Background CD62P is a platelet α‐granule membrane protein, and P10 is a platelet membrane glycoprotein thrombospondin. To better understand the effects of hemodialysis (HD), we have conducted this study to investigate CD62P and P10 in assessing the efficacy of HD in treating patients with end‐stage renal disease (ESRD). Methods The case group consisted of 111 patients suffering ESRD treated with regular HD and the control group enrolled 117 healthy subjects. Before and after HD treatment, a series of parameters were observed, based on which, CD62P and P10 levels were detected in the patients in two groups before and after HD therapy. The correlation analysis analyzed the correlations of CD62P and P10 markers with serum creatinine (Scr), blood urea nitrogen (BUN), and subjective score; and logistic regression analysis was performed to reveal factors affecting the efficacy of HD. Results BUN, Scr, serum phosphorus, intact parathyroid hormone (iPTH), fibrinogen, and β2‐microglobulin (β2‐MG) decreased while hemoglobin, albumin, and activated partial thromboplastin time increased in the patients suffering ESRD; patients presented with improvements in subjective symptoms and an increase in dry weight. CD62P and P10 levels were lower in post‐treatment patients. CD62P and P10 positively correlated with Scr, BUN and subjective score; post‐treatment CD62P and P10 levels, BUN, hemoglobin, albumin, triglyceride, iPTH, β2‐MG, and fibrinogen were correlated with the efficacy of HD. Conclusion CD62P and P10 might be correlated to the efficacy of HD in treating ESRD, in turn providing predictive markers for assessing the ability of HD in treating ESRD.
Background The aim of the study was to investigate the clinical relevance of IgM deposition in patients with lupus nephritis (LN) in a large cohort. Results 217 patients with renal biopsy-proven active LN were enrolled. The associations between glomerular IgM deposition and clinicopathological parameters were further analyzed. IgM deposition was positively correlated with glomerular C1q and C3 deposition moderately (r = 0.436, P < 0.001; r = 0.408, P < 0.001, respectively), and inversely correlated with plasma levels of C3 and CFH mildly (r = − 0.138, P = 0.043; r = − 0.147, P = 0.037, respectively). By multivariate analysis, we found that glomerular IgM deposition independently contributed to glomerular C3 deposition in patients with LN (OR = 2.002, 95% CI 1.295–3.094, P = 0.002). In addition, we also found that patients with IgM 0–2+ had similar plasma CFH levels, but in patients with IgM3+–4+, plasma CFH levels were significantly lower (300.4 ± 155.8 μg/mL vs. 429.9 ± 187.5 μg/mL, P < 0.001). Furthermore, patients with high density of glomerular IgM and low levels of CFH had heavier proteinuria, higher serum creatinine and lower plasma C3 levels (5.7 ± 3.1 g/d vs. 4.7 ± 3.5 g/d, P = 0.037; 150.1 ± 121.0 μmol/L vs. 105.6 ± 97.1 μmol/L, P = 0.005; 0.3 ± 0.2 μg/L vs. 0.4 ± 0.2 μg/L, P = 0.04, respectively), comparing with those with low density of glomerular IgM and low levels of CFH. Conclusions Our results suggested the involvement of glomerular deposited IgM in complement activation and renal injury in LN.
Introduction Osteoporosis is one of the important bone abnormalities in chronic kidney disease-mineral and bone disorder (CKD-MBD) and still lacks a sensitive biomarker to diagnose. Fibroblast growth factor 21 (FGF21) can stimulate bone loss in patients with diabetes and increase in CKD patients. In this study, we investigated whether FGF21 could serve as a biomarker to predict osteoporosis in a haemodialysis cohort. Methods We recorded demographic information, biochemical data, and serum FGF21 and FGF23 levels and measured the CT attenuation values of 339 haemodialysis patients from two large medical centres. We assessed the correlation of CT attenuation values with serum FGF21 and FGF23 levels and tested whether they were independent factors for osteoporosis. ROC curves were constructed to compare the prognostic value of FGF21 and FGF23 for osteoporosis. Results Based on the CT attenuation value, serum FGF21 levels were higher in our osteoporosis group (median 640.86 pg/ml vs. 245.46 pg/ml, P ˂ 0.01). Meanwhile, FGF21 (r = -0.136, P < 0.05) and FGF23 (r = -0.151, P < 0.05) were both negatively associated with osteoporosis. Moreover, FGF21 (β = -0.067, P < 0.05) was an independent factor for osteoporosis. Furthermore, FGF21 combined with age yielded a marked specificity (90.5 %) and sensitivity (61.8 %) in predicting osteoporosis of haemodialysis patients with less residual renal function. Conclusions FGF21 has a positive relationship with the incidence of osteoporosis in patients on haemodialysis. FGF21 combined with age is a good predictive biomarker for osteoporosis in patients on haemodialysis, especially those with less residual renal function.
Background: Protein-energy wasting (PEW) and inflammation have been recognized as two major factors associated with the poor prognosis of patients with maintenance haemodialysis (MHD). The aim of this study was to evaluate the effects of oral fat based high-energy supplements (Fresubin) on malnutrition and inflammation in MHD patients. Method: This study was open-label, prospective, nonrandomized and comparative. A total of 47 MHD patients with PEW were randomly assigned into 2 groups: a control group, and a Fresubin treatment group, in which patients received daily diet intake and Fresubin nutrient support 120 mL/d for 80 days. Laboratory data and anthropometric parameters were measured. Result: The results showed that compared with baseline, the level of serum albumin at 80 d in the Fresubin treatment group was significantly increased (35.4 ± 3.7 vs 38.9 ± 2.9, p = 0.003), while there was no significant difference in the control group. In addition, the magnitudes of changes in albumin (p = 0.009), serum prealbumin (p = 0.017), and abdominal circumference (p = 0.037) in the Fresubin treatment group were markedly increased compared with those in the control group. There was a downward trend in the inflammatory marker hypersensitive C-reactive protein in the Fresubin group (p =0.056), which decreased more dramatically than that in the control group (p = 0.026). Conclusion: Fresubin treatment is well tolerated, and improves malnutrition and inflammatory status in MHD patients with PEW.
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