Effects of vitamin D or its analogues on the mortality of patients with chronic kidney disease: an updated systematic review and meta-analysis.

The objective of this study was to assess whether vitamin D (VD) treatment alters the overall all-cause and cardiovascular mortalities in a chronic kidney disease (CKD) population. We systematically searched PubMed, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials without language restriction, until the publication date of 22 February 2016. All related literatures that compared VD treatment with non-VD treatment and reported the mortality of patients with CKD (including those undergoing dialysis) were identified. Pooled risk ratios (RR) and 95% confidence intervals (CI) were calculated by using the random- and fixed-effects models. Randomised controlled trials (RCTs) that used the intention-to-treat principle and observational studies (OSs) were analysed separately. For this study, 38 studies involving 223 429 patients (17 RCTs, n=1819 and 21 OSs, n=221610) were included. In the OSs, VD treatment was significantly associated with reductions in both all-cause and cardiovascular mortalities; however, such significant association was not found in the RCTs. The existing RCTs do not provide sufficient or precise evidence that VD supplementation affects the mortality of patients with CKD, although subsets of patients that could potentially benefit from VD treatment can be identified by using the existing data from the RCTs. Nevertheless, large-size RCTs are needed in the future to assess any potential differences in survival prospectively.

Long-term culture of human esophageal explants and cells.

Human esophageal epithelium obtained from intermediate autopsies (less than 12 h) was maintained as cell and explant cultures. In order to develop a serum-free, defined media culture model, several medias and additives were evaluated. The viability and differentiation of the epithelial cells cultured with serum-free, Keratinocyte Growth Media (KGM, Clonetics Co., San Diego, CA) was improved over that of esophageal cells and explants cultured in either serum-supplemented CMRL 1066 (OCM), serum-free additive-supplemented CMRL 1066, or cimetidine-supplemented CMRL 1066. The KGM component EGF was determined to be trophic for esophagus cells on the basis of findings of increased 3H-TdR labelling in KGM cultures when compared to control cells grown in KGM without EGF (KBM). The morphologic pattern of the cytoskeletal proteins actin, keratin, and vimentin were characterized in isolated cell populations. The intermediate filaments, keratin, and vimentin were co-expressed in these epithelial cells. Esophageal explant viability, differentiation, and outgrowth from 15 cases were also evaluated in dishes coated with basement membrane associated proteins. Explants cultured in these dishes were equally well-preserved and differentiated. There were no significant differences in the explant histology when there was protein coating of the culture dishes, although one case showed improved outgrowth with laminin coating. A main advantage for using this culture system is that the same medium (KGM) can be used for both the culture of explants and isolated epithelial cells. Future applications of this model include determining: (1) the effect different concentrations of EGF and calcium in the media will have on esophageal proliferation and differentiation, and (2) the role of different basement membrane associated proteins on the plating efficiency of either isolated or outgrowth epithelial esophageal cells.

[The decrease of serum ferritin level in women using intrauterine device and its restoration after iron-loading (author's transl)].

PIP: To study the effect of a stainless steel IUD on the incidence of anemia and iron deficiency, and thus to find a suitable way to prevent or cure it, the serum ferritin level of 176 women wearing such an IUD was determined. Compared with the control group, composed of 163 women who had undergone tubal sterilization, no distinct differences in hemoglobin levels and red cell counts were observed, but the serum ferritin level in the IUD-bearing group decreased markedly (26.6 +or- 1.4 vs. 36.3 +or- 2.2 ng/ml, p0.001) and this decrease continued even for longterm use (5 years). When treated with ferrous sulfate (0.3 g, t.i.d.) for 7 days, the ferritin level of the group of these IUD users equalled that of the control group rapidly. It was suggested that the supplement of iron in time for the IUD users suffering from menorrhagia was necessary and efficient. (author's modified)^ieng

[The level of serum ferritin as an index of iron deficiency in women using stainless steel ring intrauterine device (author's transl)].

PIP: In order to study the effect of menorrhagia induced by a stainless steel IUD on the incidence of anemia and iron deficiency, hemoglobin level (Hb), red blood cell count (RBC), and serum ferritin radioimmunoassay were examined in 176 women. 163 sterile women were used as controls. No differences in Hb level or RBC count were observed in these 2 groups; however the serum ferritin level in IUD users was significantly lower than those in the control group (26.6 +or- 1.4 ng/mg vs. 36.3 +or- 2.2 ng/mg). This tendency was continued in those women wearing IUDs for 2 and even more than 5 years. It is suggested that to prevent iron deficiency in IUD users, an iron supplement is necessary. (author's)^ieng

[The restoration of serum ferritin level of stainless steel ring IUD users after iron supplementary (author's transl)].

PIP: To find a suitable way to prevent or cure the tendency towards iron deficiency induced by the menorrhagia in IUD users, an experiment with iron supplementation was conducted. 0.3 g of ferrous sulfate and 100 mg of ascorbic acid were administered 3 times/day for 7 days. The serum ferritin level was determined 1 week after withdrawal of the drugs. The serum ferritin level rose to the same level as that of the control group consisting of sterilized women. It appears that administration of the iron supplement intermittently and in a lower dose is an efficient method of restoring the iron stores in IUD users. (author's modified)^ieng