Changes in Intestinal Flora From Chronic Renal Failure Complicated With Coronary Heart Disease and its Correlation With Arterial Stiffness Index.

Context: One common and serious cardiovascular complication of chronic renal failure (CRF) is coronary heart disease (CHD). CRF can lead to an imbalance of patients' gut microbiota, and changes in intestinal flora might heavily affect CRF's development. Objective: The study intended to investigate the changes in intestinal flora of patients with CRF complicated with CHD and their relationship with ASI to understand the association of those changes and ASI with CRF comorbid with CHD, with the goal of offering a reliable clinical basis for active prevention and treatment of CRF and CHD in the future. Design: The research team designed a prospective controlled study. Setting: The study took place at the Affiliated Hospital of Hebei University in Baoding, Hebei, China. Participants: Participants were 86 patients with both CRF and CHD and 72 patients with CHD only who had been admitted to the hospital between October 2019 and January 2021. Intervention: The intervention group included participants who had received a diagnosis of CRF complicated with CHD and the control group included participants who had received a diagnosis of CHD only. Outcome Measures: The research team counted participants' intestinal flora and measured their ambulatory blood pressure and arterial stiffness index (ASI) to analyze the correlation of the ASI with the intestinal flora and the related factors impacting CHD in patients with CRF. Results: The monitoring of participants' ambulatory blood pressures showed that the intervention group's day systolic blood pressure (dSBP) and 24h SBP were significantly higher, while the group's day diastolic blood pressure (dDBP) and 24h DBP were significantly lower than those of the control group. The intervention group's levels of lactobacillus, bacteroidaceae, and bifidobacterium were significantly lower than those of the control group, and those intestinal flora were negatively correlated with ASI. The intervention group's levels of Escherichia coli and yeasts were significantly higher than those of the control group, and those intestinal flora were positively correlated with ASI. A significant relationship existed between lactobacillus and yeast and the occurrence of CHD in the CRF participants. Conclusions: Patients with both CRF and CHD have an obvious intestinal-flora imbalance, and the imbalance is strongly bound up with their ASI, which is of great reference significance for novel therapy of such patients and for the clinical application of ASI.

Comparison Between Hemodialysis and Peritoneal Dialysis in the Risks for Disease Activity in LN-ESRD Patients: A Systematic Review and Meta-analysis.

Context: End-stage renal disease (ESRD) is the advanced stage of a progressive loss of kidney function. About 10% of all patients with lupus nephritis (LN) eventually progress to ESRD, which may necessitate renal replacement therapy (RRT), such as hemodialysis (HD), peritoneal dialysis (PD), and/or kidney transplant. Research hasn't confirmed which dialysis options, prior to kidney transplantation, are beneficial to patients' prognoses. Objective: The study intended to compare the risks-related to disease activity, exercise, all-cause infection, all-cause cardiovascular events, and mortality-of the use of HD and PD for LN-ESRD adults, as the initial alternative treatment before renal transplantation. Design: The research team performed a narrative review and analyzed the data obtained about clinical outcomes for HD and peritoneal dialysis. For the review, the research team searched the PubMed, EMBASE, and SCOPUS databases. The search used the keywords: end-stage renal disease, renal replacement therapy, hemodialysis and peritoneal dialysis. Setting: The study made in Affiliated Hospital of Hebei University, China. Participants: The studies included 15 636 patients who had been diagnosed with LN-ESRD prior to renal transplantation. Outcome Measures: For the data analysis, the research team divided the data into two groups, one of which included the data on the clinical outcomes for HD patientsand one of which included the data on the clinical outcomes for PD patients. The study evaluated four types of risks: lupus-flare risks, all-cause infection risks, all-cause cardiovascular events risk, and risk of mortality. Results: The 16 studies found in the review reported one or more outcomes of interest for the two dialysis modalities, HD and PD. The analysis of the data from the 16 studies showed that HD was associated with a higher risk than PD: (1) of lupus flares, with RR = 1.23 (confidence interval: 0.82, 1.85), but the difference didn't reach statistical significance (P = .31); (2) of all-cause infection risk, with RR = 1.02 (confidence interval: 0.66, 1.59), but the difference didn't reach statistical significance (P = .92); (3) of all-cause cardiovascular events, with RR = 1.44 (confidence interval: 1.02, 2.04), and the difference reached statistical significance (P = .04); and (4) of mortality risk, with RR = 1.29 (confidence interval: 0.95, 1.75), but the difference didn't reach statistical significance (P = .10). Conclusions: The current study may have reference significance for clinical treatment of ESRD. Except for all-cause cardiovascular events in which PD was superior to HD, offering better outcomes, both treatment modalities provide more or less similar clinical outcomes as effective initial choices for RRT in LN-ESRD patients prior to renal transplant. The current research team, however, encourages further research on the question, addressing better the possible sources of biases encountered in the current study.

Long Noncoding RNA PRNCR1 Reduces Renal Epithelial Cell Apoptosis in Cisplatin-Induced AKI by Regulating miR-182-5p/EZH1.

