Efficacy and safety of tenapanor in end-stage renal disease patients with hyperphosphatemia: a systematic review and meta-analysis.

BACKGROUND: Hyperphosphatemia occurs universally in end-stage renal disease(ESRD), and the attainment of target serum phosphate levels remains suboptimal with currently available phosphate binders. This meta-analysis aimed to evaluate the efficacy and safety of tenapanor in end-stage renal disease patients with hyperphosphatemia. METHODS: Data sources included PubMed, Embase, Web of Science, and Cochrane Library. This meta-analysis included randomized controlled trials evaluating both the efficacy of tenapanor in reducing serum phosphate levels and its safety profile. The risk of bias was assessed using the Cochrane risk of bias tool for RCTs. The GRADE system was used to assess the overall certainty of evidence. A meta-analysis was carried out by using fixed effects (I2 values < 50%) or random effects (I2 values ≥ 50%) models to calculate MD with 95% CI for continuous outcome variables and RR with 95% CI for dichotomous variables. Publication bias was evaluated using funnel plots. RESULTS: A total of seven RCTs involving 877 individuals were included. The pooling analysis demonstrates that the reduction in mean serum phosphorus levels in the tenapanor group was significantly greater than that in the placebo group [MD= -1.06 mg/dl, 95% CI (-1.59, -0.53); I2 = 83%, p < 0.0001]. The proportion of patients achieving a serum phosphorus level of < 5.5 mg/dL, along with the incidence of any adverse events (AEs) and gastrointestinal disorders, was higher in the tenapanor group compared to the placebo group. CONCLUSION: Tenapanor has the potential to significantly reduce serum phosphorus levels and enhance the rate of achieving target levels compared to placebo, all while maintaining an acceptable safety and tolerability profile. REGISTRATION: PROSPERO registration number CRD42024544531.

Non-Targeted Metabolomics Analysis of Mother and Infant in Gestational Diabetes Mellitus and Neonatal Clinical Characterization.

BACKGROUND: The goal was to analyze serums of GDM patients and healthy pregnant women using HPLC-MS and preliminarily screen differential metabolites by metabolomics. METHOD: Sixty pregnant women who underwent elective cesarean section at term in Dongguan Dalang Hospital from January 2023 to April 2023 were selected and divided into the GDM group and healthy pregnancy group. Pre-pregnancy and pregnancy examination information, such as age, BMI, OGTT results, triglyceride, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and other clinical data were col-lected for statistical analysis. Non-targeted metabolomics of serum from 30 GDM patients and 30 healthy pregnant women were studied by HPLC-MS, and different ions were searched. The structures of differential metabolites were identified by HMDB database. The metabolic pathways of differential metabolites were analyzed by KEGG database. RESULTS: The OGTT result, pCO2, pO2, HCO3, BE, Apgar score, and bilirubin levels in the GDM group were higher than those in the healthy pregnancy group (p < 0.05). However, there were no significant differences in age, triglyceride, total cholesterol, newborn birth weight, newborn birth blood glucose, and blood gas pH between the two groups (all p > 0.05). Using p < 0.05 as the screening standard, 55 differential metabolites were identified in serum, mainly including fatty acyl, carboxylic acids and their derivatives, steroids and their derivatives, ketoacids and their derivatives, and pyrimidine nucleosides, etc., all of which were up-regulated or down-regulated to varying degrees. The 55 metabolites were mainly involved in the metabolism of pyrimidine, pyruvate, alanine, aspartic acid, glutamic acid, and arachidonic acid, glycolysis, and biosynthesis of unsaturated fatty acids. CONCLUSIONS: The discovery of these metabolites provides a theoretical basis for an indepth understanding of GDM pathogenesis. Non-targeted metabonomics analysis of blood metabonomics research technology has shown great potential value in the early diagnosis of obstetric diseases and the study of disease mechanisms.

Efficacy and Adverse Effects of Atrasentan in Patients with Diabetic Nephropathy: A Meta-Analysis.

Background: About 30% of Type 1 diabetes (T1DM) patients and 40% of Type 2 diabetes (T2DM) patients were diagnosed with diabetic nephropathy, which has also greatly affected the global end-stage renal disease (ESRD) outcome. Atrasentan is a selective endothelin receptor type A (ETA) antagonist initially studied for the potential treatment of cancer. However, the role of Atrasentan was not sure in the DM. Methods: The machine searches eight databases to find studies examining the impact of Atrasentan in people with diabetic nephropathy both domestically and overseas. Type of Study Design RCTs have been published on Atrasentan's effects in patients with chronic kidney disease.Utilizing RevMan 5.3 software, data analysis was carried out following a thorough assessment of the quality of the literature. Results: This meta-analysis has included 4 papers for statistics. They were all regarded as being random controlled trials. According to 4 studies, the test group's urinary albumin/creatinine ratio (UACR) was significantly lower than the control group's (standardized mean difference (SMD): -222.47; 95% confidence interval (CI): -367.57, -77.38; P < .01), as were the test group's prevalence of cardiovascular disease (OR: 0.83; 95% CI: 0.73, 0.95; P < .01) and adverse reactions (OR: 1.00; 95% CI: 1.00). Conclusion: Atrasentan improves the UACR in individuals with chronic kidney disease as compared to the control category. However, these findings need to be confirmed by more high-quality research. Further studies could focus on the effect of the Atrasentan on the diabetic nephropathy management,which will shed light on the treatment of diabetic nephropathy.

