Publications by authors named "Qinkai Chen"

30 Publications

  • Page 1 of 1

Platelet-to-Lymphocyte Ratio is Associated with the Mortality in Peritoneal Dialysis Patients.

Iran J Kidney Dis 2021 May;15(3):206-212

Department of Nephrology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, China.

Introduction: Platelet-to-lymphocyte ratio (PLR) is widely used as an inflammatory marker and is associated with poor prognosis in some diseases, such as cardiovascular diseases and malignancies. However, the association between the PLR and all-cause mortality in peritoneal dialysis (PD) patients is unclear.

Methods: A total of 939 patients were enrolled. The X-tile program was performed to calculate the optimal cut-off values for the PLR, and the patients were divided into three groups according to the cut-off values: a low PLR group (< 108.33), medium PLR group (108.33 to 257.50), and high PLR group (> 257.50). Multivariate analysis was performed to assess the prognostic value of PLR. The primary end point was all-cause mortality.

Results: Of the 939 patients, the mean age was 49.9 years, and 57% of the patients were male. During a median follow-up of 27.5 months (interquartile range, 13.6-41.6 months), 221 (23.5%) died, in whom 114 (51.6%) deaths were attributed to cardiovascular mortality. Patients in the high PLR group had a higher mortality rate than patients in the low PLR group (log rank = 13.75, P < .001). The 1-year and 3-year overall survival rates were 88.9% and 71.7% for patients in the high PLR group compared with 98.6% and 86.2% for patients in the low PLR group, respectively. Similarly, multivariate Cox regression analysis showed that the mortality rate was higher in the high PLR group than in the low PLR group (HR = 1.64, 95% CI: 1.02 to 2.63, P < .05).

Conclusion: An increased PLR value was independently associated with all-cause mortality in PD patients.
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May 2021

Efficacy and safety of a selective URAT1 inhibitor SHR4640 in Chinese subjects with hyperuricemia: a randomized controlled phase II study.

Rheumatology (Oxford) 2021 Mar 8. Epub 2021 Mar 8.

Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.

Objectives: To evaluate the efficacy and safety of SHR4640, a highly selective urate transporter 1 inhibitor in Chinese subjects with hyperuricemia.

Methods: This was a randomized double-blind dose-ranging phase II study. Subjects whose serum uric acid levels ≥480 µmol/l with gout, or sUA levels ≥480 µmol/l without gout but with comorbidities, or sUA levels ≥540 µmol/l were enrolled. Subjects were randomly assigned (1:1:1:1:1) to receive once daily 2.5 mg/5 mg/10 mg of SHR4640, 50 mg of benzbromarone, and placebo, respectively. The primary end point was the proportion of subjects achieved target sUA level of ≤ 360 µmol/l at week 5.

Results: About 99.5% of subjects (n = 197) were male and 95.9% of subjects had gout history. The proportions of subjects achieved target sUA at week 5 were 32.5%, 72.5% and 61.5% in 5 mg, 10 mg of SHR4640 and benzbromarone groups, respectively, significantly higher than placebo group (0%; p< 0.05 for 5 mg and 10 mg of SHR4640 group). The sUA was reduced by 32.7%, 46.8% and 41.8% at week 5 with 5 mg, 10 mg of SHR4640 and benzbromarone, respectively, vs placebo (5.9%; p< 0.001 for each comparison). The incidences of gout flares requiring intervention were similar among all groups. Occurrences of treatment-emergent adverse events (TEAEs) were comparable across all groups, and serious TEAEs were not reported.

Conclusions: The present study indicated a superior sUA-lowering effect, and well tolerated safety profile after 5-week treatment with once-daily 5 mg/10 mg of SHR4640 as comparing with placebo in Chinese subjects with hyperuricemia.

Trial Registration: ClinicalTrials.gov number, NCT03185793.
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http://dx.doi.org/10.1093/rheumatology/keab198DOI Listing
March 2021

A simplified protocol for individualized regional citrate anticoagulation for hemodialysis: A single-center, randomized clinical study.

Medicine (Baltimore) 2021 Feb;100(8):e24639

Department of Nephrology, The First Affiliated Hospital of Nanchang University, Jiangxi, Nanchang, China.

