No abstract

Renal anemia is an important complication of chronic kidney disease (CKD). One of the most important complications of renal anemia is reduced red blood cell (RBC) lifespan, but there has been little research conducted into the causes of and treatments for this anemia. We measured alveolar carbon monoxide (CO) and then estimated RBC lifespan in patients on hemodialysis (HD). We also examined their requirement for erythropoiesis-stimulating agents (ESA), HD dose, nutrition factors, iron metabolism factor, reticulocyte counts and % reticulocytes. We enrolled 140 patients undergoing intermittent HD; among this group, 31 were not administered ESA and the others were on ESA therapy. Twelve healthy volunteers served as controls. The RBC lifespans in the healthy volunteers and in the HD patients were 128 ± 28 and 89 ± 28 days (mean ± SD), respectively. The RBC lifespan significantly and negatively correlated with ESA requirement (r = -0.489, P < 0.0001) in the HD patients. Other factors suspected to influence the RBC lifespan did not significantly correlate with the RBC lifespan in HD patients, in contrast to the correlation observed for S-Cr, BUN, S-ALB and total cholesterol vs. RBC lifespan. A shortened RBC lifespan seems to rather significantly affect the ESA requirement. Better nutritional status or active HD patients also seem to have longer RBC lifespans and lower ESA requirement.

The J-DAVID Investigators IMPORTANCE Patients with chronic kidney disease have impaired vitamin D activation and elevated cardiovascular risk. Observational studies in patients treated with hemodialysis showed that the use of active vitamin D sterols was associated with lower risk of all-cause mortality, regardless of parathyroid hormone levels. OBJECTIVE To determine whether vitamin D receptor activators reduce cardiovascular events and mortality in patients without secondary hyperparathyroidism undergoing hemodialysis. DESIGN, SETTING, AND PARTICIPANTS Randomized, open-label, blinded end point multicenter study of 1289 patients in 207 dialysis centers in Japan. The study included 976 patients receiving maintenance hemodialysis with serum intact parathyroid hormone levels less than or equal to 180 pg/mL. The first and last participants were enrolled on

A single, free-running, dual-wavelength mode-locked, erbium-doped fibre laser was exploited to measure the absolute frequency of continuous-wave terahertz (CW-THz) radiation in real time using dual THz combs of photo-carriers (dual PC-THz combs). Two independent mode-locked laser beams with different wavelengths and different repetition frequencies were generated from this laser and were used to generate dual PC-THz combs having different frequency spacings in photoconductive antennae. Based on the dual PC-THz combs, the absolute frequency of CW-THz radiation was determined with a relative precision of 1.2 × 10−9 and a relative accuracy of 1.4 × 10−9 at a sampling rate of 100 Hz. Real-time determination of the absolute frequency of CW-THz radiation varying over a few tens of GHz was also demonstrated. Use of a single dual-wavelength mode-locked fibre laser, in place of dual mode-locked lasers, greatly reduced the size, complexity, and cost of the measurement system while maintaining the real-time capability and high measurement precision.

Diabetic patients with stage 4 or 5 chronic kidney disease not on haemodialysis had significantly lower values of HbA1c and shorter RBC lifespan compared with diabetic patients without renal dysfunction.