{"title":"The combination of kidney function variables with cell cycle arrest biomarkers identifies distinct subphenotypes of sepsis-associated acute kidney injury: a <i>post-hoc</i> analysis (the PHENAKI study).","authors":"Dimitri Titeca-Beauport, Momar Diouf, Delphine Daubin, Ly Van Vong, Guillaume Belliard, Cédric Bruel, Yoann Zerbib, Christophe Vinsonneau, Kada Klouche, Julien Maizel","doi":"10.1080/0886022X.2024.2325640","DOIUrl":"10.1080/0886022X.2024.2325640","url":null,"abstract":"<p><strong>Background: </strong>The severity and course of sepsis-associated acute kidney injury (SA-AKI) are correlated with the mortality rate. Early detection of SA-AKI subphenotypes might facilitate the rapid provision of individualized care.</p><p><strong>Patients and methods: </strong>In this <i>post-hoc</i> analysis of a multicenter prospective study, we combined conventional kidney function variables with serial measurements of urine (tissue inhibitor of metalloproteinase-2 [TIMP-2])* (insulin-like growth factor-binding protein [IGFBP7]) at 0, 6, 12, and 24 h) and then using an unsupervised hierarchical clustering of principal components (HCPC) approach to identify different phenotypes of SA-AKI. We then compared the subphenotypes with regard to a composite outcome of in-hospital death or the initiation of renal replacement therapy (RRT).</p><p><strong>Results: </strong>We included 184 patients presenting SA-AKI within 6 h of the initiation of catecholamines. Three distinct subphenotypes were identified: subphenotype A (99 patients) was characterized by a normal urine output (UO), a low SCr and a low [TIMP-2]*[IGFBP7] level; subphenotype B (74 patients) was characterized by existing chronic kidney disease (CKD), a higher SCr, a low UO, and an intermediate [TIMP-2]*[IGFBP7] level; and subphenotype C was characterized by very low UO, a very high [TIMP-2]*[IGFBP7] level, and an intermediate SCr level. With subphenotype A as the reference, the adjusted hazard ratio (aHR) [95%CI] for the composite outcome was 3.77 [1.92-7.42] (<i>p</i> < 0.001) for subphenotype B and 4.80 [1.67-13.82] (<i>p</i> = 0.004) for subphenotype C.</p><p><strong>Conclusions: </strong>Combining conventional kidney function variables with urine measurements of [TIMP-2]*[IGFBP7] might help to identify distinct SA-AKI subphenotypes with different short-term courses and survival rates.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"46 1","pages":"2325640"},"PeriodicalIF":3.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10919311/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140040224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Renal FailurePub Date : 2024-12-01Epub Date: 2024-09-05DOI: 10.1080/0886022X.2024.2398710
Neng Bao, Jin Wang, Qiyu Yue, Fang Cao, Xuejing Gu, Kejian Wen, Wei Kong, Mingjia Gu
{"title":"Chrysophanol-mediated trx-1 activation attenuates renal fibrosis through inhibition of the JNK/Cx43 signaling pathway.","authors":"Neng Bao, Jin Wang, Qiyu Yue, Fang Cao, Xuejing Gu, Kejian Wen, Wei Kong, Mingjia Gu","doi":"10.1080/0886022X.2024.2398710","DOIUrl":"10.1080/0886022X.2024.2398710","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to investigate the inhibitory effect of chrysophanol on renal fibrosis and its molecular mechanism.</p><p><strong>Methods: </strong>Initially, potential targets of chrysophanol were predicted through network pharmacology analysis, and a protein-protein interaction network of these targets was constructed using Venn diagrams and the STRING database. GO enrichment analysis predicted the biological process of chrysophanol in treating renal fibrosis. Subsequently, both <i>in vivo</i> and <i>in vitro</i> experiments were conducted using unilateral ureteral obstruction (UUO) induced CKD mouse model and HK-2 cell model, respectively. In the mouse model, different doses of chrysophanol were administered to assess its renal protective effects through biochemical indicators, histological examination, and immunofluorescence staining. In the cell model, the regulatory effect of chrysophanol on the Trx-1/JNK/Cx43 pathway was evaluated using western blotting and flow cytometry.