eGFR Levels Research Articles

Chemokines and Cytokines Profiles in Patients with Antineutrophil Cytoplasmic Antibodies-Associated Vasculitis: A Preliminary Study.

The damage to small vessels in AAV and inflammatory reactions are accompanied by the release of various chemokines and cytokines. Using a flow cytometry technique, we assessed the levels of specific cytokines, namely IL-1β IL-6, IL-8, IL-10, IL12p70, and TNF, and chemokines, IFN-α, IP-10, and MIG in the serum from 9 healthy volunteers and 20 AAV patients, where 11 of the patients were not treated and evaluated at the time of diagnosis and 9 were already diagnosed and taking CY + GCS. The obtained results were then compared considering the activity of the disease, the type and titre of the ANCA antibodies, the inflammatory status, and the kidneys' condition. Amongst others, the IL-6, IL-8, IL-10, TNF, and MIG levels were much higher in the serum of AAV patients than in healthy controls, whereas the level of IL-1β was higher in healthy volunteers. Additionally, the levels of IL-6, IL-10, IP-10, and MIG negatively correlated with the eGFR level, while the level of IFN-α positively correlated with the titre of PR3-ANCA. As most of the molecules are implicated in trafficking primed neutrophils towards small vessels, looking for links between the levels of these cytokines/chemokines and the clinical symptoms of AAV may facilitate the diagnosis and predict the progression of the disease.

Impact of trifluoromethyl and sulfonyl groups on the biological activity of novel aryl-urea derivatives: synthesis, in-vitro, in-silico and SAR studies

We designed and prepared a novel series of urea derivatives with/without sulfonyl group in their structures to investigate the impact of the sulfonyl group on the biological activity of the evaluated compounds. Antibacterial investigations indicated that derivatives 7, 8, 9, and 11 had the most antibacterial property of all the compounds examined, their minimum inhibitory concentrations (MICs) determined against B. mycoides, E. coli, and C. albicans, with compound 8 being the most active at a MIC value of 4.88 µg/mL. Anti-cancer activity has been tested against eight human cancer cell lines; A549, HCT116, PC3, A431, HePG2, HOS, PACA2 and BJ1. Compounds 7, 8 and 9 emerged IC50 values better than Doxorubicin as a reference drug. Compounds 7 and 8 showed IC50 = 44.4 and 22.4 μM respectively against PACA2 compared to Doxorubicin (IC50 = 52.1 μM). Compound 9 showed IC50 = 17.8, 12.4, and 17.6 μM against HCT116, HePG2, and HOS, respectively. qRT-PCR revealed the down-regulation of PALB2 in compounds 7 and 15 treated PACA2 cells. Also, the down-regulation of BRCA1 and BRCA2 was shown in compound 7 treated PC3 cells. As regard A549 cells, compound 8 decreased the expression level of EGFR and KRAS genes. While compounds 7 and 9 down-regulated TP53 and FASN in HCT116 cells. Molecular docking was done against Escherichia coli enoyl reductase and human Son of sevenless homolog 1 (SOS1) and the results showed the promising inhibition of the studied proteins.

The Potential Mechanism of Curcumin in Treating Oral Squamous Cell Carcinoma Based on Integrated Bioinformatic Analysis.

This study explores the effects of curcumin as a therapeutic agent against oral squamous cell carcinoma (OSCC). We acquired the targets of curcumin from three digital databases, including the Comparative Toxicogenomics Database, Search Tool for Interactions of Chemicals, and SwissTargetPrediction. Then, we identified the differentially expressed genes (DEGs) and the weighted gene coexpression network analysis-based key modules using the expression profiles of GSE23558 to acquire the OSCC-related genes. Additionally, the GeneCards and Online Mendelian Inheritance in Man databases were also used to identify the OSCC-related genes. Finally, curcumin-OSCC interaction genes were obtained by overlapping curcumin targets and OSCC-related genes. The enrichment analysis was performed by the ClusterProfiler algorithm and Metascape, respectively. Then, a protein-protein interaction network was created, and the maximal clique centrality algorithm was used to identify the top 10 hub genes. Besides, we examined the expression levels of hub genes in OSCC using The Cancer Genome Atlas database. 927 DEGs were identified, including 308 upregulated ones and 619 downregulated ones. The cluster one-step network construction function of the WGCNA algorithm recognized a soft-thresholding power of 6, and 9083 genes were acquired. 2591 OSCC-related genes were obtained by overlapping the GSE23558-identified genes and the OSCC-related genes from disease target bases. Finally, we identified 70 candidate drug-disease interaction genes by overlapping the disease-related genes with the curcumin target. The enrichment analysis suggested that response to oxidative stress, epithelial cell proliferation, and AGE/RAGE pathway might involve in the effect of curcumin on OSCC. The topologic study identified the ten hub genes, including VEGFA, AKT1, TNF, HIF1A, EGFR, JUN, STAT3, MMP9, EGF, and MAPK3. A significant difference was observed in VEGFA, AKT1, TNF, HIF1A, EGFR, MMP9, EGF, and MAPK3 expression levels between head and neck squamous cell carcinoma and the normal controls. However, no significant difference was observed in JUN (P = 0.14) and STAT3 (P = 0.054). This study provided an overview and basis for the potential mechanism of curcumin against OSCC. The following experiments should be performed to further understand the effectiveness and safety of curcumin in treating OSCC.

