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Yuan G, Yang Y, Lin Y, Lin J, Wu Y. Current status and development trends in CKD with frailty research from 2000 to 2021: a bibliometric analysis. Ren Fail 2024; 46:2292142. [PMID: 38178378 PMCID: PMC10773684 DOI: 10.1080/0886022x.2023.2292142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 12/01/2023] [Indexed: 01/06/2024] Open
Abstract
INTRODUCTION The prevalence of chronic kidney disease (CKD) is gradually increasing in the elderly population. At the same time, frailty has become one of the research hotspots in the field of geriatrics. Bibliometric analyses help to understand the direction of a field. Therefore, this study aimed to analyze the status and emerging trends of frailty in CKD patients. DATA AND METHODS The Web of Science Core Collection (WoSCC) database was screened for relevant literature published between 1 January 2000 and 31 December 2021. Next, publications were analyzed for information including authors, journals, cited references, citing journals, institutions, countries and regions, high-frequency keywords and co-citations using VOSviewer, Microsoft Excel, and R software. RESULTS A total of 2223 articles were obtained, from which 613 relevant articles were selected based on title and abstract screening. There was an upward trend in the number of annual publications and Johansen KL was considered the most contributing author in the field. The Clinical Journal of the American Society of Nephrology was the most productive research journal. Johns Hopkins University is the most published organization. The United States is the global leader in the field and contributes the most to research. Research hotspots focus on epidemiological studies of frailty and frailty intervention. CONCLUSIONS This study presents a comprehensive bibliometric analysis of CKD and frailty research. Key findings highlight the current focus on early screening and assessment of frailty in CKD patients, as well as physical function interventions in frail patients.
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Affiliation(s)
- Guowei Yuan
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
- Department of Nephrology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
- Department of Hemodialysis, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Yaqin Yang
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
- Department of Nephrology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
- Department of Hemodialysis, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Yujie Lin
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jiarong Lin
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
- Department of Nephrology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
- Department of Hemodialysis, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Yuchi Wu
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
- Department of Nephrology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
- Department of Hemodialysis, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
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Wang T, Zhou Z, Ren L, Shen Z, Li J, Zhang L. Prediction of the risk of 3-year chronic kidney disease among elderly people: a community-based cohort study. Ren Fail 2024; 46:2303205. [PMID: 38284171 PMCID: PMC10826789 DOI: 10.1080/0886022x.2024.2303205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 01/01/2024] [Indexed: 01/30/2024] Open
Abstract
OBJECTIVE We conducted a community-based cohort study to predict the 3-year occurrence of chronic kidney disease (CKD) among population aged ≥60 years. METHOD Participants were selected from two communities through randomized cluster sampling in Jiading District of Shanghai, China. The two communities were randomly divided into a development cohort (n = 12012) and a validation cohort (n = 6248) with a 3-year follow-up. Logistic regression analysis was used to determine the independent predictors. A nomogram was established to predict the occurrence of CKD within 3 years. The area under the curve (AUC), the calibration curve and decision curve analysis (DCA) curve were used to evaluate the model. RESULT At baseline, participants in development cohort and validation cohort were with the mean age of 68.24 ± 5.87 and 67.68 ± 5.26 years old, respectively. During 3 years, 1516 (12.6%) and 544 (8.9%) new cases developed CKD in the development and validation cohorts, respectively. Nine variables (age, systolic blood pressure, body mass index, exercise, previous hypertension, triglycerides, fasting plasma glucose, glycated hemoglobin and serum creatinine) were included in the prediction model. The AUC value was 0.742 [95% confidence interval (CI), 0.728-0.756] in the development cohort and 0.881(95%CI, 0.867-0.895) in the validation cohort, respectively. The calibration curves and DCA curves demonstrate an effective predictive model. CONCLUSION Our nomogram model is a simple, reasonable and reliable tool for predicting the risk of 3-year CKD in community-dwelling elderly people, which is helpful for timely intervention and reducing the incidence of CKD.
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Affiliation(s)
- Tao Wang
- Clinical Center for Intelligent Rehabilitation Research, Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), Tongji University School of Medicine, Tongji University, Shanghai, China
| | - Zhitong Zhou
- Clinical Center for Intelligent Rehabilitation Research, Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), Tongji University School of Medicine, Tongji University, Shanghai, China
| | - Longbing Ren
- Clinical Center for Intelligent Rehabilitation Research, Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), Tongji University School of Medicine, Tongji University, Shanghai, China
| | - Zhiping Shen
- Community Health Service Center of Anting Town Affiliated to Tongji University School of Medicine, Tongji University, Shanghai, China
| | - Jue Li
- Clinical Center for Intelligent Rehabilitation Research, Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), Tongji University School of Medicine, Tongji University, Shanghai, China
- Department of Epidemiology, Tongji Hospital Affiliated to Tongji University School of Medicine, Shanghai, China
| | - Lijuan Zhang
- Clinical Center for Intelligent Rehabilitation Research, Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), Tongji University School of Medicine, Tongji University, Shanghai, China
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Király E, Szőllősi GJ, Jenei Z, Kárpáti I. Association between physical activity and quality of life in haemodialysed and peritoneal dialyzed patients in Hungary. Ren Fail 2024; 46:2324079. [PMID: 38425087 PMCID: PMC10911098 DOI: 10.1080/0886022x.2024.2324079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Accepted: 02/22/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Patients with end-stage kidney disease (ESKD) receiving peritoneal dialysis (PD) or haemodyalisis (PD) appear to be less physically active than healthy persons, a situation that could lead to reductions in quality of life. The aim of the present study was to assess and compare physical activity and health-related quality of life in renal patients on HD and PD programs. METHODS In May 2020, 130 patients (106 HD and 24 PD) were enrolled in a study of chronic dialysis programs. All participants received a questionnaire containing information on demographics, treatment, and co-morbidities. Physical activity was assessed using the International Physical Activity Questionnaire (IPAQ) short form, and quality of life was measured using the Kidney Disease Quality of Life-Short Form 12 (KDQOL-SF-12) questionnaire comprising mental (MCS) and physical components (PCS). Non-parametric statistical tests were executed with 0.05 as the level of significance. RESULTS The physical activity of patients treated in both HD and PD programs could be considered as low, without a statistically significant difference between the two modalities. For the quality of life measures, we found a significant (p = .004) difference regarding Physical Component Summary (PCS) scores, with higher PCS scores in patients treated in the PD programme compared to HD. Furthermore, higher physical activity levels were associated with better quality of life parameters in both groups. CONCLUSION This study confirms the importance of physical activity among dialysis patients with ESKD, suggesting that greater activity could be associated with a better quality of life.
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Affiliation(s)
- Enikő Király
- Department of Medical Rehabilitation and Physical Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
- Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Gergő József Szőllősi
- Coordination Center for Research in Social Sciences, Faculty of Economics and Business, University of Debrecen, Debrecen, Hungary
| | - Zoltán Jenei
- Department of Medical Rehabilitation and Physical Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - István Kárpáti
- Department of Nephrology, Institute of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
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Wang C, Zhao J, Zhou Q, Li J. Serum vitamin C levels and their correlation with chronic kidney disease in adults: a nationwide study. Ren Fail 2024; 46:2298079. [PMID: 38186336 PMCID: PMC10776057 DOI: 10.1080/0886022x.2023.2298079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 12/18/2023] [Indexed: 01/09/2024] Open
Abstract
INTRODUCTION Inflammation and oxidative stress play significant roles in the development of chronic kidney disease (CKD). Given the recognized antioxidant properties of vitamin C, our study aimed to explore the correlation between CKD and serum vitamin C levels. METHODS Data were gathered from the 2017-2018 National Health and Nutrition Examination Survey. Participants below 18 years of age, pregnant individuals, those lacking essential data for CKD diagnosis, or individuals with incomplete serum vitamin C data were excluded. Subgroup and weighted multivariable logistic regression analyses were performed to assess the potential correlation between serum vitamin C and CKD. RESULTS Our study comprised 4969 participants, revealing an overall CKD prevalence of 15.0%. The results indicated that individuals with reduced serum vitamin C levels were more likely to be male, possess lower educational attainment, have a diminished poverty-income ratio, engage in heavy drinking, and be current smokers. Additionally, they exhibited a higher prevalence of obesity and diabetes. Significantly, participants in the third quartile group experienced a 37.0%, 47.0%, and 46.6% decrease in the risk of developing albuminuria, low estimated glomerular filtration rate (eGFR), and CKD, respectively. Subgroup analysis demonstrated that individuals between 65 and 80 years of age showed a statistically reduced risk of developing CKD and low eGFR when their serum vitamin C levels fell in the third and fourth quartile groups. CONCLUSIONS Our findings reveal a correlation between elevated serum vitamin C levels and a decreased risk of developing albuminuria, low eGFR, and CKD. Appropriately increasing serum vitamin C levels may hold promise in protecting renal function, particularly among older individuals.
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Affiliation(s)
- Chunli Wang
- Department of General Internal Medicine, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Jili Zhao
- Department of General Internal Medicine, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Qiaoqiao Zhou
- Department of General Internal Medicine, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Jing Li
- Department of General Internal Medicine, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
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Li P, Lv T, Xu L, Yu W, Lu Y, Li Y, Hao J. Risk factors for cardio-cerebrovascular events among patients undergoing continuous ambulatory peritoneal dialysis and their association with serum magnesium. Ren Fail 2024; 46:2355354. [PMID: 38785302 PMCID: PMC11132858 DOI: 10.1080/0886022x.2024.2355354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 05/09/2024] [Indexed: 05/25/2024] Open
Abstract
Serum magnesium levels exceeding 0.9 mmol/L are associated with increased survival rates in patients with CKD. This retrospective study aimed to identify risk factors for cardio-cerebrovascular events among patients receiving continuous ambulatory peritoneal dialysis (CAPD) and to examine their correlations with serum magnesium levels. Sociodemographic data, clinical physiological and biochemical indexes, and cardio-cerebrovascular event data were collected from 189 patients undergoing CAPD. Risk factors associated with cardio-cerebrovascular events were identified by univariate binary logistic regression analysis. Correlations between the risk factors and serum magnesium levels were determined by correlation analysis. Univariate regression analysis identified age, C-reactive protein (CRP), red cell volume distribution width standard deviation, red cell volume distribution width corpuscular volume, serum albumin, serum potassium, serum sodium, serum chlorine, serum magnesium, and serum uric acid as risk factors for cardio-cerebrovascular events. Among them, serum magnesium ≤0.8 mmol/L had the highest odds ratio (3.996). Multivariate regression analysis revealed that serum magnesium was an independent risk factor, while serum UA (<440 μmol/L) was an independent protective factor for cardio-cerebrovascular events. The incidence of cardio-cerebrovascular events differed significantly among patients with different grades of serum magnesium (χ2 = 12.023, p = 0.002), with the highest incidence observed in patients with a serum magnesium concentration <0.8 mmol/L. High serum magnesium levels were correlated with high levels of serum albumin (r = 0.399, p < 0.001), serum potassium (r = 0.423, p < 0.001), and serum uric acid (r = 0.411, p < 0.001), and low levels of CRP (r = -0.279, p < 0.001). In conclusion, low serum magnesium may predict cardio-cerebrovascular events in patients receiving CAPD.
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Affiliation(s)
- Penglei Li
- Department of Medicine, Division of Nephrology, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
- Department of Medicine, Inner Mongolia Medical University, Hohhot, China
| | - Tiegang Lv
- Department of Medicine, Division of Nephrology, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
- Department of Medicine, Inner Mongolia Medical University, Hohhot, China
| | - Liping Xu
- Department of Medicine, Division of Nephrology, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
- Department of Medicine, Inner Mongolia Medical University, Hohhot, China
| | - Wenlu Yu
- Department of Medicine, Division of Nephrology, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
- Department of Medicine, Inner Mongolia Medical University, Hohhot, China
| | - Yuanyuan Lu
- Department of Medicine, Division of Nephrology, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
- Department of Medicine, Inner Mongolia Medical University, Hohhot, China
| | - Yuanyuan Li
- Department of Medicine, Division of Nephrology, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
- Department of Medicine, Inner Mongolia Medical University, Hohhot, China
| | - Jian Hao
- Department of Medicine, Division of Nephrology, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
- Department of Medicine, Inner Mongolia Medical University, Hohhot, China
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Reese-Petersen AL, Holm Nielsen S, Bülow Sand JM, Schattenberg JM, Bugianesi E, Karsdal MA. The sclerotic component of metabolic syndrome: Fibroblast activities may be the central common denominator driving organ function loss and death. Diabetes Obes Metab 2024; 26:2554-2566. [PMID: 38699780 DOI: 10.1111/dom.15615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 04/09/2024] [Accepted: 04/09/2024] [Indexed: 05/05/2024]
Abstract
Fibrosis is a common feature of more than 50 different diseases and the cause of more than 35% of deaths worldwide, of which liver, kidney, skin, heart and, recently, lungs are receiving the most attention. Tissue changes, resulting in loss of organ function, are both a cause and consequence of disease and outcome. Fibrosis is caused by an excess deposition of extracellular matrix proteins, which over time results in impaired organ function and organ failure, and the pathways leading to increased fibroblast activation are many. This narrative review investigated the common denominator of fibrosis, fibroblasts, and the activation of fibroblasts, in response to excess energy consumption in liver, kidney, heart, skin and lung fibrosis. Fibroblasts are the main drivers of organ function loss in lung, liver, skin, heart and kidney disease. Fibroblast activation in response to excess energy consumption results in the overproduction of a range of collagens, of which types I, III and VI seem to be the essential drivers of disease progression. Fibroblast activation may be quantified in serum, enabling profiling and selection of patients. Activation of fibroblasts results in the overproduction of collagens, which deteriorates organ function. Patient profiling of fibroblast activities in serum, quantified as collagen production, may identify an organ death trajectory, better enabling identification of the right treatment for use in different metabolic interventions. As metabolically activated patients have highly elevated risk of kidney, liver and heart failure, it is essential to identify which organ to treat first and monitor organ status to correct treatment regimes. In direct alignment with this, it is essential to identify the right patients with the right organ deterioration trajectory for enrolment in clinical studies.
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Affiliation(s)
| | | | | | - Jörn M Schattenberg
- Saarland University Medical Center, Homburg, Germany
- University of the Saarland, Saarbrücken, Germany
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Zhang J, Wu L, Wang P, Pan Y, Dong X, Jia L, Zhang A. Prevalence of cognitive impairment and its predictors among chronic kidney disease patients: A systematic review and meta-analysis. PLoS One 2024; 19:e0304762. [PMID: 38829896 DOI: 10.1371/journal.pone.0304762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 05/19/2024] [Indexed: 06/05/2024] Open
Abstract
BACKGROUND Cognitive impairment (CI) is common among patients with chronic kidney disease (CKD), and is associated with a poor prognosis. We assessed the prevalence and associated factors of CI in patients with CKD. METHODS A systematic review and meta-analysis were conducted by searching PubMed, Embase, and the Web of Science through December 1, 2023. Random effects models were performed with subgroup analyses to further explore the heterogeneity. RESULTS 50 studies involving 25,289 CKD patients were included. The overall prevalence of CI was 40% (95% confidence interval 33-46). The pooled prevalence of CI was relatively higher in CKD patients from Africa (58%), Asia (44%) and America (37%). Attention and executive dysfunction appeared to be the most common manifestations. The prevalence of CI was higher among patients with hemodialysis (53%) and peritoneal dialysis (39%) than those without dialysis (32%) and post-kidney transplanted (26%). In addition, advanced age, the presence of diabetes and hypertension might increase the risk of CI in CKD patients. CONCLUSIONS People with CKD have a high prevalence of CI, especially in patients with hemodialysis. An early and comprehensive screening for CI in CKD patients is needed to improve clinical outcomes. TRIAL REGISTRATION Registration number: PROSPERO (CRD42023412864).
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Affiliation(s)
- Jialing Zhang
- Department of Nephrology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Leiyun Wu
- Department of Nephrology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Peixin Wang
- Department of Nephrology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Yajing Pan
- Department of Nephrology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Xingtong Dong
- Department of Nephrology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Linpei Jia
- Department of Nephrology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Aihua Zhang
- Department of Nephrology, Xuanwu Hospital, Capital Medical University, Beijing, China
- The National Clinical Research Center for Geriatric Disease, Xuanwu Hospital, Capital Medical University, Beijing, China
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Imenez Silva PH, Pepin M, Figurek A, Gutiérrez-Jiménez E, Bobot M, Iervolino A, Mattace-Raso F, Hoorn EJ, Bailey MA, Hénaut L, Nielsen R, Frische S, Trepiccione F, Hafez G, Altunkaynak HO, Endlich N, Unwin R, Capasso G, Pesic V, Massy Z, Wagner CA. Animal models to study cognitive impairment of chronic kidney disease. Am J Physiol Renal Physiol 2024; 326:F894-F916. [PMID: 38634137 DOI: 10.1152/ajprenal.00338.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 03/11/2024] [Accepted: 04/04/2024] [Indexed: 04/19/2024] Open
Abstract
Mild cognitive impairment (MCI) is common in people with chronic kidney disease (CKD), and its prevalence increases with progressive loss of kidney function. MCI is characterized by a decline in cognitive performance greater than expected for an individual age and education level but with minimal impairment of instrumental activities of daily living. Deterioration can affect one or several cognitive domains (attention, memory, executive functions, language, and perceptual motor or social cognition). Given the increasing prevalence of kidney disease, more and more people with CKD will also develop MCI causing an enormous disease burden for these individuals, their relatives, and society. However, the underlying pathomechanisms are poorly understood, and current therapies mostly aim at supporting patients in their daily lives. This illustrates the urgent need to elucidate the pathogenesis and potential therapeutic targets and test novel therapies in appropriate preclinical models. Here, we will outline the necessary criteria for experimental modeling of cognitive disorders in CKD. We discuss the use of mice, rats, and zebrafish as model systems and present valuable techniques through which kidney function and cognitive impairment can be assessed in this setting. Our objective is to enable researchers to overcome hurdles and accelerate preclinical research aimed at improving the therapy of people with CKD and MCI.