</p><p><strong>Results: </strong>Chrysophanol treatment significantly ameliorated renal dysfunction and histopathological damage in the UUO mouse model, accompanied by a reduction in serum oxidative stress markers. Furthermore, chrysophanol markedly upregulated the expression of Trx-1 in renal tissues and inhibited the activation of the JNK/Cx43 signaling pathway. At the cellular level, chrysophanol enhanced the activity of Trx-1 and downregulated the JNK/Cx43 signaling pathway, thereby inhibiting TGF-β induced oxidative stress and cell apoptosis.</p><p><strong>Conclusion: </strong>This study demonstrated a significant inhibitory effect of chrysophanol on renal fibrosis, mediated by the activation of Trx-1 to inhibit the JNK/Cx43 pathway. These findings provide experimental support for the potential use of chrysophanol as a therapeutic agent for renal fibrosis.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"46 2","pages":"2398710"},"PeriodicalIF":3.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11382722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142140891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Renal FailurePub Date : 2024-12-01Epub Date: 2024-09-20DOI: 10.1080/0886022X.2024.2406403
Wenwen Du, Dan Zhang, Wenqian Chen, Wenhui Chen, Pengmei Li, Xiaoxing Wang
{"title":"Investigating an appropriate indicator of acute kidney injury for patient prognosis following lung transplantation.","authors":"Wenwen Du, Dan Zhang, Wenqian Chen, Wenhui Chen, Pengmei Li, Xiaoxing Wang","doi":"10.1080/0886022X.2024.2406403","DOIUrl":"10.1080/0886022X.2024.2406403","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this study was to investigate the correlation between different subtypes of acute kidney injury (AKI) and clinical outcomes following lung transplantation (LTx) and to identify a reliable indicator for predicting poor prognosis in the LTx population.</p><p><strong>Methods: </strong>We retrospectively analyzed the clinical data of 279 LTx patients from August 2016 to March 2023. The AKI subtypes included AKI, persistent AKI on Day 7 (P7-AKI) and Day 14 (P14-AKI) after LTx, and AKI stages. The correlations of these factors with respiratory outcomes, mortality at 90 days, mortality at 1 year and data finalization were assessed, and the risk factors for the selected AKI subtypes were evaluated.</p><p><strong>Results: </strong>AKI occurred in 215 patients (77.1%), with 129 (46.2%) experiencing P7-AKI and 95 (34.1%) experiencing P14-AKI. P7-AKI was associated with more respiratory and mortality outcomes than were AKI and AKI stages, and P7-AKI surpassed P14-AKI in terms of a shorter diagnostic time. After adjusting for age, sex, BMI, type of transplant, transplant diagnosis and comorbidities, P7-AKI independently correlated with increased mortality risk at 90 days [HR 12.312 (95% CI: 2.839-53.402)], 1 year [HR 3.847 (95% CI: 1.840-8.044)], and data finalization [HR 2.010 (95% CI: 1.331-3.033)]. Five variables were identified as independent predictors for P7-AKI, including preoperative body mass index, prothrombin activity, hemoglobin and serum creatinine, and intraoperative colloid administration.</p><p><strong>Conclusion: </strong>P7-AKI has been identified as a reliable indicator for predicting adverse outcomes in LTx patients, which may assist healthcare professionals in identifying high-risk individuals.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"46 2","pages":"2406403"},"PeriodicalIF":3.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11418035/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142294019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Renal FailurePub Date : 2024-12-01Epub Date: 2024-10-11DOI: 10.1080/0886022X.2024.2413872
Tao Zhang, Zijun Zhou, Qianyi Zhou, Jie Li, Zhiwei Zhang, Shili Cao, Bo Yang, Qingmiao Shao
{"title":"Right ventricular-pulmonary artery uncoupling in patients with atrial fibrillation on peritoneal dialysis.","authors":"Tao Zhang, Zijun Zhou, Qianyi Zhou, Jie Li, Zhiwei Zhang, Shili Cao, Bo Yang, Qingmiao Shao","doi":"10.1080/0886022X.2024.2413872","DOIUrl":"10.1080/0886022X.2024.2413872","url":null,"abstract":"<p><strong>Background: </strong>Tricuspid annular plane systolic excursion (TAPSE)/pulmonary artery systolic pressure (PASP) as a noninvasively measured index of right ventricular-pulmonary artery uncoupling is associated with poor outcomes in heart failure patients. However, the relationship by which the TAPSE/PASP is linked to atrial fibrillation (AF) in peritoneal dialysis (PD) patients is not clear. We aimed to investigate the relationship between the TAPSE/PASP and AF in PD patients.