Risk factors related to diabetic retinopathy in Vietnamese patients with type 2 diabetes mellitus

Along with the rising incidence of diabetes, the prevalence of diabetic retinopathy (DR) is quickly growing across the world. The incidence of DR complications is high, and many people are not detected until they have complications and visual impairment, causing many difficulties for the treatment process. Aims: The goal of this cross-sectional was to investigate the clinical and subclinical features of Vietnamese diabetic retinopathy patients. Methods: DR was diagnosed using International Clinical Diabetic Retinopathy scale. Complete clinical information (Age, sex, weight, height, history of hypertension and diabetes mellitus, smoking, alcohol), subclinical information (Glucose, urea, creatinine, HbA1c, uric acid, cholesterol, triglyceride, HDL-cholesterol, LDL-cholesterol blood levels, Complete blood count) were collected. Results: The research enrolled 140 type 2 diabetic patients (70 in each group: DR and no DR). DR patients had significantly higher age, RBC, Hb, eGFR, uric acid, and creatinine blood levels than patients without DR. A duration of diabetes mellitus of over 15 years was associated with an 8.319-fold increased risk of DR. In conclusion, age, RBC, Hb, eGFR, uric acid, creatinine blood levels and duration of diabetes mellitus over 15 years are risk factors for DR.

Renin Inhibition and the Long-Term Renal Function in Patients With Hypertensive Emergency: A Retrospective Cohort Study.

The rehospitalization rate in a hypertensive emergency is high, indicating the necessity for optimizing its long-term management. The role of the renin-angiotensin system (RAS) blockade in this disorder remains uncertain. We conducted a retrospective analysis involving 20 admitted patients who received aliskiren, a direct renin inhibitor (DRI), for the management of hypertensive emergency associated with elevated plasma renin activity (PRA). We analyzed the changes in blood pressure (BP), kidney function, and RAS activity in the subacute and chronic phases. The use of DRI was associated with a marked reduction in PRA (median, from 25.0 to 1.2 ng/ml/h) and serum aldosterone levels (from 404 to 130 pg/ml) during the index admission. BP also decreased from 226/143 to 142/80 mm Hg. A comparison of clinical characteristics according to the renal function indicated that dialysis-dependent patients had higher aldosterone levels than non-dialysis-dependent patients at admission, despite comparable BP levels. After a median follow-up of 567 days in non-dialysis-dependent patients with DRI, eGFR levels were significantly increased from 14.3 to 23.1 ml/min/1.73 m2. PRA levels were consistently suppressed at 0.8 ng/ml/h. We found a significant correlation between the degree of PRA suppression and changes in eGFR (r = -0.58), indicating that the effective blockade of RAS is associated with the preservation of eGFR in the study subjects. DRI can successfully suppress PRA in patients with high-renin hypertensive emergency in both subacute and chronic phases. An efficient RAS blockade is associated with preserved renal function in these patients.