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Affiliation(s)
- Pedro H Imenez Silva
- Institute of Physiology, University of Zurich, Zurich, Switzerland
- Division of Nephrology and Transplantation, Department of Internal Medicine, Erasmus Medical Center, University Medical Center, Rotterdam, The Netherlands
| | - Marion Pepin
- Institut National de la Santé et de la Recherche Médicale U-1018 Centre de Recherche en Épidémiologie et Santé des Population, Équipe 5, Paris-Saclay University, Versailles Saint-Quentin-en-Yvelines University, Villejuif, France
- Department of Geriatrics, Centre Hospitalier Universitaire Ambroise Paré, Assistance Publique-Hôpitaux de Paris Université Paris-Saclay, Paris, France
| | - Andreja Figurek
- Institute of Anatomy, University of Zurich, Zurich, Switzerland
| | - Eugenio Gutiérrez-Jiménez
- Center for Functionally Integrative Neuroscience, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Mickaël Bobot
- Centre de Néphrologie et Transplantation Rénale, Hôpital de la Conception, Assistance Publique-Hopitaux de Marseille, and INSERM 1263, Institut National de la Recherche Agronomique 1260, C2VN, Aix-Marseille Universitaire, Marseille, France
| | - Anna Iervolino
- Department of Translational Medical Sciences, University of Campania 'Luigi Vanvitelli,' Naples, Italy
| | - Francesco Mattace-Raso
- Division of Geriatrics, Department of Internal Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Ewout J Hoorn
- Division of Nephrology and Transplantation, Department of Internal Medicine, Erasmus Medical Center, University Medical Center, Rotterdam, The Netherlands
| | - Matthew A Bailey
- Edinburgh Kidney, Centre for Cardiovascular Science, The University of Edinburgh, Edinburgh, United Kingdom
| | - Lucie Hénaut
- UR UPJV 7517, Jules Verne University of Picardie, Amiens, France
| | - Rikke Nielsen
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | | | - Francesco Trepiccione
- Department of Translational Medical Sciences, University of Campania 'Luigi Vanvitelli,' Naples, Italy
| | - Gaye Hafez
- Department of Pharmacology, Faculty of Pharmacy, Altinbas University, Istanbul, Turkey
| | - Hande O Altunkaynak
- Department of Pharmacology, Gulhane Faculty of Pharmacy, University of Health Sciences, Istanbul, Turkey
| | - Nicole Endlich
- Department of Anatomy and Cell Biology, University Medicine Greifswald, Greifswald, Germany
| | - Robert Unwin
- Department of Renal Medicine, Royal Free Hospital, University College London, London, United Kingdom
| | - Giovambattista Capasso
- Department of Translational Medical Sciences, University of Campania 'Luigi Vanvitelli,' Naples, Italy
- Biogem Research Institute, Ariano Irpino, Italy
| | - Vesna Pesic
- Department of Physiology, Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia
| | - Ziad Massy
- Centre for Research in Epidemiology and Population Health, INSERM UMRS 1018, Clinical Epidemiology Team, University Paris-Saclay, University Versailles-Saint Quentin, Villejuif, France
- Department of Nephrology, Centre Hospitalier Universitaire Ambroise Paré, Assistance Publique-Hôpitaux de Paris Université Paris-Saclay, Paris, France
| | - Carsten A Wagner
- Institute of Physiology, University of Zurich, Zurich, Switzerland
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Ozdemir O, Unsar S. The effect of education given to hemodialysis patients based on the Roy Adaptation Model on fluid management, symptom control, and quality of life. Nurs Health Sci 2024; 26:e13118. [PMID: 38571314 DOI: 10.1111/nhs.13118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 03/06/2024] [Accepted: 03/16/2024] [Indexed: 04/05/2024]
Abstract
This study aimed to determine the effect of fluid management, symptom control, and quality of life on education based on the Roy Adaptation Model. This randomized controlled study was conducted with the participation of 107 patients (53 intervention, 54 control). Data were collected using the "Patient Data Collection Form," "Fluid Control in Hemodialysis Patients Scale," "Dialysis Symptom Index," and "Nottingham Health Profile." The forms were filled out through face-to-face interviews with the patients in the intervention and control groups at the 0th (onset), 1st, and 3rd months. The patients in the intervention group were trained with an education booklet based on the Roy Adaptation Model. The results revealed that the education given according to the Roy Adaptation Model improved the compliance with fluid control, quality of life, and symptom control of hemodialysis patients. It is recommended that education based on the Roy Adaptation Model be systematically used by hemodialysis nurses. The results are limited to the population included in the study, and further research on hemodialysis populations is needed.
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Affiliation(s)
- Ozlem Ozdemir
- Faculty of Health Sciences, Nursing Department, Kırklareli University, Kırklareli, Turkey
| | - Serap Unsar
- Faculty of Health Sciences, Department of Internal Medicine Nursing, Trakya University, Edirne, Turkey
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Xu X, Feng J, Cui Y, Li P, Dong J, Liao L. Renal effects and safety between Asian and non-Asian chronic kidney disease and type 2 diabetes treated with nonsteroidal mineralocorticoid antagonists. J Diabetes 2024; 16:e13566. [PMID: 38753662 PMCID: PMC11098447 DOI: 10.1111/1753-0407.13566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Revised: 03/01/2024] [Accepted: 03/26/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND Asians bear a heavier burden of chronic kidney disease (CKD), a common comorbidity of type 2 diabetes mellitus (T2DM), than non-Asians. Nonsteroidal mineralocorticoid receptor antagonists (MRAs) have garnered attention for their potential advantages in renal outcomes. Nevertheless, the impact on diverse ethnic groups remains unknown. METHODS The PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang database, and clinical trial registries were searched through August 2023 with the following keywords: nonsteroidal MRAs (finerenone, apararenone, esaxerenone, AZD9977, KBP-5074), CKD, T2DM, and randomized controlled trial (RCT). A random effects model was used to calculate overall effect sizes. RESULTS Seven RCTs with 14 997 participants were enrolled. Nonsteroidal MRAs reduced urinary albumin to creatinine ratio (UACR) significantly more in Asians than non-Asians: (weighted mean difference [WMD], -0.59, 95% CI, -0.73 to -0.45, p < .01) vs (WMD, -0.29, 95% CI, -0.32 to -0.27, p < .01), respectively. The average decline of estimated glomerular filtration rate (eGFR) was similar in Asians and non-Asians (p > .05). Regarding systolic blood pressure (SBP), nonsteroidal MRAs had a better antihypertension performance in Asians (WMD, -5.12, 95% CI, -5.84 to -4.41, p < .01) compared to non-Asians (WMD, -3.64, 95% CI, -4.38 to -2.89, p < .01). A higher incidence of hyperkalemia and eGFR decrease ≥30% was found in Asians than non-Asians (p < .01). CONCLUSIONS Nonsteroidal MRAs exhibited significant renal benefits by decreasing UACR and lowering SBP in Asian than that of non-Asian patients with CKD and T2DM, without increase of adverse events except hyperkalemia and eGFR decrease ≥30%.
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Affiliation(s)
- Xiaoming Xu
- Department of Endocrinology and Metabology, Shandong Provincial Qianfoshan HospitalShandong UniversityJinanChina
- Department of Endocrinology and MetabologyThe First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan HospitalJinanChina
| | - Jing Feng
- Department of Endocrinology and Metabology, Shandong Provincial Qianfoshan HospitalShandong UniversityJinanChina
- Department of Endocrinology and MetabologyThe First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan HospitalJinanChina
| | - Yuying Cui
- Department of Endocrinology and MetabologyThe First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan HospitalJinanChina
- First Clinical Medical CollegeShandong University of Traditional Chinese MedicineJinanChina
| | - Pingjiang Li
- Department of Endocrinology and MetabologyThe First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan HospitalJinanChina
- Shandong First Medical University and Shandong Academy of Medical SciencesJinanChina
| | - Jianjun Dong
- Department of EndocrinologyQilu Hospital of Shandong UniversityJinanChina
| | - Lin Liao
- Department of Endocrinology and Metabology, Shandong Provincial Qianfoshan HospitalShandong UniversityJinanChina
- Department of Endocrinology and MetabologyThe First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan HospitalJinanChina
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11
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Ababneh H, Tóth A, Lente G, Balogh E, Csiki DM, Nagy B, Szöőr Á, Jeney V. High phosphate and calcium induce osteoblastic phenotype switching and calcification of corneal epithelial cells in a Runx2-dependent and synergistic manner; a possible mechanism of chronic kidney disease-associated corneal calcification. Biochim Biophys Acta Mol Basis Dis 2024; 1870:167171. [PMID: 38631411 DOI: 10.1016/j.bbadis.2024.167171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 04/04/2024] [Accepted: 04/10/2024] [Indexed: 04/19/2024]
Abstract
Patients with advanced chronic kidney disease (CKD) have elevated circulating calcium × phosphate product levels and exhibit soft tissue calcification. Besides the cardiovascular system, calcification is commonly observed in the cornea in CKD patients on hemodialysis. Cardiovascular calcification is a cell-mediated, highly regulated process, and we hypothesized that a similar regulatory mechanism is implicated in corneal calcification with the involvement of corneal epithelial cells (CECs). We established a mouse model of CKD-associated corneal calcification by inducing CKD in DBA/2J mice with an adenine and high phosphate diet. CKD was associated with aorta and corneal calcification as detected by OsteoSense staining and corneal Ca measurement (1.67-fold elevation, p < 0.001). In vitro, excess phosphate and Ca induced human CEC calcification in a dose-dependent and synergistic manner, without any influence on cell viability. High phosphate and Ca-containing osteogenic medium (OM; 2.5 mmol/L excess phosphate and 0.6 mmol/L excess Ca over control) increased the protein expression of Runx2 and induced its nuclear translocation. OM increased the expression of the bone-specific Ca-binding protein osteocalcin (130-fold increase, p < 0.001). Silencing of Runx2 attenuated OM-induced CEC calcification. Immunohistology revealed upregulation of Runx2 and overlapping between the Runx2 and the Alizarin red positive areas of calcification in the cornea of CKD mice. This work sheds light on the mechanism of CKD-induced corneal calcification and provides tools to test calcification inhibitors for the prevention of this detrimental process.
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Affiliation(s)
- Haneen Ababneh
- MTA-DE Lendület Vascular Pathophysiology Research Group, Research Centre for Molecular Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary; Doctoral School of Molecular Cell and Immune Biology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Andrea Tóth
- MTA-DE Lendület Vascular Pathophysiology Research Group, Research Centre for Molecular Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Gréta Lente
- MTA-DE Lendület Vascular Pathophysiology Research Group, Research Centre for Molecular Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary; Doctoral School of Molecular Cell and Immune Biology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Enikő Balogh
- MTA-DE Lendület Vascular Pathophysiology Research Group, Research Centre for Molecular Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Dávid Máté Csiki
- MTA-DE Lendület Vascular Pathophysiology Research Group, Research Centre for Molecular Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary; Doctoral School of Molecular Cell and Immune Biology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Béla Nagy
- Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Árpád Szöőr
- Department of Biophysics and Cell Biology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Viktória Jeney
- MTA-DE Lendület Vascular Pathophysiology Research Group, Research Centre for Molecular Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.
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12
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Wang Y, Shi Y, Xiao T, Bi X, Huo Q, Wang S, Xiong J, Zhao J. A Klotho-Based Machine Learning Model for Prediction of both Kidney and Cardiovascular Outcomes in Chronic Kidney Disease. KIDNEY DISEASES (BASEL, SWITZERLAND) 2024; 10:200-212. [PMID: 38835404 PMCID: PMC11149992 DOI: 10.1159/000538510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Accepted: 03/18/2024] [Indexed: 06/06/2024]
Abstract
Introduction This study aimed to develop and validate machine learning (ML) models based on serum Klotho for predicting end-stage kidney disease (ESKD) and cardiovascular disease (CVD) in patients with chronic kidney disease (CKD). Methods Five different ML models were trained to predict the risk of ESKD and CVD at three different time points (3, 5, and 8 years) using a cohort of 400 non-dialysis CKD patients. The dataset was divided into a training set (70%) and an internal validation set (30%). These models were informed by data comprising 47 clinical features, including serum Klotho. The best-performing model was selected and used to identify risk factors for each outcome. Model performance was assessed using various metrics. Results The findings showed that the least absolute shrinkage and selection operator regression model had the highest accuracy (C-index = 0.71) in predicting ESKD. The features mainly included in this model were estimated glomerular filtration rate, 24-h urinary microalbumin, serum albumin, phosphate, parathyroid hormone, and serum Klotho, which achieved the highest area under the curve (AUC) of 0.930 (95% CI: 0.897-0.962). In addition, for the CVD risk prediction, the random survival forest model with the highest accuracy (C-index = 0.66) was selected and achieved the highest AUC of 0.782 (95% CI: 0.633-0.930). The features mainly included in this model were age, history of primary hypertension, calcium, tumor necrosis factor-alpha, and serum Klotho. Conclusion We successfully developed and validated Klotho-based ML risk prediction models for CVD and ESKD in CKD patients with good performance, indicating their high clinical utility.
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Affiliation(s)
- Yating Wang
- Department of Nephrology, The Key Laboratory for the Prevention and Treatment of Chronic Kidney Disease of Chongqing, Kidney Center of PLA, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, PR China
| | - Yu Shi
- Department of Nephrology, The Key Laboratory for the Prevention and Treatment of Chronic Kidney Disease of Chongqing, Kidney Center of PLA, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, PR China
| | - Tangli Xiao
- Department of Nephrology, The Key Laboratory for the Prevention and Treatment of Chronic Kidney Disease of Chongqing, Kidney Center of PLA, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, PR China
| | - Xianjin Bi
- Department of Nephrology, The Key Laboratory for the Prevention and Treatment of Chronic Kidney Disease of Chongqing, Kidney Center of PLA, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, PR China
| | - Qingyu Huo
- Department of Nephrology, The Key Laboratory for the Prevention and Treatment of Chronic Kidney Disease of Chongqing, Kidney Center of PLA, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, PR China
| | - Shaobo Wang
- Department of Nephrology, The Key Laboratory for the Prevention and Treatment of Chronic Kidney Disease of Chongqing, Kidney Center of PLA, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, PR China
| | - Jiachuan Xiong
- Department of Nephrology, The Key Laboratory for the Prevention and Treatment of Chronic Kidney Disease of Chongqing, Kidney Center of PLA, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, PR China
| | - Jinghong Zhao
- Department of Nephrology, The Key Laboratory for the Prevention and Treatment of Chronic Kidney Disease of Chongqing, Kidney Center of PLA, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, PR China
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13
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Ali MM, Parveen S, Williams V, Dons R, Uwaifo GI. Cardiometabolic comorbidities and complications of obesity and chronic kidney disease (CKD). J Clin Transl Endocrinol 2024; 36:100341. [PMID: 38616864 PMCID: PMC11015524 DOI: 10.1016/j.jcte.2024.100341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 03/28/2024] [Accepted: 03/29/2024] [Indexed: 04/16/2024] Open
Abstract
Obesity and chronic kidney disease are two ongoing progressive clinical pandemics of major public health and clinical care significance. Because of their growing prevalence, chronic indolent course and consequent complications both these conditions place significant burden on the health care delivery system especially in developed countries like the United States. Beyond the chance coexistence of both of these conditions in the same patient based on high prevalence it is now apparent that obesity is associated with and likely has a direct causal role in the onset, progression and severity of chronic kidney disease. The causes and underlying pathophysiology of this are myriad, complicated and multi-faceted. In this review, continuing the theme of this special edition of the journal on " The Cross roads between Endocrinology and Nephrology" we review the epidemiology of obesity related chronic kidney disease (ORCKD), and its various underlying causes and pathophysiology. In addition, we delve into the consequent comorbidities and complications associated with ORCKD with particular emphasis on the cardio metabolic consequences and then review the current body of evidence for available strategies for chronic kidney disease modulation in ORCKD as well as the potential unique role of weight reduction and management strategies in its improvement and risk reduction.
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Affiliation(s)
- Mariam M. Ali
- Southern Illinois School of Medicine, Department of Medicine, Section of Endocrinology, Diabetes and Metabolism, 751 North Rutledge Street, Moy Building, Suite 1700, Springfield, Il 62702, United States
| | - Sanober Parveen
- Southern Illinois School of Medicine, Department of Medicine, Section of Endocrinology, Diabetes and Metabolism, 751 North Rutledge Street, Moy Building, Suite 1700, Springfield, Il 62702, United States
| | - Vanessa Williams
- Southern Illinois School of Medicine, Department of Medicine, Section of Endocrinology, Diabetes and Metabolism, 751 North Rutledge Street, Moy Building, Suite 1700, Springfield, Il 62702, United States
| | - Robert Dons
- Southern Illinois School of Medicine, Department of Medicine, Section of Endocrinology, Diabetes and Metabolism, 751 North Rutledge Street, Moy Building, Suite 1700, Springfield, Il 62702, United States
| | - Gabriel I. Uwaifo
- Section of Endocrinology, Dept of Medicine, SIU School of Medicine, 751 N Rutledge St, Moy Building, Suite 1700, Room #1813, Springfield, Il 62702, United States
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14
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Jin L, Wang X, Liu Y, Xiang Q, Huang R. High levels of blood glycemic indicators are associated with chronic kidney disease prevalence in non-diabetic adults: Cross-sectional data from the national health and nutrition examination survey 2005-2016. J Clin Transl Endocrinol 2024; 36:100347. [PMID: 38737627 PMCID: PMC11081790 DOI: 10.1016/j.jcte.2024.100347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 04/22/2024] [Accepted: 04/26/2024] [Indexed: 05/14/2024] Open
Abstract
Objective Hyperglycemia in individuals with diabetes is associated with chronic kidney disease (CKD); however, little is known about its association with those without diabetes. Our goal was to investigate the association between glycemic indicators and CKD in individuals without diabetes. Methods This cross-sectional study included 9610 participants without diabetes who participated in the Health and Nutrition Examination Survey between 2005 and 2016. Exposures included postprandial glucose dip (PGD), fasting blood glucose (FBG), oral glucose tolerance test two-hour blood glucose (OGTT-2HBG), and glycated hemoglobin (HbA1C) levels. Moreover, CKD was defined as an estimated glomerular filtration rate below 60 mL/min per 1.73 m2 or a urinary albumin-creatinine ratio of ≥ 30 mg/g. Two multivariate models were constructed. Interaction effects were also explored. Results The mean age of the participants was 46.0 years, with 50.3 % being females. The prevalence of CKD was 12.6 %. In the final multivariable models, the odds ratios (ORs) for CKD were 1.51 (95 % confidence interval [CI]: 1.22,1.88, p < 0.001) for participants in the highest quartile of PGD,1.46 (95 %CI: 1.13,1.87, p = 0.004) for OGTT-2HBG, and 1.33 (95 %CI: 1.04,1.70, p = 0.020) for HbA1C, when compared with the quartile 1. No significant association was observed between FBG levels and CKD in the final model. Additionally, interactions were observed between PGD and body mass index, as well as between PGD and alcohol consumption in relation to CKD. Conclusion The study identified that high levels of PGD, OGTT-2HBG, and HBA1C were significantly associated with a high prevalence of CKD in individuals without diabetes.
