Circular RNA hsa_circ_0005519 contributes to acute kidney injury via sponging microRNA-98-5p.

BACKGROUND: This study intends to explore the role and molecular mechanism of hsa_circ_0005519 in acute kidney injury (AKI). METHODS: We conducted reverse transcription-qPCR for human serum to determine levels of hsa_circ_0005519 in AKI patients and healthy controls. Hsa_circ_0005519 was inhibited for expression in HK-2 cells using specific siRNAs. A number of techniques, MTT and ELISA assays, were used to analyze the potential role of hsa_circ_0005519 in cell viability, oxidative stress, and inflammation of LPS-induced HK-2 cells. RESULTS: The serum of patients with AKI exhibited a significant increase in hsa_circ_0005519 expression, compared with healthy controls. Hsa_circ_0005519 was knockdown by siRNA, and its knockdown led to cell viability increase in LPS-induced HK-2 cells. Inhibition of hsa_circ_0005519 can reverse the TNF-α, IL-6 and IL-1ß increase in LPS-induced HK-2 cells. Inhibiting hsa_circ_0005519 led to downregulation of MPO and MDA levels. MiR-98-5p was a downstream miRNA for hsa_circ_0005519. MiR-98-5p can offset the effects of hsa_circ_0005519 on LPS-induced HK-2 cells. IFG1R was a target gene for miR-98-5p. CONCLUSIONS: These findings indicate that the highly expressed hsa_circ_0005519 plays a promoting role in AKI.

Outcomes of elderly peritoneal dialysis patients: 65-74 years old versus ≥ 75 years old.

OBJECTIVE: To analyze the clinical data of elderly patients with peritoneal dialysis (PD) and compare patient and technique survival rates between Group 1 (65-74 years old) and Group 2 (≥75 years old). METHODS: This retrospective study enrolled 296 elderly patients (≥65 years old) on maintenance PD who were admitted to the Peritoneal Dialysis Center of the Second Hospital of Soochow University. The patients were categorized by outcome into ongoing PD, changed to hemodialysis, renal recovery dialysis stopped, or death groups. The patients were divided into Group 1 (65-74 years old) and Group 2 (≥75 years old). Patient survival and technique survival rates were calculated by the Kaplan-Meier method. Factors associated with patient survival were analyzed using the Cox regression model. RESULTS: There were 176 (59.5%) subjects in Group 1 and 120 (40.5%) subjects in Group 2. The primary causes of death were cardiovascular events, peritonitis, and other infections. The patient survival rates at 1, 3, and 5 years were 91.2%, 68.0%, and 51.3% in Group 1 and 76.8%, 37.5%, and 17.6% in Group 2 (p < 0.001, HR 0.387, 95% CI 0.282-0.530). There was no statistically significant difference in the technique survival rate between the two groups (p = 0.54). CONCLUSION: The elderly PD patients in this cohort mostly died from cardiovascular events, with a higher patient survival rate in Group 1 and similar technique survival in both groups. Older age, lower prealbumin, higher creatinine, not being on activated vitamin D, and high Charlson's comorbidity index (CCI) score were independent risk factors for death.

Development and validation of a nomogram for predicting the 6-months survival rate of patients undergoing incident hemodialysis in China.

BACKGROUND: The all-cause mortality of patients undergoing hemodialysis (HD) is higher than in the general population. The first 6 months after dialysis are important for new patients. The aim of this study was to develop and validate a nomogram for predicting the 6-month survival rate of HD patients. METHODS: A prediction model was constructed using a training cohort of 679 HD patients. Multivariate Cox regression analyses were performed to identify predictive factors. The identified factors were used to establish a nomogram. The performance of the nomogram was assessed using the C-index and calibration plots. The nomogram was validated by performing discrimination and calibration tests on an additional cohort of 173 HD patients. RESULTS: During a follow-up period of six months, 47 and 16 deaths occurred in the training cohort and validation cohort, respectively, representing a mortality rate of 7.3% and 9.2%, respectively. The nomogram comprised five commonly available predictors: age, temporary dialysis catheter, intradialytic hypotension, use of ACEi or ARB, and use of loop diuretics. The nomogram showed good discrimination in the training cohort [C-index 0.775(0.693-0.857)] and validation cohort [C-index 0.758(0.677-0.836)], as well as good calibration, indicating that the performance of the nomogram was good. The total score point was then divided into two risk classifications: low risk (0-90 points) and high risk (≥ 91 points). Further analysis showed that all-cause mortality was significantly different between the high-risk group and the low-risk group. CONCLUSIONS: The constructed nomogram accurately predicted the 6-month survival rate of HD patients, and thus it can be used in clinical decision-making.