A case of Gitelman syndrome with membranous nephropathy.

BACKGROUND: Gitelman syndrome (GS) is a rare autosomal recessive inherited salt-losing tubulopathy (SLT). Here, we report, for the first time, a case of GS overlapping nephrotic syndrome (NS) related to PLA2R-associated membranous nephropathy (MN). CASE PRESENTATION: We described a male patient had a 4-year history of recurrent fatigue. Serum biochemistry revealed hypokalemia with renal potassium wasting, hypomagnesemia, metabolic alkalosis, hyperreninemia, hypocalciuria, as well as nephrotic-range proteinuria, hypoalbuminemia, and elevated serum anti-phospholipase A2 receptor (PLA2R) antibody. Gene sequencing identified compound heterozygous mutations in SLC12A3 [c.536T > A(p.V179D) and c.1456G > A(p.D486N)]. The unusual association of SLTs and nephrotic-range glomerular proteinuria prompted us to perform a renal biopsy. Renal biopsy showed idiopathic MN. Due to the potential to activate the sodium-chloride co-transporter (NCC) and cause hyperkalemia, tacrolimus was selected to treat NS. Following treatment with potassium chloride, magnesium oxide, low-dose glucocorticoid combined with tacrolimus, the fatigue significantly improved, and concurrently hypokalemia, hypomagnesemia were corrected and NS was remitted. CONCLUSIONS: Renal biopsy should be warranted for GS patients with moderate to nephrotic-range proteinuria. Tacrolimus was preferred to the management of GS patients with NS.

Graphene-doped electrochemical copolymer coating of 2,2-bithiophene and 3-methylthiophene for the highly effective solid-phase microextraction of volatile benzene homologues.

We report the electrochemical fabrication of a poly(2,2-bithiophene-co-3-methylthiophene)-graphene composite coating and its application in the headspace solid-phase microextraction and gas chromatography determination of benzenes (i.e., bromobenzene, 4-bromotoluene, 2-nitrotoluene, 3-nitrotoluene and 1,2,4-trichlorobenzene). The coating was uniform and showed cauliflower-like microstructure. It had high thermal stability (up to 375°C) and could be used for at least 180 times of solid-phase microextraction without a decrease in extraction performance. Furthermore, it presented high extraction capacity for the benzenes due to the hydrophobic effect and π-π interaction between the analytes and the coating. Under optimized extraction conditions, good linearity (correlation coefficients higher than 0.9946), wide linear range (0.01-50 µg/L), and low limits of detection (5.25-12.5 ng/L) were achieved for these analytes. The relative standard deviation was lower than 5.7% for five successive measurements with one fiber, and the relative standard deviation for fiber-to-fiber was 4.9-6.8% (n = 5). The solid-phase microextraction and gas chromatography method was successfully applied for the determination of three real samples, and the recoveries for standards added were 89.6-106% for nail polish, 85.8-110% for hair dye, and 90-106.2% for correction fluid, respectively.

A Poly(ethylenglycol) Functionalized ZIF-8 Membrane Prepared by Coordination-Based Post-Synthetic Strategy for the Enhanced Adsorption of Phenolic Endocrine Disruptors from Water.

Metal-organic framework (MOF) membranes have received increasing attention as adsorbents, yet single phase MOF membranes have certain limitations, which frustrate their capacity performance. In this work a MOF composite membrane was successfully prepared by a facile and green strategy through reasonable design. At first, a defect-free ZIF-8 membrane was fabricated on an ionic liquid modified pencil bar by a solvothermal method. Then, a novel poly(ethylenglycol) functionalized ZIF-8 composite membrane (ZIF-8/PEG-NH2) was prepared through a flexible coordination-based post-synthetic modification strategy. We found that reaction time and temperature were two crucial factors for successfully fabricating well-defined ZIF-8/PEG-NH2 membrane. Besides, the adsorption of phenolic endocrine disruptors (e.g., 4-nonylphenol) on original ZIF-8 membrane and ZIF-8/PEG-NH2 membrane was investigated, and the good adsorption selectivity of ZIF-8/PEG-NH2 membrane towards 4-nonylphenol was demonstrated, with high adsorption capacity and fast adsorption dynamics. Excitingly, such ZIF-8/PEG-NH2 membrane was successfully employed for the selective detection of 4-nonylphenol from environmental water samples, demonstrating its great application potential in environmental monitoring.

Electrochemical preparation of poly(3-methylthiophene-carbazole)/graphene oxide composite coating for the highly effective solid-phase microextraction of some fragrance.

A poly(3-methylthiophene-carbazole)/graphene oxide composite coating was prepared on a stainless steel wire through electrochemical method. It showed high extraction efficiency, thermal stability and durability than those of corresponding single-component coatings due to the synergistic effect of different components. The resulting fiber was used for the headspace solid phase microextraction of octanal, nonanal, decanal, undecanol and dodecanol, followed by gas chromatography detection. The results showed that their GC peak areas were linear to their concentrations in the ranges of about 0.05-100µgL-1, the detection limits were 22.6-40.5ngL-1 (S/N=3). The run-to-run RSD was smaller than 4.5% (n=4), and the fiber-to-fiber RSD was 4.0-9.3% (n=4). The method was successfully applied to the determination of the five analytes in candy, orange fruit and flower.