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Affiliation(s)
- Lu Jin
- The First Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing 210029, PR China
| | - Xing Wang
- Jiangsu Health Vocational College, Nanjing 211899, PR China
| | - Yun Liu
- Department of Nephrology, Guangzhou Red Cross Hospital, Jinan University, Guangzhou 510220, PR China
| | - Qiulian Xiang
- Department of Neurology, Children’s Hospital of Nanjing Medical University, Nanjing 210008, PR China
| | - Ruiou Huang
- Department of Infection, Children’s Hospital of Nanjing Medical University, Nanjing 210008, PR China
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Katayıfçı N, Hüzmeli İ, İri Ş D, Turgut FH. Effects of different inspiratory muscle training protocols on functional exercise capacity and respiratory and peripheral muscle strength in patients with chronic kidney disease: a randomized study. BMC Nephrol 2024; 25:184. [PMID: 38811888 PMCID: PMC11137907 DOI: 10.1186/s12882-024-03610-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 05/13/2024] [Indexed: 05/31/2024] Open
Abstract
BACKGROUND Pathological changes were observed in the diaphragm due to abnormal renal function in chronic kidney disease (CKD). Inspiratory muscle training (IMT) has been suggested for patients with CKD; however, the most appropriate intensity for IMT has not been determined. Therefore, this study aimed to investigate the effects of different IMT protocols on respiratory muscle strength, quadriceps femoris muscle strength (QMS), handgrip muscle strength (HGS), functional exercise capacity, quality of life (QoL), pulmonary function, dyspnoea, fatigue, balance, and physical activity (PA) levels in patients with CKD. METHODS This randomized, controlled, single-blind study included 47 patients and they were divided into three groups: Group 1 (n = 15, IMT with 10% maximal inspiratory pressure (MIP)), Group 2 (n = 16, IMT with 30% MIP), and Group 3(n = 16; IMT with 60% MIP). MIP, maximal expiratory pressure (MEP), 6-min walking test (6-MWT), QMS, HGS, QoL, pulmonary function, dyspnoea, fatigue, balance, and PA levels were assessed before and after eight weeks of IMT. RESULTS Increases in MIP, %MIP, 6-MWT distance, and %6-MWT were significantly higher in Groups 2 and 3 than in Group 1 after IMT (p < 0.05). MEP, %MEP, FEF25-75%, QMS, HGS, and QoL significantly increased; dyspnoea and fatigue decreased in all groups (p < 0.05). FVC, PEF, and PA improved only in Group 2, and balance improved in Groups 1 and 2 (p < 0.05). CONCLUSIONS IMT with 30% and 60% MIP similarly improves inspiratory muscle strength and functional exercise capacity. IMT with 30% is more effective in increasing PA. IMT is a beneficial method to enhance peripheral and expiratory muscle strength, respiratory function, QoL and balance, and reduce dyspnoea and fatigue. IMT with %30 could be an option for patients with CKD who do not tolerate higher intensities. TRIAL REGISTRATION This study was retrospectively registered (NCT06401135, 06/05/2024).
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Affiliation(s)
- Nihan Katayıfçı
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Hatay Mustafa Kemal University, Hatay, Turkey.
| | - İrem Hüzmeli
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Hatay Mustafa Kemal University, Hatay, Turkey
| | - Döndü İri Ş
- Department of Physiotherapy and Rehabilitation, Institute of Health Sciences,, Hatay Mustafa Kemal University, Hatay, Turkey
| | - Faruk Hilmi Turgut
- Department of Nephrology, Tayfur Ata Sokmen Faculty of Medicine, Hatay Mustafa Kemal University, Hatay, Turkey
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Pintado-Outumuro E, Morin-Fraile V, Salvador-González B, Benito L, Julve-Ibáñez M, Sancho-Campos MP, Alves-Tafur C, Lumillo-Gutiérrez I. Exploring the factors influencing evidence-based approaches to advanced chronic kidney disease: a qualitative study involving nurses and physicians. BMC PRIMARY CARE 2024; 25:177. [PMID: 38773496 PMCID: PMC11107048 DOI: 10.1186/s12875-024-02418-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 05/06/2024] [Indexed: 05/23/2024]
Abstract
BACKGROUND Advanced chronic kidney disease (ACKD) is associated with a high risk of adverse cardiovascular and renal events and has a significant impact on quality of life and life expectancy. Several studies have identified areas for improvement in their management in primary care. Some professional and environmental factors can act as key barriers to appropriate care. OBJECTIVE To analyse attitudes, subjective norms, and perceived behavioural control among primary care professionals related to the implementation of an evidence-based approach for individuals with ACKD in primary care. METHODOLOGY This was a qualitative study using an interpretative phenomenological approach based on the theory of planned behaviour. Two aspects of the evidence-based approach were explored: the implementation of clinical practice guidelines and the utilisation of electronic kidney disease records within the scope of this study. Primary care nurses and physicians participated in a previous pilot interview and five focus groups. Subsequently, a thematic analysis of the gathered data was conducted. FINDINGS Thirty-three primary care professionals participated. The emerging themes included: experiences in the management of ACKD (highlighting a distinct profile of older, frail patients with comorbidities masking CKD and a CKD follow-up primarily focused on analytical monitoring and drug adjustment); factors in the professional environment influencing the use of scientific evidence (such as time constraints, excessive electronic health records, and unfamiliar reference guidelines); attitudes towards the application of recommendations on ACKD (recognising limitations of computer systems despite considering them as guidance); and capacities to implement evidence-based recommendations (acknowledging formative needs and challenges in coordinating care with nephrology services). CONCLUSIONS Several psychological elements identified through the TBP hinder the adequate implementation of an evidence-based approach for individuals with CKD. Attitudes have been identified as factors modulating the use of standardised electronic records. Instead, subjective norms (influences from the professional environment) and perceived behavioral control (perception of capabilities) acted as barriers to the proper application of clinical practice guidelines and standardised records. IMPLICATIONS FOR PRACTICE Strategies aimed at optimising the management of people with ACKD should focus not only on training but also on improving attitudes, organisational structures, IT systems and coordination between primary care and nephrology.
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Grants
- SLT021/21/000031 Departamento de Salud, Generalitat de Cataluña , España
- SLT021/21/000031 Departamento de Salud, Generalitat de Cataluña , España
- SLT021/21/000031 Departamento de Salud, Generalitat de Cataluña , España
- SLT021/21/000031 Departamento de Salud, Generalitat de Cataluña , España
- SLT021/21/000031 Departamento de Salud, Generalitat de Cataluña , España
- SLT021/21/000031 Departamento de Salud, Generalitat de Cataluña , España
- SLT021/21/000031 Departamento de Salud, Generalitat de Cataluña , España
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Affiliation(s)
- Elena Pintado-Outumuro
- Primary Care Center El Pla. Servei d'Atenció Primària Baix Llobregat Centre, Atenció Primària Metropolitana Sud, Institut Català de la Salut, Sant Feliu de Llobregat, Barcelona, 08980, Spain
- Research Group On Disease, Cardiovascular Risk and Lifestyles in Primary Care, Institut Universitari d'Investigació en Atenció Primària (IDIAP) Jordi Gol, Barcelona, 08007, Spain
| | - Victoria Morin-Fraile
- Department of Public Health, Mental Health and Maternal and Child Health Nursing. Faculty of Nursing, University of Barcelona. Pavelló de Govern, 3Rd Floor, L'Hospitalet de Llobregat, Barcelona, 08907, Spain
- Research Group On Environments and Materials for Learning, Universitat de Barcelona, Barcelona, Spain
| | - Betlem Salvador-González
- Unitat de Suport a la Recerca Metropolitana Sud, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), L'Hospitalet de Llobregat, Barcelona, 08907, Spain
- Research Group On Disease, Cardiovascular Risk and Lifestyles in Primary Care, Institut Universitari d'Investigació en Atenció Primària (IDIAP) Jordi Gol, Barcelona, 08007, Spain
| | - Llúcia Benito
- Fundamental and Clinic Nursing Department, Faculty of Nursing, University of Barcelona, Pavelló de Govern, 3Rd Floor, L'Hospitalet de Llobregat, Barcelona, 08907, Spain
- IDIBELL, Bellvitge Biomedical Research Institute, Avinguda de la Gran Via, 199, L'Hospitalet de Llobregat, Barcelona, 08908, Spain
| | - Maricel Julve-Ibáñez
- Primary Care Center El Castell, Servei d'Atenció Primària Delta del Llobregat, Atenció Primària Metropolitana Sud, Institut Català de la Salut, Castelldefels, 08860, Barcelona, Spain
| | - M-Pilar Sancho-Campos
- Primary Care Center Sant Ildefons. Servei d'Atenció Primària Baix Llobregat Centre, Atenció Primària Metropolitana Sud, Institut Català de la Salut, Cornellà de Llobregat, Barcelona, 08940, Spain
| | - Carolina Alves-Tafur
- Primary Care Center Montclar and Primary Care Center Camps Blancs. Servei d'Atenció Primària Baix Llobregat Centre, Atenció Primària Metropolitana Sud, Institut Català de la Salut, Sant Boi de Llobregat, Barcelona, 08830, Spain
| | - Iris Lumillo-Gutiérrez
- Department of Public Health, Mental Health and Maternal and Child Health Nursing. Faculty of Nursing, University of Barcelona. Pavelló de Govern, 3Rd Floor, L'Hospitalet de Llobregat, Barcelona, 08907, Spain.
- Research Group On Disease, Cardiovascular Risk and Lifestyles in Primary Care, Institut Universitari d'Investigació en Atenció Primària (IDIAP) Jordi Gol, Barcelona, 08007, Spain.
- Research Group On Environments and Materials for Learning, Universitat de Barcelona, Barcelona, Spain.
- Chronicity and Complexity Care Unit (UTACC) Baix Llobregat Centre, Atenció Primària Metropolitana Sud, Institut Català de la Salut, Cornellà de Llobregat, 08940, Spain.
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Stanford J, Stefoska-Needham A, Lambert K, Batterham MJ, Charlton K. Association between plant-based diet quality and chronic kidney disease in Australian adults. Public Health Nutr 2024; 27:e142. [PMID: 38757167 DOI: 10.1017/s1368980024001095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2024]
Abstract
OBJECTIVE To examine associations between three different plant-based diet quality indices, chronic kidney disease (CKD) prevalence and related risk factors in a nationally representative sample of the Australian population. DESIGN Cross-sectional analysis. Three plant-based diet scores were calculated using data from two 24-h recalls: an overall plant-based diet index (PDI), a healthy PDI (hPDI) and an unhealthy PDI (uPDI). Consumption of plant and animal ingredients from 'core' and 'discretionary' products was also differentiated. Associations between the three PDI scores and CKD prevalence, BMI, waist circumference (WC), blood pressure (BP) measures, blood cholesterol, apo B, fasting TAG, blood glucose levels (BGL) and HbA1c were examined. SETTING Australian Health Survey 2011-2013. PARTICIPANTS n 2060 adults aged ≥ 18 years (males: n 928; females: n 1132). RESULTS A higher uPDI score was associated with a 3·7 % higher odds of moderate-severe CKD (OR: 1·037 (1·0057-1·0697); P = 0·021)). A higher uPDI score was also associated with increased TAG (P = 0·032) and BGL (P < 0·001), but lower total- and LDL-cholesterol (P = 0·035 and P = 0·009, respectively). In contrast, a higher overall PDI score was inversely associated with WC (P < 0·001) and systolic BP (P = 0·044), while higher scores for both the overall PDI and hPDI were inversely associated with BMI (P < 0·001 and P = 0·019, respectively). CONCLUSIONS A higher uPDI score reflecting greater intakes of refined grains, salty plant-based foods and added sugars were associated with increased CKD prevalence, TAG and BGL. In the Australian population, attention to diet quality remains paramount, even in those with higher intakes of plant foods and who wish to reduce the risk of CKD.
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Affiliation(s)
- Jordan Stanford
- Nutrition and Dietetics Department, School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, NSW, Australia
- Illawarra Health and Medical Research Institute, Wollongong, NSW, Australia
| | - Anita Stefoska-Needham
- Nutrition and Dietetics Department, School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, NSW, Australia
- Illawarra Health and Medical Research Institute, Wollongong, NSW, Australia
| | - Kelly Lambert
- Nutrition and Dietetics Department, School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, NSW, Australia
- Illawarra Health and Medical Research Institute, Wollongong, NSW, Australia
| | - Marijka J Batterham
- Illawarra Health and Medical Research Institute, Wollongong, NSW, Australia
- Director of the National Institute for Applied Statistics Research Australia and the Statistical Consulting Centre, School of Mathematics and Applied Statistics, University of Wollongong, Wollongong, NSW, Australia
| | - Karen Charlton
- Nutrition and Dietetics Department, School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, NSW, Australia
- Illawarra Health and Medical Research Institute, Wollongong, NSW, Australia
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18
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Shi XY, Zhang QK, Li J, Zhu CY, Jin L, Fan S. Mendelian randomization analysis reveals causal relationships between circulating cell traits and renal disorders. Front Med (Lausanne) 2024; 11:1360868. [PMID: 38828235 PMCID: PMC11140107 DOI: 10.3389/fmed.2024.1360868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Accepted: 04/30/2024] [Indexed: 06/05/2024] Open
Abstract
Purpose The aim of this study was to investigate the causal relationships between circulating cell traits and risk of renal disorders. Methods We applied a comprehensive two-sample Mendelian randomization (MR) analysis. Single nucleotide polymorphisms (SNPs) from publicly available genome-wide association studies (GWAS) databases were utilized. Genetically predicted instrumental variables of human blood cell traits were extracted from Blood Cell Consortium (BCX) while data on renal diseases was obtained from Finngen consortium. The primary MR analysis was conducted using the inverse variance weighted (IVW) method, with the weighted median (WM) and MR-Egger models used as additional methods. Sensitivity analyses, including MR-PRESSO, radial regression and MR-Egger intercept were conducted to detect outliers and assess horizontal pleiotropy. We further utilized the leave-one-out analysis to assess the robustness of the results. Causal associations were considered significant based on false rate correction (FDR), specifically when the IVW method provided a pFDR < 0.05. Results Our results demonstrated that both white blood cell (WBC) count (OR = 1.50, 95% CI = 1.10-2.06, pFDR = 0.033, pIVW = 0.011) and lymphocyte count (OR = 1.50, 95% CI = 1.13-1.98, pFDR = 0.027, pIVW = 0.005) were causally associated with a higher risk of IgA nephropathy. Furthermore, WBC count was identified as a significant genetic risk factor for renal malignant neoplasms (OR = 1.23, 95% CI = 1.06-1.43, pFDR = 0.041, pIVW = 0.007). Additionally, an increased level of genetically predicted eosinophils was found to be causally associated with a higher risk of diabetic nephropathy (OR = 1.21, 95% CI = 1.08-1.36, pFDR = 0.007, pIVW = 0.001). No evidence of pleiotropy was determined. Conclusion Our findings provide evidence of causal associations of circulating WBC count, lymphocyte count and IgA nephropathy, WBC count and renal malignant neoplasms, and eosinophil count and diabetic nephropathy. These results have the potential to contribute to the development of novel diagnostic options and therapeutic strategies for renal disorders.
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Affiliation(s)
- Xing-yu Shi
- Department of Nephrology, Lishui Municipal Central Hospital, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, China
| | - Qian-kun Zhang
- Department of Nephrology, Lishui Municipal Central Hospital, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, China
| | - Jie Li
- Department of Nephrology, Lishui Municipal Central Hospital, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, China
| | - Chao-yong Zhu
- Department of Nephrology, Lishui Municipal Central Hospital, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, China
| | - Lie Jin
- Department of Nephrology, Lishui Municipal Central Hospital, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, China
| | - Shipei Fan
- Department of Ophthalmology, Lishui Municipal Central Hospital, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, China
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19
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Podadera-Herreros A, Arenas-de Larriva AP, Gutierrez-Mariscal FM, Alcala-Diaz JF, Ojeda-Rodriguez A, Rodriguez-Cantalejo F, Cardelo MP, Rodriguez-Cano D, Torres-Peña JD, Luque RM, Ordovas JM, Perez-Martinez P, Delgado-Lista J, Lopez-Miranda J, Yubero-Serrano EM. Mediterranean diet as a strategy for preserving kidney function in patients with coronary heart disease with type 2 diabetes and obesity: a secondary analysis of CORDIOPREV randomized controlled trial. Nutr Diabetes 2024; 14:27. [PMID: 38755195 PMCID: PMC11099022 DOI: 10.1038/s41387-024-00285-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 04/22/2024] [Accepted: 04/25/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) is recognized an independent risk factor for chronic kidney disease (CKD). The precise contribution and differential response to treatment strategies to reduce kidney dysfunction, depending on whether obesity is present alongside T2DM or not, remain to be fully clarified. Our objective was to improve our understanding of how obesity contributes to kidney function in patients with T2DM and coronary heart disease (CHD), who are highly predisposed to CKD, to assign the most effective dietary approach to preserve kidney function. METHODS 1002 patients with CHD and estimated glomerular filtration rate (eGFR)≥30 ml/min/1.73m2, were randomized to consume a Mediterranean diet (35% fat, 22% MUFA, < 50% carbohydrates) or a low-fat diet (28% fat, 12% MUFA, > 55% carbohydrates). Patients were classified into four groups according to the presence of T2DM and/or obesity at baseline: Non-Obesity/Non-T2DM, Obesity/Non-T2DM, Non-Obesity/T2DM and Obesity/T2DM. We evaluated kidney function using serum creatinine-based estimated glomerular filtration rate (eGFR) and urinary albumin-to-creatinine ratio (uACR) before and after 5-years of dietary intervention. RESULTS Patients with Obesity/T2DM had the lowest baseline eGFR and the highest baseline uACR compared to non-diabetics (p < 0.05). After dietary intervention, the Mediterranean diet induced a lower eGFR decline in patients with Obesity/T2DM, compared to a low-fat diet but not in the other groups (p = 0.014). The Mediterranean diet, but not the low-fat diet, also reduced uACR only in patients with Obesity/T2DM (p = 0.024). CONCLUSIONS Obesity provided an additive effect to T2DM resulting in a more pronounced decline in kidney function compared to T2DM alone when compared to non-diabetics. In patients with concomitant presence of T2DM and obesity, with more metabolic complications, consumption of a Mediterranean diet seemed more beneficial than a low-fat diet in terms of preserving kidney function. These findings provide valuable insights for tailoring personalized lifestyle modifications in secondary prevention of cardiovascular disease. TRIAL REGISTRATION URL, http://www.cordioprev.es/index.php/en . CLINICALTRIALS gov number, NCT00924937.
