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Normoalbuminuric diabetic kidney disease
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《医学前沿(英文)》 2017年 第11卷 第3期 页码 310-318 doi: 10.1007/s11684-017-0542-7
Diabetic kidney disease (DKD) is one of the primary causes of end-stage renal disease (ESRD). Early diagnosis is very important in preventing the development of DKD. Urinary albumin excretion rate (UAER) and glomerular filtration rate (GFR) are widely accepted as criteria for the diagnosis and clinical grading of DKD, and microalbuminuria has been recommended as the first clinical sign of DKD. The natural history of DKD has been divided into three stages: normoalbuminuria, microalbuminuria, and macroalbuminuria. However, this clinical paradigm has been questioned recently, as studies have shown that a portion of diabetes mellitus (DM) patients with normoalbuminuria have progressive renal insufficiency, referred to as normoalbuminuric diabetic kidney disease (NADKD) or nonalbuminuric diabetic nephropathy. Epidemiologic research has demonstrated that normoalbuminuric diabetic kidney disease is common, and the large number of NADKD patients suggests that the traditional paradigm needs to be shifted. Currently, the pathogenesis of NADKD remains unclear, but many clinical studies have identified some clinical and pathological features of NADKD. In addition, the long-term outcomes of NADKD patients remain controversial. In this article, we reviewed the latest studies addressing the pathogenesis, pathology, treatment and prevention of NADKD.
关键词: diabetes diabetic kidney disease normoalbuminuria renal impairment
Netrin-1 works with UNC5B to regulate angiogenesis in diabetic kidney disease
Xiaojing Jiao, Dong Zhang, Quan Hong, Lei Yan, Qiuxia Han, Fengmin Shao, Guangyan Cai, Xiangmei Chen, Hanyu Zhu
《医学前沿(英文)》 2020年 第14卷 第3期 页码 293-304 doi: 10.1007/s11684-019-0715-7
关键词: netrin-1 VEGF-165 UNC5B angiogenesis diabetic kidney disease
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《医学前沿(英文)》 2017年 第11卷 第3期 页码 378-385 doi: 10.1007/s11684-017-0541-8
The purpose of this study is to characterize a meta-signature of differentially expressed mRNA in chronic kidney disease (CKD) to predict putative microRNA (miRNA) in CKD–mineral bone disorder (CKD–MBD) and confirm the changes in these genes and miRNA expression under uremic conditions by using a cell culture system. PubMed searches using MeSH terms and keywords related to CKD, uremia, and mRNA arrays were conducted. Through a computational analysis, a meta-signature that characterizes the significant intersection of differentially expressed mRNA and expected miRNAs associated with CKD–MBD was determined. Additionally, changes in gene and miRNA expressions under uremic conditions were confirmed with human Saos-2 osteoblast-like cells. A statistically significant mRNA meta-signature of upregulated and downregulated mRNA levels was identified. Furthermore, miRNA expression profiles were inferred, and computational analyses were performed with the imputed microRNA regulation based on weighted ranked expression and putative microRNA targets (IMRE) method to identify miRNAs associated with CKD occurrence. TLR4 and miR-146b levels were significantly associated with CKD–MBD. TLR4 levels were significantly downregulated, whereas pri-miR-146b and miR-146b were upregulated in the presence of uremic toxins in human Saos-2 osteoblast-like cells. Differentially expressed miRNAs associated with CKD-MBD were identified through a computational analysis, and changes in gene and miRNA expressions were confirmed with an in vitro cell culture system.
