Uremia Patients Research Articles

Co-Expression Analysis of Blood Cell Genome Expression to Preliminary Investigation of Regulatory Mechanisms in Uremia.

BackgroundUremia involves a series of clinical manifestations and is a common syndrome that occurs in nearly all end-stage kidney diseases. However, the exact genetic and/or molecular mechanisms that underlie uremia remain poorly understood.Material/MethodsIn this case-control study, we analyzed whole-genome microarray of 75 uremia patients and 20 healthy controls to investigate changes in gene expression and cellular mechanisms relevant to uremia. Gene co-expression network analysis was performed to construct co-expression networks using differentially expressed genes (DEGs) in uremia. We then determined hub models of co-expressed gene networks by MCODE, and we used miRNA enrichment analysis to detect key miRNAs in each hub module.ResultsWe found nine co-expressed hub modules implicated in uremia. These modules were enriched in specific biological functions, including “proteolysis”, “membrane-enclosed lumen”, and “apoptosis”. Finally, miRNA enrichment analysis to detect key miRNAs in each hub module found 15 miRNAs that were specifically targeted to uremia-related hub modules. Of these, miRNA-21-3p and miRNA-210-3p have been identified in other studies as being important for uremia.ConclusionsIn summary, our study connected biological functions, genes, and miRNAs that underpin the network modules that can be used to elucidate the molecular mechanisms involved in uremia.

Chinese medicine-based nursing in uremia patients with gastritis: Nursing effect and impact on nursing quality

Chinese medicine-based nursing in uremia patients with gastritis: Nursing effect and impact on nursing quality

Evaluation Of The Effect Of Hemodialysis On Left Ventricular Longitudinal Strain Function Of Myocardium In Patients With Uremia By Velocity Vector Imaging

With the continuous improvement of dialysis technology, the survival rate of uremic patients was significantly increased. But so far, there are few studies about the effects of single dialysis on the left ventricular function in patients with uremia maintenance hemodialysis, and there are still controversial. Echocardiography was performed with 35 cases of uremia patients respectively 2H before and after high flux hemodialysis. VVI software was used to analyze the two-dimensional images after conventional measurement and image acquisition,and17 segments of left ventricular peak systolic longitudinal strain (LPS) and layered whole layer strain waa obtained. Comparing with results before hemodialysis,the values including left atrial diameter (LAD), left ventricular end diastolic and end systolic diameter (LVIDd, LVIDs), and left ventricular diastolic end and end systolic volume (EDV, ESV), stroke volume (SV)were reduced after dialysis(P<0.05).There was no significant difference about left ventricular ejection fraction(LVEF) (P>0.05).Layered strain parameters show that the peak systolic longitudinal strain (LPS) of left ventricular global layer and inner layer,the global layer, subendocardial layer, middle layer and epicardial layer of the basal segment ,the global layer and subendocardial layer of middle segment become lower than the values before dialysis and the difference was statistically significant (P < 0.05).However,there was no significant among global epicardial, middle and epicardial of middle segment, global and three layers of apical segments between before and after dialysis in LPS (P > 0.05).Single hemodialysis presents a negative effect on left ventricular function.Therefore, it is necessary to monitor the heart function for hemodialysis patients to avoid the occurrence of cardiovascular events during and after dialysis. VVI technique can be more accurate and effective to evaluate the effect of blood dialysis in uremic patients with left ventricular myocardial regional and global function, and exhibit potential applications in clinical practice.

Lion face in a uremia patient.

Lion face in a uremia patient.