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Affiliation(s)
- Alicia Podadera-Herreros
- Unidad de Gestión Clinica Medicina Interna, Lipids and Atherosclerosis Unit, Maimonides Institute for Biomedical Research in Córdoba, Reina Sofia University Hospital, 14004 University of Córdoba, Córdoba, Spain
| | - Antonio P Arenas-de Larriva
- Unidad de Gestión Clinica Medicina Interna, Lipids and Atherosclerosis Unit, Maimonides Institute for Biomedical Research in Córdoba, Reina Sofia University Hospital, 14004 University of Córdoba, Córdoba, Spain
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| | - Francisco M Gutierrez-Mariscal
- Unidad de Gestión Clinica Medicina Interna, Lipids and Atherosclerosis Unit, Maimonides Institute for Biomedical Research in Córdoba, Reina Sofia University Hospital, 14004 University of Córdoba, Córdoba, Spain
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| | - Juan F Alcala-Diaz
- Unidad de Gestión Clinica Medicina Interna, Lipids and Atherosclerosis Unit, Maimonides Institute for Biomedical Research in Córdoba, Reina Sofia University Hospital, 14004 University of Córdoba, Córdoba, Spain
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| | - Ana Ojeda-Rodriguez
- Unidad de Gestión Clinica Medicina Interna, Lipids and Atherosclerosis Unit, Maimonides Institute for Biomedical Research in Córdoba, Reina Sofia University Hospital, 14004 University of Córdoba, Córdoba, Spain
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| | | | - Magdalena P Cardelo
- Unidad de Gestión Clinica Medicina Interna, Lipids and Atherosclerosis Unit, Maimonides Institute for Biomedical Research in Córdoba, Reina Sofia University Hospital, 14004 University of Córdoba, Córdoba, Spain
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| | | | - Jose D Torres-Peña
- Unidad de Gestión Clinica Medicina Interna, Lipids and Atherosclerosis Unit, Maimonides Institute for Biomedical Research in Córdoba, Reina Sofia University Hospital, 14004 University of Córdoba, Córdoba, Spain
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| | - Raul M Luque
- Department of Cell Biology, Physiology and Immunology, University of Córdoba, Maimonides Institute for Biomedical Research in Córdoba, Reina Sofia University Hospital, University of Córdoba, 14004, Córdoba, Spain
| | - Jose M Ordovas
- Nutrition and Genomics Laboratory, JM-USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, 02111, USA
- Precision Nutrition and Obesity Program, IMDEA Alimentación, 28049, Madrid, Spain
| | - Pablo Perez-Martinez
- Unidad de Gestión Clinica Medicina Interna, Lipids and Atherosclerosis Unit, Maimonides Institute for Biomedical Research in Córdoba, Reina Sofia University Hospital, 14004 University of Córdoba, Córdoba, Spain
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| | - Javier Delgado-Lista
- Unidad de Gestión Clinica Medicina Interna, Lipids and Atherosclerosis Unit, Maimonides Institute for Biomedical Research in Córdoba, Reina Sofia University Hospital, 14004 University of Córdoba, Córdoba, Spain
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| | - Jose Lopez-Miranda
- Unidad de Gestión Clinica Medicina Interna, Lipids and Atherosclerosis Unit, Maimonides Institute for Biomedical Research in Córdoba, Reina Sofia University Hospital, 14004 University of Córdoba, Córdoba, Spain
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| | - Elena M Yubero-Serrano
- Unidad de Gestión Clinica Medicina Interna, Lipids and Atherosclerosis Unit, Maimonides Institute for Biomedical Research in Córdoba, Reina Sofia University Hospital, 14004 University of Córdoba, Córdoba, Spain.
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.
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20
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Zhang Z, Cao B, Wu Q. Causality of Genetically Determined Metabolites on Chronic Kidney Disease: A Two-Sample Mendelian Randomization Study In Silico. Metab Syndr Relat Disord 2024. [PMID: 38742978 DOI: 10.1089/met.2024.0030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2024] Open
Abstract
Introduction: Chronic kidney disease (CKD) is associated with metabolic disorders. However, the evidence for the causality of circulating metabolites to promote or prevent CKD is still lacking. Methods: The two-sample Mendelian randomization (MR) analysis was conducted to evaluate the latent causal relationship between the genetically proxied 486 blood metabolites and CKD. Genome-wide association study (GWAS) data for exposures were derived from 7824 European GWAS on metabolite levels, which have been extensively utilized in the medical field to elucidate the mechanisms underlying disease onset and progression. The random inverse variance weighted (IVW) is the primary analysis for causality analysis while MR-Egger and weighted median as complementary analyses. For the further identification of metabolites, reverse MR and linkage disequilibrium score regression were performed for further evaluation. The drug target for N-acetylornithine was subsequently supplemented into the analysis, with MR and colocalization analysis being utilized. Key metabolic pathways were identified via MetaboAnalyst 4.0 (https://www.metaboanalyst.ca/) online website. Results: N-acetylornithine was identified as a reliable metabolite that increases the susceptibility to estimated glomerular filtration rate (eGFR) decrease (β = 0.047; 95% confidence interval: -0.068 to -0.026; PIVW = 1.5E-5). The "glyoxylate and dicarboxylate metabolism" pathway showed significant relevance to CKD development (P = 6E-4), whereas the "glycine, serine, and threonine metabolism" pathway was also recognized as associated with CKD by general practitioners (P = 7E-4). Colocalization analysis revealed a robust genetic link between N-acetylornithine and both CKD and eGFR, with 85.1% and 99.4% colocalization rates, respectively. IVW-MR analysis substantiated these findings with a significant positive association for CKD (odds ratio = 1.43, P = 4.7E-5) and a negative correlation with eGFR (b = -0.04, P = 1.13E-31). Conclusions: MR was utilized to explore the potential causal links between 61 genetic serum metabolites and CKD. N-acetylornithine and NAT8 were further explored as a potential therapeutic target for CKD treatment.
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Affiliation(s)
- Zekai Zhang
- Second College of Clinical Medicine, Nanjing Medical University, Nanjing, China
| | - Beibei Cao
- Academy of Paediatrics, Nanjing Medical University, Nanjing, China
| | - Qiutong Wu
- Second College of Clinical Medicine, Nanjing Medical University, Nanjing, China
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21
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León-Figueroa DA, Aguirre-Milachay E, Barboza JJ, Valladares-Garrido MJ. Prevalence of hypertension and diabetes mellitus in Peruvian patients with chronic kidney disease: a systematic review and meta-analysis. BMC Nephrol 2024; 25:160. [PMID: 38730295 PMCID: PMC11088108 DOI: 10.1186/s12882-024-03595-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Accepted: 04/30/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Chronic Kidney Disease (CKD) represents a major challenge for public health, with hypertension and diabetes being the main causes of its occurrence. Therefore, this study aims to determine the prevalence of hypertension (HTN) and diabetes mellitus (DM) in Peruvian patients with CKD. METHODS A systematic search for studies about CKD in Peru was carried out in PubMed, Scopus, Embase, Web of Science, ScienceDirect, Google Scholar, Virtual Health Library (VHL), and Scielo from 2011 to December 2023. The protocol of this research was registered in the international registry of systematic reviews, the Prospective International Registry of Systematic Reviews (PROSPERO), with registration number CRD42023425118. Study selection, quality assessment, and data extraction were performed independently by two authors. Study quality was assessed using the Joanna Briggs Institute Statistical Meta-Analysis Assessment and Review Instrument. A random-effects model with inverse variance weighting was used to estimate the combined prevalence of HTN and DM in Peruvian patients with CKD. To analyze data heterogeneity, the I2 statistical test was used. Statistical analysis was performed with R version 4.2.3. RESULTS A total of 1425 studies were retrieved, of which 23 were included in the final meta-analysis. A total of 43,321 patients with CKD were evaluated, of whom 52.22% were male and 47.78% were female. The combined prevalence of HTN in Peruvian patients with CKD was 38% (95% CI: 30-46%; 41,131 participants; 21 studies, I2 = 99%, p = 0), while the combined prevalence of DM in Peruvian patients with CKD was 33% (95% CI: 26-40%; 43,321 participants; 23 studies, I2 = 99%, p = 0). CONCLUSION Approximately one-third of Peruvian patients with CKD have HTN and DM. These findings highlight the importance of implementing prevention and control measures for these chronic noncommunicable diseases in the Peruvian population, such as promoting healthy lifestyles, encouraging early detection and proper management of hypertension and diabetes, and improving access to medical care and health services.
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Affiliation(s)
| | | | - Joshuan J Barboza
- Vicerrectorado de Investigación, Universidad Norbert Wiener, Lima, 15046, Peru
| | - Mario J Valladares-Garrido
- Universidad Continental, Lima, 15046, Peru.
- Oficina de Epidemiología, Hospital Regional Lambayeque, Chiclayo, 14012, Peru.
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22
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Li H, Li D, Ledru N, Xuanyuan Q, Wu H, Asthana A, Byers LN, Tullius SG, Orlando G, Waikar SS, Humphreys BD. Transcriptomic, epigenomic, and spatial metabolomic cell profiling redefines regional human kidney anatomy. Cell Metab 2024; 36:1105-1125.e10. [PMID: 38513647 PMCID: PMC11081846 DOI: 10.1016/j.cmet.2024.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 12/20/2023] [Accepted: 02/26/2024] [Indexed: 03/23/2024]
Abstract
A large-scale multimodal atlas that includes major kidney regions is lacking. Here, we employed simultaneous high-throughput single-cell ATAC/RNA sequencing (SHARE-seq) and spatially resolved metabolomics to profile 54 human samples from distinct kidney anatomical regions. We generated transcriptomes of 446,267 cells and chromatin accessibility profiles of 401,875 cells and developed a package to analyze 408,218 spatially resolved metabolomes. We find that the same cell type, including thin limb, thick ascending limb loop of Henle and principal cells, display distinct transcriptomic, chromatin accessibility, and metabolomic signatures, depending on anatomic location. Surveying metabolism-associated gene profiles revealed non-overlapping metabolic signatures between nephron segments and dysregulated lipid metabolism in diseased proximal tubule (PT) cells. Integrating multimodal omics with clinical data identified PLEKHA1 as a disease marker, and its in vitro knockdown increased gene expression in PT differentiation, suggesting possible pathogenic roles. This study highlights previously underrepresented cellular heterogeneity underlying the human kidney anatomy.
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Affiliation(s)
- Haikuo Li
- Division of Nephrology, Department of Medicine, Washington University in St. Louis, St. Louis, MO, USA
| | - Dian Li
- Division of Nephrology, Department of Medicine, Washington University in St. Louis, St. Louis, MO, USA
| | - Nicolas Ledru
- Division of Nephrology, Department of Medicine, Washington University in St. Louis, St. Louis, MO, USA
| | - Qiao Xuanyuan
- Division of Nephrology, Department of Medicine, Washington University in St. Louis, St. Louis, MO, USA
| | - Haojia Wu
- Division of Nephrology, Department of Medicine, Washington University in St. Louis, St. Louis, MO, USA
| | - Amish Asthana
- Department of Surgery, Atrium Health Wake Forest Baptist, Wake Forest Institute for Regenerative Medicine, Wake Forest School of Medicine, Winston Salem, NC, USA
| | - Lori N Byers
- Department of Surgery, Atrium Health Wake Forest Baptist, Wake Forest Institute for Regenerative Medicine, Wake Forest School of Medicine, Winston Salem, NC, USA
| | - Stefan G Tullius
- Division of Transplant Surgery and Transplant Surgery Research Laboratory, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Giuseppe Orlando
- Department of Surgery, Atrium Health Wake Forest Baptist, Wake Forest Institute for Regenerative Medicine, Wake Forest School of Medicine, Winston Salem, NC, USA
| | - Sushrut S Waikar
- Section of Nephrology, Department of Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston Medical Center, Boston, MA, USA
| | - Benjamin D Humphreys
- Division of Nephrology, Department of Medicine, Washington University in St. Louis, St. Louis, MO, USA; Department of Developmental Biology, Washington University in St. Louis, St. Louis, MO, USA.
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23
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Guglielmi V, Dalle Grave R, Leonetti F, Solini A. Female obesity: clinical and psychological assessment toward the best treatment. Front Endocrinol (Lausanne) 2024; 15:1349794. [PMID: 38765954 PMCID: PMC11099266 DOI: 10.3389/fendo.2024.1349794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 04/19/2024] [Indexed: 05/22/2024] Open
Abstract
Obesity is a heterogeneous condition which results from complex interactions among sex/gender, sociocultural, environmental, and biological factors. Obesity is more prevalent in women in most developed countries, and several clinical and psychological obesity complications show sex-specific patterns. Females differ regarding fat distribution, with males tending to store more visceral fat, which is highly correlated to increased cardiovascular risk. Although women are more likely to be diagnosed with obesity and appear more motivated to lose weight, as confirmed by their greater representation in clinical trials, males show better outcomes in terms of body weight and intra-abdominal fat loss and improvements in the metabolic risk profile. However, only a few relatively recent studies have investigated gender differences in obesity, and sex/gender is rarely considered in the assessment and management of the disease. This review summarizes the evidence of gender differences in obesity prevalence, contributing factors, clinical complications, and psychological challenges. In addition, we explored gender differences in response to obesity treatments in the specific context of new anti-obesity drugs.
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Affiliation(s)
- Valeria Guglielmi
- Unit of Internal Medicine and Obesity Center, Department of Systems Medicine, Policlinico Tor Vergata, University of Rome Tor Vergata, Rome, Italy
| | - Riccardo Dalle Grave
- Department of Eating and Weight Disorders, Villa Garda Hospital, Garda, VR, Italy
| | - Frida Leonetti
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy
| | - Anna Solini
- Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, Pisa, Italy
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24
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Garmaa G, Bunduc S, Kói T, Hegyi P, Csupor D, Ganbat D, Dembrovszky F, Meznerics FA, Nasirzadeh A, Barbagallo C, Kökény G. A Systematic Review and Meta-Analysis of microRNA Profiling Studies in Chronic Kidney Diseases. Noncoding RNA 2024; 10:30. [PMID: 38804362 PMCID: PMC11130806 DOI: 10.3390/ncrna10030030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 04/24/2024] [Accepted: 04/28/2024] [Indexed: 05/29/2024] Open
Abstract
Chronic kidney disease (CKD) represents an increasing health burden. Evidence suggests the importance of miRNA in diagnosing CKD, yet the reports are inconsistent. This study aimed to determine novel miRNA biomarkers and potential therapeutic targets from hypothesis-free miRNA profiling studies in human and murine CKDs. Comprehensive literature searches were conducted on five databases. Subgroup analyses of kidney diseases, sample types, disease stages, and species were conducted. A total of 38 human and 12 murine eligible studies were analyzed using Robust Rank Aggregation (RRA) and vote-counting analyses. Gene set enrichment analyses of miRNA signatures in each kidney disease were conducted using DIANA-miRPath v4.0 and MIENTURNET. As a result, top target genes, Gene Ontology terms, the interaction network between miRNA and target genes, and molecular pathways in each kidney disease were identified. According to vote-counting analysis, 145 miRNAs were dysregulated in human kidney diseases, and 32 were dysregulated in murine CKD models. By RRA, miR-26a-5p was significantly reduced in the kidney tissue of Lupus nephritis (LN), while miR-107 was decreased in LN patients' blood samples. In both species, epithelial-mesenchymal transition, Notch, mTOR signaling, apoptosis, G2/M checkpoint, and hypoxia were the most enriched pathways. These miRNA signatures and their target genes must be validated in large patient cohort studies.
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Affiliation(s)
- Gantsetseg Garmaa
- Institute of Translational Medicine, Semmelweis University, Nagyvárad tér 4, 1089 Budapest, Hungary; (G.G.); (A.N.)
- Center for Translational Medicine, Semmelweis University, Üllői út 26, 1085 Budapest, Hungary; (S.B.); (T.K.); (P.H.); (D.C.); (F.D.); (F.A.M.)
- Department of Pathology, School of Medicine, Mongolian National University of Medical Sciences, Ulan-Bator 14210, Mongolia;
| | - Stefania Bunduc
- Center for Translational Medicine, Semmelweis University, Üllői út 26, 1085 Budapest, Hungary; (S.B.); (T.K.); (P.H.); (D.C.); (F.D.); (F.A.M.)
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Dionisie Lupu Street 37, 020021 Bucharest, Romania
- Fundeni Clinical Institute, Fundeni Street 258, 022328 Bucharest, Romania
- Division of Pancreatic Diseases, Heart and Vascular Center, Semmelweis University, Baross út 22-24, 1085 Budapest, Hungary
| | - Tamás Kói
- Center for Translational Medicine, Semmelweis University, Üllői út 26, 1085 Budapest, Hungary; (S.B.); (T.K.); (P.H.); (D.C.); (F.D.); (F.A.M.)
- Department of Stochastics, Institute of Mathematics, Budapest University of Technology and Economics, Műegyetem rkp. 3, 1111 Budapest, Hungary
| | - Péter Hegyi
- Center for Translational Medicine, Semmelweis University, Üllői út 26, 1085 Budapest, Hungary; (S.B.); (T.K.); (P.H.); (D.C.); (F.D.); (F.A.M.)
- Division of Pancreatic Diseases, Heart and Vascular Center, Semmelweis University, Baross út 22-24, 1085 Budapest, Hungary
- Institute for Translational Medicine, Medical School, University of Pécs, 7624 Pécs, Hungary
| | - Dezső Csupor
- Center for Translational Medicine, Semmelweis University, Üllői út 26, 1085 Budapest, Hungary; (S.B.); (T.K.); (P.H.); (D.C.); (F.D.); (F.A.M.)
- Institute for Translational Medicine, Medical School, University of Pécs, 7624 Pécs, Hungary
- Institute of Clinical Pharmacy, University of Szeged, Szikra utca 8, 6725 Szeged, Hungary
| | - Dariimaa Ganbat
- Department of Pathology, School of Medicine, Mongolian National University of Medical Sciences, Ulan-Bator 14210, Mongolia;
- Department of Public Health, Graduate School of Medicine, International University of Health and Welfare, Tokyo 107-840, Japan
| | - Fanni Dembrovszky
- Center for Translational Medicine, Semmelweis University, Üllői út 26, 1085 Budapest, Hungary; (S.B.); (T.K.); (P.H.); (D.C.); (F.D.); (F.A.M.)
- Division of Pancreatic Diseases, Heart and Vascular Center, Semmelweis University, Baross út 22-24, 1085 Budapest, Hungary
| | - Fanni Adél Meznerics
- Center for Translational Medicine, Semmelweis University, Üllői út 26, 1085 Budapest, Hungary; (S.B.); (T.K.); (P.H.); (D.C.); (F.D.); (F.A.M.)
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Mária utca 41, 1085 Budapest, Hungary
| | - Ailar Nasirzadeh
- Institute of Translational Medicine, Semmelweis University, Nagyvárad tér 4, 1089 Budapest, Hungary; (G.G.); (A.N.)
| | - Cristina Barbagallo
- Section of Biology and Genetics “G. Sichel”, Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy;
| | - Gábor Kökény
- Institute of Translational Medicine, Semmelweis University, Nagyvárad tér 4, 1089 Budapest, Hungary; (G.G.); (A.N.)
- International Nephrology Research and Training Center, Semmelweis University, Nagyvárad tér 4, 1089 Budapest, Hungary
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25
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Krecak I, Verstovsek S, Lucijanic M. Optimization of cardiovascular risk factor management in patients with BCR::ABL1 negative chronic myeloproliferative neoplasms, current knowledge, and perspectives. Ann Hematol 2024; 103:1513-1523. [PMID: 37665349 DOI: 10.1007/s00277-023-05426-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 08/24/2023] [Indexed: 09/05/2023]
Abstract
The exact prognostic role of cardiovascular (CV) risk factors in patients with BCR::ABL1 negative chronic myeloproliferative neoplasms (MPNs) remains unknown as it is often masked by other MPN-related features that bear strong prognostic impact on thrombotic risk. Therefore, current MPN treatment is not primarily guided by presence of CV risk factors. Treatment of CV risk factors in MPN patients usually mirrors that from the general population, despite the fact that CV risk factors in MPNs have their own specificities. Moreover, the optimal target levels for different metabolic deflections in MPNs (i.e., low-density lipoprotein, serum uric acid, or glycated hemoglobin levels) have not been defined. In the current review, we separately discuss the most important aspects of every individual CV risk factor (arterial hypertension, hyperlipidemia, chronic kidney disease, smoking, diabetes mellitus, hyperuricemia, and obesity and cachexia) in MPNs, summarize recent advances in the field, and propose future directions and research areas which may be needed to appropriately manage CV risk factors in MPNs.
