Purpose In this study, we focused on the role of elevated serum interleukin 6 (IL-6) concentration in predicting 5-year cardiovascular mortality in hemodialysis patients using low-flux dialyzer reuse. Materials and methods We measured serum IL-6 concentrations in 236 hemodialysis patients (138 males and 98 females) to predict 5-year cardiovascular mortality. We assessed the baseline demographics of all patients who had a mean age of 44 years and a median hemodialysis duration of 38.5 months. We divided all patients into two equal groups based on the serum IL-6 concentration: G1 (n = 118) with serum IL-6 concentration < 6.78 pg/L and G2 (n = 118) with serum IL-6 concentration ≥ 6.78 pg/L. Results After the 5-year follow-up, 45 patients died due to cardiovascular causes (19.1%). Lipid disorder, hemoglobin, serum albumin, β2-M, and IL-6 concentration were independent risk factors for predicting cardiovascular mortality during the 60-month follow-up in hemodialysis patients. Based on the Kaplan-Meier analysis, we realized that patients with a higher interleukin 6 concentration (G2) had a significantly higher cardiovascular mortality rate than patients in G1 (log-rank test p < 0.001). Serum IL-6 concentration was a better predictor of 5-year cardiovascular mortality than high-sensitivity C-reactive protein in hemodialysis patients using low-flux dialyzer reuse (AUC = 0.818; p < 0.001; cut-off value: 8.055 pg/ mL, Se = 77.8%, Sp = 78.5%). Conclusion Serum IL-6 concentration was a better predictor of 5-year cardiovascular mortality than high-sensitivity C-reactive protein in maintenance hemodialysis patients using low-flux dialysis reuse.

Purpose Beta2-microglobulin (β2-M) is recognized as a surrogate marker relating to the mechanisms of dialysis-associated amyloidosis. Few studies have evaluated the association of serum β2-M with clinical outcome in hemodialysis patients using high-flux type. However, study on patients using low-flux dialyzer reuse has not been done yet. Patients and methods Using serum β2-M level on predicting long-term mortality of hemodialysis patients was examined in 326 prevalent hemodialysis patients (45.59±14.46 years, hemodialysis duration of 47.5 (26–79) months, 186 males and 140 females). The patients were divided into 3 groups with equal number of patients, according to their serum β2-M levels: group A (n=109, serum β2-M concentration ≤55.7 mg/L), group B (n=109, serum β2-M level from 55.8 mg/L to 75.4 mg/L) and group C (n=108, serum β2-M concentration >75.4 mg/L). Results During the follow-up period of 5 years, there were 75 all-cause deaths (23.0%). Kaplan–Meier analysis revealed that all-cause mortality in the higher β2-M group was significantly higher compared to that in the lower β2-M groups ( p <0.001). Serum β2-M level was a significant predictor for all-cause mortality (AUC =0.898; p <0.001; Cut-off value: 74.9 mg/L, Se=93.3%, Sp=92.9%). Conclusion Serum β2-M levels were a significant predictor of long-term mortality in hemodialysis patients, who use only low-flux dialyzers and reuse 6 times.

Objectives:The current study aimed at evaluating the predictive value of serum IgG and IgG/IgM ratio measured on admission for steroid-resistant response after eight weeks of treatment in pediatric patients with idiopathic nephrotic syndrome (NS). Methods: The current cross sectional study was conducted on 69 children, including 41 patients with idiopathic NS and 28 healthy subjects as controls. Serum IgA, IgG, and IgM levels were measured in all subjects using immunoturbidimetric method. Results: The median serum IgA, IgG, and IgM levels were 1.15, 2.23, and 1.7 g/L, respectively. Serum IgA and IgG levels in patients were lower than controls (P < 0.001). In addition, 46.3% of children had steroid-resistant nephrotic syndrome (SRNS). IgG had a positive predictive value for SRNS (area under the curve (AUC) = 0.923, P < 0.001). With the cutoff point of 2.04 g/L, this test had the sensitivity and specificity of 89.5% and 95.5%, respectively. The IgG/IgM ratio also had a positive predictive value for SRNS (AUC = 0.892, P < 0.001). With the cutoff point of 1.64 g/L, this test had the sensitivity of and specificity of 89.5% and 81.8%, respectively. Conclusions: Serum IgG level and IgG/IgM ratio can be considered as predictive markers for steroid resistance in children first diagnosed with idiopathic NS.