</p><p><strong>Methods: </strong>This study was divided into two parts. First, we included 329 PD patients. All the subjects provided detailed a medical history, laboratory analysis and transthoracic echocardiography on admission. We evaluated the differences in the TASPE/PASP ratios between the AF and non-AF groups. Second, a total of 121 patients were followed up to compare mortality between the AF and non-AF groups.</p><p><strong>Results: </strong>Age, BNP, RDW, LA, and septal E/e' were significantly higher, and TAPSE/PASP was significantly lower in patients with AF than in those without AF (<i>p</i> < 0.05). Moreover, the TAPSE/PASP was more pronounced in persistent AF patients. PD patients with AF had a greater risk of mortality (7.2%) than did those without AF (3.8%) after an average follow-up of 12 months. Kaplan-Meier analysis revealed that patients with TAPSE/PASP ratios ≤ 0.715 had a greater risk of mortality than did those with TAPSE/PASP ratios > 0.715.</p><p><strong>Conclusions: </strong>The results suggested that the TAPSE/PASP was lower in AF patients than in non-AF patients. The TAPSE/PASP may be a useful factor for predicting mortality in AF patients with PD, but large-scale prospective studies are needed for verification.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"46 2","pages":"2413872"},"PeriodicalIF":3.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11486252/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142401097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Renal FailurePub Date : 2024-12-01Epub Date: 2024-10-28DOI: 10.1080/0886022X.2024.2417738
Shasha Hu, Yuling Chen, Mingjie He, Jun Wen, Aimin Zhong, Dandan Zhan, Zhibin Ye
{"title":"The role of moderate to vigorous physical activity level and number of treatments/medications in mediating the effect of body mass index on diabetic nephropathy: a Mendelian randomization study.","authors":"Shasha Hu, Yuling Chen, Mingjie He, Jun Wen, Aimin Zhong, Dandan Zhan, Zhibin Ye","doi":"10.1080/0886022X.2024.2417738","DOIUrl":"10.1080/0886022X.2024.2417738","url":null,"abstract":"<p><strong>Background: </strong>Body mass index (BMI) is associated with diabetic nephropathy (DN). However, the mediator factors in the BMI-DN effects remain unclear.</p><p><strong>Methods: </strong>Univariate and multivariate Mendelian randomization (MR) analysis were performed to estimate the association between six lifestyles (moderate to vigorous physical activity levels, years of schooling, BMI, nap during day, number of treatments/medications taken and coffee intake) and DN. MR Egger, Weighted median, Simple mode, and Weighted mode was supplemental methods to Inverse variance weighted. Sensitivity analysis included heterogeneity test, horizontal pleiotropy test, and Leave-One-Out. Additionally, mediation MR was conducted to evaluate the mediating role of lifestyles between BMI and DN. Finally, functional enrichment analysis based on the mediation MR results was performed.</p><p><strong>Results: </strong>univariate and multivariate Mendelian randomization (MR) analysis were performed to estimate the association between six lifestyles (moderate to vigorous physical activity levels, years of schooling, BMI, nap during day, number of treatments/medications taken and coffee intake) and DN. MR Egger, Weighted median, Simple mode, and Weighted mode was supplemental methods to Inverse variance weighted. Sensitivity analysis included heterogeneity test, horizontal pleiotropy test, and Leave-One-Out. Additionally, mediation MR was conducted to evaluate the mediating role of lifestyles between BMI and DN. Finally, functional enrichment analysis based on the mediation MR results was performed.</p><p><strong>Conclusion: </strong>our results supported mediation role of vigorous physical activity level and number of treatments/medications in BMI-DN effects.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"46 2","pages":"2417738"},"PeriodicalIF":3.