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Affiliation(s)
- Ivan Krecak
- Department of Internal Medicine, General Hospital of Sibenik-Knin County, Stjepana Radića 83, 22000, Sibenik, Croatia.
- Faculty of Medicine, University of Rijeka, Rijeka, Croatia.
- University of Applied Sciences, Sibenik, Croatia.
| | | | - Marko Lucijanic
- Department of Hematology, University Hospital Dubrava, Zagreb, Croatia
- School of Medicine, University of Zagreb, Zagreb, Croatia
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Ho YS, Fülöp T, Krisanapan P, Soliman KM, Cheungpasitporn W. Artificial intelligence and machine learning trends in kidney care. Am J Med Sci 2024; 367:281-295. [PMID: 38281623 DOI: 10.1016/j.amjms.2024.01.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 12/12/2023] [Accepted: 01/23/2024] [Indexed: 01/30/2024]
Abstract
BACKGROUND The integration of artificial intelligence (AI) and machine learning (ML) in kidney care has seen a significant rise in recent years. This study specifically analyzed AI and ML research publications related to kidney care to identify leading authors, institutions, and countries in this area. It aimed to examine publication trends and patterns, and to explore the impact of collaborative efforts on citation metrics. METHODS The study used the Science Citation Index Expanded (SCI-EXPANDED) of Clarivate Analytics Web of Science Core Collection to search for AI and machine learning publications related to nephrology from 1992 to 2021. The authors used quotation marks and Boolean operator "or" to search for keywords in the title, abstract, author keywords, and Keywords Plus. In addition, the 'front page' filter was applied. A total of 5425 documents were identified and analyzed. RESULTS The results showed that articles represent 75% of the analyzed documents, with an average author to publications ratio of 7.4 and an average number of citations per publication in 2021 of 18. English articles had a higher citation rate than non-English articles. The USA dominated in all publication indicators, followed by China. Notably, the research also showed that collaborative efforts tend to result in higher citation rates. A significant portion of the publications were found in urology journals, emphasizing the broader scope of kidney care beyond traditional nephrology. CONCLUSIONS The findings underscore the importance of AI and ML in enhancing kidney care, offering a roadmap for future research and implementation in this expanding field.
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Affiliation(s)
- Yuh-Shan Ho
- Trend Research Centre, Asia University, Wufeng, Taichung, Taiwan
| | - Tibor Fülöp
- Medical Services, Ralph H. Johnson VA Medical Center, Charleston, SC, USA; Department of Medicine, Division of Nephrology, Medical University of South Carolina, Charleston, SC, USA.
| | - Pajaree Krisanapan
- Division of Nephrology, Department of Internal Medicine, Thammasat University, Pathum Thani, Thailand, 12120
| | - Karim M Soliman
- Medical Services, Ralph H. Johnson VA Medical Center, Charleston, SC, USA; Department of Medicine, Division of Nephrology, Medical University of South Carolina, Charleston, SC, USA
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Almadani AK, Ahmed W, Al Obaidli AAK, Holt SG. Gender, age and nationality differences in chronic kidney disease prevalence in the emirate of Abu Dhabi, UAE. Nephrology (Carlton) 2024; 29:288-296. [PMID: 38450898 DOI: 10.1111/nep.14285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 02/19/2024] [Accepted: 02/21/2024] [Indexed: 03/08/2024]
Abstract
AIM We aimed to better understand the prevalence of chronic kidney disease in Abu Dhabi, UAE, where a very diverse ethnic population lives, each with their own risk profile. METHODS Data were analysed on all patients who were tested for serum creatinine in December 2019 for 4 years within our healthcare network. We analysed data for kidney disease by age, gender and nationality to study differences in prevalence and risk. RESULTS The entire cohort (EC) consisted 1 925 672 samples from 703 122 patients. 24% of patients had GFR < 90 mL/min/1.73 m2 (CKD2-5), 4% had more severe kidney dysfunction (CKD3-5) and 2% had UACR >3 mg/mmol and with GFR > 90 (CKD1). The long follow-up (LFU) group comprised 45.6% of patients who had eGFR on at least two occasions more than 90 days apart, and of these 19.5% had sustained eGFR <90, and 5.2% had CKD3-5. Males had lower eGFR than females in the EC (RR 1.68) and the LFU group (RR 1.76). Emirati Females had the lowest prevalence in the EC (2.9%) and expatriate females in the LFU (3.5%) groups. The relative risks of CKD in expatriate males were highest in the EC (2.14) and the LFU (2.39) groups. When we looked at the age distribution by nationality there were highly significant differences in some populations being highly represented at younger ages. CONCLUSION The prevalence of kidney disease in Abu Dhabi has a male predominance, with younger expatriates highly represented. A targeted strategy to identify those at high risk may identify early CKD to prevent progression to end-stage kidney disease.
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Affiliation(s)
- Ayman Kamal Almadani
- SEHA Kidney Care, Abu Dhabi, United Arab Emirates
- College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates
| | - Wasim Ahmed
- SEHA Kidney Care, Abu Dhabi, United Arab Emirates
- College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates
| | - Ali Abdul Kareem Al Obaidli
- SEHA Kidney Care, Abu Dhabi, United Arab Emirates
- College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates
| | - Stephen G Holt
- SEHA Kidney Care, Abu Dhabi, United Arab Emirates
- College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates
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Yang X, Cai S, Gong J, Zhang J, Lian M, Chen R, Zhou L, Bai P, Liu B, Zhuang M, Tan H, Xu J, Li M. Characterization of gut microbiota in patients with stage 3-4 chronic kidney disease: a retrospective cohort study. Int Urol Nephrol 2024; 56:1751-1762. [PMID: 38085410 DOI: 10.1007/s11255-023-03893-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 11/16/2023] [Indexed: 04/09/2024]
Abstract
PURPOSE Multiple factors, such as dietary patterns, pharmaceutical interventions, and exposure to harmful substances, possess the capacity to influence gut microbiota composition. Gut microbiota dysbiosis has emerged as a significant contributor to the progression of chronic kidney disease (CKD) and its associated complications. By comprehending the intricacies of the intestinal microbiota, this research endeavor holds the potential to offer novel perspectives on potential strategies for mitigating CKD progression. METHODS In this retrospective analysis, we assessed gut microbiota composition in CKD patients. Fecal samples were collected from a cohort of 44 patients with stage 3-4 CKD, alongside a control group consisting of 132 healthy volunteers. Subsequently, 16 s rDNA sequencing was conducted to examine the composition of the gut microbiota. RESULTS Our findings revealed significant alterations in the diversity of intestinal microbiota in fecal samples between patients with stage 3-4 CKD and healthy subjects. Among the 475 bacterial genera, 164 were shared, while 242 dominant genera were exclusive to healthy subjects and 69 to CKD stages 3-4 samples. Notably, healthy volunteers exhibited a prevalence of intestinal Firmicutes and Bacteroidetes, whereas stage 3-4 CKD patients displayed higher abundance of Proteobacteria and Actinobacteria. The presence of uncultured Coprobacillus sp. notably contributed to distinguishing between the two groups. ROC curve analysis identified distinct microbiota with superior diagnostic efficacy for discriminating stage 3-4 CKD patients from healthy individuals. Metabolic pathway analysis revealed differing dominant pathways between the two groups-the NADH dehydrogenase pathway in healthy individuals and the phosphate acetyltransferase pathway in stage 3-4 CKD patients. Moreover, the CKD cohort displayed a higher proportion of Gram-negative bacteria and facultative anaerobes. CONCLUSIONS In conclusion, our study underscores the profound influence of gut microbiota dysbiosis on CKD progression. The distinct microbial profiles observed in CKD patients highlight the potential efficacy of microbiota-based interventions in mitigating CKD advancement.
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Affiliation(s)
- Xiali Yang
- Department of Nephrology, The First Affiliated Hospital of Xiamen University, Xiamen, 361003, Fujian Province, People's Republic of China
| | - Shiying Cai
- Department of Nursing, Shenzhen Hospital of Southern Medical University, Shenzhen, 518101, People's Republic of China
- School of Nursing, Southern Medical University, Guangzhou, 510515, People's Republic of China
| | - Jinsheng Gong
- Department of Nephrology, The First Affiliated Hospital of Xiamen University, Xiamen, 361003, Fujian Province, People's Republic of China
| | - Jun Zhang
- Department of Nephrology, The First Affiliated Hospital of Xiamen University, Xiamen, 361003, Fujian Province, People's Republic of China
| | - Minling Lian
- Department of Nephrology, The First Affiliated Hospital of Xiamen University, Xiamen, 361003, Fujian Province, People's Republic of China
| | - Rufu Chen
- Department of Nephrology, The First Affiliated Hospital of Xiamen University, Xiamen, 361003, Fujian Province, People's Republic of China
| | - Linghui Zhou
- Department of Nephrology, The First Affiliated Hospital of Xiamen University, Xiamen, 361003, Fujian Province, People's Republic of China
| | - Peijin Bai
- Department of Nephrology, The First Affiliated Hospital of Xiamen University, Xiamen, 361003, Fujian Province, People's Republic of China
| | - Bo Liu
- Department of Nephrology, The First Affiliated Hospital of Xiamen University, Xiamen, 361003, Fujian Province, People's Republic of China
| | - Minting Zhuang
- Department of Nephrology, The First Affiliated Hospital of Xiamen University, Xiamen, 361003, Fujian Province, People's Republic of China
| | - Honghong Tan
- Department of VIP Clinic, Shanghai East Hospital, Tongji University School of Medicine, No.150 Jimo Road, Shanghai, 200120, People's Republic of China.
| | - Juan Xu
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Xiamen University, No.55 Zhenhai Road, Xiamen, 361003, Fujian Province, People's Republic of China.
| | - Meizhen Li
- Department of Nutrition, The First Affiliated Hospital of Xiamen University, No.55 Zhenhai Road, Xiamen, 361003, Fujian Province, People's Republic of China.
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Mourchid R, Yassine A, Bellahcen M, Cherrah Y, Serragui S. Chronic kidney disease in America, Africa, and Asia: Overview of treatment cost and options. ANNALES PHARMACEUTIQUES FRANÇAISES 2024; 82:392-400. [PMID: 38218427 DOI: 10.1016/j.pharma.2024.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 01/02/2024] [Accepted: 01/07/2024] [Indexed: 01/15/2024]
Abstract
Chronic kidney disease (CKD) is one of the non-infectious diseases that threaten patients' lives on a daily basis. Its prevalence is high, but under-reported by patients and those living with the disease, as it is silent and asymptomatic in the early stages. Kidney disease increases the risk of heart and vascular disease. These problems can manifest themselves slowly, over a long period of time. Early detection and treatment can often prevent chronic kidney disease from worsening. As kidney disease progresses, it can lead to kidney failure, requiring dialysis or a kidney transplant to stay alive. In this narrative review, we will mainly discuss different treatment option costs in different countries and how much they cost healthcare systems in countries in three different continents.
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Affiliation(s)
- Rania Mourchid
- Pharmaco-epidemiology and pharmacoeconomics research team, Pharmacology and Toxicology Laboratory, Faculty of Medicine and Pharmacy, Mohammed V University, 10100 Rabat, Morocco.
| | - Amal Yassine
- National health Insurance agency, 10100 Rabat, Morocco.
| | - Mohammed Bellahcen
- Hemodialysis Center Fondation Amal Hay Nahda Rabat, 10210 Rabat, Morocco.
| | - Yahia Cherrah
- Pharmaco-epidemiology and pharmacoeconomics research team, Pharmacology and Toxicology Laboratory, Faculty of Medicine and Pharmacy, Mohammed V University, 10100 Rabat, Morocco.
| | - Samira Serragui
- Pharmaco-epidemiology and pharmacoeconomics research team, Pharmacology and Toxicology Laboratory, Faculty of Medicine and Pharmacy, Mohammed V University, 10100 Rabat, Morocco.
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Couchoud C, Raffray M, Lassalle M, Duisenbekov Z, Moranne O, Erbault M, Lazareth H, Parmentier C, Guebre-Egziabher F, Hamroun A, Metzger M, Mansouri I, Goldberg M, Zins M, Bayat-Makoei S, Kab S. Prevalence of chronic kidney disease in France: methodological considerations and pitfalls with the use of Health claims databases. Clin Kidney J 2024; 17:sfae117. [PMID: 38774439 PMCID: PMC11106789 DOI: 10.1093/ckj/sfae117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Indexed: 05/24/2024] Open
Abstract
Background Health policy-making require careful assessment of chronic kidney disease (CKD) epidemiology to develop efficient and cost-effective care strategies. The aim of the present study was to use the RENALGO-EXPERT algorithm to estimate the global prevalence of CKD in France. Methods An expert group developed the RENALGO-EXPERT algorithm based on healthcare consumption. This algorithm has been applied to the French National Health claims database (SNDS), where no biological test findings are available to estimate a national CKD prevalence for the years 2018-2021. The CONSTANCES cohort (+219 000 adults aged 18-69 with one CKD-EPI eGFR) was used to discuss the limit of using health claims data. Results Between 2018 and 2021, the estimated prevalence in the SNDS increased from 8.1% to 10.5%. The RENALGO-EXPERT algorithm identified 4.5% of the volunteers in the CONSTANCES as CKD. The RENALGO-EXPERT algorithm had a positive predictive value of 6.2% and negative predictive value of 99.1% to detect an eGFR<60 ml/min/1.73 m². Half of 252 false positive cases (ALGO+, eGFR > 90) had been diagnosed with kidney disease during hospitalization, and the other half based on healthcare consumption suggestive of a 'high-risk' profile; 95% of the 1661 false negatives (ALGO-, eGFR < 60) had an eGFR between 45 and 60 ml/min, half had medication and two-thirds had biological exams possibly linked to CKD. Half of them had a hospital stay during the period but none had a diagnosis of kidney disease. Conclusions Our result is in accordance with other estimations of CKD prevalence in the general population. Analysis of diverging cases (FP and FN) suggests using health claims data have inherent limitations. Such an algorithm can identify patients whose care pathway is close to the usual and specific CKD pathways. It does not identify patients who have not been diagnosed or whose care is inappropriate or at early stage with stable GFR.
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Affiliation(s)
- Cécile Couchoud
- Réseau Epidémiologie et Information en Néphrologie, Agence de la Biomédecine, Saint-Denis-La-Plaine, France
| | - Maxime Raffray
- Univ. Rennes, EHESP, CNRS, Inserm, Arènes - UMR 6051, RSMS (Recherche sur les Services et Management en Santé)- U 1309 – Rennes, France
| | - Mathilde Lassalle
- Réseau Epidémiologie et Information en Néphrologie, Agence de la Biomédecine, Saint-Denis-La-Plaine, France
| | - Zhanibek Duisenbekov
- Réseau Epidémiologie et Information en Néphrologie, Agence de la Biomédecine, Saint-Denis-La-Plaine, France
| | - Olivier Moranne
- Service Néphrologie-Dialyse-Apherese, Hôpital Universitaire Caremau, Nîmes, IDESP Université de Montpellier, France
| | - Marie Erbault
- Haute Autorité de Santé, Saint-Denis-La-Plaine, France
| | | | | | - Fitsum Guebre-Egziabher
- Service Néphrologie-Dialyse-Aphérèse-Hypertension, Hôpital Edouard Herriot, Hospices Civils de Lyon, Université Lyon-1 INSERM U 1060, Lyon, France
| | - Aghiles Hamroun
- Department of Public Health – Epidemiology, Department of Nephrology, Lille University Hospital Center, RIDAGE, Pasteur Institute of Lille, Inserm, Lille University, Lille, France
| | - Marie Metzger
- Center for Research in Epidemiology and Population Health, Paris-Saclay University, Paris-Sud University, Versailles Saint Quentin University, Inserm, Villejuif, France
| | - Imene Mansouri
- Direction Procréation, Embryologie et Génétique Humaine, Agence de la Biomédecine, Saint-Denis-La-Plaine, France
| | | | - Maris Zins
- Cohorte CONSTANCES, Inserm UMS11, Villejuif, France
| | - Sahar Bayat-Makoei
- Univ. Rennes, EHESP, CNRS, Inserm, Arènes - UMR 6051, RSMS (Recherche sur les Services et Management en Santé)- U 1309 – Rennes, France
| | - Sofiane Kab
- Cohorte CONSTANCES, Inserm UMS11, Villejuif, France
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Palmeira E, de Liz Pérez-Losada F, Díaz-Flores-García V, Segura-Sampedro JJ, Segura-Egea JJ, López-López J. Prevalence of oral infections in chronic kidney disease patients: A cross-sectional study. Oral Dis 2024; 30:2708-2715. [PMID: 37392430 DOI: 10.1111/odi.14663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 06/11/2023] [Accepted: 06/16/2023] [Indexed: 07/03/2023]
Abstract
OBJECTIVES The purpose of this investigation was to analyze the prevalence of apical periodontitis (AP) and periodontal disease (periodontitis) (PD) in Chronic kidney disease (CKD) patients in relation to their treatment phase. SUBJECTS AND METHODS In this cross-sectional study, 188 patients with CKD were divided into two groups: patients without dialysis (WD group, n = 53) and patients on dialysis (DP group, n = 135). Panoramic radiographs were used to diagnose AP. The presence of periodontal disease was evaluated radiographically assessing alveolar bone loss. Student's t-test, chi-squared test, and logistic regression analysis were used to determine the significance of differences between groups. RESULTS In the WD group, 55% of patients had at least one tooth with AP, whereas in the DP group 67% had at least one tooth with AP (OR = 2.11; 95% CI = 1.09-4.08; p < 0.05). PD was more prevalent in the DP group (78%) than in the WD group (36%) (OR = 6.26; CI 95% = 3.13-12.52; p < 0.01). CONCLUSIONS Oral infections are more prevalent in the advanced stages of CKD. The treatment of PD and AP should be incorporated in the treatment planning of patients with CKD.