Peritoneal dialysis-related peritonitis caused by gram-negative organisms: ten-years experience in a single center.

OBJECTIVES: Concerns are increasing about the clinical characteristics of gram- negative bacterial peritonitis for providing reference for clinical diagnosis, treatment and prevention. METHODS: A retrospective analysis was performed examining patients who developed peritoneal dialysis-related peritonitis (PDRP) from 1 January 2009 to 31 December 2018. RESULTS: Among 898 PD patients, 677 episodes of peritonitis occurred in 344 patients. Over 10 years, the proportion of gram-negative bacterial peritonitis increased from 0% to 26.15% (p = .045). E. coli was the leading cause (38.51%) of the 148 cases of gram-negative bacterial peritonitis. The increase of E. coli peritonitis between the first 5 and the last 5 years was obvious (20.45% vs. 46.15%). The antimicrobial sensitivity of gram-negative organisms to cefotaxime decreased from 71.43% to 55.84% (p = .017). In the gram-negative group, the effluent white cell count (WCC) on the first day was larger (OR: 1.374;95%CI: 1.248-1.563; p < .001), the time required for the WCC to normalize was longer (OR: 1.100;95%CI: 1.037-1.189; p = .003), and the level of C-reactive protein (CRP) was higher (OR: 1.038;95%CI: 1.026-1.042; p < .001) than those in the gram-positive group. The complete cure rate and treatment failure rate of gram-negative bacteria peritonitis were 87.8% and 12.2% respectively. CONCLUSIONS: Over 10 years, the proportion of gram-negative bacterial peritonitis increased, with E. coli epidermidis being the most common pathogen. More effluent WCC on the first day, longer time required for the WCC to normalize, and higher level of CRP are more common for gram-negative bacterial peritonitis. Prognosis of gram-negative bacterial peritonitis is worse.

Correlation between plasma proprotein convertase subtilisin/kexin type 9 and blood lipids in patients with newly diagnosed primary nephrotic syndrome.

Background: Proprotein convertase subtilisin/kexin type 9 (PCSK9) is a major post-transcriptional regulator of low-density lipoprotein receptor degradation. Recently, PCSK9 was shown to be overexpressed by liver cells in rats with proteinuria. However, the levels of PCSK9 in newly diagnosed primary nephrotic syndrome (PNS) patients and correlations involving PCSK9 and blood lipids are not clearly understood.Methods: One hundred and sixteen patients who were newly diagnosed with PNS were enrolled in this study.Results: Plasma PCSK9 levels in PNS patients were significantly higher than those in healthy controls [310.86 (250.87, 390.25) ng/ml vs 255.67 (202.26, 320.26) ng/ml, p = 0.002]. Plasma PCSK9 in PNS patients was positively correlated with total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) (γ = 0.246, p = 0.008, and γ = 0.183, p = 0.049). When plasma PCSK9 was >267.60 ng/ml, the risk of developing hypercholesterolemia significantly increased in PNS patients (OR = 6.40, 95% CI 2.06-19.87, p = 0.001). When plasma PCSK9 was >255.05 ng/ml, the risk of developing higher levels of LDL-C significantly increased in PNS patients (OR = 3.83, 95%CI 1.25-11.68, p = 0.018).Conclusions: Plasma PCSK9 levels in newly diagnosed PNS patients were markedly increased, and elevated PCSK9 abundance was positively correlated with elevated serum TC and LDL-C levels, suggesting that PCSK9 may emerge as a novel therapeutic target in NS-associated hypercholesterolemia.

The influence of seasonal factors on the incidence of peritoneal dialysis-associated peritonitis.