A single center observational study about effect of high-flux hemodialysis treatmemt on mineral metabolism and imflammation status in uremia patients

Objective To evaluate the impact of high-flux hemodialysis on mineral metabolism and micro-inflammatory state in patients with uremia. Methods A single-center, retrospective, self-contrast method study was conducted.165 patients with maintenance hemodialysis(MHD) in our dialysis center were chosen, they all received high-flux hemodialysis treatment.After three months therapy, the serum levels of calcium, phosphorus, parathyroid hormone(PTH) and hsCRP were measured. Results After three months treatment, the serum level of phosphorus was significantly lower than before treatment[(2.29±0.71)mmol/L vs.(2.14±0.79)mmol/L, t=3.087, P 0.05) and hsCRP(t=0.854, P>0.05). Conclusion High-flux hemodialysis therapy can reduce hyperphosphatemia and relieve parathyroid gland hyperfunction, but cannot improve micro-inflammatory state in patients with uremia. Key words: Uremia; Hemodiafiltration; Metabolism; Inflammation

Comparison of HLA-A, -B and -DRB1 Loci Polymorphism between Kidney Transplants of Uremia Patients and Healthy Individuals in Central China.

Chronic kidney disease is becoming a global public health problem, which will usually cause uremia at the end stage of chronic kidney failure. So far, kidney transplant is the most effective and proper therapy for uremia, however, the short supply of matched donor kidney has been a persistent bottleneck for transplantation. HLA matching of HLA-A, -B and -DRB1 loci is very important for the allocation of kidney transplants. In this study, we investigated genotypes of HLA-A, -B and -DRB1 loci based on 1,464 uremia patients and 10,000 unrelated healthy individuals in Henan province of China, and compared the frequency distribution of these HLA alleles and corresponding haplotypes between patient and healthy groups. We detected 23 HLA-A, 49 HLA-B and 17 HLA-DRB1 alleles in total. The predominant alleles of HLA-A, -B and -DRB1 loci in patients are the same as those in healthy group. The seven most frequent alleles account for about 87%, 50%, and 77% at HLA-A, -B and -DRB1 loci, respectively. The haplotypes (combinations of HLA-A, -B, and -DRB1) with significantly different frequency between patients and controls mostly account for less than 1%. Overall, this suggests that HLA matching is not a potential difficulty for kidney transplant of uremia patients. However, three of the top seven frequent HLA-DRB1 alleles have a significantly different distribution in patients and controls, while only one alleles for HLA-B and zero for HLA-A loci. These HLA-DRB1 alleles may be closely associated with uremia. This study sheds new lights on the composition and difference of HLA genotypes in uremia patients and healthy populations in Central China that can serve as a guide to HLA matching for kidney transplants and a resource for HLA typing-related studies.

Comparison of on-line hemodiafiltration and high-flux hemodialysis for correcting calcium and phosphate metabolic disorder in uremia patients

Objective To compare the effect on correcting calcium and phosphate metabolic disorder and the impact on quality of life in uremia patients between on-line hemodiafiltration and high-flux hemodialysis. Methods 90 patients with uremia, digital watches were randomly divided into QL-HDF group and HFHD group, Ca2+ , P3+ , serum parathyroid hormone(PTH) level were measured before and after dialysis blood.The survival quality of patients were evaluated by the KDQOL-SFTM1.3 scale.The incidence of adverse reactions were collected.The similarities and differences of two groups were compared. Results The comparison of Ca2+ levels in the two groups before and after dialysis showed no significant difference(P>0.05); Of the QL-HDF group after treatment, P3+ was (1.82±0.19)mmol/L, PTH was (401.6±16.7)pg/L, which were significantly lower than those of QL-HDF group[P3+ (2.14±0.22)mmol/L, PTH(425.0±17.2)pg/L](t=24.256, 21.059, all P 0.05); 6 cases of adverse reactions was in the QL-HDF group (13.33%), 14 cases of adverse reactions was in the HFHD group(31.11%), there was significant difference between the two groups(χ2=5.361, P<0.05). Conclusion The two methods can improve the metabolic disorders of calcium and phosphorus in patients with uremia, and QL-HDF showed stronger ability to remove the ability, and the quality of life is higher, it is worth promoting in clinical practice. Key words: Calcium metabolism disorders; Phosphorus metabolism disorders; Uremia; Hemodiafiltration; Renal dialysis; Quality of life

