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Objective@#To evaluate whether hemodialysis before percutaneous renal biopsy (PRB) reduces the risk of bleeding complications in patients with acute kidney injury (AKI).@*Methods@#This study was a cohort observational study. Patients who were diagnosed as AKI and received PRB in Nanfang Hospital of Southern Medical University from January 2015 to December 2018 were included in the study. Patients were divided into preoperative dialysis group and preoperative non-dialysis group according to whether PRB patients received hemodialysis treatment. According to whether perirenal hematoma occurred after the operation, the patients were divided into the groups with and without the perirenal hematoma. The baseline clinical data of AKI stage, hemoglobin, coagulation function and renal pathological changes before PRB, and perirenal hemorrhage complications after operation, including the size of perirenal hematoma within 24 hours, gross hematuria, low back pain, decreased hemoglobin value and interventional treatment (such as interventional surgery, blood transfusion, etc) in the two groups were compared. The logistic regression model was used to analyze the risk factors of perirenal hematoma after PRB.@*Results@#Ninety patients with AKI were enrolled in this study, including 41 in the preoperative dialysis group and 49 in the preoperative non-dialysis group. The proportion of patients AKI with stage 2-3 in the preoperative dialysis group was significantly higher than that in preoperative non-dialysis group (100.0% vs 75.5%, P<0.001). There were no significant differences in coagulation function indexes and platelet counts between the two groups. Renal ultrasound within 24 hours after PRB showed that there were no significant differences in the incidence of postoperative perirenal hematoma (56.1% vs 63.3%, P=0.489), the incidence of postoperative perirenal large size hematoma (≥5 cm, 26.1% vs 22.6%, P=0.766), and the magnitude of the decrease in hemoglobin (3.7% vs 1.2%, P=0.505) between the preoperative dialysis group and the preoperative non-dialysis group. No blood transfusion, arteriovenous fistula, renal vascular intervention or surgery, and no hospital death occurred in the two groups. The renal pathological manifestations of the patients with and without perirenal hematoma were mainly acute tubular necrosis (ATN) and there were no significant differences between the patients with and without perirenal hematoma in indicators such as age, gender, body mass index, diabetes percentage, hypertension percentage, AKI staging, preoperative dialysis or not, serum creatinine, blood urea nitrogen, hemoglobin, platelet count and renal pathological types. After adjusting for indicators such as preoperative AKI stage and renal pathological changes, logistic regression analysis results showed that perirenal after PRB was not independently correlated with preoperative dialysis (β=0.568, P=0.241); Multivariate logistic regression analysis resluts showed that hematoma (≥5 cm) after PRB was also not independently correlated with preoperative dialysis (β=0.967, P=0.958).@*Conclusions@#Preoperative hemodialysis does not reduce the risk of bleeding complications after PRB in patients with AKI. The role of preoperative hemodialysis in reducing the risk of bleeding complications after PRB needs further study and verification.
