Publications by authors named "Linglin Jiang"

5 Publications

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Impact of acute kidney injury on in-hospital outcomes in Chinese patients with community acquired pneumonia.

BMC Pulm Med 2021 May 1;21(1):143. Epub 2021 May 1.

Department of Nephrology, Nanjing First Hospital, Nanjing Medical University, 68 Changle Road, Nanjing, 210006, Jiangsu, China.

Background: Acute kidney injury (AKI) is a frequent complication of community acquired pneumonia (CAP). However, the impact of AKI on in-hospital outcomes of patients with CAP in the Chinese population remains unclear.

Methods: Patients diagnosed with CAP were evaluated in this retrospective observational study. Multiple Cox regression models were employed to identify the association between AKI and in-hospital mortality and 30-day mortality, respectively.

Results: A total of 4213 patients were recruited; 950 (22.5%) patients were diagnosed with AKI. Independent risk factors for AKI were age, male gender, hypertension, cardiac dysfunction, diabetes, chronic kidney disease, acute respiratory failure, use of diuretics, use of vasoactive drugs, and CURB-65. Cox proportional hazards regression revealed AKI, use of angiotensin receptor blocker, hypertension, CURB-65, acute respiratory failure, and use of vasoactive drugs to be independent risk factors for both in-hospital and 30-day mortality. Compared to patients without AKI, those suffering AKI were found to have 1.31-fold (HR 1.31, 95% CI, 1.04-1.66; P = 0.023) and 1.29-fold (HR 1.29, 95% CI, 1.02-1.62; P = 0.033) increased in-hospital and 30-day mortality risks, respectively. In addition, patients with AKI were likely to require admission to intensive care unit (ICU) (42.9% versus 11.4%; P < 0.001), mechanical ventilation (33.8% versus 9.3%; P < 0.001), invasive mechanical ventilation (25.9% versus 5.8%; P < 0.001), non-invasive mechanical ventilation (25.4% versus 7.1%; P < 0.001), and experienced a longer duration of hospital stay (14 days versus 10 days; P < 0.001) than those without AKI. However, no significant difference in ICU stay (11 days versus 10 days; P = 0.099) and duration of mechanical ventilation (8 days versus 8 days; P = 0.369) between AKI and non-AKI groups was found.

Conclusion: AKI was common in Chinese patients with CAP. Patients with CAP who developed AKI had worse in-hospital outcomes.
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http://dx.doi.org/10.1186/s12890-021-01511-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8088559PMC
May 2021

Serum cystatin C: A potential predictor for hospital-acquired acute kidney injury in patients with acute exacerbation of COPD.

Chron Respir Dis 2020 Jan-Dec;17:1479973120940677

Department of Nephrology, 385685Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China.

Hospital-acquired acute kidney injury (HA-AKI) is associated with poor prognosis. In this study, we evaluated whether serum cystatin C on admission could predict AKI in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). The retrospective study was conducted using data on adult inpatients with AECOPD from January 2014 to January 2017. A total of 1035 patients were included, among which 79 (7.6%) with HA-AKI were identified. Univariate and multivariate logistic regression analyses were used to investigate predictors of HA-AKI in patients with AECOPD. HA-AKI was associated with poor prognosis, and patients with HA-AKI had higher inpatient mortality (34.2% vs. 2.6%, < 0.001). Furthermore, after adjusting for confounders, HA-AKI was an independent risk factor for inpatient mortality for patients with AECOPD (odds ratio (OR) 11.02; 95% confidence interval (CI) 4.77-25.45; < 0.001). Four independent risk factors for HA-AKI (age, levels of urea and cystatin C, and platelet count on admission) were identified in patients with AECOPD. Cystatin C (OR 5.22; 95% CI 2.49-10.95; < 0.001) was a significant independent predictor of AKI in patients with AECOPD. HA-AKI in patients with AECOPD could be identified with a sensitivity of 73.5% and a specificity of 75.9% (area under the curve (AUC) = 0.803, 95% CI 0.747-0.859) by cystatin C level (cutoff value = 1.3 mg/L) and with a sensitivity of 75.9% and a specificity of 82.0% (AUC = 0.853, 95% CI 0.810-0.896) using a model comprising all significant predictors. Serum cystatin C has the potential for use to predict the risk of HA-AKI in patients with AECOPD.
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http://dx.doi.org/10.1177/1479973120940677DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7493270PMC
September 2020

Is the Chronic Kidney Disease Epidemiology Collaboration four-level race equation better than the cystatin C equation?

Nephrology (Carlton) 2012 May;17(4):407-14

Department of Nephrology, Nanjing First Hospital Affiliated to Nanjing Medical University, Nanjing, China.

Aim: To evaluate the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) four-level race equation in the assessment of glomerular filtration rate (GFR) in Chinese people with chronic kidney disease (CKD), which was published in 2011, compared with the cystatin C-based GFR estimation equation (CysC GFR) and the combination of CysC and serum creatinine equation (CysC-Scr GFR).