Introduction: The lack of individualized treatment protocols and complicated procedures are important factors limiting the use of regional citrate anticoagulation (RCA) technology in hemodialysis. This study aims to validate the safety and efficacy of a simplified individualized RCA protocol for hemodialysis.

Materials And Methods: From June 2019 to August 2019, 45 patients with active bleeding or bleeding tendency undergoing maintenance hemodialysis in the Nephrology Department of the First Affiliated Hospital of Nanchang University were randomly divided into a modified conventional RCA protocol group with a low-flux dialyzer, a simplified individualized RCA protocol group with a high-flux dialyzer, and a simplified individualized RCA protocol group with a low-flux dialyzer.

Results: A total of 45 patients were included in this study. The mean age of the patients was 57.38 ± 19.05 years, and 78% were men. Forty-three patients completed 4 hours of hemodialysis, and the median total clotting scores in the 3 groups were 11, 12, and 12. Compared with the modified conventional RCA protocol group with a low-flux dialyzer, the 2 simplified individualized RCA protocol groups had better clotting scores for the dialyzer, arterial bubble trap, and single-pool urea clearance index (spKt/VBUN) and lower costs. Moreover, these parameters did not differ between the 2 simplified individualized RCA protocol groups. No electrolyte or acid-base imbalances or citrate poisoning was observed in any of the 3 groups. Adverse events did not differ significantly among the 3 groups.

Conclusions: The simplified individualized RCA protocol is safe, effective, and easy to implement. Therefore, this protocol can be promoted for clinical practice.

Trial Registration: This study was registered in the Chinese Clinical Study Registry under registration number ChiCTR1900023801.
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http://dx.doi.org/10.1097/MD.0000000000024639DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7909225PMC
February 2021

High Neutrophil/Lymphocyte Ratio as an Independent Risk Factor for the First Occurrence of Stroke in Peritoneal Dialysis Patients.

Iran J Kidney Dis 2020 07;14(4):282-289

Department of Nephrology, The Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, China.

Introduction: Though neutrophil/lymphocyte ratio (NLR) level appears to be related with stroke events in general population, its relationship with stroke in peritoneal dialysis (PD) patients is still uncertain. This study aims to investigate the association between NLR and the first occurrence of stroke in PD patients.

Methods: In this retrospective cohort study, 1507 PD patients were enrolled from four centers in China and stratified into tertiles of NLR levels. The incidence of the first occurrence of stroke was analyzed by Kaplan-Meier cumulative incidence curve among different NLR tertiles, competing risk analysis was used to calculate the incidence of the first occurrence of stroke in the presence of competing risk of other events, multivariable COX regression analysis was performed to estimate the hazard ratios (HRs) for the first occurrence of stroke, as well as forest plot was utilized to describe the relationship between NLR and the first occurrence of stroke in different subgroups.

Results: During follow-up, 84 new-onset stroke events were recorded. Kaplan-Meier cumulative incidence curves showed significant differences in the incidence of the first occurrence of stroke among three groups (log-rank test: P < .001). In competing risk analysis, the cumulative incidence curves for tertiles of NLR levels were highly significant for the first occurrence of stroke (P < .001), but they were not statistically different for the occurrence of other events. Compared to the lowest tertile of NLR level, the highest tertile was associated with increased risk of the first occurrence of stroke in the adjusted Cox model (HR = 2.39, 95% CI: 1.37 to 4.15; P < .05). As for forest plot, there was no interaction in all subgroups.

Conclusion: High NLR was an independent risk factor for the first occurrence of stroke in PD patients.
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July 2020

Neutrophil to Lymphocyte Ratio Predicts Adverse Cardiovascular Outcome in Peritoneal Dialysis Patients Younger than 60 Years Old.

Mediators Inflamm 2020 20;2020:4634736. Epub 2020 May 20.

Department of Nephrology, The Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, China.

Background: Neutrophil to lymphocyte ratio (NLR) is a new inflammatory marker; the relationship between NLR and adverse cardiovascular (CV) prognosis has been gradually emphasized in the general population. However, their association in peritoneal dialysis (PD) patients remains unclear.