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Affiliation(s)
| | - Flor de Liz Pérez-Losada
- Department of Odontostomatology, Faculty of Medicine and Health Sciences (School of Dentistry), University of Barcelona, Barcelona, Spain
| | - Víctor Díaz-Flores-García
- Department of Pre-Clinical Dentistry, Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, Madrid, Spain
| | - Juan J Segura-Sampedro
- General & Digestive Surgery Unit, Hospital Universitario Son Espases, School of Medicine, Health Research Institute of Balearic Islands, University of Balearic Islands, Palma de Mallorca, Spain
| | - Juan J Segura-Egea
- Department of Stomatology, School of Dentistry, University of Seville, Seville, Spain
| | - José López-López
- Department of Odontostomatology, Faculty of Medicine and Health Sciences (School of Dentistry), University of Barcelona, Barcelona, Spain
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Li Y, Kong Y, Hu Y, Li Y, Asrosa R, Zhang W, Deka Boruah B, Yetisen AK, Davenport A, Lee TC, Li B. A paper-based dual functional biosensor for safe and user-friendly point-of-care urine analysis. LAB ON A CHIP 2024; 24:2454-2467. [PMID: 38644805 PMCID: PMC11060138 DOI: 10.1039/d4lc00163j] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 04/10/2024] [Indexed: 04/23/2024]
Abstract
Safe, accurate, and reliable analysis of urinary biomarkers is clinically important for early detection and monitoring of the progression of chronic kidney disease (CKD), as it has become one of the world's most prevalent non-communicable diseases. However, current technologies for measuring urinary biomarkers are either time-consuming and limited to well-equipped hospitals or lack the necessary sensitivity for quantitative analysis and post a health risk to frontline practitioners. Here we report a robust paper-based dual functional biosensor, which is integrated with the clinical urine sampling vial, for the simultaneous and quantitative analysis of pH and glucose in urine. The pH sensor was fabricated by electrochemically depositing IrOx onto a paper substrate using optimised parameters, which enabled an ultrahigh sensitivity of 71.58 mV pH-1. Glucose oxidase (GOx) was used in combination with an electrochemically deposited Prussian blue layer for the detection of glucose, and its performance was enhanced by gold nanoparticles (AuNPs), chitosan, and graphite composites, achieving a sensitivity of 1.5 μA mM-1. This dual function biosensor was validated using clinical urine samples, where a correlation coefficient of 0.96 for pH and 0.98 for glucose detection was achieved with commercial methods as references. More importantly, the urine sampling vial was kept sealed throughout the sample-to-result process, which minimised the health risk to frontline practitioners and simplified the diagnostic procedures. This diagnostic platform, therefore, holds high promise as a rapid, accurate, safe, and user-friendly point-of-care (POC) technology for the analysis of urinary biomarkers in frontline clinical settings.
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Affiliation(s)
- Yujia Li
- Institute for Materials Discovery, University College London, London, WC1E 7JE, UK.
- Department of Chemistry, University College London, London, WC1E 7JE, UK
| | - Yingqi Kong
- Institute for Materials Discovery, University College London, London, WC1E 7JE, UK.
- Department of Chemistry, University College London, London, WC1E 7JE, UK
| | - Yubing Hu
- Department of Chemical Engineering, Imperial College London, London, SW7 2AZ, UK
| | - Yixuan Li
- Institute for Materials Discovery, University College London, London, WC1E 7JE, UK.
- Department of Chemistry, University College London, London, WC1E 7JE, UK
| | - Rica Asrosa
- Institute for Materials Discovery, University College London, London, WC1E 7JE, UK.
- Department of Chemistry, University College London, London, WC1E 7JE, UK
- Department of Physics, Faculty of Mathematics and Natural Science, Universitas Sumatera Utara, Medan 20155, Sumatera Utara, Indonesia
| | - Wenyu Zhang
- Department of Materials, University of Oxford, Parks Road, Oxford, OX1 3PH, UK
| | - Buddha Deka Boruah
- Institute for Materials Discovery, University College London, London, WC1E 7JE, UK.
| | - Ali K Yetisen
- Department of Chemical Engineering, Imperial College London, London, SW7 2AZ, UK
| | - Andrew Davenport
- UCL Department of Renal Medicine, Royal Free Hospital, University College London, Rowland Hill Street, London, NW3 2PF, UK
| | - Tung-Chun Lee
- Institute for Materials Discovery, University College London, London, WC1E 7JE, UK.
| | - Bing Li
- Institute for Materials Discovery, University College London, London, WC1E 7JE, UK.
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Feng Y, Guo J, Luo S, Zhang Z, Liu Z. A Study on Risk Factors for Readmission of Elderly Patients with Pulmonary Tuberculosis Within One Month Using Propensity Score Matching Method. Infect Drug Resist 2024; 17:1625-1632. [PMID: 38699076 PMCID: PMC11063109 DOI: 10.2147/idr.s459260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 04/19/2024] [Indexed: 05/05/2024] Open
Abstract
Objective Exploring the risk factors for readmission of elderly patients with pulmonary tuberculosis (PTB) within one month using the propensity score matching(PSM). Methods A retrospective analysis was conducted on the clinical data of elderly patients with PTB who were admitted to the Tuberculosis Department of Lishui Hospital of Traditional Chinese Medicine from January 2020 to October 2023. The patients were divided into two groups: non-readmission group and readmission group based on whether they were readmitted within one month after discharge. The PSM method was used to match the baseline data of the two groups of patients, and multivariate logistic regression analysis was conducted to explore the risk factors for readmission of elderly patients with PTB within one month after discharge. Results A total of 1268 hospitalized elderly patients with PTB were included in the study, comprising 977 readmitted patients and 291 newly admitted patients (22.95%). Using the PSM, 288 pairs of patients were successfully matched. Following matching, there were no statistically significant differences between the two groups in terms of gender, age, occupation, body mass index(BMI), past medical history, etc. (all P>0.05). Multivariate logistic regression analysis indicated that infection, drug-induced liver injury(DILI), acute heart failure(AHF), chronic kidney disease(CKD), and extrapulmonary tuberculosis(EPTB) were all identified as risk factors for readmission of elderly patients with PTB. Conclusion After controlling for confounding factors through PSM, the study revealed that infection, DILI, AHF, CKD, and EPTB are risk factors for readmission among elderly patients with PTB, highlighting the need for early intervention.
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Affiliation(s)
- Yinping Feng
- Department of Tuberculosis, Lishui Hospital of Traditional Chinese Medicine Affiliated to Zhejiang University of Traditional Chinese Medicine, Lishui Tuberculosis Clinical Medical Research Center, Lishui, Zhejiang, People’s Republic of China
| | - Jing Guo
- Department of Tuberculosis, Lishui Hospital of Traditional Chinese Medicine Affiliated to Zhejiang University of Traditional Chinese Medicine, Lishui Tuberculosis Clinical Medical Research Center, Lishui, Zhejiang, People’s Republic of China
| | - Shuirong Luo
- Department of Tuberculosis, Lishui Hospital of Traditional Chinese Medicine Affiliated to Zhejiang University of Traditional Chinese Medicine, Lishui Tuberculosis Clinical Medical Research Center, Lishui, Zhejiang, People’s Republic of China
| | - Zunjing Zhang
- Department of Tuberculosis, Lishui Hospital of Traditional Chinese Medicine Affiliated to Zhejiang University of Traditional Chinese Medicine, Lishui Tuberculosis Clinical Medical Research Center, Lishui, Zhejiang, People’s Republic of China
| | - Zhongda Liu
- Department of Tuberculosis, Lishui Hospital of Traditional Chinese Medicine Affiliated to Zhejiang University of Traditional Chinese Medicine, Lishui Tuberculosis Clinical Medical Research Center, Lishui, Zhejiang, People’s Republic of China
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Maranduca MA, Cozma CT, Clim A, Pinzariu AC, Tudorancea I, Popa IP, Lazar CI, Moscalu R, Filip N, Moscalu M, Constantin M, Scripcariu DV, Serban DN, Serban IL. The Molecular Mechanisms Underlying the Systemic Effects Mediated by Parathormone in the Context of Chronic Kidney Disease. Curr Issues Mol Biol 2024; 46:3877-3905. [PMID: 38785509 PMCID: PMC11120161 DOI: 10.3390/cimb46050241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2024] [Revised: 04/22/2024] [Accepted: 04/23/2024] [Indexed: 05/25/2024] Open
Abstract
Chronic kidney disease (CKD) stands as a prominent non-communicable ailment, significantly impacting life expectancy. Physiopathology stands mainly upon the triangle represented by parathormone-Vitamin D-Fibroblast Growth Factor-23. Parathormone (PTH), the key hormone in mineral homeostasis, is one of the less easily modifiable parameters in CKD; however, it stands as a significant marker for assessing the risk of complications. The updated "trade-off hypothesis" reveals that levels of PTH spike out of the normal range as early as stage G2 CKD, advancing it as a possible determinant of systemic damage. The present review aims to review the effects exhibited by PTH on several organs while linking the molecular mechanisms to the observed actions in the context of CKD. From a diagnostic perspective, PTH is the most reliable and accessible biochemical marker in CKD, but its trend bears a higher significance on a patient's prognosis rather than the absolute value. Classically, PTH acts in a dichotomous manner on bone tissue, maintaining a balance between formation and resorption. Under the uremic conditions of advanced CKD, the altered intestinal microbiota majorly tips the balance towards bone lysis. Probiotic treatment has proven reliable in animal models, but in humans, data are limited. Regarding bone status, persistently high levels of PTH determine a reduction in mineral density and a concurrent increase in fracture risk. Pharmacological manipulation of serum PTH requires appropriate patient selection and monitoring since dangerously low levels of PTH may completely inhibit bone turnover. Moreover, the altered mineral balance extends to the cardiovascular system, promoting vascular calcifications. Lastly, the involvement of PTH in the Renin-Angiotensin-Aldosterone axis highlights the importance of opting for the appropriate pharmacological agent should hypertension develop.
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Affiliation(s)
- Minela Aida Maranduca
- Discipline of Physiology, Department of Morpho-Functional Sciences II, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania; (M.A.M.); (C.T.C.); (A.C.); (A.C.P.); (I.T.); (I.P.P.); (C.I.L.); (D.N.S.); (I.L.S.)
| | - Cristian Tudor Cozma
- Discipline of Physiology, Department of Morpho-Functional Sciences II, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania; (M.A.M.); (C.T.C.); (A.C.); (A.C.P.); (I.T.); (I.P.P.); (C.I.L.); (D.N.S.); (I.L.S.)
| | - Andreea Clim
- Discipline of Physiology, Department of Morpho-Functional Sciences II, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania; (M.A.M.); (C.T.C.); (A.C.); (A.C.P.); (I.T.); (I.P.P.); (C.I.L.); (D.N.S.); (I.L.S.)
| | - Alin Constantin Pinzariu
- Discipline of Physiology, Department of Morpho-Functional Sciences II, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania; (M.A.M.); (C.T.C.); (A.C.); (A.C.P.); (I.T.); (I.P.P.); (C.I.L.); (D.N.S.); (I.L.S.)
| | - Ionut Tudorancea
- Discipline of Physiology, Department of Morpho-Functional Sciences II, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania; (M.A.M.); (C.T.C.); (A.C.); (A.C.P.); (I.T.); (I.P.P.); (C.I.L.); (D.N.S.); (I.L.S.)
| | - Irene Paula Popa
- Discipline of Physiology, Department of Morpho-Functional Sciences II, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania; (M.A.M.); (C.T.C.); (A.C.); (A.C.P.); (I.T.); (I.P.P.); (C.I.L.); (D.N.S.); (I.L.S.)
| | - Cristina Iuliana Lazar
- Discipline of Physiology, Department of Morpho-Functional Sciences II, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania; (M.A.M.); (C.T.C.); (A.C.); (A.C.P.); (I.T.); (I.P.P.); (C.I.L.); (D.N.S.); (I.L.S.)
| | - Roxana Moscalu
- Division of Cell Matrix Biology & Regenerative Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M13 9PL, UK;
| | - Nina Filip
- Discipline of Biochemistry, Department of Morpho-Functional Sciences II, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania;
| | - Mihaela Moscalu
- Department of Preventive Medicine and Interdisciplinarity, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Mihai Constantin
- Internal Medicine Department, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania;
| | - Dragos Viorel Scripcariu
- Department of Surgery, Grigore T. Popa University of Medicine and Pharmacy, 16 University Str., 700115 Iasi, Romania;
| | - Dragomir Nicolae Serban
- Discipline of Physiology, Department of Morpho-Functional Sciences II, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania; (M.A.M.); (C.T.C.); (A.C.); (A.C.P.); (I.T.); (I.P.P.); (C.I.L.); (D.N.S.); (I.L.S.)
| | - Ionela Lacramioara Serban
- Discipline of Physiology, Department of Morpho-Functional Sciences II, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania; (M.A.M.); (C.T.C.); (A.C.); (A.C.P.); (I.T.); (I.P.P.); (C.I.L.); (D.N.S.); (I.L.S.)
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Miljuš G, Penezić A, Pažitná L, Gligorijević N, Baralić M, Vilotić A, Šunderić M, Robajac D, Dobrijević Z, Katrlík J, Nedić O. Glycosylation and Characterization of Human Transferrin in an End-Stage Kidney Disease. Int J Mol Sci 2024; 25:4625. [PMID: 38731843 PMCID: PMC11083005 DOI: 10.3390/ijms25094625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 04/10/2024] [Accepted: 04/17/2024] [Indexed: 05/13/2024] Open
Abstract
Chronic kidney disease (CKD) is a global health concern affecting approximately one billion individuals worldwide. End-stage kidney disease (ESKD), the most severe form of CKD, is often accompanied by anemia. Peritoneal dialysis (PD), a common treatment for ESKD, utilizes the peritoneum for solute transfer but is associated with complications including protein loss, including transferrin (Tf) a key protein involved in iron transport. This study investigated Tf characteristics in ESKD patients compared to healthy individuals using lectin microarray, spectroscopic techniques and immunocytochemical analysis to assess Tf interaction with transferrin receptors (TfRs). ESKD patients exhibited altered Tf glycosylation patterns, evidenced by significant changes in lectin reactivity compared to healthy controls. However, structural analyses revealed no significant differences in the Tf secondary or tertiary structures between the two groups. A functional analysis demonstrated comparable Tf-TfR interaction in both PD and healthy samples. Despite significant alterations in Tf glycosylation, structural integrity and Tf-TfR interaction remained preserved in PD patients. These findings suggest that while glycosylation changes may influence iron metabolism, they do not impair Tf function. The study highlights the importance of a glucose-free dialysis solutions in managing anemia exacerbation in PD patients with poorly controlled anemia, potentially offering a targeted therapeutic approach to improve patient outcomes.
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Affiliation(s)
- Goran Miljuš
- Institute for the Application of Nuclear Energy (INEP), Department for Metabolism, University of Belgrade, 11000 Belgrade, Serbia
| | - Ana Penezić
- Institute for the Application of Nuclear Energy (INEP), Department for Metabolism, University of Belgrade, 11000 Belgrade, Serbia
| | - Lucia Pažitná
- Institute of Chemistry, Slovak Academy of Sciences, 84538 Bratislava, Slovakia
| | - Nikola Gligorijević
- Institute of Chemistry, Technology and Metallurgy, Department of Chemistry, University of Belgrade, 11000 Belgrade, Serbia
| | - Marko Baralić
- School of Medicine, University of Belgrade, 11000 Belgrade, Serbia
- Clinic of Nephrology, University Clinical Centre of Serbia, 11000 Belgrade, Serbia
| | - Aleksandra Vilotić
- Institute for the Application of Nuclear Energy (INEP), Department for Biology of Reproduction, University of Belgrade, 11000 Belgrade, Serbia
| | - Miloš Šunderić
- Institute for the Application of Nuclear Energy (INEP), Department for Metabolism, University of Belgrade, 11000 Belgrade, Serbia
| | - Dragana Robajac
- Institute for the Application of Nuclear Energy (INEP), Department for Metabolism, University of Belgrade, 11000 Belgrade, Serbia
| | - Zorana Dobrijević
- Institute for the Application of Nuclear Energy (INEP), Department for Metabolism, University of Belgrade, 11000 Belgrade, Serbia
| | - Jaroslav Katrlík
- Institute of Chemistry, Slovak Academy of Sciences, 84538 Bratislava, Slovakia
| | - Olgica Nedić
- Institute for the Application of Nuclear Energy (INEP), Department for Metabolism, University of Belgrade, 11000 Belgrade, Serbia
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Kislikova M, Gaitán-Valdizán JJ, Parra Blanco JA, García Unzueta MT, Rodríguez Vidriales M, Escagedo Cagigas C, Piñera Haces VC, Valentín Muñoz MDLO, Benito Hernández A, Ruiz San Millan JC, Rodrigo Calabia E. Looking into the Eyes to See the Heart of Chronic Kidney Disease Patients. Life (Basel) 2024; 14:533. [PMID: 38672803 PMCID: PMC11051204 DOI: 10.3390/life14040533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 04/03/2024] [Accepted: 04/17/2024] [Indexed: 04/28/2024] Open
Abstract
In patients with chronic kidney disease (CKD), the main cause of morbidity and mortality is cardiovascular disease (CVD). Both coronary artery calcium scoring by computed tomography (CT) and optical coherence tomography (OCT) are used to identify patients at increased risk for ischemic heart disease, thereby indicating a higher cardiovascular risk profile. Our study aimed to investigate the utility of these techniques in the CKD population. In patients with CKD, OCT was used to measure the choroidal thickness (CHT) and the thickness of the peripapillary retinal nerve fiber layer (pRNFL). A total of 127 patients were included, including 70 men (55%) with an estimated glomerular filtration rate (eGFR) of 39 ± 30 mL/min/1.73 m2. Lower pRNFL thickness was found to be related to high-sensitivity troponin I (r = -0.362, p < 0.001) and total coronary calcification (r = -0.194, p = 0.032). In a multivariate analysis, pRNFL measurements remained associated with age (β = -0.189; -0.739--0.027; p = 0.035) and high-sensitivity troponin I (β = -0.301; -0.259--0.071; p < 0.001). Severe coronary calcification (Agatston score ≥ 400 HU) was related to a worse eGFR (p = 0.008), a higher grade of CKD (p = 0.036), and a thinner pRNFL (p = 0.011). The ROC curve confirmed that the pRNFL measurement could determine the patients with an Agatston score of ≥400 HU (AUC 0.638; 95% CI 0.525-0.750; p = 0.015). Our study concludes that measurement of pRNFL thickness using OCT is related to the markers associated with ischemic heart disease, such as coronary calcification and high-sensitivity troponin I, in the CKD population.
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Affiliation(s)
- Maria Kislikova
- Immunopathology Group, Nephrology Department, Marqués de Valdecilla University Hospital—IDIVAL, 39008 Santander, Spain; (M.R.V.); (C.E.C.); (V.C.P.H.); (M.d.l.O.V.M.); (A.B.H.); (J.C.R.S.M.); (E.R.C.)
| | | | | | | | - María Rodríguez Vidriales
- Immunopathology Group, Nephrology Department, Marqués de Valdecilla University Hospital—IDIVAL, 39008 Santander, Spain; (M.R.V.); (C.E.C.); (V.C.P.H.); (M.d.l.O.V.M.); (A.B.H.); (J.C.R.S.M.); (E.R.C.)
| | - Clara Escagedo Cagigas
- Immunopathology Group, Nephrology Department, Marqués de Valdecilla University Hospital—IDIVAL, 39008 Santander, Spain; (M.R.V.); (C.E.C.); (V.C.P.H.); (M.d.l.O.V.M.); (A.B.H.); (J.C.R.S.M.); (E.R.C.)
| | - Vicente Celestino Piñera Haces
- Immunopathology Group, Nephrology Department, Marqués de Valdecilla University Hospital—IDIVAL, 39008 Santander, Spain; (M.R.V.); (C.E.C.); (V.C.P.H.); (M.d.l.O.V.M.); (A.B.H.); (J.C.R.S.M.); (E.R.C.)
| | - María de la Oliva Valentín Muñoz
- Immunopathology Group, Nephrology Department, Marqués de Valdecilla University Hospital—IDIVAL, 39008 Santander, Spain; (M.R.V.); (C.E.C.); (V.C.P.H.); (M.d.l.O.V.M.); (A.B.H.); (J.C.R.S.M.); (E.R.C.)
| | - Adalberto Benito Hernández
- Immunopathology Group, Nephrology Department, Marqués de Valdecilla University Hospital—IDIVAL, 39008 Santander, Spain; (M.R.V.); (C.E.C.); (V.C.P.H.); (M.d.l.O.V.M.); (A.B.H.); (J.C.R.S.M.); (E.R.C.)
| | - Juan Carlos Ruiz San Millan
- Immunopathology Group, Nephrology Department, Marqués de Valdecilla University Hospital—IDIVAL, 39008 Santander, Spain; (M.R.V.); (C.E.C.); (V.C.P.H.); (M.d.l.O.V.M.); (A.B.H.); (J.C.R.S.M.); (E.R.C.)
| | - Emilio Rodrigo Calabia
- Immunopathology Group, Nephrology Department, Marqués de Valdecilla University Hospital—IDIVAL, 39008 Santander, Spain; (M.R.V.); (C.E.C.); (V.C.P.H.); (M.d.l.O.V.M.); (A.B.H.); (J.C.R.S.M.); (E.R.C.)