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11520093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142522806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Glymphatic system dysfunction in nondialysis-dependent ESRD patients with diabetic kidney disease: associations with clinical characteristics and cognitive function.","authors":"Bingxin Yu, Wenbo Yang, Lijun Song, Mingan Li, Boyan Xu, Zhenchang Wang, Zongli Diao, Hao Wang","doi":"10.1080/0886022X.2024.2425160","DOIUrl":"10.1080/0886022X.2024.2425160","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate glymphatic function in nondialysis-dependent ESRD (ND-ESRD) patients with diabetic kidney disease (DKD) or non-DKD using the diffusion tensor image analysis along the perivascular space (DTI-ALPS) method and choroid plexus (CP) volume to explore the associations among DTI-ALPS index, CP volume, clinical characteristics, and cognitive function.</p><p><strong>Methods: </strong>25 DKD patients, 25 non-DKD patients, and 25 healthy control (HC) were included in this study. All participants underwent cerebral MRI and cognitive assessments. Bilateral DTI-ALPS index and CP volume were calculated and were compared among three groups. Correlations among the DTI-ALPS index, CP volume, clinical characteristics, and cognitive function were analyzed.</p><p><strong>Results: </strong>DKD patients had significantly lower left DTI-ALPS index (<i>p</i> = 0.001) and mean DTI-ALPS index (<i>p</i> = 0.003) than non-DKD patients. In ND-ESRD patients, there was a significant positive correlation between the left DTI-ALPS index and phosphorus (<i>r</i> = 0.377, <i>p</i> = 0.007) and attention score (<i>r</i> = 0.434, <i>p</i> = 0.002). In DKD group, the mean DTI-ALPS was positively correlated with total cholesterol (<i>r</i> = 0.631, <i>p</i> = 0.001). In non-DKD group, there was a significant positive correlation between the left DTI-ALPS index and phosphorus (<i>r</i> = 0.696, <i>p</i> < 0.001). Both DKD and non-DKD patients exhibited significant higher CP volume than HC group. In non-DKD group, CP volume was negatively correlated with mean DTI-ALPS (r = -0.535, <i>p</i> = 0.006) and attention score of MoCA (r = -0.538, <i>p</i> = 0.006).</p><p><strong>Conclusions: </strong>Glymphatic system dysfunction may contribute to the pathogenesis of clinical and cognitive impairment in ND-ESRD patients especially with DKD.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"46 2","pages":"2425160"},"PeriodicalIF":3.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11544731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142591404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Renal FailurePub Date : 2024-12-01Epub Date: 2024-10-16DOI: 10.1080/0886022X.2024.2414841
Shujuan Li, Ziyu Wang, Zhen Dong, Yanwei Cao, Hongyang Wang
{"title":"Cumulative rabbit anti-human thymocyte globulin dose to recipient weight during the peri-operative period is an independent risk factor for early postoperative urinary tract infection after kidney transplantation.","authors":"Shujuan Li, Ziyu Wang, Zhen Dong, Yanwei Cao, Hongyang Wang","doi":"10.1080/0886022X.2024.2414841","DOIUrl":"https://doi.org/10.1080/0886022X.2024.2414841","url":null,"abstract":"<p><p>Anti-human thymocyte globulin-Fresenius (ATG-F) is frequently utilized to achieve successful induction for kidney transplantation recipients. This study aimed to examine the association between the ATG-F dose-to-recipient-weight ratio (ADR) and the risk of developing urinary tract infections (UTIs) following kidney transplantation. Data of kidney transplant recipients who underwent ATG-F-induction peri-operatively in a medical center were retrospectively collected, and the incidence of UTIs during the first postoperative year was also recorded. The risk of UTI associated with ADR was analyzed, and receiver operating characteristic curves were drawn to determine the optimal ADR, followed by Cox regression models. In total, 131 recipients were included, with an UTI incidence of 19.08% and a mean interval of 3.08 months. The optimal ADR was 6.34, involving 41 and 90 patients in the low ADR and high ADR groups, respectively. The UTI-free rate in the low ADR group was significantly higher than that in the high ADR group (<i>p</i> = 0.007). Cox regression analysis indicated that a high ADR independently increased the risk of UTI following kidney transplantation (hazard ratio: 5.306, 95% confidence interval: 1.243-22.660, <i>p</i> = 0.024). There was no significant difference in rejection rate between the high ADR and low ADR groups. In conclusion, a high ADR increased the incidence of early postoperative UTI among kidney transplant recipients.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"46 2","pages":"2414841"},"PeriodicalIF":3.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11485816/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142473267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Renal FailurePub Date : 2024-12-01Epub Date: 2024-10-21DOI: 10.1080/0886022X.2024.2406402