Clinical analysis of laparoscopic surgery in patients with maintenance hemodialysis and colon cancer

To explore the safety of laparoscopic assisted radical resection of colon cancer in uremic patients. Retrospective analysis of Zhejiang Jinhua Guangfu hospital 2012 March to 2015 March 5 cases of uremia patients complicated with colon cancer underwent laparoscopic assisted colorectal cancer radical resection, and compared with 10 cases, observing two groups of operative time, intraoperative bleeding volume, postoperative drainage volume, lymph nodes dissect, anal exhaust time, postoperative complications, postoperative hospitalization time and postoperative pathological staging. Before operation two groups of age, gender, tumor location was no significant difference (P>0.05). In preoperative comorbidities uremic patients were significantly more than that of ordinary patients, mainly in cardiovascular complications, and patients in the two groups in operation time, intraoperative bleeding, post operative drainage volume, lymph node dissection numbers were no significant difference, the postoperative gastrointestinal function recovery was almost no difference, but postoperative hospitalization time significantly prolonged (P<0.05). Patients with uremia as long as full preoperative preparation, perioperative management, plus timely hemodialysis, uremia patients undergoing laparoscopic assisted radical surgery is safe and feasible, and it is worth promoting.

An empirical study of a hybrid imbalanced-class DT-RST classification procedure to elucidate therapeutic effects in uremia patients.

The high prevalence and incidence of severe renal diseases exhaust constrained medical resources for the treatment of uremia patients. In addition, the problem of imbalanced-class data distributions induces negative effects on classifier learning algorithms. Hemodialysis is the most common treatment for uremia diseases due to the limited supply of donated organs available for transplantation. This study focused on assessing the adequacy of hemodialysis. The lack of available information represents the primary obstacle limiting the evaluation of adequacy, namely: (1) the imbalanced-class problem in a given dataset, (2) obeying mathematical distributions for a given dataset, (3) a lack of effective methods for identifying determinant attributes, and (4) developing effective decision rules to explain a given dataset. To address these issues for determining the therapeutic effects of hemodialysis in uremia patients, this study proposes a hybrid imbalanced-class decision tree-rough set model to integrate the knowledge of expert physicians, a feature selection method, imbalanced sampling techniques, a rough set classifier, and a rule filter. The method was assessed by examining the medical records of uremia patients from a medical center in Taiwan. The proposed method yields better performance compared to previously reported methods according to the evaluation criteria.

Electronegative Low-density Lipoprotein Increases Coronary Artery Disease Risk in Uremia Patients on Maintenance Hemodialysis.

Electronegative low-density lipoprotein (LDL) is a recognized factor in the pathogenesis of coronary artery disease (CAD) in the general population, but its role in the development of CAD in uremia patients is unknown. L5 is the most electronegative subfraction of LDL isolated from human plasma. In this study, we examined the distribution of L5 (L5%) and its association with CAD risk in uremia patients.The LDL of 39 uremia patients on maintenance hemodialysis and 21 healthy controls was separated into 5 subfractions, L1-L5, with increasing electronegativity. We compared the distribution and composition of plasma L5 between uremia patients and controls, examined the association between plasma L5% and CAD risk in uremia patients, and studied the effects of L5 from uremia patients on endothelial function.Compared to controls, uremia patients had significantly increased L5% (P < 0.001) and L5 that was rich in apolipoprotein C3 and triglycerides. L5% was significantly higher in uremia patients with CAD (n = 10) than in those without CAD (n = 29) (P < 0.05). Independent of other major CAD risk factors, the adjusted odds ratio for CAD was 1.88 per percent increase in plasma L5% (95% CI, 1.01-3.53), with a near-linear dose-response relationship. Compared with controls, uremia patients had decreased flow-mediated vascular dilatation. In ex vivo studies with preconstricted rat thoracic aortic rings, L5 from uremia patients inhibited acetylcholine-induced relaxation. In cultured human endothelial cells, L5 inhibited endothelial nitric oxide synthase activation and induced endothelial dysfunction.Our findings suggest that elevated plasma L5% may induce endothelial dysfunction and play an important role in the increased risk of CAD in uremia patients.