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Objective:To analyze the clinicopathological features in diabetic kidney disease (DKD) and non-diabetic kidney disease (NDKD) patients, and provide reference for patients who will receive renal biopsy with diabetes mellitus complicated with chronic kidney disease.Methods:The patients with type 2 diabetes mellitus complicated with chronic kidney disease who underwent renal biopsy were collected through the database at the Nanfang Hospital of Southern Medical University from February 2002 to June 2018. According to the results of renal biopsy, they were divided into DKD group and NDKD group (including DKD+NDKD). The clinical manifestations and pathological types were compared between the two groups.Results:A total of 507 patients were eventually included in the study. There were 114 cases (22.5%) with DKD and 393 cases (77.5%) with NDKD. Pathologically, the most common pathological types of NDKD were membranous nephropathy (30.0%) and IgA nephropathy (19.1%). Among NDKD patients, 5.6% patients had DKD combing with NDKD. In term of the clinical manifestations, DKD patients had a longer history of diabetes (>1 year, 76.3% vs 36.1%, P<0.001), higher quantity of urinary protein [3.69(1.70, 6.74) g/24 h vs 2.21(0.91, 4.97) g/24 h, P<0.001], higher serum creatinine [117.5(85.8, 194.5) μmol/L vs 89.0(68.0, 143.8) μmol/L, P<0.001] than NDKD patients. But the hemoglobin [(105.07±20.85) g/L vs (124.41±25.02) g/L, P=0.002] and cholesterol [(5.69±1.87) mmol/L vs (6.43±2.75) mmol/L, P=0.001] in DKD patients were lower than those in NDKD patients. Logistic regression analysis showed that diabetes mellitus history ( OR=4.162, 95% CI 1.717-10.098, P=0.002) , higer systolic pressure (every 1 mmHg, OR=1.028, 95% CI 1.011-1.045, P=0.001) , history of antihypertensive medication ( OR=3.141, 95% CI 1.496-6.591, P=0.002), diabetic retinopathy ( OR=5.561, 95% CI 2.361-13.100, P<0.001) and higher glycated hemoglobin level (every 1%, OR=1.680, 95% CI 1.333-2.118, P<0.001) were related factors of DKD, while hematuria ( OR=2.781, 95% CI 1.334-5.798, P=0.006) and higher hemoglobin level (every 1 g/L, OR=1.022, 95% CI 1.008-1.037, P=0.002) were related factors of NDKD. Conclusions:There are differences in clinical manifestations and pathological types between DKD and NDKD. The history of diabetes, antihypertensive medication, fundus examination, higher of proteinuria and glycosylated hemoglobin may predict DKD, while hematuria and higher level of hemoglobin may have certain guiding significance for the diagnosis of NDKD. The indication of renal biopsy in patients with diabetes mellitus complicated with chronic kidney disease should include comprehensive clinical manifestations.
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Objective To evaluate whether hemodialysis before percutaneous renal biopsy (PRB) reduces the risk of bleeding complications in patients with acute kidney injury (AKI).Methods This study was a cohort observational study.Patients who were diagnosed as AKI and received PRB in Nanfang Hospital of Southern Medical University from January 2015 to December 2018 were included in the study.Patients were divided into preoperative dialysis group and preoperative non-dialysis group according to whether PRB patients received hemodialysis treatment.According to whether perirenal hematoma occurred after the operation,the patients were divided into the groups with and without the perirenal hematoma.The baseline clinical data of AKI stage,hemoglobin,coagulation function and renal pathological changes before PRB,and perirenal hemorrhage complications after operation,including the size of perirenal hematoma within 24 hours,gross hematuria,low back pain,decreased hemoglobin value and interventional treatment (such as interventional surgery,blood transfusion,etc) in the two groups were compared.The logistic regression model was used to analyze the risk factors of perirenal hematoma after PRB.Results Ninety patients with AKI were enrolled in this study,including 41 in the preoperative dialysis group and 49 in the preoperative non-dialysis group.The proportion of patients AKI with stage 2-3 in the preoperative dialysis group was significantly higher than that in preoperative non-dialysis group (100.0％ vs 75.5％,P＜0.001).There were no significant differences in coagulation function indexes and platelet counts between the two groups.Renal ultrasound within 24 hours after PRB showed that there were no significant differences in the incidence of postoperative perirenal hematoma (56.1％ vs 63.3％,P=0.489),the incidence of postoperative perirenal large size hematoma (≥5 cm,26.1％ vs 22.6％,P=0.766),and the magnitude of the decrease in hemoglobin (3.7％ vs 1.2％,P=0.505) between the preoperative dialysis group and the preoperative nondialysis group.No blood transfusion,arteriovenous fistula,renal vascular intervention or surgery,and no hospital death occurred in the two groups.The renal pathological manifestations of the patients with and without perirenal hematoma were mainly acute tubular necrosis (ATN) and there were no significant differences between the patients with and without perirenal hematoma in indicators such as age,gender,body mass index,diabetes percentage,hypertension percentage,AKI staging,preoperative dialysis or not,serum creatinine,blood urea nitrogen,hemoglobin,platelet count and renal pathological types.After adjusting for indicators such as preoperative AKI stage and renal pathological changes,logistic regression analysis results showed that perirenal after PRB was not independently correlated with preoperative dialysis (β=0.568,P=0.241);Multivariate logistic regression analysis resluts showed that hematoma (≥5 cm) after PRB was also not independently correlated with preoperative dialysis (β=0.967,P=0.958).Conclusions Preoperative hemodialysis does not reduce the risk of bleeding complications after PRB in patients with AKI.The role of preoperative hemodialysis in reducing the risk of bleeding complications after PRB needs further study and verification.
