Chronic kidney disease (CKD), impairment of kidney function, is a serious public health problem, and the assessment of genetic factors influencing kidney function has substantial clinical relevance. Here, we report a meta-analysis of genome-wide association studies for kidney function–related traits, including 71,149 east Asian individuals from 18 studies in 11 population-, hospital- or family-based cohorts, conducted as part of the Asian Genetic Epidemiology Network (AGEN). Our meta-analysis identified 17 loci newly associated with kidney function–related traits, including the concentrations of blood urea nitrogen, uric acid and serum creatinine and estimated glomerular filtration rate based on serum creatinine levels (eGFRcrea) (P < 5.0 × 10−8). We further examined these loci with in silico replication in individuals of European ancestry from the KidneyGen, CKDGen and GUGC consortia, including a combined total of ~110,347 individuals. We identify pleiotropic associations among these loci with kidney function–related traits and risk of CKD. These findings provide new insights into the genetics of kidney function.
Our study demonstrated the potential of metabolomics to infer asthma-related biomarkers by the identification of potentially deregulated phospholipids that associate with asthma and asthma risk alleles.
The results of core decompression of the femoral head in the treatment of osteonecrosis are analyzed. This study includes 94 hips in 74 patients with a followup time ranging between 18 months and 15 years (average 6 years). There had been no need for further surgery 2 years postoperatively in 85% of the hips with preoperative Steinberg stages 0, I and II when compared with 66% with preoperative stages III, IV and V. At 4 years postoperatively the corresponding figures are 73 compared to 55%; and 6 years postoperatively 69 compared to 49%. This difference was significant (P=0.0402). Further significant risk factors are corticosteroid administration, smoking and alcohol intake. The results of core decompression are good when the preoperative lesion is at Steinberg stage 0, I and II and the patient does not present with other risk factors. In cases with risk factors the outcome is significantly less good. The procedure is not indicated in the presence of advanced disease.Résumé Dans cette étude nous avons analysé les résul-tats de la décompression de la tête fémorale chez des patients avec ostéonécrose de la tête du fémur. 94 hanches de 74 patients ont été analysées. La durée de suivi a varié entre 18 mois et 15 ans. Deux ans après la décom-pression les résultats ont été satisfaisants (aucune reintervention chirurgicale) dans 85% des cas avec une nécrose préoperatoire dans les stades de Steinberg 0, I ou II. Avec les stades III, IV ou V les résultats ont été satisfaisant dans 66% des cas. Quatre ans après la décompres-sion les résultats satisfaisant ont été 73% (0, I ou II) et 55% (III, IV ou V). Six ans après la décompression les résultats satisfaisant ont été 69% et 49%. Les traitements avec corticoide, l'alccol et la nicotine augmentent le risque d'une ré intervention chirurgicale après la decompression d'une maniére significative. Les résultats de la decompréssion sont bons, si la 1ésion de la nécrose n'excéde pas le stade II de Steinberg et s'il n'a pas autres facteurs risque. Avec des facteurs de risque les résultats dé-clinent significativement. Dans les stades de Steinberg III, IV ou V la décompression n'est pas indiquée. IntroductionOsteonecrosis of the femoral head (ONFH) is a disease of unknown pathology. The natural history normally progresses to femoral head arthrosis with the need for total hip replacement (THR) [4]. Nonoperative treatment, such as limited weight-bearing, has been shown to be of little value. About 80% of conservatively treated patients require THR [21]. Core decompression (CD) is a treatment option that has been in use since the 1960s [4,10]. Although widely used, published clinical results are inconsistent and range from disappointing [1,8,14] to encouraging [3,25,27].This study was undertaken to evaluate the postoperative success of CD as judged by the need for re-operation, radiographic progression and clinical outcome, by using survivorship analysis. Patients and methodsIn 1997 we performed a retrospective study of patients who had undergone a CD procedure as treatment fo...
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