OBJECTIVES: To investigate the effects of climatic variables on peritoneal dialysis-associated peritonitis (PDAP) among patients receiving PD, such as seasonal variations in temperature and humidity. METHODS: A retrospective analysis was performed on PD patients, from 1 January 2011, to 31 December 2019. We evaluated the influence of seasonal factors on peritonitis rates and outcomes. RESULTS: Over the 9-year study period, 667 peritonitis episodes occurred, in 401 PD patients. Diarrhea-associated peritonitis occurred more frequently in summer compared with other seasons. Eating raw and cold food was identified as the primary cause of peritonitis in the summer. More peritonitis episodes occurred during summer. The peritonitis rate associated with gram-negative bacteria (p = 0.050) during summer was higher than those in all other seasons. The gram-negative bacterial peritonitis rate was positively correlated with monthly mean temperature (r = 0.504, p < 0.01) and humidity (r = 0.561, p < 0.01). A similar trend was observed for Enterobacterial peritonitis (temperature: r = 0.518, p < 0.01; humidity: r = 0.456, p = 0.001). Logistic regression analysis showed that summer was a risk factor for peritonitis (p = 0.041). Peritonitis prognosis during summer was significantly worse than those for all other seasons (p = 0.037). CONCLUSIONS: Seasonal variations exist in the incidence of dialysis-associated peritonitis, with peak incidents caused by gram-negative bacteria in the summer. High average temperature and humidity are associated with significant increases in the gram-negative bacteria and Enterobacterial peritonitis rates. Peritonitis prognosis during summer is worse.

Early peritonitis is an independent risk factor for mortality in elderly peritoneal dialysis patients.

BACKGROUND/AIMS: The impact of early peritonitis on the outcome of elderly peritoneal dialysis (PD) patients has not been studied. We aimed to research the influence of early peritonitis on patient outcomes in elderly PD patients. METHODS: This study involved elderly PD patients (age ≥65) who underwent PD between Jan 1, 2004 and Jul 31, 2013. Patient characteristics were collected in our database. Early peritonitis was defined as peritonitis within 6 months after the initiation of PD. Patient survival and technique were compared among the non-peritonitis, early peritonitis and late peritonitis groups using Cox regression analysis. RESULTS: There were 155 subjects involved in this study. The patients were divided among a non-peritonitis group (n=78), early peritonitis group (n=32) and late peritonitis group (n=45). The organisms causing first peritonitis in the two groups did not differ significantly. After adjustment for age, diabetes, serum albumin and residual renal function, multivariable Cox regression model revealed that compared with the early peritonitis group, both the non-peritonitis group (HR 0.57, RI 0.32-0.99, p=0.046) and the late peritonitis group (HR 0.37, RI 0.16-0.75, p=0.004) exhibited a lower patient mortality rate. CONCLUSIONS: Early peritonitis is an independent risk factor for mortality in elderly peritoneal dialysis patients.

LncRNA SNHG1 serves as a biomarker for systemic lupus erythematosus and participates in the disease progression.

LncRNAs play an important role in autoimmune diseases. The purpose of this study was to explore the role of lncRNA SNHG1 in systemic lupus erythematosus (SLE), and laid a theoretical foundation for the study of SLE. The basic clinical information of all subjects was first collected for statistical analysis, and SNHG1 expression in the serum of all subjects was detected by RT-qPCR. The value of SNHG1 in the diagnosis of SLE was assessed by ROC. The correlation between SNHG1 and each blood sample index was analyzed by Pearson correlation analysis. The role of SNHG1 in primary peripheral blood mononuclear cells (PBMCs) apoptosis was explored. SNHG1 expression is relatively upregulated in patients with SLE compared to healthy people. SNHG1 expression was positively correlated with SLEDAI score, IgG, CRP, and ESR, and negatively correlated with C3 and C4. ROC indicated that SNHG1 has the potential to assist in the diagnosis of SLE. PBMCs apoptosis in SLE was higher than that in control group, the knockdown and overexpression of SNHG1 could correspondingly inhibit and promote PBMCs apoptosis. SNHG1 has the potential to be a diagnosis marker for SLE and may be involved in regulating PBMCs apoptosis.

Risk factor analysis of calcification in aortic and mitral valves in maintenance peritoneal dialysis patients.