Introduction Chronic low-grade inflammation (LGI) plays a role in the pathogenesis of gestational diabetes mellitus (GDM). LGI, on the one hand, promotes insulin resistance and at the same time, affects fetal development. The study aimed to use clinically feasible means to evaluate the association between maternal LGI and maternal insulin resistance and fetal growth indices by ultrasound in the third trimester. Methods A crossectional and descriptive study on 248 first-time diagnosed GDM in Vietnam. Results Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte (PLR) indices were significantly higher in GDM than in normal glucose-tolerant pregnancies (p = 0.048 and 0.016, respectively). GDM with LGI witnessed significantly higher systolic blood pressure, BMI, HbA1c, and significantly lower quantitative Insulin Sensitivity Check Index (QUICKI) than those without LGI. After adjusting for maternal BMI, fasting plasma glucose (FPG), age, and parity, C-reactive protein (CRP) was positively correlated with HOMA2-IR (B=0.13, p<0.01) and Mathews index (B=0.29, p<0.01). Regarding fetal characteristics, LGI was associated with fetal growth indices in the third trimester of GDM. NLR was negatively correlated with estimated fetal weight (EFW) (B=−64.4, p<0.05) after adjusting for maternal BMI and FPG. After adjusting for maternal BMI, FPG, age, and parity, PLR was negatively correlated with biparietal diameter (B=−0.02, p<0.01) and abdominal circumference (AC) (B=−0.16, p<0.05), and EFW (B=−1.1, p<0.01), and head circumference (HC) (B=−0.06, p<0.01); CRP was negatively correlated with AC (B=−0.16, p<0.001), EFW (B=−85.3, p<0.001), and HC (B=−5.0, p<0.001). Conclusion In the third trimester, LGI was associated with maternal glucose and insulin resistance in GDM. Moreover, LGI was associated with fetal characteristics in ultrasonic images. There were negative correlations between LGI and fetal developmental characteristics.

Aim To determine the proportion of contrast‐associated acute kidney injury (CA‐AKI) after percutaneous coronary intervention (PCI) and the predictive value of urine neutrophil gelatinase‐associated lipocalin (uNGAL) for CA‐AKI in elderly patients with chronic coronary artery disease. Methods A total of 509 patients who had planned percutaneous coronary intervention (mean age was 63.58 ± 11.63 years and 63.3% of males) were divided into two groups: group 1 (n = 153; elderly patients) with ≥70 years old and group 2 (n = 356) with <70 years old. Urine NGAL was measured by the ELISA method. Clinical and laboratory data were collected on the day before intervention. CA‐AKI was defined based on Kidney Disease: Improving Global Outcomes criteria. Results The ratio of CA‐AKI in group 1 was 23.5% which was higher than that of group 2 (8.7%) with a p‐value < 0.001. Urine NGAL level in group 1 was significantly higher than that of group 2 [31.3 (19.16–55.13) ng/ml vs. 19.86 (13.21–29.04) ng/ml, p < 0.001]. At a cut‐off value of 44.43 ng/ml, uNGAL had a predictive value for CA‐AKI in all patients (AUC = 0.977, p < 0.001). Especially at a cut‐off value of 44.14 ng/ml, uNGAL had a predictive value for CA‐AKI in elderly patients (AUC = 0.979, p < 0.001). Conclusions The rate of CA‐AKI after PCI in elderly patients was 23.5%. Urine NGAL before PCI had a good predictive value for CA‐AKI in elderly patients with chronic coronary artery disease.