Mafalda Ramos, Laetitia Gerlier, Anastasia Uster, Louise Muttram, Dominik Steubl, Andrew H Frankel, Mark Lamotte
{"title":"Development and validation of a chronic kidney disease progression model using patient-level simulations.","authors":"Mafalda Ramos, Laetitia Gerlier, Anastasia Uster, Louise Muttram, Dominik Steubl, Andrew H Frankel, Mark Lamotte","doi":"10.1080/0886022X.2024.2406402","DOIUrl":"10.1080/0886022X.2024.2406402","url":null,"abstract":"<p><p>Chronic disease progression models are available for several highly prevalent conditions. For chronic kidney disease (CKD), the scope of existing progression models is limited to the risk of kidney failure and major cardiovascular (CV) events. The aim of this project was to develop a comprehensive CKD progression model (CKD-PM) that simulates the risk of CKD progression and a broad range of complications in patients with CKD. A series of literature reviews informed the selection of risk factors and identified existing risk equations/algorithms for kidney replacement therapy (KRT), CV events, other CKD-related complications, and mortality. Risk equations and transition probabilities were primarily sourced from publications produced by large US and international CKD registries. A patient-level, state-transition model was developed with health states defined by the Kidney Disease Improving Global Outcomes categories. Model validation was performed by comparing predicted outcomes with observed outcomes in the source cohorts used in model development (internal validation) and other cohorts (external validation). The CKD-PM demonstrated satisfactory modeling properties. Accurate prediction of all-cause and CV mortality was achieved without calibration, while prediction of CV events through CKD-specific equations required implementation of a calibration factor to balance time-dependent versus baseline risk. Predicted annual changes in estimated glomerular filtration rate (eGFR) and urine albumin-creatinine ratio were acceptable in comparison to external values. A flexible eGFR threshold for KRT equations enabled accurate prediction of these events. This CKD-PM demonstrated reliable modeling properties. Both internal and external validation revealed robust outcomes.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"46 2","pages":"2406402"},"PeriodicalIF":3.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11494709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142473268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Factors associated with dysfunction of autogenous arteriovenous fistula in patients with secondary hyperparathyroidism after parathyroidectomy.","authors":"Boxi Chen, Qiying Fang, Yiming Tao, Siqi Peng, Shuting Deng, Ye Yuan, Nan Jiang, Sichun Wen, Bohou Li, Qiong Wu, Zewen Zhao, Pingjiang Ge, Sijia Li, Ting Lin, Zhonglin Feng, Feng Wen, Lei Fu, Zhuo Li, Jia Wen, Renwei Huang, Chaosheng He, Wenjian Wang, Guibao Ke, Lixia Xu, Shuangxin Liu, Jianchao Ma","doi":"10.1080/0886022X.2024.2402515","DOIUrl":"https://doi.org/10.1080/0886022X.2024.2402515","url":null,"abstract":"<p><strong>Background: </strong>Secondary hyperparathyroidism (SHPT) is a prevalent chronic complication in patients undergoing hemodialysis. Parathyroidectomy (PTX) is crucial for reducing mortality and improving the prognosis in the treatment of refractory hyperparathyroidism. However, it is often associated with a number of postoperative complications such as postoperative hypotension, hyperkalemia, and hungry bone syndrome. A previous study demonstrated that low blood pressure influences the patency of autogenous arteriovenous fistulas (AVF). Few studies have examined AVF dysfunction following PTX. This study aimed to identify and describe the risk variables associated with AVF dysfunction after PTX.</p><p><strong>Methods: </strong>Cases of AVF dysfunction after PTX between 2015 and 2021 were studied. Four controls were identified for each patient and were matched for sex and age. Biochemical parameters and blood pressure of the patients before and after PTX were recorded. Risk factors for AVF dysfunction after PTX were identified using conditional logistic regression analysis.