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Objective To evaluate the efficacy and safety of continuous erythropoietin receptor activator (C.E.R.A.) once every 4 weeks by subcutaneous administration on hemoglobin (Hb)maintenance in dialytic patients with chronic renal anemia who had been treated with stable dose of erythropoietin (EPO).Methods This was an open,randomized,controlled,multi-center trial.All the hemodialysis or peritoneal dialytic patients in EPO maintenance treatment received subcutaneous EPO-β during the 6-week pre-treatment period to maintain Hb level between 100 g/L and 120 g/L.Eligible patients were randomized (2∶1 ) to accept either C.E.R.A.once every 4 weeks by subcutaneous administration ( C.E.R.A.group,n =187 ) or subcutaneous EPO-β 1-3 times weekly ( EPO group,n =94) for 28 weeks (including 20-week dose titration period and 8-week efficacy evaluation period ). The starting dose of C.E.R.A.was converted according to the dose of EPO-β administered in the week preceding the first study drug administration.The primary outcome was the change of Hb level between the baseline and that in the efficacy evaluation period.Results Totally 253 patients completed the whole 28-week treatment.The change of baseline-adjusted mean Hb was +2.57 g/L for C.E.R.A.group and + 1.23 g/L for EPO group,resulting in a treatment difference of 1.34 g/L (95％ CI - 1.11-3.78 g/L).Since the lower limit of 95％ CI was greater than the pre-defined non-inferiority margin -7.5 g/L( P ＜ 0.0001 ),C.E.R.A.once every 4 weeks by subcutaneous administration was clinically non-inferior to EPO regarding the maintenance of stable Hb level.The proportion of patients maintaining Hb level within the range of 100-120 g/L through efficacy evaluation period was similar between the two groups ( 69.0％ for C.E.R.A.group vs 68.9％ for EPO group,P ＞0.05 ).The overall incidence of adverse events was similar between the C.E.R.A.(41.7％)and EPO (46.2％ ) groups ( P ＞ 0.05 ).The safety findings were in accordance with the patients' primary diseases rather than the administration.Conclusions Conversion from EPO to C.E.R.A.once every 4 weeks by subcutaneous injection could maintain the Hb in target level in dialytic patients with renal anemia,and it was non-inferior to EPO.In general,subcutaneous administration of C.E.R.A.is well tolerated in dialytic patients with chronic renal anemia.
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Objective:To prepare the polyclonal antibodies against advanced oxidation protein products (AOPP),and to provide an effective agent for research on the pathogenesis of AOPP and assess exactly the relationship between AOPP and relative diseases.Methods:AOPP-rabbit serum albumin (AOPP-RSA) was prepared by treating RSA with hypochloric acid.The rabbit anti-AOPP-RSA polyclonal antibodies were generated and purified by affinity chromatography. The titers and the specificity of the antibodies were measured by ELISA.The plasma AOPP and the localization of AOPP in nephridial tissues of some patients with chronic kidney disease (CKD) were determined using rabbit anti-AOPP-RSA.Results:Titers of the antibodies were 10-6.Purified antibodies reacted specifically with oxidized albumin from different genus,but could not react with normal albumin and glycosylated albumin.The high level of AOPP in plasma from CKD patients was confirmed by Western blot.The antibodies could be used to immunostain AOPP deposition in different regions of kidney tissues from both CKD patients and CKD rat models.Conclusion:We successfully generate rabbit anti-AOPP polyclonal antibodies with high titers and striking specificity.The presence of plasma AOPP and localizations of AOPP in kidney tissues of CKD patients can be demonstrated using the antibodies.The development of anti-AOPP polyclonal antibodies may provide a new tool to explore the pathogensis of AOPP and assess exactly the relationship between AOPP and relative diseases.