Methods: The CKD-EPI four-level race equation estimated GFR (CKD-EPI GFR) was compared with the CysC GFR and CysC-Scr GFR. Three equations were compared with body surface area (BSA) standardized GFR (sGFR), which was measured by (99m) Tc-DTPA renal dynamic imaging method in 111 CKD cases.

Results: A statistically significant correlation was found between sGFR and CKD-EPI GFR, CysC GFR and CysC-Scr GFR. Three estimated GFR (eGFR) equations of 30% accuracy were 58.6%, 56.8% and 63.5%, respectively. Average deviations of eGFR from sGFR were 2.34, 1.19, and 1.32 (mL/min per 1.73 m(2)) (P > 0.05), respectively. There was no significant deviation in the CKD from stages 1 to 5 in CKD-EPI GFR and CysC-Scr GFR. However, when estimated by CysC GFR, the deviation was increased, with the value of 12.41 mL/min per 1.73 m(2) (P= 0.002) in CKD stage 5.

Conclusion: Our results showed that in a Chinese population with CKD, CKD-EPI GFR, CysC GFR and CysC-Scr GFR of bias and overall accuracy of 30% were very similar. There was little advantage in adding Asian coefficient to modifying the CKD-EPI equation. CysC GFR overestimated GFR in patients with CKD stages 4 and 5.
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http://dx.doi.org/10.1111/j.1440-1797.2012.01568.xDOI Listing
May 2012

Implication of CKD-EPI equation to estimate glomerular filtration rate in Chinese patients with chronic kidney disease.

Ren Fail 2011 18;33(9):859-65. Epub 2011 Aug 18.

Department of Nephrology, Nanjing First Hospital Affiliated to Nanjing Medical University, Nanjing, PR China.

Objective: To evaluate the applicability of the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation to estimate glomerular filtration rate (GFR) in Chinese patients of different stages of CKD.

Methods: The CKD-EPI equation estimated GFR (eGFR) was compared with body surface area standardized GFR (sGFR), which was measured by diethylenetriaminepentaacetic acid renal dynamic imaging method in 142 CKD cases.

Results: eGFR was positively correlated with sGFR (r = 0.838, p < 0.001). eGFR of 15%, 30%, and 50% accuracy were 31.0%, 57.7%, and 76.8%, respectively. Average deviation of eGFR from sGFR was -0.92 ± 16.36 mL/min/1.73 m2 (p = 0.506). There was no significant deviation in the CKD from stages 2 to 5. However, in CKD stage 1, the deviation was increased with the value of 13.36 ± 18.44 mL/min/1.73 m(2) (p = 0.023).

Conclusion: CKD-EPI equation might be widely used in evaluation of Chinese CKD patients of different stages, with a less deviation and higher accuracy. However, in CKD stage 1, eGFR was higher than sGFR on average. It was suggested that eGFR might be overcorrected or overestimated. These results demonstrated that careful modification of CKD-EPI equation would be necessary in Chinese populations with CKD.
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http://dx.doi.org/10.3109/0886022X.2011.605533DOI Listing
February 2012

Glycine-induced cytoprotection is mediated by ERK1/2 and AKT in renal cells with ATP depletion.

Eur J Cell Biol 2011 Apr 30;90(4):333-41. Epub 2010 Nov 30.

Institute of Reproductive Medicine, Nanjing Medical University, Nanjing, Jiangsu 210029, People's Republic of China.

Glycine receptor (GlyR) activation by glycine protects cells against ATP depletion. However, the underlying mechanisms remain unclear. To define signaling pathways responsible for the GlyR mediated cytoprotection, we examined the phosphorylation status of key kinases signaling pathways in Madin-Darby canine kidney (MDCK) cells. Our results indicated that growing the ATP-depleted MDCK cells in glycine-containing media increased the level of phosphorylated extracellular signal-regulated kinase 1 and 2 (ERK1/2), Ets-like transcription factor-1 (Elk1), AKT, and Forkhead box O-class 1 (FoxO1), decreased the level of phosphorylated p38 mitogen-activated protein kinase, while having little effect on the phosphorylation status of c-Jun N-terminal kinase 1 and 2. Similar phosphorylation changes in these molecules took place in the GlyRα1 stably expressing HEK-293 cell. We also showed that treating MDCK cells with ERK1/2 inhibitor PD98059 or AKT inhibitor LY294002 diminished cytoprotection against cell death by glycine, as determined by assessment of lactate dehydrogenase release and 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide activity. In contrast, treatment with p38 inhibitor SB203580 enhanced the glycine-induced cytoprotection. Finally, RNAi-mediated silencing of GlyRα1 abolished the glycine-induced changes in phosphorylation status of the above kinases in ATP-depleted cells. Taken together, our results suggest that the ERK1/2 and AKT signaling pathways are involved in the glycine-GlyR protection of MDCK cells against death induced by ATP depletion.
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http://dx.doi.org/10.1016/j.ejcb.2010.10.003DOI Listing
April 2011
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