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Lubkowicz D, Hava DL, Lewis K, Isabella VM. Rational Engineering of Escherichia coli Nissle 1917 as Live Biotherapeutic to Degrade Uremic Toxin Precursors. ACS Synth Biol 2024; 13:1077-1084. [PMID: 38588591 DOI: 10.1021/acssynbio.3c00686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Abstract
Uremic toxins (UTs) are microbiota-derived metabolites that accelerate the progression of kidney damage in patients with chronic kidney disease (CKD). One of the major UTs involved in CKD progression is p-cresol-sulfate (PCS), derived from dietary l-tyrosine (l-Tyr). Here, we engineered a probiotic strain of Escherichia coli Nissle 1917, to convert l-Tyr to the nontoxic compound p-coumaric acid via tyrosine ammonia lyase (TAL). First, a small metagenomic library was assessed to identify the TAL with the greatest whole-cell activity. Second, accessory genes implicated in the import of l-Tyr and export of PCA were overexpressed to enhance l-Tyr degradation by 106% and 56%, respectively. Last, random mutagenesis coupled to a novel selection and screening strategy was developed that identified a TAL variant with a 25% increase in whole-cell activity. Taken together, the final strain exhibits a 183% improvement over initial whole-cell activity and provides a promising candidate to degrade l-Tyr mediated PCS accumulation.
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Affiliation(s)
- David Lubkowicz
- Synlogic Inc., Cambridge, Massachusetts 02142, United States
| | - David L Hava
- Synlogic Inc., Cambridge, Massachusetts 02142, United States
| | - Kim Lewis
- Northeastern University, Boston, Massachusetts 02115, United States
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Sundström J, Norhammar A, Karayiannides S, Bodegård J, Gustafsson S, Cars T, Eriksson Svensson M, Ärnlöv J. Are there lost opportunities in chronic kidney disease? A region-wide cohort study. BMJ Open 2024; 14:e074064. [PMID: 38643002 PMCID: PMC11033666 DOI: 10.1136/bmjopen-2023-074064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 04/03/2024] [Indexed: 04/22/2024] Open
Abstract
OBJECTIVES Identify the windows of opportunity for the diagnosis of chronic kidney disease (CKD) and the prevention of its adverse outcomes and quantify the potential population gains of such prevention. DESIGN AND SETTING Observational, population-wide study of residents in the Stockholm and Skåne regions of Sweden between 1 January 2015 and 31 December 2020. PARTICIPANTS All patients who did not yet have a diagnosis of CKD in healthcare but had CKD according to laboratory measurements of CKD biomarkers available in electronic health records. OUTCOME MEASURES We assessed the proportions of the patient population that received a subsequent diagnosis of CKD in healthcare, that used guideline-directed pharmacological therapy (statins, renin-angiotensin aldosterone system inhibitors (RAASi) and/or sodium-glucose cotransporter-2 inhibitors (SGLT2i)) and that experienced adverse outcomes (all-cause mortality, cardiovascular mortality or major adverse cardiovascular events (MACE)). The potential to prevent adverse outcomes in CKD was assessed using simulations of guideline-directed pharmacological therapy in untreated subsets of the study population. RESULTS We identified 99 382 patients with undiagnosed CKD during the study period. Only 33% of those received a subsequent diagnosis of CKD in healthcare after 5 years. The proportion that used statins or RAASi was of similar size to the proportion that didn't, regardless of how advanced their CKD was. The use of SGLT2i was negligible. In simulations of optimal treatment, 22% of the 21 870 deaths, 27% of the 14 310 cardiovascular deaths and 39% of the 22 224 MACE could have been avoided if every patient who did not use an indicated medication for their laboratory-confirmed CKD was treated with guideline-directed pharmacological therapy for CKD. CONCLUSIONS While we noted underdiagnosis and undertreatment of CKD in this large contemporary population, we also identified a substantial realisable potential to improve CKD outcomes and reduce its burden by treating patients early with guideline-directed pharmacological therapy.
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Affiliation(s)
- Johan Sundström
- Department of Medical Sciences, Clinical Epidemiology, Uppsala University, Uppsala, Sweden
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Anna Norhammar
- Cardiology Unit, Department of Medicine, Karolinska Institutet, Solna, Stockholm, Sweden
- Capio S:t Görans Hospital, Stockholm, Sweden
| | - Stelios Karayiannides
- Department of Clinical Sciences, Danderyd Hospital, Karolinska Institute, Stockholm, Sweden
- Center for Diabetes, Academic Specialist Center, Region Stockholm, Stockholm, Sweden
| | - Johan Bodegård
- Cardiovascular, Renal and Metabolism, Medical Department, BioPharmaceuticals, AstraZeneca PLC, Oslo, Norway
| | | | | | - Maria Eriksson Svensson
- Department of Medical Sciences, Renal Medicine, Uppsala University, Uppsala, Sweden
- Uppsala Clinical Research Center, Uppsala, Sweden
| | - Johan Ärnlöv
- Division of Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- School of Health and Social Studies, Dalarna University, Falun, Dalarna, Sweden
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Tao P, Chien CW, Liu C, Zheng J, Sun D, Zeng J, Song Q, Liu Y, Tung TH, Kang L. Diabetes mellitus is a risk factor for incident chronic kidney disease: A nationwide cohort study. Heliyon 2024; 10:e28780. [PMID: 38586402 PMCID: PMC10998112 DOI: 10.1016/j.heliyon.2024.e28780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 03/24/2024] [Accepted: 03/25/2024] [Indexed: 04/09/2024] Open
Abstract
Objective Diabetes mellitus and chronic kidney disease are multifactorial conditions with multiple etiologies that share similar pathophysiologies. This nationwide cohort study examined the impact of diabetes mellitus on the follow-up development of chronic kidney disease. Methods By retrieving the Longitudinal Health Insurance Database 2005, 5121 patients with diabetes mellitus were included in this study and 5121 patients without diabetes mellitus, who were matched according to sex, age, and Charlson comorbidity index made up the control group. The adjusted hazard ratios for chronic kidney disease were calculated using Cox proportional hazards regression analysis. Kaplan-Meier analysis was used to estimate the cumulative incidence of chronic kidney disease rate in the diabetes mellitus and control groups. Results After adjusting for sex, age, and Charlson comorbidity index score, the diabetes mellitus group had a 1.380 times higher (95% CI: 1.277-1.492) risk of developing chronic kidney disease than the control group. Further stratified analysis showed that patients with diabetes mellitus had a significantly higher risk of developing chronic kidney disease regardless of their sex, age, and Charlson comorbidity index score, compared to those without diabetes mellitus. Conclusions There is a possibility that diabetes mellitus serves as an independent risk factor for chronic kidney disease development. Early screening and monitoring of diabetes mellitus appear to be of great importance in the prevention of chronic kidney disease.
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Affiliation(s)
- Ping Tao
- Department of Medical Affairs & Planning, Kaohsiung Veterans General Hospital, Taiwan, China
| | - Ching-Wen Chien
- Institute for Hospital Management, Tsinghua University, Shenzhen Campus, Shenzhen, China
| | - Chao Liu
- Shenzhen Dapeng New District Medical and Health Group, Shenzhen, China
| | - Jinghang Zheng
- Shenzhen Bao'an Chinese Medicine Hospital, Shenzhen, China
| | - Dongping Sun
- Shenzhen Bao'an Chinese Medicine Hospital, Shenzhen, China
| | - Jibin Zeng
- Shenzhen Bao'an Chinese Medicine Hospital, Shenzhen, China
| | - Qunli Song
- Shenzhen Bao'an Chinese Medicine Hospital, Shenzhen, China
| | - Yuzhou Liu
- Shenzhen Bao'an Chinese Medicine Hospital, Shenzhen, China
| | - Tao-Hsin Tung
- Evidence-based Medicine Center, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China
| | - Linlin Kang
- Shenzhen Bao'an Chinese Medicine Hospital, Shenzhen, China
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Lin DW, Yang TM, Ho C, Shih YH, Lin CL, Hsu YC. Targeting Macrophages: Therapeutic Approaches in Diabetic Kidney Disease. Int J Mol Sci 2024; 25:4350. [PMID: 38673935 PMCID: PMC11050450 DOI: 10.3390/ijms25084350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Revised: 04/10/2024] [Accepted: 04/11/2024] [Indexed: 04/28/2024] Open
Abstract
Diabetes is not solely a metabolic disorder but also involves inflammatory processes. The immune response it incites is a primary contributor to damage in target organs. Research indicates that during the initial phases of diabetic nephropathy, macrophages infiltrate the kidneys alongside lymphocytes, initiating a cascade of inflammatory reactions. The interplay between macrophages and other renal cells is pivotal in the advancement of kidney disease within a hyperglycemic milieu. While M1 macrophages react to the inflammatory stimuli induced by elevated glucose levels early in the disease progression, their subsequent transition to M2 macrophages, which possess anti-inflammatory and tissue repair properties, also contributes to fibrosis in the later stages of nephropathy by transforming into myofibroblasts. Comprehending the diverse functions of macrophages in diabetic kidney disease and regulating their activity could offer therapeutic benefits for managing this condition.
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Affiliation(s)
- Da-Wei Lin
- Department of Internal Medicine, St. Martin De Porres Hospital, Chiayi City 60069, Taiwan;
| | - Tsung-Ming Yang
- Division of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital, Chiayi County 61363, Taiwan
- School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan 33303, Taiwan;
| | - Cheng Ho
- Division of Endocrinology and Metabolism, Chang Gung Memorial Hospital, Chiayi County 61363, Taiwan
| | - Ya-Hsueh Shih
- Departments of Nephrology, Chang Gung Memorial Hospital, Chiayi County 61363, Taiwan
- Kidney and Diabetic Complications Research Team (KDCRT), Chang Gung Memorial Hospital, Chiayi County 61363, Taiwan
| | - Chun-Liang Lin
- School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan 33303, Taiwan;
- Departments of Nephrology, Chang Gung Memorial Hospital, Chiayi County 61363, Taiwan
- Kidney and Diabetic Complications Research Team (KDCRT), Chang Gung Memorial Hospital, Chiayi County 61363, Taiwan
- Kidney Research Center, Chang Gung Memorial Hospital, Taipei 10507, Taiwan
- Center for Shockwave Medicine and Tissue Engineering, Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan
| | - Yung-Chien Hsu
- Departments of Nephrology, Chang Gung Memorial Hospital, Chiayi County 61363, Taiwan
- Kidney and Diabetic Complications Research Team (KDCRT), Chang Gung Memorial Hospital, Chiayi County 61363, Taiwan
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan 33303, Taiwan
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Liu ZH, Wang LY, Hu ZF. Evaluation of risk factors related to sleep disorders in patients undergoing hemodialysis using a nomogram model. Medicine (Baltimore) 2024; 103:e37712. [PMID: 38608110 PMCID: PMC11018214 DOI: 10.1097/md.0000000000037712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 03/04/2024] [Indexed: 04/14/2024] Open
Abstract
This study aimed to investigate the risk factors related to sleep disorders in patients undergoing hemodialysis using a nomogram model. A cross-sectional survey was conducted in a hospital in Zhejiang province, China from January 1, 2020, to November 31, 2022 among patients undergoing hemodialysis. Dietary intake was assessed applying a Food Frequency Questionnaire. Sleep quality was evaluated by the Pittsburgh Sleep Quality Index. Evaluation of risk factors related to sleep disorders in patients undergoing hemodialysis was using a nomogram model. This study included 201 patients and 87 individuals (43.3%, 87/201) exhibited sleep disorders. The average age of included patients was 51.1 ± 9.0 years, with males accounting for 55.7% (112/201). Results from nomogram model exhibited that potential risk factors for sleep disorders in patients undergoing hemodialysis included female, advanced age, increased creatinine and alanine aminotransferase levels, as well as higher red meat consumption. Inversely, protective factors against sleep disorders in these patients included higher consumption of poultry, fish, vegetables, and dietary fiber. The C-index demonstrated a high level of discriminative ability (0.922). This study found that age, sex, and dietary factors were associated with sleep disorders in hemodialysis patients. Hemodialysis patients with sleep disorders require urgent dietary guidance.
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Affiliation(s)
- Zhang-hong Liu
- Department of Nephrology and Rheumatology, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China
| | - Li-yong Wang
- Department of Nephrology and Rheumatology, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China
| | - Zhen-fen Hu
- Department of Blood Purification, Wenzhou TCM Hospital of Zhejiang Chinese Medical University, Wenzhou, Zhejiang Province, China
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Aljohani A, Shokri A, Mukalazi H. Analyzing the dynamic patterns of COVID-19 through nonstandard finite difference scheme. Sci Rep 2024; 14:8466. [PMID: 38605097 PMCID: PMC11009417 DOI: 10.1038/s41598-024-57356-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Accepted: 03/18/2024] [Indexed: 04/13/2024] Open
Abstract
This paper presents a novel approach to analyzing the dynamics of COVID-19 using nonstandard finite difference (NSFD) schemes. Our model incorporates both asymptomatic and symptomatic infected individuals, allowing for a more comprehensive understanding of the epidemic's spread. We introduce an unconditionally stable NSFD system that eliminates the need for traditional Runge-Kutta methods, ensuring dynamical consistency and numerical accuracy. Through rigorous numerical analysis, we evaluate the performance of different NSFD strategies and validate our analytical findings. Our work demonstrates the benefits of using NSFD schemes for modeling infectious diseases, offering advantages in terms of stability and efficiency. We further illustrate the dynamic behavior of COVID-19 under various conditions using numerical simulations. The results from these simulations demonstrate the effectiveness of the proposed approach in capturing the epidemic's complex dynamics.
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Affiliation(s)
- Abeer Aljohani
- Department of Computer Science, Applied College, Taibah University, Medina, 42353, Kingdom of Saudi Arabia
| | - Ali Shokri
- Department of Mathematics, Faculty of Science, University of Maragheh, Maragheh, 83111-55181, Iran
| | - Herbert Mukalazi
- Department of Mathematics and Statistics, Kyambogo University, Kampala, Uganda.
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43
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Kliewe F, Siegerist F, Hammer E, Al-Hasani J, Amling TRJ, Hollemann JZE, Schindler M, Drenic V, Simm S, Amann K, Daniel C, Lindenmeyer M, Hecker M, Völker U, Endlich N. Zyxin is important for the stability and function of podocytes, especially during mechanical stretch. Commun Biol 2024; 7:446. [PMID: 38605154 PMCID: PMC11009394 DOI: 10.1038/s42003-024-06125-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 03/29/2024] [Indexed: 04/13/2024] Open
Abstract
Podocyte detachment due to mechanical stress is a common issue in hypertension-induced kidney disease. This study highlights the role of zyxin for podocyte stability and function. We have found that zyxin is significantly up-regulated in podocytes after mechanical stretch and relocalizes from focal adhesions to actin filaments. In zyxin knockout podocytes, we found that the loss of zyxin reduced the expression of vinculin and VASP as well as the expression of matrix proteins, such as fibronectin. This suggests that zyxin is a central player in the translation of mechanical forces in podocytes. In vivo, zyxin is highly up-regulated in patients suffering from diabetic nephropathy and in hypertensive DOCA-salt treated mice. Furthermore, zyxin loss in mice resulted in proteinuria and effacement of podocyte foot processes that was measured by super resolution microscopy. This highlights the essential role of zyxin for podocyte maintenance in vitro and in vivo, especially under mechanical stretch.
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Affiliation(s)
- Felix Kliewe
- Department of Anatomy and Cell Biology, University Medicine Greifswald, Greifswald, Germany.
| | - Florian Siegerist
- Department of Anatomy and Cell Biology, University Medicine Greifswald, Greifswald, Germany
| | - Elke Hammer
- Interfaculty Institute for Genetics and Functional Genomics, University Medicine Greifswald, Greifswald, Germany
| | - Jaafar Al-Hasani
- Department of Cardiovascular Physiology, Heidelberg University, Heidelberg, Germany
| | | | | | - Maximilian Schindler
- Department of Anatomy and Cell Biology, University Medicine Greifswald, Greifswald, Germany
| | - Vedran Drenic
- NIPOKA GmbH, Center of High-End Imaging, Greifswald, Germany
| | - Stefan Simm
- Institute of Bioinformatics, University Medicine Greifswald, Greifswald, Germany
| | - Kerstin Amann
- Department of Nephropathology; Friedrich-Alexander University (FAU) Erlangen-Nuremberg, Erlangen, Germany
| | - Christoph Daniel
- Department of Nephropathology; Friedrich-Alexander University (FAU) Erlangen-Nuremberg, Erlangen, Germany
| | - Maja Lindenmeyer
- III. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Hamburg Center for Kidney Health (HCKH), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Markus Hecker
- Department of Cardiovascular Physiology, Heidelberg University, Heidelberg, Germany
| | - Uwe Völker
- Interfaculty Institute for Genetics and Functional Genomics, University Medicine Greifswald, Greifswald, Germany
| | - Nicole Endlich
- Department of Anatomy and Cell Biology, University Medicine Greifswald, Greifswald, Germany
- NIPOKA GmbH, Center of High-End Imaging, Greifswald, Germany
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Arasnezhad M, Namazinia M, Mazlum SR, Miri K. The effect of ascending- descending ultrafiltration and sodium profiles on blood pressure in hemodialysis patients: a randomized cross-over study. BMC Nephrol 2024; 25:128. [PMID: 38605298 PMCID: PMC11007972 DOI: 10.1186/s12882-024-03554-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 03/20/2024] [Indexed: 04/13/2024] Open
Abstract
BACKGROUND Considering no previous research into the utilization of ascending/descending ultrafiltration and linear sodium profiles in improving blood pressure among hemodialysis patients, the present study aimed to explore the effect of the A/D-UF along with linear sodium profiles on HD patients with hypotension. METHODS Applying a crossover design, this clinical trial was fulfilled between December 2022 and June 2023 on 20 patients undergoing HD, randomized into two groups, each one receiving two intervention protocols, viz., (a) an intervention protocol in which the liquid sodium in the dialysis solution was linear and the UF profiling was A/D, and (b) a routine protocol or HD, wherein both liquid sodium and UF in the dialysis solution remained constant. The HD patients' BP was then checked and recorded at six intervals, namely, before HD, one, two, three, and four hours after it, and following its completion, within each session. The data were further statistically analyzed using the IBM SPSS Statistics 20 and the related tests. RESULTS In total, 20 patients, including 12 men (60%) and 8 women (40%), with the mean age of 58.00 ± 14.54 on HD for an average of 54 months, were recruited in this study. No statistically significant difference was observed in the mean systolic and diastolic BP levels in the group receiving the A/D-UF profile all through the desired hours (p > 0.05), indicating that the patients did not face many changes in these two numbers during HD. Our cross-over clinical trial demonstrated a statistically significant reduction in symptomatic IDH episodes from 55 to 15% with the application of the A/D-UF profile (p < 0.05). CONCLUSION The study demonstrated that the A/D-UF profile could contribute to the stability of blood pressure levels among HD patients, with no significant fluctuations observed during treatment sessions. TRIAL REGISTRATION This study was registered in the Iranian Registry of Clinical Trials (no. IRCT20180429039463N5) on 07/01/2023.