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Objective To determine the association between asymmetric dimethylarginine (ADMA), an endogenous inhibitor of nitric oxide (NO) synthase, with atherosclerosis in patients with chronic kidney disease (CKD). Methods One hundred thirty-eight CKD patients were enrolled in this study. Serum levels of L-arginine, ADMA, and SDMA were measured by high-performance liquid chromatography (HPLC). Common carotid arteries intimae-medial thickness (CCA-IMT) ,cross-sectional calculated intimae-medial thickness(cIM area)and atherosclerotic plaque were detected by noninvasive high-resolution B-mode ultrasonography. Results Serum levels of ADMA and SDMA were significantly increased in CKD patients (n=138) compared with age matched healthy subjects (n=42,P＜0.01). ADMA and SDMA levels increased with the progression of renal dysfunction and were negatively related to creatinine clearance (Ccr) in pre-dialysis patients (r=-0.315,P＜0.05;r=-0.426,P＜0.01). Serum levels of ADMA and SDMA in dialysis patients (n=74)were significantly higher than those in pre-dialysis patients (P＜0.05). Patients with carotid artery plaques showed significantly higher levels of ADMA compared with those without plaques. Serum levels of ADMA closely correlated with the mean IMT (r=0.471, P＜0.01) and cIM area value (r=0.430, P＜0.01). These correlations remained significant even after adjusting GFR,age,gender ,and other risk factors for atherosclerosis in the multiple regression analysis. Conclusion Serum levels of ADMA increased with the progression of CKD and may play a role in the pathogenesis of accelerated atherosclerosis in CKD patients.
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Objective To assess the effects of early correction of anemia with recombinant human erythropoietin (rHuEPO) on the development and progression of left ventricular hypertrophy (LVH) in patients with mild-to-moderate chronic renal insufficiency (CRI) who are not on hemodialysis. Methods A total of 158 patients with serum creatinine from 147μmol/L to 400μmol/L were nrolled in this prospective, multicenter study. Eighty-six patients with hemoglobin (Hb)＜110g/L received rHuEPO treatment with a target Hb of ≥110g/L (Group A). Forty patients with comparable Hb concentration (＜110g/L) but did not receive rHuEPO (Group B) and 32 patients with Hb≥110g/L and without rHuEPO treatment (Group C) were served as controls. Left ventricular mass index (LVMI) was evaluated by echocardiography at baseline and every 3 months for 2 years. Results There was no difference in age, gender, etiology of renal failure, blood pressure and cardiovascular risk factors among the 3 groups. At baseline, the prevalence of LVH was 72.1% in group A,72.5% in group B and 59.4% in group C. LVMI was inversely correlated with Hb levels (r=0.70, P＜0.01). During the 2-year period, the mean LVMI decreased from 142.6±25.7g/m2 to 132.4±18.5 g/m2 in group A, while increased significantly in both group B and group C. The mean Hb concentration increased from 93.8±14.6g/L to 111.2±10.3g/L (P＜0.05) in group A, but tended to decrease in group B and group C. There was no significant change of the mean blood pressure, number of anti-hypertensive drugs and serum creatinine concentrations in all 3 groups. However, patients' serum creatinine doubled more often in group B and group C than in group A.Conclusions LVH was common in predialysis CRI patients and was associated with the severity of anemia. Early intervention with rHuEPO may reverse LVH in these patients.