关键词: chronic kidney disease microRNA mineral bone disorder uremia
Type 2 diabetic patients with non-alcoholic fatty liver disease exhibit significant haemorheological
Hui Dong, Fu’er Lu, Nan Wang, Xin Zou, Jingjing Rao
《医学前沿(英文)》 2011年 第5卷 第3期 页码 288-293 doi: 10.1007/s11684-011-0127-9
关键词: diabetes mellitus type 2 haemorheology non-alcoholic fatty liver disease
Huiwen Ren, Can Wu, Ying Shao, Shuang Liu, Yang Zhou, Qiuyue Wang
《医学前沿(英文)》 2020年 第14卷 第5期 页码 642-650 doi: 10.1007/s11684-019-0719-3
关键词: type 2 diabetes mellitus diabetic kidney disease miR-154-5p urinary albumin to creatinine ratio
Clinical characteristics and outcomes of biopsy-proven diabetic nephropathy
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《医学前沿(英文)》 2017年 第11卷 第3期 页码 386-392 doi: 10.1007/s11684-017-0574-z
Kidney damage is common in patients with diabetes mellitus (DM). However, whether the type of kidney damage can be reliably diagnosed using clinical data alone remains unclear. Predictive factors for diabetic nephropathy (DN) outcomes are also poorly understood. In this study, the clinical manifestations of 111 cases of biopsy-proven DN were described, and the clinical and pathological parameters of patients with different DN outcomes were compared. Results showed that long DM duration (>10 years in 32.4% of patients), severe proteinuria (62.2%), and renal dysfunction (estimated glomerular filtration rate [eGFR]<60 mL/(min·1.73 m2)) (52.3%) did not accurately indicate whether the condition of these patients progressed to DN. Hematuria (48.6%) failed to specify either DN or nondiabetic renal disease. Diabetic retinopathy (78.4%) was a crucial complication in patients with DN. Kaplan–Meier analysis revealed that the renal survival of 53 patients who were diagnosed with DN and were followed up was not significantly associated with glomerular classification (P>0.05). Cox’s regression analysis demonstrated that renal survival time was significantly influenced by sex (b= 1.394, P= 0.038), hematuria (b= 0.036, P= 0.029), and eGFR (b= −0.039, P= 0.002) but was not significantly affected by age, 24 h urinary protein excretion, or glomerular classification (P>0.05). In conclusion, the clinical characteristics of DN vary, and renal biopsy is necessary to determine renal damage patterns. Sex, hematuria, and the eGFR may affect DN outcomes, whereas the glomerular classification may not.
关键词: diabetic nephropathy clinical characteristics renal biopsy outcomes
《医学前沿(英文)》 doi: 10.1007/s11684-023-1019-5
关键词: sleep physical activity chronic kidney disease isotemporal substitution behavioral pattern
Hyperglycemic memory in diabetic cardiomyopathy
《医学前沿(英文)》 2022年 第16卷 第1期 页码 25-38 doi: 10.1007/s11684-021-0881-2
Successful kidney transplantation in highly sensitized patients
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《医学前沿(英文)》 2011年 第5卷 第1期 页码 80-85 doi: 10.1007/s11684-011-0115-0
Highly sensitized patients experience an increased number of rejection episodes and have poorer graft survival rates; hence, sensitization is a significant barrier to both access to and the success of organ transplantation. This study reports our experience in kidney transplantation in highly sensitized patients. Fourteen patients with sensitization or high levels of panel-reactive antibodies (PRA) were studied. All patients were desensitized with pre-transplant intravenous immunoglobulin (IVIG)/plasmapheresis (PP) with or without rituximab and thymoglobulin induction therapy, combined with a Prograf/MMF/Pred immunosuppressive regimen. Of 14 patients, 10 showed good graft functions without acute rejection (AR) episodes. Acute cellular rejection in two patients was reversed by methylprednisolone. Two patients underwent antibody-mediated rejection; one was treated with PP/IVIG successfully, whereas the other lost graft functions due to the de novoproduction of donor-specific antibodies (DSA). Graft functions were stable, and there were no AR episodes in other patients. Conclusively, desensitization using PP/IVIG with or without rituximab increases the likelihood of successful live-donor kidney transplantation in sensitized recipients.
Carbon dots-based fluorescence sensor for two-photon imaging of pH in diabetic mice
《化学科学与工程前沿(英文)》 2023年 第17卷 第3期 页码 298-306 doi: 10.1007/s11705-022-2212-9
Mechanisms of “kidney governing bones” theory in traditional Chinese medicine
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《医学前沿(英文)》 2014年 第8卷 第3期 页码 389-393 doi: 10.1007/s11684-014-0362-y
Studies conducted by our group on the mechanism of “kidney governing bones” theory in traditional Chinese medicine (TCM) are reviewed in this paper. Conclusions can be summarized as follows. (1) Neuroendocrine-immune network (NIN)-osteoclast regulatory pathway OPG-RANKL-RANK is one of the mechanisms of “kidney governing bones.” Although kidney-reinforcing therapy is regarded as one of the holistic regulatory mechanisms of the body, characteristic holistic regulation in TCM can be reflected through nonselective regulation of the NIN during kidney reinforcement therapy, which can be used to treat osteoporosis through microadjustments in the microenvironment of the bone marrow. (2) Marrow exhaustion in TCM, which is the state wherein lipocytes in the bone marrow increase whereas other cells decrease, serves as the pathogenesis of osteoporosis brought about by failure of the “kidney governing bones.” (3) The kidney in TCM can be regarded as a complex system comprising multiple functional units in the body, including the unit “governing bones.” Kidney deficiency refers to a deficiency in only one or more units of the kidney system and not the whole system itself, which explains the kidney-reinforcing effect of many herbs; some herbs can treat osteoporosis, but some cannot. Although both classified as kidney-reinforcing agents, the former can resolve failure of the “kidney governing bones” unit while the latter regulates the failure of other units in the kidney system. Despite the current understanding on “kidney governing bones” theory, the mechanism of “kidney governing bones” remains complicated and unresolved. Thus, further studies in this area are warranted.