</p><p><strong>Results: </strong>Sixteen patients and 64 controls were included in this study. Baseline demographic and laboratory data were compared. Patients in the AVF dysfunction group had lower levels of postoperative calcium than the controls. After surgery, calcium levels decreased more in patients with AVF dysfunction than in the control group. The decrease in systolic blood pressure (ΔSBP) after PTX was greater in the AVF dysfunction group than that in the control group. For each 1 mmHg increment in ΔSBP, the risk of AVF dysfunction after surgery increased by 11.6% (OR = 1.116, 95% CI, 1.005-1.239, <i>p</i> = .040). The likelihood of developing AVF dysfunction after surgery was twelvefold higher in diabetic patients than in non-diabetic patients (OR = 12.506, 95% CI, 1.113-140.492, <i>p</i> = .041). Among patients with ΔSBP > 5.8 mmHg after PTX, the AVF failure rate was significantly greater in patients with diabetes than in those without diabetes. Patients with a history of AVF failure had a nine-fold higher risk of developing AVF dysfunction (OR = 9.143, 95% CI, 1.151-72.627, <i>p</i> = .036). Serum albumin, hemoglobin, ΔiPTH, and age were not independent predictors of AVF dysfunction. The cutoff value for SBP was 5.8 mmHg, as determined by the Youden index of the receiver operating characteristic curve.</p><p><strong>Conclusion: </strong>Decreased systolic blood pressure (ΔSBP) after PTX, diabetes, and AVF failure history were risk factors for AVF dysfunction following PTX in patients with SHPT. Diabetes patients with ΔSBP > 5.8 mmHg were more prone to AVF dysfunction after PTX.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"46 2","pages":"2402515"},"PeriodicalIF":3.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11486174/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142473270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"HDAC6 promotes inflammation in lupus nephritis mice by regulating transcription factors MAFF and KLF5 in renal fibrosis.","authors":"Meihui Deng, Xiao Tan, Xiaojie Peng, Weimin Zheng, Rui Fu, Shanshan Tao","doi":"10.1080/0886022X.2024.2415517","DOIUrl":"10.1080/0886022X.2024.2415517","url":null,"abstract":"<p><strong>Aim: </strong>This study explored the effect and mechanism of MAFF and HDAC6 on renal fibrosis and inflammation in lupus nephritis (LN).</p><p><strong>Methods: </strong>IL-33 treated renal epithelial cells and MRL/lpr mice were respectively used for <i>in vitro</i> and <i>in vivo</i> experiments. The expressions of HDAC6, MAFF, and KLF5 were measured in cells and renal tissues. Before and after cell transfection, the morphological changes in renal tissues were observed using Hematoxylin and eosin (H&E) and Masson staining. The proteinuria, serum creatinine (SCr), blood urea nitrogen (BUN), and double-stranded DNA (dsDNA) levels were detected by biochemical analysis. The expressions of fibrosis and inflammation related proteins (including α-SMA, Vimentin, IL-1β, IL-6, and TNF-α), p65, and iNOS were also detected. The relationship among MAFF, HDAC6, and KLF5 was determined by chromatin immunoprecipitation and dual luciferase reporter gene assay.</p><p><strong>Results: </strong>Renal tissues and cell models had elevated expressions of HDAC6 and KLF5, and decreased MAFF expression. HDAC6 suppression or MAFF overexpression led to suppression of proteinuria, SCr, BUN, and dsDNA levels, as well as attenuation of inflammatory infiltration and collagen deposition. HDAC6 can suppress MAFF expression <i>via</i> deacetylation to abolish its suppression of KLF5 expression, thus increasing KLF5 expression. <i>In vivo</i> and <i>in vitro</i> experiments showed the suppressive effect of HDAC6 suppression on renal fibrosis and inflammation can be abolished by KLF5 overexpression.</p><p><strong>Conclusion: </strong>HDAC6 suppresses MAFF expression <i>via</i> deacetylation to elevate KLF5 expression, which consequently enhances fibrosis and inflammatory response in LN.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"46 2","pages":"2415517"},"PeriodicalIF":3.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11485742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142473306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}