Association between elevated serum uric acid levels and high estimated glomerular filtration rate with reduced risk of low muscle strength in older people: a retrospective cohort study

BackgroundWe aimed to investigate the interaction between serum uric acid (SUA) levels with estimated glomerular filtration rate (eGFR) to low muscle strength (LMS) among older people in China.MethodsCohort data were obtained from China Health and Retirement Longitudinal Study (CHARLS) in 2011 and 2015. A total of 2,822 community-dwelling adults aged 60 and above were enrolled for the follow-up. Serum uric acid was collected after 8 h of fasting, and handgrip strength was measured with a dynamometer. eGFR was calculated with an equation based on the Chinese population. A generalized additive model was employed for interaction analysis and progressively adjusted confounders.ResultsDuring the follow-up, a total of 659 individuals were excluded due to the lack of grip strength data, leaving 2,163 participants for analysis. Despite the protective effect of high uric acid against low muscle strength, especially in older females, it is not statistically significant (OR = 0.69, 95%CI = 0.45–1.04, P = 0.075). Following the progressive adjustment of covariates, the association between higher eGFR and elevated SUA levels remained statistically significant in females, showing a reduced odds ratio with low muscle strength (OR = 0.82, 95%CI = 0.70–0.97, P = 0.021). However, this trend was not observed in male participants.ConclusionsThis Chinese population-based cohort study suggests that among older females, a higher serum uric acid level combined with a higher estimated glomerular filtration rate is linked to a reduced risk of low muscle strength. This implies that the relationship between high serum uric acid levels and the risk of low grip strength might differ by gender.

An integrated machine learning predictive scheme for longitudinal laboratory data to evaluate the factors determining renal function changes in patients with different chronic kidney disease stages.

Chronic kidney disease (CKD) is a global health concern. This study aims to identify key factors associated with renal function changes using the proposed machine learning and important variable selection (ML&IVS) scheme on longitudinal laboratory data. The goal is to predict changes in the estimated glomerular filtration rate (eGFR) in a cohort of patients with CKD stages 3-5. A retrospective cohort study. A total of 710 outpatients who presented with stable nondialysis-dependent CKD stages 3-5 at the Shin-Kong Wu Ho-Su Memorial Hospital Medical Center from 2016 to 2021. This study analyzed trimonthly laboratory data including 47 indicators. The proposed scheme used stochastic gradient boosting, multivariate adaptive regression splines, random forest, eXtreme gradient boosting, and light gradient boosting machine algorithms to evaluate the important factors for predicting the results of the fourth eGFR examination, especially in patients with CKD stage 3 and those with CKD stages 4-5, with or without diabetes mellitus (DM). Subsequent eGFR level after three consecutive laboratory data assessments. Our ML&IVS scheme demonstrated superior predictive capabilities and identified significant factors contributing to renal function changes in various CKD groups. The latest levels of eGFR, blood urea nitrogen (BUN), proteinuria, sodium, and systolic blood pressure as well as mean levels of eGFR, BUN, proteinuria, and triglyceride were the top 10 significantly important factors for predicting the subsequent eGFR level in patients with CKD stages 3-5. In individuals with DM, the latest levels of BUN and proteinuria, mean levels of phosphate and proteinuria, and variations in diastolic blood pressure levels emerged as important factors for predicting the decline of renal function. In individuals without DM, all phosphate patterns and latest albumin levels were found to be key factors in the advanced CKD group. Moreover, proteinuria was identified as an important factor in the CKD stage 3 group without DM and CKD stages 4-5 group with DM. The proposed scheme highlighted factors associated with renal function changes in different CKD conditions, offering valuable insights to physicians for raising awareness about renal function changes.

Serum anti-phospholipase A2 receptor antibody in pathological diagnosis of type 2 diabetes mellitus patients with proteinuria

Patients with diabetes mellitus complicated with proteinuria can be diabetic nephropathy (DN), diabetic complicated with non-diabetic kidney disease (NDKD), or DN with NDKD. Among these membranous nephropathy accounted for a large proportion of DN with NDRD. At present, serum anti-phospholipase A2 receptor (PLA2R) antibody is widely used in the diagnosis and evaluation of therapy in idiopathic membranous nephropathy, our study aimed to investigate the diagnostic significance of anti-PLA2R antibody in type 2 diabetes mellitus (T2DM) patients with proteinuria, providing a method for patients with contraindications of kidney biopsy. Eighty-seven T2DM patients with proteinuria who went on kidney biopsy were divided into the DN group, idiopathic membranous nephropathy (IMN) group, and others group according to their pathological results. In our study, 52.87% and 28.74% of patients were found to have IMN and diabetic nephropathy respectively. The levels of anti-PLA2R antibody, total cholesterol, triglyceride, and estimated glomerular filtration rate (eGFR) were higher in the IMN group, while the prevalence of diabetic retinopathy (DR), systolic blood pressure (SBP) and HbA1c were higher in the DN group. For T2DM patients with proteinuria, anti-PLA2R antibody (AUC = 0.904, 95%CI 0.838–0.970) has a high diagnostic value for IMN. The duration of diabetes (OR = 0.798, P = 0.030), eGFR level (OR = 1.030, P = 0.024), and positive anti-PLA2R antibody (OR = 72.727, P < 0.001) favor the diagnosis of IMN, while DR (OR = 50.234, P < 0.001), SBP (OR = 1.041, P = 0.030), and negative anti-PLA2R antibody (OR = 0.008, P = 0.001) is beneficial to the diagnosis of DN. Our study found that NDKD is not uncommon in patients with T2DM and proteinuria, and IMN was the main pathological type. Positive anti-PLA2R antibody has a strong accuracy in the diagnosis of IMN in patients with T2DM and proteinuria.