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Objective To investigate the expression and significance of hepatocyte growth factor (HGF) in cyclosporin A nephropathy model of SD rats. Methods Twenty eight rats were fed on low salt diet for 7 days,then they were randomly divided into four groups:controls(n=7),CsA treatment (n=7),CsA+verapamil (n=7),and CsA+enalapril (n=7).All the rats except for controls received a daily subcutaneous injection of CsA (15 mg?kg -1 ?d -1 ) for 4 weeks.Renal tissue angiotensin Ⅱ level was measured by radioimmunoassay.The expression of HGF mRNA was examined by Northern blot and in situ hybridization. Results Renal tissue angiotensin Ⅱ level were significantly elevated in CsA treated rats when compared to that in control rats [(29.8?6.0) vs (8.7?1.7)ng/g, P 0.05 ).Renal tissue HGF mRNA expression was negatively correlated with tubular injury degree ( P
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Infection is a common, serious and costly complication in patients with chronic renal failure (CRF) and has been the major cause of high mortality in these patients. Increased evidences suggest that prophylaxis can significantly decrease the prevalence of infections in CRF patients, such as tuberculosis, S. aureus infection and hepatitis virus induced liver diseases. It remains an important issue for clinical nephrologists to investigate and to provide strategies for prevention and treatment of various infections in CRF patients.
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The purpose of this study was to explore the incidence of tuberculosis (TB) in chronic renal failure (CRF) patients with or without renal replacement therapy and to evaluate the effect of chemoprophylaxis on incidence of active TB. A total of 3360 CRF patients from April 1989 to Sept. 2002 were enrolled in this study. Chemoprophylaxis for TB was given to the patients with increased serum anti PPD IgG levels from Jan. 1995 to Sept. 2002. The prevalence of active TB during this period was compared with that of the historical control group from April 1989 to Dec. 1998 (without prophylaxis). The results showed that the overall incidence of active TB in all patients was 2 4% (82/3360). Extrapulmonary TB was the most common feature (75 6%) with the major infective sites in pleura (20 7%) and lymph node (17 7%). There were 58 5% patients with active TB showing increased serum and/or serous exudate anti PPD IgG levels and 24 2% patients showing positive TB bacillus DNA (PCR). The total incidences of TB (1 76%) and disseminated TB (2 3%) in the chemoprophylaxis group were significantly lower than those in the non chemoprophylaxis group (4 1% and 7 5%, respectively, P
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The study was performed to investigate the prevalence of nasal carriage of Staphylococcus aureus (NCSA) in patients with chronic renal failure(CRF) and its relationship with incidence of bacteremia in patients on hemodialysis(HD). The preventive effect of external application of mupirocin ointment on HD patients with venous catheters was also observed. Nasal swabs were taken from 114 CRF patients hospitalized from Nov. 2000 to April 2002. Samples from 42 patients in CCU with normal renal function and 48 staffs working in HD centre were also analyzed. External application of mupirocin ointment near the exit sites of catheters was performed as prophylaxis in HD patients with venous catheters. The prevalence of SA bacteremia was compared with that of the historical control group from Jan.1999 to Oct.2000. The results showed that the prevalence of NCSA in CRF patients was 14% (16/114). Nasal swab cultures were all negative in CCU patients, as well as staffs working in the HD centre. The mean frequency of SA bacteremia in HD patients with NCSA was 0 12/catheter month, compared to 0 in HD patients with no NCSA( P
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The aim of this study was to investigate the effect of patients isolation,paying careful attention to hygienic measure and strict sterilization on prevention of hepatitis C infection in hemodialysis(HD) unit. Patients in our HD unit from May 1994 to May 1998 were isolated and strict sterilization of dialysis apparatuses were performed, while patients from April 1990 to April 1994 were not isolated. The rate of HCV infection in these two groups of patients were 18 20% and 26 72%, respectively ( P
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The pathogenesis of dialysis related amyloidosis, which occurs preferentially in osteo articular tissues, is still incom pletely understood. Although recent histological studies have shown the accumulation of monocytes/macrophages around amyloid deposits, the factor(s) causing their infiltration and pathological involvement have yet to be fully elucidated. The present studies demonstrate that ? 2 microglobulin (? 2 m), the major constituent protein in amyloid fibrils, can be modified in situ by advanced glycation end products (AGE) through binding to AGE modified collagen. AGE ? 2 m attracts monocytes via direct chemotaxis and through regulation of synoviocyte derived chemokine. AGE modified ? 2 m significantly delays spontaneous apoptosis of human monocytes via a pathway mediated by the receptor for AGE (RAGE), processes which may increase the accumulation of inflammatory monocytes. In addition to recruit monocytes, AGE ? 2 m stimulates macrophages to release IL 1?, TNF ? and IL 6.These proinflammatory cytokines upregulate the expression of adhesion molecules such as ICAM 1 and VCAM 1 by synovial cells and induce the release of synoviocyte derived collagenase which may contribute to the degradation of matrix. These AGE ? 2 m induced perturbation of monocytes and cellular inflammatory reactions eventually result in osteo articular tissue damage and destruction seen in DRA.
