD patients have been uploaded to public databases but not thoroughly analyzed. This study integrated 2 human microarray profile datasets to elucidate the potential pathways and protein-protein interactions (PPIs) involved in ADPKD via bioinformatics analysis in order to identify possible therapeutic targets. Methods: The kidney tissue microarray data of ADPKD patients and normal individuals were searched and obtained from NCBI Gene Expression Omnibus. Differentially expressed genes (DEGs) were identified, and enriched pathways and central node genes were elucidated using related websites and software according to bioinformatics analysis protocols. Seven DEGs were validated between polycystic kidney disease and control kidney samples by quantitative real-time polymerase chain reaction. Results: Two original human microarray datasets, GSE7869 and GSE35831, were integrated and thoroughly analyzed. In total, 6,422 and 1,152 DEGs were extracted from GSE7869 and GSE35831, respectively, and of these, 561 DEGs were consistent between the databases (291 upregulated genes and 270 downregulated genes). From 421 nodes, 34 central node genes were obtained from a PPI network complex of DEGs. Two significant modules were selected from the PPI network complex by using Cytotype MCODE. Most of the identified genes are involved in protein binding, extracellular region or space, platelet degranulation, mitochondrion, and metabolic pathways. Conclusions: The DEGs and related enriched pathways in ADPKD identified through this integrated bioinformatics analysis provide insights into the molecular mechanisms of ADPKD and potential therapeutic strategies. Specifically, abnormal decorin expression in different stages of ADPKD may represent a new therapeutic target in ADPKD, and regulation of metabolism and mitochondrial function in ADPKD may become a focus of future research.","PeriodicalId":17810,"journal":{"name":"Kidney and Blood Pressure Research","volume":"8 1","pages":"533 - 552"},"PeriodicalIF":0.0,"publicationDate":"2019-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84576887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 14
Triglyceride Glucose Index Predicting Cardiovascular Mortality in Chinese Initiating Peritoneal Dialysis: A Cohort Study 甘油三酯葡萄糖指数预测开始腹膜透析的中国人心血管死亡率:一项队列研究
Kidney and Blood Pressure Research Pub Date : 2019-07-17 DOI: 10.1159/000500979
Zechen Yan, Dahai Yu, Yamei Cai, J. Shang, R. Qin, Jing Xiao, Bin Zhao, Zhanzheng Zhao, D. Simmons
{"title":"Triglyceride Glucose Index Predicting Cardiovascular Mortality in Chinese Initiating Peritoneal Dialysis: A Cohort Study","authors":"Zechen Yan, Dahai Yu, Yamei Cai, J. Shang, R. Qin, Jing Xiao, Bin Zhao, Zhanzheng Zhao, D. Simmons","doi":"10.1159/000500979","DOIUrl":"https://doi.org/10.1159/000500979","url":null,"abstract":"Background: Insulin resistance (IR) is increased among people with end-stage renal disease (ESRD). The Triglyceride glucose (TyG) index is a marker of IR and is also associated with the prognosis of cardiovascular disease among patients initiating peritoneal dialysis (PD). This study was aimed at examining the associations between TyG index and cardiovascular deaths in patients initiating PD. Methods and Results: Three thousand fifty-four patients initiating PD between 2007 and 2014 were included in a prospective cohort derived from Henan PD Registry, TyG index alongside other baseline characteristics were measured when ESRD patients initiated PD. Logistic regression adjusting for age, gender, and major cardiovascular risk factors estimated the association between TyG index and subsequent cardiovascular mortality within 2 years since the initiation of PD. Results: TyG index was positively associated with cardiovascular mortality: adjusted incidence rates ratio (95% CI) comparing the highest