A systems biology approach and in vitro experiment indicated Rapamycin targets key cancer and cell cycle-related genes and miRNAs in triple-negative breast cancer cells.

An anticancer drug known as Rapamycin acts by inhibiting the mammalian target of the Rapamycin pathway. This agent has recently been investigated for its potential therapeutic benefits in sensitizing drug-resistant breast cancer (BC) treatment. The molecular mechanism underlying these effects, however, is still a mystery. Using a systems biology method and in vitro experiment, this study sought to discover essential genes and microRNAs (miRNAs) targeted by Rapamycin in triple-negative BC (TNBC) cells to aid prospective new medications with less adverse effects in BC treatment. We developed the transcription factor-miRNA-gene and protein-protein interaction networks using the freely accessible microarray data sets. FANMOD and MCODE were utilized to identify critical regulatory motifs, clusters, and seeds. Then, functional enrichment analyses were conducted. Using topological analysis and motif detection, the most important genes and miRNAs were discovered. We used quantitative real-time polymerase chain reaction (qRT-PCR) to examine the effect of Rapamycin on the expression of the selected genes and miRNAs to verify our findings. We performed flow cytometry to investigate Rapamycin's impact on cell cycle and apoptosis. Furthermore, wound healing and migration assays were done. Three downregulated (PTGS2, EGFR, VEGFA) and three upregulated (c-MYC, MAPK1, PIK3R1) genes were chosen as candidates for additional experimental verification. There were also three upregulated miRNAs (miR-92a, miR-16, miR-20a) and three downregulated miRNAs (miR-146a, miR-145, miR-27a) among the six selected miRNAs. The qRT-PCR findings in MDA-MB-231 cells indicated that c-MYC, MAPK1, PIK3R1, miR-92a, miR-16, and miR-20a expression levels were considerably elevated following Rapamycin treatment, whereas PTGS2, EGFR, VEGFA, miR-146a, and miR-145 expression levels were dramatically lowered (p < 0.05). These genes are engaged in cancer pathways, transcriptional dysregulation in cancer, and cell cycle, according to the top pathway enrichment findings. Migration and wound healing abilities of the cells declined after Rapamycin treatment, and the number of apoptotic cells increased. We demonstrated that Rapamycin suppresses cell migration and metastasis in the TNBC cell line. In addition, our data indicated that Rapamycin induces apoptosis in this cell line. The discovered vital genes and miRNAs affected by Rapamycin are anticipated to have crucial roles in the pathogenesis of TNBC and its therapeutic resistance.

Associations between ultra-processed food consumption and kidney function in an older adult population with metabolic syndrome