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The study was performed to detect the binding proteins for advanced glycation end products (AGEs) on human joint synovial cells (HSCs). Normal human synovial cells (type A and type B cells) were isolated and cultured in vitro. Binding assay was performed with radiolabeled human serum albumin modified by AGE (AGE HSA). Specific binding was defined as total binding minus binding in the presence of excess unlabeled AGE HSA. The result showed that: specific dose dependent binding of 125 I AGE HSA to immobilized HSCs was observed with R=4.90 0.75 10 4 /cell , Kd = 1.27 0.19 10 -6 M in type A HSCs , and R= 3.48 0.32 10 5 /cell, Kd= 1.38?0.16 10 -7 M in type B HSCs. TNF ?,IL 1? and AGE HSA upregulated the expression of AGE binding proteins on HSCs. Normal HSCs express specific AGE binding proteins. TNF ?, IL 1? and AGE HSA upregulate the expression of these proteins, suggesting that joint resident cells may be involved in the pathogenesis of dialysis related amyloidosis.
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Objective To investigate the relationship between hyperhomocysteinemia and cardiovascular structure in maintenance hemodialysis uremia.Methods One hundred and twenty-two patients with maintenance hemodialysis were involved in the study.The level of plasma total homocysteine(tHcy) was determined by fluorescence polarization immunoassay.The morphosis of left artrium was investigated by Doppler echocardiography.Echocardiographic parameters such as interventricular septum thickness(IVST),left ventricular posterior wall thickness(PWTH),left ventricular mass index(LVMI) and left ventricular ejection fraction(EF) were measured.Results The mean level of tHcy in the patients on hemodialysis was(23.52?11.91)?mol/L and the prevalence of hyperhomocysteinemia was 77.0%.The overall prevalence of left ventricular hypertrophy(LVH) was 42.6%.The level of tHcy in the group with LVH was higher than that of the group without LVH(31.75?10.43 vs 15.89?4.15?mol/L)(P
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Objective To investigate the cellular receptor pathway and the intracellular signaling of advanced glycation end products(AGE)-induced inflammatory reaction in monocytes. Methods Human peripheral monocytes were isolated from healthy volunteers. Cells were incubated with AGE modified by the addition of human serum albumin (AGE-HSA) either with pretreatment or no pretreatment of anti-AGE receptor (RAGE) IgG, NADPH oxidase inhibitor (apocynin)or a specific inhibitor of p38(SB 203580). The levels of interleukin-1?(IL-1?)and tumor necrosis factor-?(TNF-?) in the supernatants were assayed with enzyme-linked immunoadsorbent assay (ELISA). Reactive oxygen species (ROS) production was determined by MCLA chemiluminescence. Nuclear factor-?B translocation was assayed by immunochemical staining with anti-NF-?B/p65 and electrophoretic mobility shift assay(EMSA). Results AGE-HSA was found to induce activation of NF-?B, increase levels of IL-1? and TNF-? in the supernatants, and enhance production of ROS by monocytes. Pre-treatment of cells with anti-RAGE IgG or apocynin inhibited AGE-HSA to induce NF-?B translocation and IL-1? or TNF-? production. AGE stimulated ROS production could also be blocked by pre-treatment of cultured cells with anti-RAGE IgG or apocynin. Pre-treatment of cultured cells with SB 203580 inhibited both NF-?B activation and cytokines production, but showed no significant effect the cells to produce ROS. Conclusion AGE-HSA could induce IL-1? and TNF-? release as well as ROS production in human monocytes via a pathway mediated by RAGE. Activation of NADPH oxidase may be the upstream of the intracellular pathway. AGE-induced cytokines production was p38 pathway-dependent.