BACKGROUND/AIMS: This study aimed to investigate potential risk factors for calcification in aortic and mitral valves in maintenance peritoneal dialysis (MPD) patients. METHODS: We enrolled MPD patients who had undergone over 18 months of dialysis in our dialysis center, examined their cardiac valve calcification status by echocardiography, and recorded their biochemical data and dialysis-related indicators. These results were compared by logistic regression analyses to identify the risk factors associated with calcification in aortic and mitral valves. RESULTS: Among the 117 enrolled MPD patients, 41 exhibited calcification in aortic or mitral valves, including 38 with aortic valve calcification (AVC) and 17 with mitral valve calcification (MVC); 14 of them had calcification in both aortic and mitral valves. Multivariate logistic regression analysis revealed that age (OR=1.965, p=0.01), diabetes history (OR=4.693, p=0.029), calcium-phosphorus product (OR=2.373, p=0.001) and prealbumin (OR=0.908, p=0.012) were independently related to AVC, whereas age (OR=3.179, p=0.023), calcium-phosphorus product (OR=6.512, p=0.001), prealbumin (OR=0.885, p=0.033), high-density lipoprotein (OR=19.540, p=0.011) and diabetes history (OR=6.948, p=0.038) were independently related to MVC. CONCLUSIONS: The incidence of cardiac valve calcification in MPD patients is high, and the incidence of AVC is higher than MVC. Age, diabetes history, calcium-phosphorus product and hypo-prealbuminemia are independent risk factors for AVC, whereas age, calcium-phosphorus product and hypo-prealbuminemia are independent risk factors for MVC.

Development of GRAPES-CUACE adjoint model version 2.0 and its application in sensitivity analysis of ozone pollution in north China.

We presented the development of the gaseous chemistry adjoint module of the meteorological-chemical model system GRAPES-CUACE (Global/Regional Assimilation and PrEdiction System coupled with CMA Unified Atmospheric Chemistry Environmental Forecasting System) on the basis of the previously constructed aerosol adjoint module. The latest version of the GRAPES-CUACE adjoint model mainly includes the adjoint of the physical and chemical processes, the adjoint of the transport processes, and the adjoint of interface programs, of both gas and aerosol. The adjoint implementation was validated for the full model, and adjoint results showed good agreement with brute force sensitivities. We also applied the newly developed adjoint model to the sensitivity analysis of an ozone episode occurred in Beijing on July 2, 2017, as well as the design of emission-reduction strategies for this episode. The relationships between the ozone concentration and precursor emissions were well captured by the adjoint model. It is indicated that for a case used here, the Beijing peak ozone concentration was influenced mostly by local emissions (6.2-24.3%), as well as by surrounding emissions, including Hebei (4.4-16.8%), Tianjin (1.8-6.6%), Shandong (1.8-2.6%), and Shanxi (<1%). In addition, reduction of NOx, VOCs, and CO emissions in these regions would effectively decrease the Beijing peak ozone concentration. This study highlights the capability of GRAPES-CUACE adjoint model in quantifying "emission-concentration" relationship and in providing guidance for environmental control policy.

Valvular Calcific Deposits and Mortality in Peritoneal Dialysis Patients: A Propensity Score-Matched Cohort Analysis.

OBJECTIVE: This study aimed to compare mortality between peritoneal dialysis (PD) patients with and without cardiac valve calcification (CVC). METHODS: Patients undergoing PD at the dialysis center of the Second Affiliated Hospital of Soochow University from January 1, 2009, to June 31, 2016, were included and followed through December 31, 2018. The inclusion criteria were (1) age ≥18 years and (2) PD vintage ≥1 month. The exclusion criteria were (1) a history of hemodialysis or renal transplantation before PD; (2) diagnosed congenital heart disease, rheumatic heart disease, or hyperthyroid heart disease; and (3) loss to follow-up. Differences in mortality rates were compared using a Fine-Gray proportional hazards model. RESULTS: A total of 310 patient cases were included in this study, including 237 cases without CVC (non-CVC group). The CVC group included 59 cases with aortic valve calcification (AVC), 6 cases with mitral valve calcification (MVC), and 8 cases of AVC associated with MVC. After propensity score matching, 68 pairs were selected. The multivariate competing risk regression analysis revealed that age (hazard ratio [HR]: 1.06, 95% confidence interval [95% CI]: 1.03-1.10, p < 0.001) and CVC group (HR: 1.83, 95% CI: 1.04-3.20, p < 0.05) were independent risk factors associated with mortality. No significant difference was observed in technique survival between the 2 groups. CONCLUSION: CVC is an independent risk factor for mortality in PD patients.