BACKGROUND/AIMS: This study was designed to examine the role of long noncoding RNA PRNCR1 in cisplatin-induced acute kidney injury (AKI) in vitro and in vivo. METHODS: The expression levels of PRNCR1 and miR-182-5p in cisplatin-induced AKI mice were examined. HK-2 cells were treated with cisplatin to induce cell damage. Then, the effects of PRNCR1 and miR-182-5p on cisplatin-stimulated HK-2 cell viability and apoptosis were detected by the CCK-8 and annexin V-FITC/PI method. Target genes of PRNCR1 and miR-182-5p were analyzed by bioinformatics analysis and luciferase. RESULTS: The expression level of PRNCR1 was significantly reduced in cisplatin-induced AKI mice. In addition, overexpression of PRNCR1 attenuated the damage of cisplatin to HK-2. The expression level of miR-182-5p was significantly raised in cisplatin-induced AKI mice. MiR-182-5p was negatively regulated by PRNCR1 and leaded to an upregulation of EZH1 expression. Overexpression of PRNCR1 attenuated cisplatin-induced apoptosis by downregulating the miR-182-5p/EZH1 axis. CONCLUSION: LncPRNCR1 reduced the apoptosis of renal epithelial cells induced by cisplatin by modulating miR-182-5p/EZH1.

Analysis of the association between glomerular filtration rate, proteinuria and metabolic syndrome in chronic kidney patients based on longitudinal data.

Chronic kidney disease (CKD) is a group of chronic diseases caused by kidney damage from multiple causes. Metabolic syndrome (MS) manifests as dysfunction of endothelial cells and chronic functional inflammatory states, and may be involved in pathological changes related to renal impairment. Based on longitudinal data analysis of the association between estimated glomerular filtration rate (eGFR), proteinuria and MS in patients with CKD, this study aims to provide new ideas for the pathophysiological mechanism of CKD and a theoretical basis for the early prevention and effective intervention of MS-related kidney damage. A total of 126 patients with CKD were divided into non-MS group and MS group. According to the eGFR level, 126 patients with CKD were divided into G1 group, G2 group, G3a group, G3b group, G4 group and G5 group. Serum markers such as eGFR, urine protein, and triglycerides (TG) were collected. The correlation between eGFR, urine protein and MS-related indexes was analysed, and the risk factors affecting CKD complicated by MS were analysed. In patients with CKD, the levels of urine protein, abdominal circumference, TG, systolic blood pressure (SBP), diastolic blood pressure (DBP), and fasting blood glucose (FPG) were increased with the course of the disease, but the levels of eGFR and high density lipoprotein (HDL-C) were decreased (p < 0.05). Abdominal circumference, TG, SBP, DBP, FP were significantly negatively correlated with eGFR, but HDL-C was positively correlated with eGFR (p < 0.05). Diabetes, hyperlipidemia, UA, and SBP were independent risk factors affecting CKD complicated MS, and eGFR were independent protective factors (p < 0.05). The combination of diabetes, hyperlipidemia, UA, SBP, and eGFR exhibited higher prediction value for the CKD patients complicated by MS. There was a certain correlation between between MS components with eGFR and urinary protein in patients with CKD. The early intervention treatment of MS was helpful in delaying the development of CKD and reducing proteinuria.

Determinants of Sarcopenia in Elderly Patients with Chronic Kidney Disease.

INTRODUCTION: This study was conducted to determine the factors affecting the development of sarcopenias in elderly patients with chronic kidney disease (CKD), in order to provide future clinical reference and guidance in preventing the occurrence of sarcopenias in patients with CKD. METHODS: We included 116 CKD patients admitted to affiliated Hospital of Hebei University for retrospective analysis between September 2019 and March 2022. Fifty-one CKD patients with sarcopenias were selected as the observation group (OG) and 65 CKD patients without sarcopenias were considered as the control group (CG). Clinical baseline data such as age and sex were recorded, venous blood was collected for routine examination, and a multi-frequency body composition analyzer was applied to measure patients' body composition. Grip strength, middle arm circumstances (MAC) and triceps skin-fold thickness (TSF) were also measured. Then, patients' sleep quality, nutritional status and negative psychological status were assessed by using the Pittsburgh Sleep Quality Index (PSQI), Malnutrition inflammation score (MIS), and Self-rating Anxiety/Depression Scale (SAS/SDS), respectively. Differences in test results were compared inter-group, and the factors affecting the occurrence of sarcopenias in CKD patients were analyzed by multiple Logistic regression. RESULTS: OG patients were older than CG patients, with a higher number of female patients. Their BMI, bone mass, MAC, serum creatinine (Scr), uric acid (UA) and triglyceride (TG) were lower (P < .05). According to multiple Logistic regression analysis, age, as well as PSQI, MIS, SAS, and SDS scores were the risk factors for sarcopenias in CKD, while BMI, bone mass, MAC, Scr, UA and TG were protective factors (P < .05). CONCLUSION: Age, poor sleep quality, poor nutritional status and negative emotions are independent risk factors for sarcopenias in CKD patients, while BMI, bone mass, MAC, UA, TG, and Scr are independent protective factors.  DOI: 10.52547/ijkd.7537.