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Objective A close relationship between atherosclerosis and plasma levels of advanced oxidation protein products (AOPP) has been demonstrated in patients with chronic renal failure. The present study was performed to investigate the effect of AOPP on human endothelial cells. Methods Human umbilical vein endothelial cell line ECV304 was incubated with different concentrations of AOPP-BSA, which prepared by combining BSA with HOCl at different molar ratios. Cell viability was measured by MTT assay. Intracellular production of reactive oxygen species (ROS) was evaluated kinetically using VICTOR Wallac 1420 mutilabel counter. Results AOPP-BSA decreased endothelial cell viability, which was dependent on the molar ratio of BSA/HOCl and the concentration of AOPP-BSA. AOPP-BSA also enhanced the intracellular ROS production in ECV304. AOPP-induced ROS production was correlated with the molar ratio of BSA/HOCl and the concentration of AOPP-BSA. Pretreatment of cells with a small molecular glutathione peroxidase mimic (ebselen) reduced AOPP-induced ROS production by 53% with preservation of cell viability. Conclusion AOPP decreased endothelial cell viability via induction of oxidative stress.
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Objective To investigate the effect of vitamin E supplementation on oxidative stress in hemodialysis patients. Methods Fifty-six uremic patients undergoing hemodialysis (HD) were involved in this self-controlled study. The patients were observed for one month to evaluate the status of oxidative stress and then divided into two groups randomly. Group A patients (n=28) received 200mg/d of vitamin E and Group B patients (n=28) were treated with 400mg/d of vitamin E. Vitamin E was supplied for one month in both groups. The serum levels of advanced oxidation protein products (AOPP), malondialdehyde (MDA), vitamin E and activity of glutathione peroxidase (GSHPx) were measured at the initial and the end of vitamin E supplementation respectively. Results Serum levels of AOPP and MDA were significantly higher in HD patients compared with healthy controls (n=56, P
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Objective The study was performed to determined the significance and safety of liver biopsies in these patients as a pre-transplantation screening test. Methods From January 1999 to August 2002, seventy-four renal transplant recipients with hepatitis B or C virus infection were received the percutaneous liver biopsy. The severity of liver inflammation(G) and fibrosis(S) were evaluated by semi-quantity technique. The patients whose liver histological diagnosis was G 0-2 S 0-2 received renal transplantation(n=31). Patients with hepatitis B or C virus infection who received renal transplantation in the period of January 1995 to December 1998 were selected as historic controls. Normal level of serum transaminase was considered as a indication for the received renal transplantation during this period. The incidence of liver dysfunction after transplantation was compared between the two groups. Results It showed among thirty-one patients received renal transplantation from 1999-2002, only 1 patient (3.2%) developed liver failure after transplantation. However, among 60 patients of historic control, 17 (23.8%) suffered from liver dysfunction (P
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Objective: Enhanced expression of adhesion molecules on synovial tissu e has been demonstrated in patients with dialysis-related amyloidosis (DRA). T he study was conducted to elucidate the mechanisms by which the expression of adh esion molecules on synovial cells was up-regulated.Methods: Human type-B synov ial cells were cultured in vitro with β2-microglobulin modified with adva nced glycation end products (AGE-β2m) , native β2-microglobulin (β2 m) , tumor necrosis factor-α（TNF-α）and interleukin -1β（ IL-1β）. The expression of intercellular adhesion molecule-1(ICAM-1), vasc ular cell adhesion molecule-1(VCAM-1), and E-selectin was examined by immunofluor esc enct staining and flow cytometer analysis. Results:ICAM-1 and VCAM-1, but not E -selectin, were constitutively expressed on human type-B synovial cells. TNF -α a nd IL-1β enhanced the expression of ICAM-1 and VCAM-1 in a dose- and time - depen dent manner. Neither of these cytokines appeared to induce the expression of E - selectin. Both β2m and AGE-β2m had no direct effect on the expression of the a dhesion molecules.Conclusion: Elevated level of IL-1β and TNF-α in the synov ial tissue may up-regulate the expression of adhesion molecules on synovial cel ls and therefore promote local monocytes infiltration.