vs. lowest TyG index quartile was 2.32 (2.12–2.55) in all, 2.22 (2.01–2.46) in those with body mass index (BMI) <25 kg/m2, and 2.82 (2.24–3.54) in those with BMI ≥25 kg/m2, respectively. Linear dose-response relationships were revealed in all and by BMI. Conclusions: TyG index might be a prognostic factor in predicting cardiovascular mortality among patients initiating PD.","PeriodicalId":17810,"journal":{"name":"Kidney and Blood Pressure Research","volume":"305 1","pages":"669 - 678"},"PeriodicalIF":0.0,"publicationDate":"2019-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76860171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 15
The Cholinergic Anti-Inflammatory Pathway as a Conceptual Framework to Treat Inflammation-Mediated Renal Injury 胆碱能抗炎途径作为治疗炎症介导的肾损伤的概念框架
Kidney and Blood Pressure Research Pub Date : 2019-07-15 DOI: 10.1159/000500920
J. Jarczyk, B. Yard, S. Hoeger
{"title":"The Cholinergic Anti-Inflammatory Pathway as a Conceptual Framework to Treat Inflammation-Mediated Renal Injury","authors":"J. Jarczyk, B. Yard, S. Hoeger","doi":"10.1159/000500920","DOIUrl":"https://doi.org/10.1159/000500920","url":null,"abstract":"Background: The cholinergic anti-inflammatory pathway, positioned at the interface of the nervous and immune systems, is the efferent limb of the “inflammatory reflex” which mainly signals through the vagus nerve. As such, the brain can modulate peripheral inflammatory responses by the activation of vagal efferent fibers. Importantly, immune cells in the spleen express most cholinergic system components such as acetylcholine (ACh), choline acetyltransferase, acetylcholinesterase, and both muscarinic and nicotinic ACh receptors, making communication between both systems possible. In general, this communication down-regulates the inflammation, achieved through different mechanisms and depending on the cells involved. Summary: With the awareness that the cholinergic anti-inflammatory pathway serves to prevent or limit inflammation in peripheral organs, vagus nerve stimulation has become a promising strategy in the treatment of several inflammatory conditions. Both pharmacological and non-pharmacological methods have been used in many studies to limit organ injury as a consequence of inflammation. Key Messages: In this review, we will highlight our current knowledge of the cholinergic anti-inflammatory pathway, with emphasis on its potential clinical use in the treatment of inflammation-triggered kidney injury.","PeriodicalId":17810,"journal":{"name":"Kidney and Blood Pressure Research","volume":"152 1","pages":"435 - 448"},"PeriodicalIF":0.0,"publicationDate":"2019-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85302458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 25
Urine Epidermal Growth Factor, Monocyte Chemoattractant Protein-1 or Their Ratio as Biomarkers for Interstitial Fibrosis and Tubular Atrophy in Primary Glomerulonephritis 尿表皮生长因子、单核细胞趋化蛋白-1或其比值作为原发性肾小球肾炎间质纤维化和小管萎缩的生物标志物
Kidney and Blood Pressure Research Pub Date : 2016-12-01 DOI: 10.1159/000452595
S. Worawichawong, S. Worawichawong, P. Radinahamed, D. Muntham, N. Sathirapongsasuti, A. Nongnuch, M. Assanatham, C. Kitiyakara
{"title":"Urine Epidermal Growth Factor, Monocyte Chemoattractant Protein-1 or Their Ratio as Biomarkers for Interstitial Fibrosis and Tubular Atrophy in Primary Glomerulonephritis","authors":"S. Worawichawong, S. Worawichawong, P. Radinahamed, D. Muntham, N. Sathirapongsasuti, A. Nongnuch, M. Assanatham, C. Kitiyakara","doi":"10.1159/000452595","DOIUrl":"https://doi.org/10.1159/000452595","url":null,"abstract":"Background/Aims: The degree of tubular atrophy and interstitial fibrosis (IFTA) is an important prognostic factor in glomerulonephritis. Imbalance between pro-inflammatory cytokines such as monocyte chemoattractant protein- 1 (MCP-1) and protective cytokines such as epidermal growth factor (EGF) likely determine IFTA severity. In separate studies, elevated MCP-1 and decreased EGF have been shown to be associated with IFTA severity. In this study, we aim to evaluate the predictive value of urinary EGF/MCP-1 ratio compared to each biomarker individually for moderate to severe IFTA in primary glomerulonephritis (GN). Methods: Urine samples were collected at biopsy from primary GN (IgA nephropathy, focal and segmental glomerulosclerosis, minimal change disease, membranous nephropathy). MCP-1 and EGF were analyzed by enzyme-linked immunosorbent assay. Results: EGF, MCP-1 and EGF/MCP-1 ratio from primary GN, all correlated with IFTA (n=58). By univariate analysis, glomerular filtration rate, EGF, and EGF/MCP-1 ratio were associated with IFTA. By multivariate analysis, only EGF/MCP-1 ratio was independently associated with IFTA. EGF/MCP-1 ratio had a sensitivity of 88% and specificity of 74 % for IFTA. EGF/MCP-1 had good discrimination for IFTA (AUC=0.85), but the improvement over EGF alone was not significant. Conclusion: EGF/MCP-1 ratio is independently associated IFTA severity in primary glomerulonephritis, but the ability of EGF/MCP-1 ratio to discriminate moderate to severe IFTA may not be much better than EGF alone.","PeriodicalId":17810,"journal":{"name":"Kidney and Blood Pressure Research","volume":"20 1","pages":"997 - 1007"},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87895712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 37
GSK-3beta Inhibitor Induces Expression of Nrf2/TrxR2 Signaling Pathway to Protect against Renal Ischemia/Reperfusion Injury in Diabetic Rats gsk -3 β抑制剂诱导Nrf2/TrxR2信号通路表达对糖尿病大鼠肾缺血再灌注损伤的保护作用
Kidney and Blood Pressure Research Pub Date : 2016-12-01 DOI: 10.1159/000452598
Bo Hu, Yuhong Wu, Jie Liu, Xiaohua Shen, F. Tong, Guangtao Xu, R. Shen
{"title":"GSK-3beta Inhibitor Induces Expression of Nrf2/TrxR2 Signaling Pathway to Protect against Renal Ischemia/Reperfusion Injury in Diabetic Rats","authors":"Bo Hu, Yuhong Wu, Jie Liu, Xiaohua Shen, F. Tong, Guangtao Xu, R. Shen","doi":"10.1159/000452598","DOIUrl":"https://doi.org/10.1159/000452598","url":null,"abstract":"Background/Aims: Diabetes mellitus (DM) can lead to renal damage and dysfunction, and exacerbate renal ischemia/reperfusion injury (RI/RI). The aim of this study was to investigate the protective effect of GSK-3β inhibitor TDZD-8 against RI/RI through Nrf2/TrxR2 signaling pathway in a rat DM model. Methods: A DM rat model was established by a single injection of streptozocin. Diabetic rats were pretreated with TDZD-8 (1 mg/kg bw) or TDZD-8+auranofin (10 nmol/L, 5ml/kg bw), and then subjected to 45-min ischemia and 24-h reperfusion. Rats were equally randomized into four groups: a Sham-operated group, a RI/RI group, a TDZD-8 group, and a TDZD-8+auranofin group. Serum levels of BUN and Scr were measured. SOD activity, MDA content, and Nrf2, TrxR2 and caspase-3 expressions in rat kidney tissues were determined. Results: Renal function was improved, oxidative stress and cell apoptosis were reduced, and the expression of Nrf2 and TrxR2 was up-regulated in TDZD-8 treated rats as compared with those in auranofin treated rats. Conclusion: TDZD-8 may exert its protective effect against RI/RI by regulating the Nrf2/TrxR2 signaling pathway in the kidney tissue in DM.","PeriodicalId":17810,"journal":{"name":"Kidney and Blood Pressure Research","volume":"5 1","pages":"937 - 946"},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88882386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 49
Clinical Course of Acute Kidney Injury in Elderly Individuals Above 80 Years 80岁以上老年人急性肾损伤的临床过程分析
Kidney and Blood Pressure Research Pub Date : 2016-12-01 DOI: 10.1159/000452599
Isabell Funk, E. Seibert, S. Markau, M. Girndt