Ultra-processed food (UPF) consumption has increased dramatically over the last decades worldwide. Although it has been linked to some cardiometabolic comorbidities, there is limited evidence regarding kidney function. This study aimed to cross-sectionally and longitudinally assess the association between UPF consumption and estimated-glomerular filtration rate (eGFR) based on Cystatin C (CysC). Older adults (mean age 65±5.0 years, 46% women) with overweight/obesity and metabolic syndrome (MetS) who had available data of CysC at baseline (n=1909), at one-year and at 3-years of follow-up (n=1700) were analyzed. Food consumption was assessed using a validated 143-item semi-quantitative food frequency questionnaire and UPF consumption (% of g/d) at baseline and changes after one-year of follow-up were estimated according to NOVA classification system. Multivariable-adjusted linear and logistic regression models were performed to evaluate the cross-sectional associations between UPF consumption with eGFR levels and decreased kidney function (eGFR <60ml/min/1.73m2) at baseline. Multivariable-adjusted mixed-effects linear regression models were fitted to investigate the associations between one-year changes in UPF and eGFR over 3-years of follow-up. Individuals with the highest baseline UPF consumption showed lower eGFR (β:-3.39ml/min/1.73m2; 95% CI:-5.59 to-1.20) and higher odds of decreased kidney function (OR: 1.64; 95% CI: 1.21 to 2.22) at baseline, compared to individuals in the lowest tertile. Participants in the highest tertile of one-year changes in UPF consumption presented a significant decrease in eGFR after one-year of follow-up (β:-1.45ml/min/1.73m2; 95% CI:-2.90 to-0.01) as well as after 3-years of follow-up (β:-2.18ml/min/1.73m2; 95% CI:-3.71 to-0.65) compared to those in the reference category. In a Mediterranean population of older adults with overweight/obesity and MetS, higher UPF consumption at baseline and one-year changes towards higher consumption of UPF were associated with worse kidney function at baseline and over 3-years of follow-up, respectively. ISRCTN89898870.

Estimated glomerular filtration rate and serum neurofilament light chain: Insight from National Health and Nutrition Examination Survey

The neurofilament light chain is a protein biomarker associated with neurodegenerative diseases. Neurofilament light chain levels may increase as kidney function declines due to reduced clearance. However, the relationship between estimated glomerular filtration rate (eGFR) and serum neurofilament light chain (sNfL) has not been extensively studied. Therefore, the objective of this study was to examine the association between eGFR and sNfL levels. Health survey data from 2071 eligible participants in the National Health and Nutrition Examination Survey (NHANES) were used in three multivariate-adjusted weighted linear regression models to analyze the correlation between eGFR and sNfL. Subsequently, segmental linear regression analysis was employed to determine the inflection point of eGFR. Finally, through subgroup analysis, we aimed to assess the impact of all covariates on the association between eGFR and sNfL. According to our results, sNfL levels decreased as eGFR increased. The segmental linear regression model analysis identified an inflection point at 59.9. When eGFR reached 59.9 or exceeded it, each unit increase in eGFR was associated with a 1 pg/mL decrease in sNfL (&amp;beta; = &amp;minus;0.1, P = 0.01). Furthermore, subgroup analysis revealed that hypertension exhibited a significant interaction with the association between eGFR and sNfL (P = 0.01). These findings suggest that eGFR holds promise as a potential marker for neurodegenerative disorders, and hypertension could affect this association to some extent. Moreover, these results could have significant implications for the early detection and prevention of neurodegenerative diseases in patients with kidney disease. However, further research is needed to corroborate these results and elucidate the underlying mechanisms.

Circulating epigenomic biomarkers correspond with kidney disease susceptibility in high-risk populations with type 2 diabetes mellitus

AimsTo investigate epigenomic indices of diabetic kidney disease (DKD) susceptibility among high-risk populations with type 2 diabetes mellitus. MethodsKDIGO (Kidney Disease: Improving Global Outcomes) clinical guidelines were used to classify people living with or without DKD. Differential gene methylation of DKD was then assessed in a discovery Aboriginal Diabetes Study cohort (PROPHECY, 89 people) and an external independent study from Thailand (THEPTARIN, 128 people). Corresponding mRNA levels were also measured and linked to levels of albuminuria and eGFR. ResultsIncreased DKD risk was associated with reduced methylation and elevated gene expression in the PROPHECY discovery cohort of Aboriginal Australians and these findings were externally validated in the THEPTARIN diabetes registry of Thai people living with type 2 diabetes mellitus. ConclusionsNovel epigenomic scores can improve diagnostic performance over clinical modelling using albuminuria and GFR alone and can distinguish DKD susceptibility.

