Renal fibrosis is the final common pathway of all progressive renal disease. Excessive and chronic activation of the Wnt/β-catenin signaling pathway results in chronic kidney disease (CKD) progression. To mimic CKD, the present study used 5/6-nephrectomized rats, and alterations in kidney histology, expression of β-catenin and renal cell apoptosis were assessed. In addition, mesangial cells were cultured in vitro and transfected with β-catenin siRNA to evaluate the effect of blocking Wnt/β-catenin signaling on cell apoptosis and the expression of markers of renal fibrosis. The results demonstrated that CKD rat kidney tissues exhibited moderate renal fibrosis and significantly increased expression levels of β-catenin and apoptosis associated proteins compared with sham-operated rats. In vitro, silencing of β-catenin by siRNA attenuated tumor necrosis factor-α-induced apoptosis and decreased mRNA expression levels of various markers of fibrosis, including fibronectin, transforming growth factor-β, and collagen I, III and IV. In conclusion, inhibition of Wnt/β-catenin signaling by β-catenin silencing attenuated apoptosis and expression of fibrosis-associated markers in renal cells. The present study suggested that the Wnt/β-catenin signaling pathway may serve as a potential treatment strategy for renal fibrotic disorders.

Objective The impact of dialysis initiation on survival is still somewhat controversial. Given that race or ethnicity has been observed to be a predictor of mortality and the rate of progression of chronic kidney disease, we conducted a meta-analysis to investigate the effect of early vs. late dialysis initiation on mortality in East Asian populations. Methods All eligible cohort studies of target were selected from the MEDLINE (PubMed), EMBASE, The Cochrane Library and the Clinical Trials Registry databases from inception to October 2014. The data were extracted with all-cause mortality rates as the primary outcome, and pooled adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated. Results Ten studies examined the association between early vs. late dialysis initiation and mortality. Compared to late dialysis initiation, patients who received early dialysis initiation had a higher overall mortality risk (adjusted HR, 1.36; 95% CI, 1.0-1.85; p<0.05) in East Asian populations. In a subgroup analysis, baseline characteristic differences (adjusted HR, 2.0; 95%CI, 1.56-2.57; p<0.001), initial dialysis modalities (adjusted HR, 2.12; 95% CI, 1.72-2.62; p<0.001) and follow up duration (adjusted HR, 1.59; 95% CI, 1.19-2.12; p=0.002), demonstrated that the association between early dialysis initiation and mortality were significant. Conclusion A higher glomerular filtration rate (early) at the initiation of dialysis is associated with a higher all-cause mortality risk in East Asian populations.

To test the hypothesis whether serum advanced oxidation protein products (AOPP) are associated with increased acute kidney injury (AKI) after cardiopulmonary bypass (CPB) and could serve as a biomarker in this aspect, we performed a prospective cohort study. Thirty-five (22.3%) patients developed AKI, and 32 age- and gender-matched patients without AKI were selected as control. Serum AOPP 1 h after CPB were significantly higher among AKI patients compared with non-AKI patients (81.8 ± 18.6 versus 67.4 ± 12.5 μmol/L, p < 0.001), with an area under the receiver-operating characteristic (ROC) curve of 0.714. An optimal serum AOPP 1 h after CPB cutoff of 69.9 μmol/L had a sensitivity of 74%, specificity of 63% and a positive predictive value of 68% for predicting AKI. These results demonstrated that serum AOPP might be an early biomarker for AKI after CPB.

This study was designed to test the hypothesis that whether the plasma level of advanced oxidant protein products (AOPPs) would be useful for the clinical diagnosis of acute lung injury (ALI) following cardiac surgery with the technique of cardiopulmonary bypass (CPB). In this prospective study, seventy consecutive adults undergoing open heart surgery with CPB were included and assigned into the ALI (n = 18) and non-ALI (n = 52) groups according to the American-European Consensus Criteria. Plasma concentrations of AOPPs were measured at baseline, postoperative 1 h, 12 h, 24 h, and 48 h. Eighteen patients (25.7 %) developed ALI after surgery. The plasma levels of AOPPs in the ALI group were significantly increased and remained considerably higher at all time points after operation (all P < 0.05). Multivariate logistic regression analysis revealed that the plasma level of AOPPs at 1 h after operation was an independent predictor for the diagnosis of ALI (OR 1.164; 95 % CI 1.068–1.269; P = 0.001). Plasma level of AOPPs could serve as an early biomarker of the incidence of ALI in adult patients who underwent open cardiac surgery with the technique of CPB.