关键词: kidney governing bones kidney deficiency marrow osteoporosis neuroendocrine-immune network osteoclast regulatory pathway
Risk factors of prognosis after acute kidney injury in hospitalized patients
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《医学前沿(英文)》 2017年 第11卷 第3期 页码 393-402 doi: 10.1007/s11684-017-0532-9
The risk factors, especially laboratory indicators, of prognosis after acute kidney injury (AKI) remain unclear. We conducted a retrospective survey of Chinese People’s Liberation Army General Hospital from January 1, 2012 to December 31, 2012 according to the AKI diagnosis standard issued by Kidney Disease Improving Global Outcomes. The epidemiological features and factors influencing hospital mortality and renal function recovery were evaluated through logistic regression analysis. Among 77 662 cases of hospitalized patients, 1387 suffered from AKI. The incidence rate and mortality of AKI were 1.79% and 14.56%, respectively. Multivariate logistic regression analysis revealed that high AKI stage, age greater than 80 years, neoplastic disease, low cardiac output, increased white blood cell count, and decreased platelet count and serum albumin levels were the risk factors affecting the mortality of AKI patients. Conversely, body mass index between 28 and 34.9 was a protective factor. Increased AKI stage, tumor disease, post-cardiopulmonary resuscitation, and RRT were the risk factors of renal function recovery upon discharge. In addition to traditional risk factors, white blood cell count, platelet count, albumin, and BMI were the predictors of the mortality of AKI patients. No laboratory indicators were found to be the risk factors of renal function recovery in AKI patients.
Non-genetic mechanisms of diabetic nephropathy
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《医学前沿(英文)》 2017年 第11卷 第3期 页码 319-332 doi: 10.1007/s11684-017-0569-9
Diabetic nephropathy (DN) is one of the most common microvascular complications in diabetes mellitus patients and is characterized by thickened glomerular basement membrane, increased extracellular matrix formation, and podocyte loss. These phenomena lead to proteinuria and altered glomerular filtration rate, that is, the rate initially increases but progressively decreases. DN has become the leading cause of end-stage renal disease. Its prevalence shows a rapid growth trend and causes heavy social and economic burden in many countries. However, this disease is multifactorial, and its mechanism is poorly understood due to the complex pathogenesis of DN. In this review, we highlight the new molecular insights about the pathogenesis of DN from the aspects of immune inflammation response, epithelial–mesenchymal transition, apoptosis and mitochondrial damage, epigenetics, and podocyte–endothelial communication. This work offers groundwork for understanding the initiation and progression of DN, as well as provides ideas for developing new prevention and treatment measures.
关键词: diabetic nephropathy immune inflammatory response epithelial–mesenchymal transition apoptosis mitochondrial damage epigenetics podocyte–endothelial communication
YU Xiaofang, XU Xialian, YE Zhibin
《医学前沿(英文)》 2007年 第1卷 第3期 页码 308-311 doi: 10.1007/s11684-007-0059-6
White blood cell count and the incidence of hyperuricemia: insights from a community-based study
Jian Liu, Pingyan Shen, Xiaobo Ma, Xialian Yu, Liyan Ni, Xu Hao, Weiming Wang, Nan Chen
《医学前沿(英文)》 2019年 第13卷 第6期 页码 741-746 doi: 10.1007/s11684-017-0579-7
关键词: white blood cell count hyperuricemia chronic kidney disease inflammation
标题 作者 时间 类型 操作
Netrin-1 works with UNC5B to regulate angiogenesis in diabetic kidney disease
Xiaojing Jiao, Dong Zhang, Quan Hong, Lei Yan, Qiuxia Han, Fengmin Shao, Guangyan Cai, Xiangmei Chen, Hanyu Zhu
期刊论文
Identification of differentially expressed miRNAs associated with chronic kidney disease–mineral bone
null
期刊论文
Type 2 diabetic patients with non-alcoholic fatty liver disease exhibit significant haemorheological
Hui Dong, Fu’er Lu, Nan Wang, Xin Zou, Jingjing Rao
期刊论文
Correlation between serum miR-154-5p and urinary albumin excretion rates in patients with type 2 diabetes mellitus: a cross-sectional cohort study
Huiwen Ren, Can Wu, Ying Shao, Shuang Liu, Yang Zhou, Qiuyue Wang
期刊论文
Associations of sleeping patterns and isotemporal substitution of other behavior with the prevalence of CKD in Chinese adults
期刊论文
Effect of renal function and hemodialysis on the serum tumor markers in patients with chronic kidneydisease
YU Xiaofang, XU Xialian, YE Zhibin
期刊论文