Analysis of Clinical Characteristics of Patients with Different Types of Primary Hyperuricemia

Objective: This paper aims to study the clinical characteristics of patients with different types of primary hyperuricemia (HUA). Methods: Using a retrospective research method, 200 patients with primary HUA in the hospital from June 2020 to January 2023 were selected as the research objects. Patients were grouped according to the detection results of 24-hour urinary uric acid excretion (UUE) and fractional excretion of uric acid (FEUA) (renal insufficiency type, renal overload type, mixed type, and other types). The general information of patients in the four groups (gender, age, body mass index, living habits, etc.), underlying diseases (hypertension, diabetes), blood test results [uric acid (UA), creatinine (Cre)], urine test results (24-hour urine UA, 24-hour urine Cre) were summarized and the differences between the groups were analyzed. Results: The 200 cases of HUA patients were divided into 54.00% with renal insufficiency type, 38.50% with mixed type, 6.00% with renal overload type, and 1.50% with other types. The age of patients with mixed HUA was younger than that of patients with other types, renal overload type, and renal insufficiency type, and the difference was statistically significant (P &lt; 0.05). The UA level of patients with other types of HUA was lower than that of patients with mixed type HUA, and there was statistical significance (P &lt; 0.05). The Cre level of patients with mixed type HUA was lower than that of patients with renal insufficiency type and renal overload type, and the difference was statistically significant (P &lt; 0.05). The 24-hour urinary UA level in patients with renal insufficiency type HUA was lower than that in patients with renal overload type and mixed type HUA, and the difference was statistically significant (P &lt; 0.05). The 24-hour urinary Cre level of patients with other types of HUA was lower than that of patients with renal overload type and mixed HUA, the difference was statistically significant (P &lt; 0.05). The estimated glomerular filtration rate (eGFR) level of patients with other types of HUA was lower than that of patients with mixed type HUA, and the difference was statistically significant (P &lt; 0.05). There was no significant difference in the proportions of hypertension, diabetes, coronary heart disease, and urinary calculi among patients with renal insufficiency type, renal overload type, mixed type, and other types of HUA (P &gt; 0.05). Conclusion: The primary HUA patients are mainly of renal insufficiency type, followed by mixed type. There are significant differences in the clinical characteristics of patients with different types of HUA. Among them, patients with other types of HUA are the oldest and have the lowest uric acid levels. Patients with mixed HUA had the best renal function but the highest 24-hour urine creatinine level. This study can be used as a basis for rational selection of urate-lowering drugs for different HUA patients.

CLINICAL STUDY TO EVALUATE THE NEPHROPROTECTIVE EFFECT OF ELADI CHURNA IN DIABETIC KIDNEY DISEASE.

Diabetic Kidney Disease is now a worldwide health crisis. It is a spectrum of different pathophysiologic processes associated with abnormal kidney function and a progressive decline in glomerular filtration rate. Globally it is the 12th cause of death and 17th cause of disability. Clinically this condition can be correlated to Madumeha and Mutrakshaya. The present study focuses on the efficacy of the Poly herbo-mineral compound, Eladi Churna in the nephroprotective effect in DKD. Consent from all the selected patients was taken before the study. Ethical clearance was accredited by the Government Ayurvedic college and Hospital, Guwahati Assam and CTRI registration was done for the trial. The patients were given the trial drug 1gm twice daily after food with Tandulodak 25 ml and Swadangstradi kwath 25 ml as Anupana for 3 months. A marked improvement was found in eGFR, Serum Creatinine, Blood Urea and Urine Albumin levels. Satisfactory results were noted in chief complaints like urine output, oedema, nausea, vomiting and muscle cramps and Serum Uric acid level. No change was observed in Serum Sodium and Serum Potassium levels at the end of the course.

Renal outcomes in IgA nephropathy following inactivated SARS-CoV-2 vaccination.

There are increasing case reports on de novo or relapsing IgA nephropathy (IgAN) following SARS-CoV-2 vaccines, although the follow-up information on renal outcomes in IgAN patients post-SARS-CoV-2 vaccination is limited. In this study, we evaluated the renal outcomes of IgAN patients following inactivated vaccines. We investigated the change in eGFR, proteinuria and hematuria in 113 primary IgAN patients post-vaccination. Worsening proteinuria was defined as an increase in proteinuria by more than 0.5 times and proteinuria > 1g/d. Univariate and multivariable logistic regression analysis were used to evaluate possible predictors of worsening proteinuria. We then compared the renal outcomes of vaccinated patients after 6months with 101 unvaccinated patients who were followed during the same period. A 2.54% (0.64, 8.61) decrease in renal function was observed in post-vaccination patients. Subgroup analysis revealed a significant decrease in eGFR in patients with 30 ≤ eGFR < 60 (mL/min/1.73m2) post second SARS-CoV-2 dose (n = 18, p = 0.01). In addition, 10 individuals displayed worsening proteinuria post-vaccination, with the proteinuria subsequently ameliorating significantly after 6-month. Multivariate analysis showed that higher eGFR levels was an independent protective factor for worsening proteinuria. The renal outcome tended towards a decrease in eGFR in vaccinated patients after 6months follow-up, although the difference was not significant (p = 0.06). Kidney function in IgAN patients tended to worsen after SARS-CoV-2 vaccination, particularly those with initial poor kidney function. This pattern of disease flare appears to be clinically mild, and further research is needed to determine whether the impact on kidney function is long-term.