{"title":"Clinical Course of Acute Kidney Injury in Elderly Individuals Above 80 Years","authors":"Isabell Funk, E. Seibert, S. Markau, M. Girndt","doi":"10.1159/000452599","DOIUrl":"https://doi.org/10.1159/000452599","url":null,"abstract":"Background/Aims: Aging is associated with renal function decline and elderly patients are more vulnerable to acute kidney injury (AKI). The causes and prognosis of AKI according to new KDIGO definition that broadened the diagnosis and included more patients without dialysis dependence have not yet been compared between younger and elderly patients. Methods: In a retrospective analysis all patients with AKI admitted to a tertiary care Nephrology department (N=424) were included. Individuals were stratified by age (≤80 years, >80 years). Primary end-point was death or dialysis dependence at hospital discharge, secondary analyses addressed the need for dialysis, creatinine at discharge, mortality, and length of stay. Results: The distribution of AKI causes was different between the age groups. Circulatory AKI was the most important cause in both groups; however, septic or toxic AKI contributed relevantly in younger patients. Nevertheless, the number of patients reaching the primary end-point was similar (younger, 20.4%; older, 18.0%; OR 1.17, 95%CI, 0.703-1.948). While mortality tended to be higher in the older population, none of the secondary analyses indicated worse outcome for the older patients. Conclusion: The prognosis of AKI in elderly patients is not necessarily worse than in middle aged individuals. Nevertheless, older patients may be particularly vulnerable to circulatory or ischemic insults of the kidneys.","PeriodicalId":17810,"journal":{"name":"Kidney and Blood Pressure Research","volume":"27 1","pages":"947 - 955"},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86542966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 18
Indoxyl Sulfate Impairs Endothelial Progenitor Cells and Might Contribute to Vascular Dysfunction in Patients with Chronic Kidney Disease 硫酸吲哚酚损害内皮祖细胞并可能导致慢性肾病患者血管功能障碍
Kidney and Blood Pressure Research Pub Date : 2016-12-01 DOI: 10.1159/000452604
Cheng-jui Lin, Chih-jen Wu, Pei-Chen Wu, C. Pan, Tuan-Jen Wang, Fang-Ju Sun, Hsuan-Liang Liu, Han-hsiang Chen, H. Yeh
{"title":"Indoxyl Sulfate Impairs Endothelial Progenitor Cells and Might Contribute to Vascular Dysfunction in Patients with Chronic Kidney Disease","authors":"Cheng-jui Lin, Chih-jen Wu, Pei-Chen Wu, C. Pan, Tuan-Jen Wang, Fang-Ju Sun, Hsuan-Liang Liu, Han-hsiang Chen, H. Yeh","doi":"10.1159/000452604","DOIUrl":"https://doi.org/10.1159/000452604","url":null,"abstract":"Background/Aims: Indoxyl sulfate (IS) is a protein-bound uremic toxin that accumulates in patients with chronic kidney disease (CKD). We explored the effect of IS on human early endothelial progenitor cells (EPCs) and analyzed the correlation between serum IS levels and parameters of vascular function, including endothelial function in a CKD-based cohort. Methods: A cross-sectional study with 128 stable CKD patients was conducted. Flow-mediated dilation (FMD), pulse wave velocity (PWV), ankle brachial index, serum IS and other biochemical parameters were measured and analyzed. In parallel, the activity of early EPCs was also evaluated after exposure to IS. Results: In human EPCs, a concentration-dependent inhibitory effect of IS on chemotactic motility and colony formation was observed. Additionally, serum IS levels were significantly correlated with CKD stages. The total IS (T-IS) and free IS (F-IS) were strongly associated with age, hypertension, cardiovascular disease, blood pressure, PWV, blood urea nitrogen, creatine and phosphate but negatively correlated with FMD, the estimated glomerular filtration rate (eGFR), hemoglobin, hematocrit, and calcium. A