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Affiliation(s)
- Morteza Arasnezhad
- 9 Dey Educational Hospital, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | - Mohammad Namazinia
- Department of Nursing, School of Nursing and Midwifery, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran.
| | - Seyyed Reza Mazlum
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Kheizaran Miri
- Department of Nursing, School of Nursing and Midwifery, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran.
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Haruna I, Obeng-Gyasi E. Association of Combined Per- and Polyfluoroalkyl Substances and Metals with Chronic Kidney Disease. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:468. [PMID: 38673379 PMCID: PMC11050583 DOI: 10.3390/ijerph21040468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 04/04/2024] [Accepted: 04/09/2024] [Indexed: 04/28/2024]
Abstract
Background: Exposure to environmental pollutants such as metals and Per- and Polyfluoroalkyl Substances (PFAS) has become common and increasingly associated with a decrease in the estimated Glomerular Filtration Rate (eGFR), which is a marker often used to measure chronic kidney disease (CKD). However, there are limited studies involving the use of both eGFR and the urine albumin creatinine ratio (uACR), which are more comprehensive markers to determine the presence of CKD and the complexity of pollutant exposures and response interactions, especially for combined metals and PFAS, which has not been comprehensively elucidated. Objective: This study aims to assess the individual and combined effects of perfluorooctanoic acid (PFOA), perfluorooctanesulfonic acid (PFOS), Cadmium (Cd), Mercury (Hg), and Lead (Pb) exposure on CKD using data from the National Health and Nutritional Examination Survey (NHANES) 2017-2018. Methods: We employed the use of bivariate logistic regression and Bayesian Kernel Machine Regression (BKMR) in our analysis of the data. Results: Logistic regression results revealed a positive association between PFOA and CKD. Our BKMR analysis revealed a non-linear and bi-phasic relationship between the metal exposures and CKD. In our univariate exposure-response function plot, Cd and Hg exhibited a U and N-shaped interaction, which indicated a non-linear and non-additive relationship with both low and high exposures associated with CKD. In addition, the bivariate exposure-response function between two exposures in a mixture revealed that Cd had a U-shaped relationship with CKD at different quantiles of Pb, Hg, PFOA, and PFOS, indicating that both low and high levels of Cd is associated with CKD, implying a non-linear and complex biological interaction. Hg's interaction plot demonstrated a N-shaped association across all quantiles of Cd, with the 75th quantile of Pb and the 50th and 75th quantiles of PFOA and PFOS. Furthermore, the PIP results underscored Cd's consistent association with CKD (PIP = 1.000) followed by Hg's (PIP = 0.9984), then PFOA and PFOS with a closely related PIP of 0.7880 and 0.7604, respectively, and finally Pb (PIP = 0.6940), contributing the least among the five environmental pollutants on CKD, though significant. Conclusions: Our findings revealed that exposure to environmental pollutants, particularly Hg and Cd, are associated with CKD. These findings highlight the need for public health interventions and strategies to mitigate the cumulative effect of PFAS and metal exposure and elucidate the significance of utilizing advanced statistical methods and tools to understand the impact of environmental pollutants on human health. Further research is needed to understand the mechanistic pathways of PFAS and metal-induced kidney injury and CKD, and longitudinal studies are required to ascertain the long-term impact of these environmental exposures.
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Affiliation(s)
- Issah Haruna
- Department of Built Environment, North Carolina A&T State University, Greensboro, NC 27411, USA
- Environmental Health and Disease Laboratory, North Carolina A&T State University, Greensboro, NC 27411, USA
| | - Emmanuel Obeng-Gyasi
- Department of Built Environment, North Carolina A&T State University, Greensboro, NC 27411, USA
- Environmental Health and Disease Laboratory, North Carolina A&T State University, Greensboro, NC 27411, USA
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Hustrini NM, Susalit E, Widjaja FF, Khumaedi AI, Dekkers OM, van Diepen M, Rotmans JI. The Etiology of Advanced Chronic Kidney Disease in Southeast Asia: A Meta-analysis. J Epidemiol Glob Health 2024:10.1007/s44197-024-00209-5. [PMID: 38587764 DOI: 10.1007/s44197-024-00209-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 02/14/2024] [Indexed: 04/09/2024] Open
Abstract
INTRODUCTION Chronic kidney disease (CKD) etiology varies greatly between developed and developing countries. In addition, differences in underlying pathogenesis and therapeutic options affect the progression towards advanced-CKD. This meta-analysis aims to identify the etiology of advanced-CKD in Southeast Asia. METHODS A systematic search in four electronic-databases and complementary search on national kidney registries and repository libraries was conducted until July 20, 2023. The risk of bias was assessed using Newcastle-Ottawa Scale for observational studies and Version-2 of Cochrane for intervention studies. A random-effects model was used to estimate pooled prevalence. The protocol is registered in the International Prospective Register of Systematic Reviews PROSPERO; Registration ID:CRD42022300786. RESULTS We analyzed 81 studies involving 32,834 subjects. The pooled prevalence of advanced-CKD etiologies are diabetic kidney disease (DKD) 29.2% (95%CI 23.88-34.78), glomerulonephritis 20.0% (95%CI 16.84-23.38), hypertension 16.8% (95%CI 14.05-19.70), other 8.6% (95%CI 6.97-10.47), unknown 7.5% (95%CI 4.32-11.50), and polycystic kidney disease 0.7% (95%CI 0.40-1.16). We found a significant increase in DKD prevalence from 21% (9.2%, 95%CI 0.00-33.01) to 30% (95%CI 24.59-35.97) before and after the year 2000. Among upper-middle-income and high-income countries, DKD is the most prevalent (26.8%, 95%CI 21.42-32.60 and 38.9%, 95%CI 29.33-48.79, respectively), while glomerulonephritis is common in lower-middle-income countries (33.8%, 95%CI 15.62-54.81). CONCLUSION The leading cause of advanced-CKD in Southeast Asia is DKD, with a substantial proportion of glomerulonephritis. An efficient screening program targeting high-risk populations (diabetes mellitus and glomerulonephritis) is needed, with the aim to delay CKD progression.
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Affiliation(s)
- Ni Made Hustrini
- Division of Nephrology and Hypertension, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia
- Department of Internal Medicine, Leiden University Medical Center, Albinusdreef 2, Leiden, The Netherlands
| | - Endang Susalit
- Division of Nephrology and Hypertension, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia
| | | | - Anandhara Indriani Khumaedi
- Division of Nephrology and Hypertension, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia
| | - Olaf M Dekkers
- Department of Internal Medicine, Leiden University Medical Center, Albinusdreef 2, Leiden, The Netherlands
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Merel van Diepen
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Joris I Rotmans
- Department of Internal Medicine, Leiden University Medical Center, Albinusdreef 2, Leiden, The Netherlands.
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47
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Nozu H, Tamura H, Kudo T, Araki T, Sato H, Watanabe T, Sasagawa I. The role of advanced practice nurses in improving healthcare outcomes for patients with chronic kidney disease: A scoping review protocol. PLoS One 2024; 19:e0301676. [PMID: 38574093 PMCID: PMC10994302 DOI: 10.1371/journal.pone.0301676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 03/15/2024] [Indexed: 04/06/2024] Open
Abstract
INTRODUCTION The number of patients with chronic kidney disease is increasing worldwide; previous studies have suggested that advanced practice nurses, including nurse practitioners and clinical nurse specialists, with expert practice skills can provide high-quality care and solve complex healthcare problems. In general, nurse practitioners are generalist nurses who work as autonomous clinicians with whole personal care. Clinical nurse specialists, in contrast, are nurses with advanced nursing knowledge and skills for individuals or specific populations. Their roles are independent and different; however, similarities exist in their role in potentially improving healthcare outcomes. Although two previous studies described the role of nephrology nurse practitioners, they were systematic reviews, and their outcomes were limited. To clarify the overall aspect of advanced practice nurses' role, it is necessary to extract the studies illustrating advanced practice nurses' practices for patients with chronic kidney disease. OBJECTIVE This study aims to map the literature describing the role of advanced practice nurses in improving healthcare outcomes for patients with chronic kidney disease. MATERIALS AND METHODS This scoping review will be conducted using the Joanna Briggs Institute methodology for scoping review. Online databases will be searched across MEDLINE (PubMed), CINAHL (EBSCOhost), Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, and Web of Science. Only studies published in English will be included, and no date limit will be set. Chronic kidney disease, renal replacement therapy, and advanced practice nurses as keywords and related search terms will be used. Two independent reviewers will screen the title and abstract/full-text; in case of discrepancy, a third reviewer will make the final decision. The results will be extracted and presented following the review question concerning the study characteristics, patients' characteristics, condition of chronic kidney disease, and role of advanced practice nurses.
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Affiliation(s)
- Hanako Nozu
- Department of Nursing, Yamagata Tokushukai Hospital, Yamagata, Yamagata, Japan
| | - Haruka Tamura
- Graduate School of Medicine, Nagoya University, Nagoya, Aichi, Japan
| | - Takemi Kudo
- Graduate School of Health and Environment Sciences, Tohoku Bunka Gakuen University, Sendai, Miyagi, Japan
| | - Tomoko Araki
- Graduate School of Health and Environment Sciences, Tohoku Bunka Gakuen University, Sendai, Miyagi, Japan
| | - Hidetaka Sato
- Graduate School of Health and Environment Sciences, Tohoku Bunka Gakuen University, Sendai, Miyagi, Japan
| | - Takao Watanabe
- Graduate School of Health and Environment Sciences, Tohoku Bunka Gakuen University, Sendai, Miyagi, Japan
| | - Isoji Sasagawa
- Department of Urology, Yamagata Tokushukai Hospital, Yamagata, Yamagata, Japan
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48
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Liu S, Shen Y, Nie M, Fang C, Dai H, Yao M, Zhou X. The status and influencing factors of fatigue in kidney transplant recipients based on the theory of unpleasant symptoms: A cross-sectional study in China. Int J Nurs Pract 2024:e13256. [PMID: 38570821 DOI: 10.1111/ijn.13256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 10/13/2023] [Accepted: 03/10/2024] [Indexed: 04/05/2024]
Abstract
AIMS This study describes the incidence of fatigue in kidney transplant recipients and analyses the relationship between physiological factors, psychological factors, situational factors and fatigue in kidney transplant recipients. BACKGROUND Fatigue, as a common symptom after kidney transplantation, is affected by many factors, but the influence of some factors on the fatigue of kidney transplant recipients is still controversial. DESIGN This cross-sectional study was designed based on the theory of unpleasant symptoms. METHODS Our survey involved 307 participants attending the kidney transplant outpatient clinic of a tertiary Class A hospital (Changsha, Hunan, China). Data were collected between February and April 2021 using a structured questionnaire and electronic medical records. Data were analysed using IBM SPSS 25.0 (SPSS Inc.) RESULTS: It was found that the incidence of fatigue in kidney transplant recipients was 53.1%. According to the binary logistic regression analysis, sleep quality, hypokalemia, anxiety, depression and education level were independent risk factors for fatigue in kidney transplant recipients. CONCLUSION The incidence of fatigue in kidney transplant recipients was high and was influenced by physical, psychological and situational factors. Clinical nurses should assess fatigue levels in a timely and multidimensional manner in clinical practice and provide effective and scientific guidance about fatigue self-coping and symptom management for kidney transplant recipients.
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Affiliation(s)
- Sai Liu
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, China
- Department of Kidney Transplantation, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Yuehan Shen
- Department of Clinical Laboratory, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Manhua Nie
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, China
- Department of Kidney Transplantation, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Chunhua Fang
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, China
- Department of Kidney Transplantation, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Helong Dai
- Department of Kidney Transplantation, The Second Xiangya Hospital of Central South University, Changsha, China
- Clinical Research Center for Organ Transplantation in Hunan Province, Changsha, China
- Clinical Immunology Center, Central South University, Changsha, China
| | - Ming Yao
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Xihong Zhou
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, China
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Wołos K, Pstras L, Debowska M, Dabrowski W, Siwicka-Gieroba D, Poleszczuk J. Non-invasive assessment of stroke volume and cardiovascular parameters based on peripheral pressure waveform. PLoS Comput Biol 2024; 20:e1012013. [PMID: 38635856 PMCID: PMC11060565 DOI: 10.1371/journal.pcbi.1012013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 04/30/2024] [Accepted: 03/19/2024] [Indexed: 04/20/2024] Open
Abstract
Cardiovascular diseases are the leading cause of death globally, making the development of non-invasive and simple-to-use tools that bring insights into the state of the cardiovascular system of utmost importance. We investigated the possibility of using peripheral pulse wave recordings to estimate stroke volume (SV) and subject-specific parameters describing the selected properties of the cardiovascular system. Peripheral pressure waveforms were recorded in the radial artery using applanation tonometry (SphygmoCor) in 35 hemodialysis (HD) patients and 14 healthy subjects. The pressure waveforms were then used to estimate subject-specific parameters of a mathematical model of pulse wave propagation coupled with the elastance-based model of the left ventricle. Bioimpedance cardiography measurements (PhysioFlow) were performed to validate the model-estimated SV. Mean absolute percentage error between the simulated and measured pressure waveforms was 4.0% and 2.8% for the HD and control group, respectively. We obtained a moderate correlation between the model-estimated and bioimpedance-based SV (r = 0.57, p<0.05, and r = 0.58, p<0.001, for the control group and HD patients, respectively). We also observed a correlation between the estimated end-systolic elastance of the left ventricle and the peripheral systolic pressure in both HD patients (r = 0.84, p<0.001) and the control group (r = 0.70, p<0.01). These preliminary results suggest that, after additional validation and possibly further refinement to increase accuracy, the proposed methodology could support non-invasive assessment of stroke volume and selected heart function parameters and vascular properties. Importantly, the proposed method could be potentially implemented in the existing devices measuring peripheral pressure waveforms.
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Affiliation(s)
- Kamil Wołos
- Laboratory of Mathematical Modeling of Physiological Processes, Nalecz Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences, Warsaw, Poland
| | - Leszek Pstras
- Laboratory of Mathematical Modeling of Physiological Processes, Nalecz Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences, Warsaw, Poland
| | - Malgorzata Debowska
- Laboratory of Mathematical Modeling of Physiological Processes, Nalecz Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences, Warsaw, Poland
| | - Wojciech Dabrowski
- Department of Anesthesiology and Intensive Therapy, Medical University of Lublin, Lublin, Poland
| | - Dorota Siwicka-Gieroba
- Department of Anesthesiology and Intensive Therapy, Medical University of Lublin, Lublin, Poland
| | - Jan Poleszczuk
- Laboratory of Mathematical Modeling of Physiological Processes, Nalecz Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences, Warsaw, Poland
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50
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Wang MY, Yu TX, Wang QY, Han X, Hu X, Ye SJ, Long XH, Wang Y, Zhu H, Luo W, Liang G. OTUD1 promotes hypertensive kidney fibrosis and injury by deubiquitinating CDK9 in renal epithelial cells. Acta Pharmacol Sin 2024; 45:765-776. [PMID: 38110583 PMCID: PMC10943066 DOI: 10.1038/s41401-023-01192-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 11/05/2023] [Indexed: 12/20/2023] Open
Abstract
Hypertensive renal disease (HRD) contributes to the progression of kidney dysfunction and ultimately leads to end-stage renal disease. Understanding the mechanisms underlying HRD is critical for the development of therapeutic strategies. Deubiquitinating enzymes (DUBs) have been recently highlighted in renal pathophysiology. In this study, we investigated the role of a DUB, OTU Domain-Containing Protein 1 (OTUD1), in HRD models. HRD was induced in wild-type or Otud1 knockout mice by chronic infusion of angiotensin II (Ang II, 1 μg/kg per min) through a micro-osmotic pump for 4 weeks. We found that OTUD1 expression levels were significantly elevated in the kidney tissues of Ang II-treated mice. Otud1 knockout significantly ameliorated Ang II-induced HRD, whereas OTUD1 overexpression exacerbated Ang II-induced kidney damage and fibrosis. Similar results were observed in TCMK-1 cells but not in SV40 MES-13 cells following Ang II (1 μM) treatment. In Ang II-challenged TCMK-1 cells, we demonstrated that OTUD1 bound to CDK9 and induced CDK9 deubiquitination: OTUD1 catalyzed K63 deubiquitination on CDK9 with its Cys320 playing a critical role, promoting CDK9 phosphorylation and activation to induce inflammatory responses and fibrosis in kidney epithelial cells. Administration of a CDK9 inhibitor NVP-2 significantly ameliorated Ang II-induced HRD in mice. This study demonstrates that OTUD1 mediates HRD by targeting CDK9 in kidney epithelial cells, suggesting OTUD1 is a potential target in treating this disease.
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Affiliation(s)
- Meng-Yang Wang
- Department of Pharmacy and Institute of Inflammation, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, 310014, China
- Chemical Biology Research Center, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, 325035, China
- Department of Pharmacology, College of Pharmacy, Beihua University, Jilin, 132013, China
| | - Tian-Xiang Yu
- Department of Pharmacy and Institute of Inflammation, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, 310014, China
- Chemical Biology Research Center, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, 325035, China
| | - Qin-Yan Wang
- Department of Pharmacy and Institute of Inflammation, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, 310014, China
- Chemical Biology Research Center, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, 325035, China
| | - Xue Han
- Department of Pharmacy and Institute of Inflammation, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, 310014, China
- Chemical Biology Research Center, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, 325035, China
| | - Xiang Hu
- Department of Endocrinology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325035, China
| | - Shi-Ju Ye
- Chemical Biology Research Center, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, 325035, China
| | - Xiao-Hong Long
- Chemical Biology Research Center, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, 325035, China
| | - Yi Wang
- Chemical Biology Research Center, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, 325035, China
| | - Hong Zhu
- Department of Endocrinology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325035, China
| | - Wu Luo
- Chemical Biology Research Center, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, 325035, China.
| | - Guang Liang
- Department of Pharmacy and Institute of Inflammation, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, 310014, China.
- Chemical Biology Research Center, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, 325035, China.
- School of Pharmaceutical Sciences, Hangzhou Medical College, Hangzhou, 310014, China.
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