Positive blood pressure response may predict the recovery of renal function after transcatheter aortic valve implantation.

Transcatheter aortic valve implantation (TAVI) may ameliorate renal function and increase blood pressure (BP). We aimed to investigate the association between increased BP and improved renal function (IRF) after TAVI. A total of 176 patients who had undergone TAVI were evaluated retrospectively. BP records that were taken 24 h before and 72 h after TAVI were reviewed. Pre-procedural, post-procedural 48 h, and the first month estimated glomerular filtration rate (eGFR) levels were noted. IRF was accepted as a ≥ 10% increase in eGFR. The predictors of acute kidney injury (AKI) development at 48 h and IRF at 1 month were investigated. The association between mortality and BP response was assessed. A total of 157 patients were included in this study after exclusion as defined in the methodology. Mean age was 78.1 ± 7,1 and 51.6% were female. AKI occurred in 25.5% of patients and baseline eGFR and male gender were found as independent predictors for AKI development. IRF was observed in 16% at 48 h and 31.8% of patients at 1-month follow-up. Positive BP response was seen in 42% of patients. Pre-procedural chronic kidney disease, positive BP response, and an early increase in eGFR emerged as independent predictors of IRF at the first month. The patients with positive BP response were found to have decreased mortality at 710 days follow-up. Positive BP response after TAVI is related to improved survival and renal functions. The beneficial effect of TAVI on renal function may be precisely evaluated at 1st month rather than 48 h.

The correlation of urinary strontium with the risk of chronic kidney disease among the general United States population.

This study sought to illustrate whether urinary strontium levels were related to developing chronic kidney disease (CKD) in the United States population. A total of 5,005 subjects were identified from the National Health and Nutrition Examination Survey 2011-2016. Survey-weighted logistic regression analysis, multivariate linear regression analysis, restricted cubic spline (RCS) plots curve and stratified analyses were undertaken to explicate the correlation between urinary strontium and CKD. With the increase of urinary strontium, the incidence rate of CKD and urinary albumin to creatinine ratio (UACR) levels gradually decreased, and estimated glomerular filtration rate (eGFR) levels gradually increased. After controlling all confounders, only urinary strontium in the fourth quartile was correlated to a lower CKD prevalence (OR: 0.59; 95% CI, 0.44-0.79) compared to the lowest quartile. Multivariate linear regression analysis showed that urinary strontium was positively correlated with eGFR but negatively with UACR. RCS curve suggested a nonlinear relationship between urinary strontium and CKD (P for non-linearity <0.001). Stratified analyses indicated no significant difference in the correlation between urinary strontium and CKD among different subgroups. Urinary strontium was strongly correlated with a low risk of CKD, and this association was non-linear among the US population.

Association of MG53 with presence of type 2 diabetes mellitus, glycemic control, and diabetic complications.

Mitsugumin 53 (MG53) is a myokine that acts as a membrane repair protein in tissues. Data on the effect of MG53 on insulin signaling and type 2 diabetes mellitus (T2 DM) are still unknown; most are from preclinical studies. Nevertheless, some researchers have argued that it may be a new pathogenic factor, and therapies targeting MG53 may be a new avenue for T2 DM. Our study aims to evaluate the relationship of circulating MG53 levels with the presence of diabetes, diabetic complications, and glycemic control. We conducted a case-control study with 107 patients with T2 DM and 105 subjects without insulin resistance-related disease. Concurrent blood samples were used for serum MG53 levels and other biochemical laboratory data. MG53 concentration was measured using Human-MG53, an enzyme-linked immunosorbent assay kit (Cat# CSB-EL024511HU). We found no difference in MG53 levels between the diabetic and control groups (p = 0.914). Furthermore, when the subjects were divided into tertiles according to their MG53 levels, we did not find any difference between the groups in terms of the presence of diabetes (p = 0.981). Additionally, no correlation was observed between weight, BMI, waist circumference, systolic and diastolic blood pressure, fasting blood glucose, HbA1c, albumin excretion in the urine, e-GFR levels, and MG53. Finally, MG53 levels were similar between the groups with and without microvascular and macrovascular complications of diabetes. Our research finding provides insightful clinical evidence of lack of association between the levels of MG53 and T2 DM or glycemic control, at least in the studied population of Turkeys ethnicity. However, further clinical studies are warranted to establish solid evidence of the link between MG53, insulin resistance and glycemic control in a wider population elsewhere in the world.