Effect of 1,25-(OH)2D3 and lipopolysaccharide on mononuclear cell inflammation in type 2 diabetes mellitus and diabetic nephropathy uremia

The prevention and treatment of type-2 diabetes mellitus (T2DM) and diabetic nephropathy (DN), which are disorders with high incidence rates, is of primary importance. In this study, we analyzed the effect of 1,25-(OH)2D3 and lipopolysaccharide (LPS) in combination with interleukin (IL)-15 on the inflammatory immune response and expression of vitamin D receptor (VDR) in mononuclear cells of T2DM and DN uremia (DNU) patients. The human acute monocytic leukemia cell line THP-1 was treated with peripheral blood serum isolated from 30 healthy controls and T2DM and DNU patients each, cultured in the presence or absence of 1,25-(OH)2D3, and subsequently treated with LPS and IL-15. The VDR mRNA and protein expression in THP-1 cells was detected by real-time polymerase chain reaction and western blot (and immunofluorescence assay), respectively, and IL-6 and IL-10 concentrations in the culture supernatant were detected by enzyme-linked immunosorbent assay. LPS treatment induced a significant decrease in VDR mRNA expression in T2DM and DNU serum-treated THP-1 cells compared to the control cells (P < 0.05). The VDR protein expression in DNU serum-treated THP-1 cells was also significantly down-regulated (P < 0.05). LPS treatment induced IL-6 secretion in serum-treated THP-1 cells (P < 0.05), while 1,25-(OH)2D3 treatment inhibited IL-6 secretion to some extent. These findings suggested that LPS down-regulates the expression of VDR in mononuclear cells of T2DM and DNU patients and induces an imbalance in the pro-inflammatory and anti-inflammatory cytokine response, while 1,25-(OH)2D3 partially reversed the effect of LPS and protected patients with T2DM and DNU.

Evaluation of left ventricular diastolic function in patients with uremia by using vector flow mapping

Objective To assess the clinical application value of vector flow mapping (VFM) in evaluating the left ventricular diastolic function in patients with uremia. Methods Forty patients with uremia and forty healthy volunteers were enrolled. The quantitative parameters, including vorticity, sum total energy loss (sEL), average energy loss(aEL), and the alteration circulation were measured in the VFM imaging mode. Difference was evaluated between two groups at apical, mid and basal segments at different periods. E/e'was derived via dual-Doppler imaging technology. And correlationship was analyzed between vorticity, sEL, aEL, circulation and E/e', separately. Results ①At apex segment of isovolumetric relaxation time and at three segments of atrial systole, there were difference in vorticity, sEL, aEL between two groups(P<0.05). Circulation in rapid filling phase of anterior mitral valve and slow filling phase of posterior mitral valve were different[(15.94±8.40)m2/s vs (8.36±7.84)m2/s, (5.34±5.24)m2/s vs (13.37±10.42)m2/s, P<0.05]. ②In control group, vorticity, sEL and aEL were different in different segments of same phase or at different phases of same segment, and also did in the uremia group(P<0.01). ③In uremia group, vorticity had a good correlation with E/e'at basal segment of rapid filling phase(r=0.34, P=0.046)and atrial systole(r=0.38, P=0.02). And sEL had a good correlation with E/e'at basal segment of rapid filling phase, isovolumetric relaxation time and at mid segment of rapid filling phase(r1=0.44, P1=0.008; r2=0.48, P2=0.003; r3=0.50, P3=0.002), and in time phase mentioned above, there were also the correlationship between aEL and E/e'(r1=0.39, P1=0.017; r2=0.49, P2=0.002; r3=0.48, P3=0.003). Conclusions VFM can be utilized to analyze 1eft ventricular hemodynamics features of uremia patients and it may be a good supplement for assessing cardiac diastolic function. Key words: Echocardiography; Uremia; Ventricular function, left