multivariate linear regression analysis also showed that FMD was significantly associated with IS after adjusting for other confounding factors. Conclusions: In humans, IS impairs early EPCs and was strongly correlated with vascular dysfunction. Thus, we speculate that this adverse effect of IS may partly result from the inhibition of early EPCs.","PeriodicalId":17810,"journal":{"name":"Kidney and Blood Pressure Research","volume":"36 1","pages":"1025 - 1036"},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86763291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 31
Association of MYH9 Polymorphisms with Hypertension in Patients with Chronic Kidney Disease in China 中国慢性肾病患者MYH9多态性与高血压的关系
Kidney and Blood Pressure Research Pub Date : 2016-12-01 DOI: 10.1159/000452597
Liping Liu, Caili Wang, Yan Mi, Dan Liu, Li Li, Junying Fan, L. Nan, Niya Jia, Yu Du
{"title":"Association of MYH9 Polymorphisms with Hypertension in Patients with Chronic Kidney Disease in China","authors":"Liping Liu, Caili Wang, Yan Mi, Dan Liu, Li Li, Junying Fan, L. Nan, Niya Jia, Yu Du","doi":"10.1159/000452597","DOIUrl":"https://doi.org/10.1159/000452597","url":null,"abstract":"Background/Aims: This study explored the correlation between hypertension and non-muscle myosin heavy chain 9 (MYH9) gene polymorphisms in Chinese chronic kidney disease (CKD) patients. Methods: This case-control study included 301 patients with CKD and 293 healthy controls. The E1 haplotype single nucleotide polymorphisms (SNPs) rs3752462 and rs4821480 were genotyped by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis. The association between MYH9 polymorphisms and high systolic blood pressure (SBP ≥ 140 mmHg) susceptibility in CKD patients was analysed. Results: The cases and controls had similar genotype and allele distributions at rs3752462 and rs4821480. No GG genotype at rs4821480 was observed. Patients with SBP < 140 mmHg were more likely to have the CC genotype (17.1%) than patients with SBP ≥ 140 mmHg (4.3%) (P = 0.001). Creatinine clearance (OR = 0.99, 95% CI = 0.98-0.10, P = 0.01) was associated with SBP in patients with CKD. The risk of SBP ≥ 140 mmHg was 0.24-fold greater among patients with the CC genotype than among patients with the TT genotype (P = 0.002). Conclusion: The rs3752462 polymorphism of MYH9 is associated with SBP in patients with CKD. The T allele in the dominant model was associated with an elevated risk for high SBP.","PeriodicalId":17810,"journal":{"name":"Kidney and Blood Pressure Research","volume":"1 1","pages":"956 - 965"},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76304472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 12
High Dialysate Calcium Concentration May Cause More Sympathetic Stimulus During Hemodialysis 高透析液钙浓度可能引起血液透析过程中更多的交感刺激
Kidney and Blood Pressure Research Pub Date : 2016-12-01 DOI: 10.1159/000452601
Z. Jimenez, B. C. Silva, L. Reis, M. Castro, C. D. Ramos, V. Costa-Hong, L. Bortolotto, F. Consolim-Colombo, W. Dominguez, I. Oliveira, R. Moysés, R. M. Elias
{"title":"High Dialysate Calcium Concentration May Cause More Sympathetic Stimulus During Hemodialysis","authors":"Z. Jimenez, B. C. Silva, L. Reis, M. Castro, C. D. Ramos, V. Costa-Hong, L. Bortolotto, F. Consolim-Colombo, W. Dominguez, I. Oliveira, R. Moysés, R. M. Elias","doi":"10.1159/000452601","DOIUrl":"https://doi.org/10.1159/000452601","url":null,"abstract":"Background/Aims: Acute activation of sympathetic activation during hemodialysis is essential to maintain blood pressure (BP), albeit long-term overactivity contributes to higher mortality. Low heart rate variability (HRV), a measure of autonomic nervous system activity, and abnormal ankle-brachial index (ABI) are associated with higher mortality in patients on hemodialysis. In this study, we assessed HRV and ABI pre and post