Background. The presence of acute kidney injury in the setting of acute heart failure (AHF) or acute decompensated heart failure (ADHF) is a very common occurrence and was termed cardiorenal syndrome 1 (CRS1). Neutrophil gelatinase-associated lipocalin (NGAL) in the blood and urine is one of the earliest biomarkers of acute kidney injury due to ischemia or renal toxicity. This study was aimed to evaluate the diagnostic efficacy of plasma NGAL in the diagnosis of CRS1. Methods. There were 139 patients with AHF or ADHF in the department of Cardiovascular Resuscitation and Interventional Cardiology at Ho Chi Minh City 115 People Hospital from September 2018 to March 2019. This was a prospective cohort study. Results. There were 48 cases (rate 34.5%) with CRS1, mean age was 66.12 ± 15.77 and men accounted for 50.4%. There were no significant differences of vital signs at admission, diagnosis, and EF-based heart failure between CRS1 and non-CRS1 groups. The urea, creatinine on first day (creatinine D1) and third day (creatinine D3), NT-proBNP, and NGAL levels were higher in the CRS1 group than the non-CRS1 group, p < 0.05 . The optimal cutoff plasma NGAL for diagnosing CRS1 was >353.23 ng/ml, area under curve (AUC) 0.732 (95% CI 0.65–0.80, p < 0.001 ), sensitivity 74.47%, specificity 68.48%, positive predictive value 54.7%, and negative predictive value 84%. Multivariable logistic regression analysis eGFRCKDEPID1 remained the strongest independent predictor of CRS1. Building the optimal regression model (without eGFRCKDEPID1) by the BMA (Bayesian model average) method with two variables NGAL and Creatinine D1, we had the equation: odds ratio = ey while y = −2.39 + 0.0037 × NGAL + 0.17 × Creatinine D1. The nomogram (without eGFRCKDEPID1) was designed to predict the likelihood of CRS1 with AUC 0.79. Conclusions. The combination of plasma NGAL and creatinine D1 on the first day at admission had a high accuracy of predictive model for CRS1.

Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a hereditary disorder of the cardiac muscle characterised by ventricular arrhythmias, cardiac failure and sudden cardiac death. Desmosomes -the intercellular junctions of both epithelial and cardiovascular tissues that connect intermediate filaments of adjacent cells, generating a large and mechanically resilient network -are disordered in ARVC. Here, we exploit new insights into desmoplakin (DP), a critical component of desmosome structures. Indeed, both patient skin and keratinocytes expressing DP mutant construct showed large intercellular aggregates and a decrease in the amount of junctional proteins at areas of cell-cell contact. Moreover, experiments with DP knockout mice indicated that mislocalization of another junctional protein, connexin 43 was ameliorated by b-blocker (beta-blocker), or b-adrenergic receptor blocker -known to interfere with the binding to the receptor of epinephrine and other stress hormones to weaken the effects of stress hormones. Thus, these novel findings fortify the genetic and cellular mechanisms behind the marked heterogeneity of the disease and provide new therapeutic interventions that target intercellular junctions.

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Background: Glucose-based peritoneal dialysis (PD) is the predominantly used dialysate in PD patients. Glucose absorption in peritoneal dialysis (PD) patients may contribute to adverse metabolic complications. The impact of high peritoneal dialysate glucose concentration (PDGC) on all-cause as well as cardiovascular disease (CVD) mortality in peritoneal dialysis (PD) patients is unclear. The current researchs widely applied formulae may be not suitable for estimation of glucose absorption in continuous ambulatory peritoneal dialysis (CAPD) patients. Objective: This study examined the actual glucose absorption in a cohort of CAPD patients and compared the results with estimates from three current formulae. Our study provides an overview of glucose associated metabolic complications and to investigate the impact of high glucose in dialysate on our CAPD patients. Methods: We conducted a survey of glucose absorption of a cohort of 56 CAPD patients and compared actual dialysate glucose absorbed with the one of K/DOQI formula, Grodstein formula, or a percentage estimate of 60%. Results: The total dialysate glucose infused each day varied from 108.8 to 181.6 g/day with average of 130±19.6 g, with the mean glucose concentration in dialysate is 1.79%. The average of glucose absorbed was 83.2±24.3 g/day (ranging from 28.6 to 145.2 g) by actual measurements. The mean absorption rate was 64.1% (ranging from 22.6% to 99.6%). There are no significant differences between 4 methods estimating glucose absorption in CAPD patients. There are strong correlations between glucose concentration using in PD patients with levels of total cholesterol, triglyceride, urea, creatinine and uric acid. Only triglyceride concentration associated with glucose absorption from dialysate. Conclusions: The applications of current estimating methods may have limitations. The actual measurement providesdietitians and doctors more exact information of absorbed glucose and energy compared to the current estimating methods. Key words: dialysate, Glucose absorption, peritoneal dialysis, continuous ambulatory peritoneal dialysis, acid uric, triglyceride

Background/Aim: End-stage-renal-disease (ESRD) patients/CAPD have a high rate of abnormal thyroid hormone (include subclinical hypothyroidism and non-thyroidal illness syndrome) compared with those without kidney disease. These thyroid dysfunctions are associated with higher death risk due to cardiovascular disease in the general population, little is known about the effect of thyroid disease in patients received peritoneal dialysis. Methods: Cross-sectional research, 118 participants (59 healthy people, 57 CAPD patients) were enrolled. We examined the association of thyroid status, assessed by serum TSH, free T3, free T4 levels which were measured by immunoassay method. Results: Mean serum TSH level of patients were higher than those of control group, p<0.05 (3.15±2.28 μUI/mL versus 1.65±0.82 μUI/mL); mean FT3 level of patients were lower than those of control group, p<0.05 (2.42±0.46 pg/mL versus 3.01±0.41 pg/mL); mean FT4 level of patients were lower than those of control group, p>0.05(1.26±0.24 ng/dL vs 1.18±0.18 ng/dL). Among 57 CAPD patients, 35.1% abnormal thyroid function; 19.3% subclinical hypothyroidism; 15.8% low FT3; 1 patient has low FT4. Mean serum TSH level of patients were higher than those of control group, p<0.05 (3.15±2.28 μUI/mL versus 1.65±0.82 μUI/mL); mean FT3 level of patients were lower than those of control group, p<0.05 (2.42±0.46 pg/mL versus 3.01±0.41 pg/mL); mean FT4 level of patients were lower than those of control group, (p>0.05, 1.26±0.24 ng/dL vs 1.18±0.18 ng/dL). Conclusion: Subclinical hypothyroidism and low FT3syndrome are high in CAPD patients. Additionally, FT4 serum concentration is associated with PD duration and serum creatinine; FT3 is dependent risk factor of rate Kt/V Urea weekly, also cardiovascular disease. Key words: ambulatory peritoneal dialysis, continous ambulatory peritoneal dialysis patients (CAPD), abnormal thyroid function, subclinical hypothyroidism