Study on 3′-UTR length polymorphism in peripheral blood mononuclear cells of uremia patient

Objective: The objective of this study was to measure the 3′-untranslated region (3′-UTR) polymorphism lengths in peripheral blood mononuclear cells (PBMCs) from uremia patients.Method: We sequenced the alternative polyadenylation sites in the 3′-UTR of PBMCs from 10 uremic patients and 10 healthy people to detect different gene expression levels between uremia patients and healthy controls. Quantitative reverse transcription polymerase chain reaction was used as validation. Result: Compared with the healthy control group, 691 genes in uremic patients had significantly different 3′-UTR lengths. Of these genes, 475 genes showed shortened 3′-UTRs, and the 3′-UTRs of 216 genes were lengthened. The verification results matched the original sequencing results. Conclusion: There were significant differences in 3′-UTR lengths between uremic patients and healthy controls, and analysis of the differential genes may contribute to the understanding of uremia pathogenesis.

Effect of Treatment of Hemoperfusion on FGF23 and PTH Level in Uremia Patients

Effect of Treatment of Hemoperfusion on FGF23 and PTH Level in Uremia Patients

Is there necessary to perform ureterectomy in renal cell carcinoma treatment

Is there necessary to perform ureterectomy in renal cell carcinoma treatment

Intratympanic steroid injection as a first-line therapy in uremia patients with sudden sensorineural hearing loss

Conclusions: ITSI as a first-line therapy in uremia patients with SSNHL offers a valid and safe treatment compared with intravenous systemic steroid treatment. A specific pathophysiology caused by possible sodium pump paralysis may be explained for uremia patients with SSNHL. Objective: To compare the efficacy of intratympanic steroid injection (ITSI) with that of systemic intravenous steroids as a first-line therapy in uremia patients with sudden sensorineural hearing loss (SSNHL). Materials and methods: A total of 23 consecutive uremia patients with SSNHL were enrolled in this study. Patients were divided into two groups: the ITSI group (n = 15) and the non-ITSI group (n = 8), in which patients received intravenous systemic steroid treatment. The two groups were homogeneous in all respects. Results: The hearing improvement and relative gain were statistically significant between the two groups. The value of hearing gain (ΔPTA = PTA pre – PTA post) in the ITSI group and the non-ITSI group was 24.6 ± 16.4dB and 8.4 ± 19.3dB. The value of relative gain (ΔPTA/PTApre) in the ITIS group and the non-ITSI group was 31.1 ± 22% and 9.4 ± 20.5%. In the ITSI group, 11 patients (73.3%) exhibited hearing recovery (ΔPTA > 10 dB).

Omeprazole for prevention of upper gastrointestinal bleeding in uremia patients with hemofiltration: Clinical efficacy and nursing

Omeprazole for prevention of upper gastrointestinal bleeding in uremia patients with hemofiltration: Clinical efficacy and nursing

A study of median nerve entrapment neuropathy at wrist in uremic patients.

Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy seen in uremic patients. The study was undertaken to estimate the frequency of CTS in uremic patients and to identify the most sensitive electrodiagnostic test. Study was conducted on 80 subjects of age 30–60 years. End-stage kidney disease patients were recruited for the clinical evaluation, motor nerve conduction studies (NCS), sensory NCS, F wave study and median-versus-ulnar comparison studies (palm-to-wrist mixed comparison study, digit 4 sensory latencies study and lumbrical-interossei comparison study). Among three different diagnostic modalities, frequency of CTS was found to be 17.5% with clinical evaluation, 15% with routine NCS studies and 25% with median-versus-ulnar comparison studies. Among the median-versus-ulnar comparison studies, lumbrical-interossei comparison study was found to be most sensitive (90%). The comparative tests for CTS are more sensitive compared to routine NCS and clinical examination. Among the comparative tests, lumbrical-interossei comparison study is the most sensitive. Early diagnosis of CTS may help patients of uremia to seek proper treatment at an appropriate time.