dialysis in incident patients on hemodialysis using high (1.75mmol/l) and low (1.25mmol/l) dialysate calcium concentration (DCa). Methods: HRV was measured as the ratio between low frequency and high frequency power (LF/HF). Thirty patients (age 47±16 years, 67% men) were studied in two consecutive mid-week hemodialysis sessions. Results: Mean BP variation was positive with DCa 1.75 and negative with DCa 1.25 [4.0 (-6.0, 12.2 mmHg) vs. -3.2 (-9.8, 1.3 mmHg); p=0.050]. Reduction of ABI from pre to post HD was related to higher sympathetic activity (p=0.031). The increase in LF/HF ratio was higher with DCa 1.75 (58.3% vs. 41.7% in DCa 1.75 and 1.25, respectively, RR 2.8; p=0.026). Conclusion: Although higher DCa is associated with better hemodynamic tolerability during hemodialysis, this occurs at the expense of increased sympathetic activity. Higher sympathetic activity was associated with a decrease of ABI during hemodialysis.","PeriodicalId":17810,"journal":{"name":"Kidney and Blood Pressure Research","volume":"36 1","pages":"978 - 985"},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79074907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 14
Cognitive Impairment and Structural Neuroimaging Abnormalities Among Patients with Chronic Kidney Disease 慢性肾病患者的认知障碍和结构神经影像学异常
Kidney and Blood Pressure Research Pub Date : 2016-12-01 DOI: 10.1159/000452603
H. Pi, Yu-Feng Xu, R. Xu, Zhikai Yang, Zhen Qu, Yu-Qing Chen, Gui-ling Liu, Jie Dong
{"title":"Cognitive Impairment and Structural Neuroimaging Abnormalities Among Patients with Chronic Kidney Disease","authors":"H. Pi, Yu-Feng Xu, R. Xu, Zhikai Yang, Zhen Qu, Yu-Qing Chen, Gui-ling Liu, Jie Dong","doi":"10.1159/000452603","DOIUrl":"https://doi.org/10.1159/000452603","url":null,"abstract":"Background/Aims: Cognitive impairment and abnormal structural neuroimaging is common in chronic kidney disease patients. We aimed to explore its association with dialysis modality and the relationship between cognitive impairment and abnormal structural neuroimaging. Methods: Sixty peritoneal dialysis patients and 30 hemodialysis and 30 non-dialyzed stage 3-5 chronic kidney disease patients without history of stroke were enrolled for the study. Participants were matched for age, gender, education, diabetes status, and dialysis duration (if appropriate). Cognitive functions were measured using a battery of recognized instruments. Brain features were examined with 3-dimensional magnetic resonance imaging. Results: Cognitive impairment was significantly more severe in dialysis patients than in non-dialyzed patients. The global and specific cognitive function were not significantly different between patients on peritoneal dialysis and hemodialysis. Hemodialysis patients had more severe white matter hyperintensity, sulcal and ventricular atrophy, and SVIs than other patients. In all groups, higher white matter grade, ventricular grade, and hippocampal atrophy were significantly associated with global cognitive impairment, with hazard ratios of 1.80 (1.22-2.64), 1.67 (1.09-2.57), and 2.49 (1.07-5.77), respectively. White matter grade was also significantly associated with delayed memory (hazard ratio 1.63; 1.12-2.39). Conclusion: Dialysis modality showed no association with cognitive impairment, although hemodialysis patients had more severe neuroimaging abnormalities. For the whole group, white matter hyperintensity, and ventricular and hippocampal atrophy, were independently associated with global cognitive impairment in chronic kidney disease patients.","PeriodicalId":17810,"journal":{"name":"Kidney and Blood Pressure Research","volume":"15 1","pages":"986 - 996"},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74421674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 28
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