Prospective Cohort Study of Soluble Urokinase Plasminogen Activation Receptor and Cardiovascular Events in Patients With CKD

Soluble urokinase plasminogen activation receptor (suPAR) is an immune-derived pathogenic factor for kidney and atherosclerotic disease. Whether the association between suPAR and cardiovascular (CV) outcomes is dependent on the severity of underlying kidney disease is unclear. We measured serum suPAR levels in 4994 participants (mean age 60 years; 60% men; 36% with diabetes mellitus; mean estimated glomerular filtration rate (eGFR) 49 ml/min per 1.73 m2, SD 18) of the German Chronic Kidney Disease (GCKD) cohort and examined its association with all-cause death, CV death, and major CV events (MACE) across the range of eGFR and urine albumin-to-creatinine ratio (UACR). The median suPAR level was 1771 pg/ml (interquartile range [IQR] 1447-2254 pg/ml). SuPAR levels were positively and independently correlated with age, eGFR, UACR, and parathyroid hormone levels. There were 573 deaths, including 190 CV deaths and 683 MACE events at a follow-up time of 6.5 years. In multivariable analyses, suPAR levels (log2) were associated with all-cause death (hazard ratio [HR] 1.36, 95% confidence interval [CI] 1.21-1.53), CV death (HR 1.27, 95% CI 1.03-1.57), and MACE (HR 1.13, 95% CI 1.00-1.28), and were not found to differ according to diabetes mellitus status, baseline eGFR, UACR, or parathyroid hormone levels. In mediation analysis, suPAR's direct effect on all-cause death, CV death, and MACE accounted for 77%, 67%, and 60% of the total effect, respectively; whereas the effect mediated through eGFR accounted for 23%, 34%, and 40%, respectively. In a large cohort of individuals with chronic kidney disease (CKD), suPAR levels were associated with mortality and CV outcomes independently of indices of kidney function, consistent with its independent role in the pathogenesis of atherosclerosis.

Efficacy and safety of apatinib combined with dose-dense paclitaxel and carboplatin in neoadjuvant therapy for locally advanced triple-negative breast cancer: A prospective cohort study with propensity-matched analysis.

Optimizing neoadjuvant therapy for triple-negative breast cancer (TNBC) is still an urgent problem to be solved in the clinic. In this prospective cohort study, we investigated the efficacy and safety of apatinib combined with dose-dense paclitaxel and carboplatin (Apa+ddTCb) vs dose-dense paclitaxel plus carboplatin regimens alone (ddTCb) in neoadjuvant therapy for locally advanced TNBC. TNBC patients with clinical stage I-IIIC were enrolled to receive neoadjuvant Apa+ddTCb therapy. Enrolled patients who underwent surgery were matched with TNBC patients who received neoadjuvant ddTCb therapy by propensity score matching. 25 locally advanced TNBC patients were enrolled for neoadjuvant Apa+ddTCb therapy. The overall clinical ORR achieved 88.00% and DCR achieved 100.0% after 6 cycles. For 23 patients who received surgery, 69 TNBC patients who received neoadjuvant ddTCb therapy were matched. The pCR rate (60.9% vs 30.4%, P = .009) and the BCS rate (47.8% vs 21.7%, P = .016) were significantly improved in the Apa+ddTCb group. The incidence of adverse events, especially those related to antiangiogenic therapy, was higher in the Apa+ddTCb group. Further immunohistochemical analysis suggested that the expression levels of VEGF, EGFR, p-VEGFR2 and CK17 were significantly decreased after receiving neoadjuvant therapy in the Apa+ddTCb group, and the baseline CK17 expression level in non-pCR patients was significantly higher than those in the pCR patients. Progression-free survival was not reached yet. Apa+ddTCb regimen achieved an improved efficacy and acceptable adverse events compared with ddTCb regimen, which might be a promising strategy in the neoadjuvant therapy for locally advanced TNBC.