Association of dietary niacin intake with all-cause and cardiovascular mortality of adult patients with chronic kidney disease in the United States: results from NHANES 1999-2018.

Objective: The relationship between dietary niacin intake (DNI) and mortality rates among patients afflicted with chronic kidney disease (CKD) is a subject of debate. Utilizing data derived from the National Health and Nutrition Examination Survey (NHANES), this study adopts a retrospective cohort design with an aim to investigate the association in the American adult patients with CKD. Methods: A cohort study was conducted in the National Health and Nutrition Examination Survey (NHANES) between 2009 and 2018 that enrolled 6,191 CKD patients aged 20 years and above. We collected data on mortality through 31 December 2018. DNI was measured using a 24-h recall method. The relationship between DNI levels and mortality from all causes and cardiovascular causes was analyzed using weighted Cox proportional hazards models. The Kaplan-Meier (K-M) survival curve was plotted to illustrate these associations. Results: Following a median monitoring period of 85 months, it was observed that 2,419 individuals (33.08%) succumbed to all causes, whereas cardiovascular-related deaths were recorded for 746 participants (10.45%). When controlling for confounders, an inverse relationship was established between DNI and mortality rates. Specifically, a marginal increase of 1 mg/day in DNI corresponded to a reduced Hazard Ratios (HRs) of 0.993 (0.987, 0.999; p = 0.027) for all-cause mortality and 0.980 (0.969, 0.991; p < 0.001) for cardiovascular mortality. A further stratified analysis by quartiles of DNI, with the lowest quartile serving as the reference, revealed that the highest quartile was associated with HRs of 0.820 (0.697, 0.966) for all-cause mortality and 0.663 (0.465, 0.944) for cardiovascular mortality, both displaying a significant trend (p < 0.001). However, a subdivision of CKD patients by age showed that the protective effects of higher DNI were only confined to individuals aged 60 years and above but not to those under 60 years of age. Conclusion: A negative correlation between DNI and mortality due to all causes and cardiovascular issues among CKD patients aged 60 and above was revealed based on the datasets; however, this association was not observed in younger individuals under 60. Consequently, enhancing DNI might serve as a beneficial therapeutic strategy specifically for the older CKD demographic.

Hypertension/prehypertension and its determinants in pediatric IgA nephropathy.

Immunoglobulin A nephropathy (IgAN) is a major cause of secondary hypertension (HT) of renal origin - a significant prognostic factor of IgAN. In children, similar to HT, prehypertension (pre-HT) is becoming a significant health issue. However, the role of secondary HT and pre-HT (HT/pre-HT) in the progression of pediatric IgAN remains unclear. We investigated the effects of HT/pre-HT on prognosis and its determinants as well as their correlation with clinicopathological parameters to identify more effective therapeutic targets.This single-center retrospective study compared clinicopathological features and treatment outcomes between patients with and without HT/pre-HT in 108 children with IgAN. Independent risk factors for HT/pre-HT were evaluated; segmental glomerulosclerosis was a significant variable, whose relationship with clinicopathological parameters was analyzed.Clinical outcomes of patients with and without HT/pre-HT differed considerably (P = .006) on ≥6 months follow-up. Patients with HT/pre-HT reached complete remission less frequently than those without HT/pre-HT (P = .014). Age, serum creatinine, prothrombin time, and segmental glomerulosclerosis or adhesion were independent risk factors for HT/pre-HT in pediatric IgAN (P = .012, P = .017, P = .002, and P = .016, respectively). Segmental glomerulosclerosis or adhesion was most closely associated with glomerular crescents (r = 0.456, P < .01), followed by Lees grades (r = 0.454, P < .01), renal arteriolar wall thickening (r = 0.337, P < .01), and endocapillary hypercellularity (r = 0.306, P = .001). The intensity of IgA deposits, an important marker of pathogenetic activity in IgAN, was significantly associated with the intensity and location of fibrinogen deposits (intensity: r = 0.291, P = .002; location: r = 0.275, P = .004).HT/pre-HT in pediatric IgAN patients is an important modifiable factor. A relationship is observed between HT/pre-HT and its determinants, especially segmental glomerulosclerosis. Potential therapeutic approaches for IgAN with HT/pre-HT might be directed toward the management of coagulation status, active lesions, and hemodynamics for slowing disease progression.

Topological Nodal States in Circuit Lattice.

The search for artificial structure with tunable topological properties is an interesting research direction of today's topological physics. Here, we introduce a scheme to realize topological nodal states with a three-dimensional periodic inductor-capacitor (LC) circuit lattice, where the topological nodal line state and Weyl state can be achieved by tuning the parameters of inductors and capacitors. A tight-binding-like model is derived to analyze the topological properties of the LC circuit lattice. The key characters of the topological states, such as the drumhead-like surface bands for nodal line state and the Fermi arc-like surface bands for Weyl state, are found in these systems. We also show that the Weyl points are stable with the fabrication errors of electric devices.