Impact of hemodialysis and uremia on serum levels of tumor markers

Objective: The aim was to study the possible impact of uremia and hemodialysis on tumor markers including carcinoembryonic antigen, carbohydrate antigen (CA)19-9, neuron-specific enolase, CA242, ferritin, β-human chorionic gonadotropin, alpha 1-fetoprotein, human growth hormone, CA153, CA125, prostate-specific antigen (PSA), and free PSA (fPSA). Materials and Methods: Under a controlled study design, we assigned 143 uremia patients receiving maintenance hemodialysis into hemodialysis group, 143 uremia patients (chronic kidney disease phase 5) who did not receive hemodialysis into nonhemodialysis group, and 429 healthy people into the control group. Serum levels of tumor markers were determined using protein chip and were compared among groups. Patients in hemodialysis group were further divided into two subgroups according to the duration of hemodialysis: Group A (maintenance hemodialysis was over 3 mo), Group B (maintenance hemodialysis was Results: Ferritin levels were 22.1% and 5.8% in hemodialysis and nonhemodialysis groups, respectively, with statistically significance ( P P > 0.05). In hemodialysis group, 12.23% of patients were found with higher serum levels of CA125 than normal, 9.75% with higher levels of PSA than normal, and 11.3% with higher levels of fPSA than normal. In nonhemodialysis group, 14.91% of patients were found with higher levels of CA125 than normal, 8.76% with higher levels of PSA than normal, and 10.8% with higher levels of fPSA than normal. In the control group, patients with higher levels of the above markers accounted for Conclusion: Ferritin, CA19-9 and CA125 are elevated to various degrees in patients with uremia who are receiving hemodialysis or do not receive hemodialysis. Hemodialysis is not able to eliminate tumor markers.

Left ventricular myocardial function in hemodialysis and nondialysis uremia patients: a three-dimensional speckle-tracking echocardiography study.

BackgroundSeveral studies have demonstrated that uremic patients who have preserved left ventricular ejection fraction (LVEF) could still have the potential for systolic dysfunction. The aim of this study was to assess the differences between the left ventricular (LV) myocardial function in hemodialysis and nondialysis uremic patients based on three-dimensional speckle-tracking echocardiography.MethodsThe study population consisted of 35 maintenance hemodialysis patients (the hemodialysis group), 30 uremic patients who were hospitalized for the creation of a primary arteriovenous fistula (the nondialysis group), and 32 healthy volunteers. All of the patients had normal left ventricular ejection fractions (i.e., 55% or greater). Three-dimensional speckle tracking echocardiography was performed to assess the left ventricle's global three-dimensional strain, regional longitudinal strain, circumferential strain, and radial strain.ResultsThe left ventricular regional longitudinal strain, radial strain, circumferential strain, and global three-dimensional strain were significantly decreased in the nondialysis patients compared with the other two groups (all, P<0.001). However, the three-dimensional strain and the regional longitudinal strain were lower in the hemodialysis patients than in the controls (P<0.01). In the hemodialysis patients and the control group, the longitudinal strain, circumferential strain, and radial strain were higher at the apical level than they were at the basal level and midlevels. A multivariate linear regression analysis showed that the blood urea nitrogen and creatinine levels were independently associated with the values of the global three-dimensional strain (β = −0.217, P = 0.000; β = −0.243, P = 0.011, respectively) and the longitudinal strain (β = −0.154, P = 0.032; β = −0.188, P = 0.029, respectively).ConclusionsThree-dimensional speckle-tracking echocardiography may detect myocardial dysfunction in patients with uremia who have preserved LVEF. The global three-dimensional strain and the regional longitudinal strain appear to be superior in hemodialysis patients compared with nondialysis patients.