Methods: From January 1, 2010, to May 31, 2017, a total of 1652 patients were recruited. NLR was categorized in triplicates: NLR ≤ 2.74, 2.74 < NLR ≤ 3.96, and NLR > 3.96. Kaplan-Meier cumulative incidence curve and multivariable COX regression analysis were used to determine the relationship between NLR and the incidence of adverse CV outcome, while a competitive risk model was applied to assess the effects of other outcomes on adverse CV prognosis. Besides, forest plot was investigated to analyze the adverse CV prognosis in different subgroups.

Results: During follow-up, 213 new-onset CV events and 153 CV disease (CVD) deaths were recorded. Multivariable COX regression models showed that the highest tertile of NLR level was associated with increased risk of CV events (HR = 1.39, 95%CI = 1.01-1.93, = 0.046) and CVD mortality (HR = 1.81, 95%CI = 1.22-2.69, = 0.003), while compared to the lowest tertile. Competitive risk models showed that the differences in CV event ( < 0.001) and CVD mortality ( = 0.004) among different NLR groups were still significant while excluding the effects of other outcomes. In subgroups, with each 1 increased in the NLR level, adjusted HR of new-onset CV event was 2.02 (95%CI = 1.26 - 3.23, = 0.003) and CVD mortality was 2.98 (95%CI = 1.58 - 5.62, = 0.001) in the younger group (age < 60 years).

Conclusions: NLR is an independent risk factor for adverse CV prognosis in PD patients younger than 60 years old.
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http://dx.doi.org/10.1155/2020/4634736DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7256716PMC
May 2020

Efficacy and safety of Abelmoschus manihot for IgA nephropathy: A multicenter randomized clinical trial.

Phytomedicine 2020 May 18;76:153231. Epub 2020 May 18.

Department of Nephrology, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Chinese PLA General Hospital, Chinese PLA Medical School, Beijing 100853, China. Electronic address:

Rationale And Objective: IgA nephropathy (IgAN) is an important cause for end-stage renal disease worldwide. The treatment for IgAN remains challenging, and few randomized and controlled clinical trials have been conducted to evaluate new therapies. The present study assesses the efficacy and safety of Abelmoschus manihot (AM) in IgAN patients.

Study Design: Randomized, non-inferiority, double-blind, double-dummy multicenter trial.

Setting And Participants: This trial was designed to recruit 1,600 biopsy-proven IgAN patients (proteinuria between 0.5-3.0 g/d and estimated glomerular filtration rate [eGFR] of ≥ 45 ml/min/1.73 m) across China.

Interventions: The participants were randomized at 1:1 to AM (2.5 g for three times per day) or losartan potassium (100 mg per day) for 48 weeks.

Outcomes: The primary outcome was the change in 24-hour proteinuria from baseline to week 48. The secondary outcomes were the change in eGFR from baseline to week 48, and the incidents of endpoint events (proteinuria ≥ 3.5 g/24 h, doubling of serum creatinine, or receiving renal replacement treatment).

Results: Among 1,470 randomized patients (mean age, 37.4 [SD, 10.6] years old; 777 [52.9%] were female; mean eGFR, 95.0 [SD, 24.3] mL/min/1.73 m; mean 24-hour proteinuria, 1.2 [SD, 0.7] g/d), the mean decline in 24-h proteinuria at week 48 was 230 mg and 253 mg in the AM and losartan potassium groups, respectively (P = 0.676). The mean difference in the change in 24-h proteinuria between these two groups was -23.32 mg (95% confident interval: -123.2 to 76.6, p = 0.647). The mean decline in eGFR was 0.41 ml/min/1.73 m and 0.76 ml/min/1.73 m in the AM and losartan potassium groups, respectively (p = 0.661). The mean difference in the change in eGFR between these two groups was -0.43 ml/min/1.73 m (95% confident interval: -1.99 to 1.13, p = 0.589). The incidence of endpoint events was 8.6% in the AM group and 8.2% in the losartan group (p = 0.851).

Limitations: The results of the trial may not be generalized to IgAN patients with a proteinuria of > 3.0 g/d and an eGFR of < 45 ml/min/1.73 m. The long-term benefits of AM in reducing the risk of progressive renal dysfunction remains unclear, based on this 48-week observation.

Conclusion: AM can be recommended as a promising treatment for IgAN patients.
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http://dx.doi.org/10.1016/j.phymed.2020.153231DOI Listing
May 2020

The relationship between neutrophil-to-lymphocyte ratio and the first occurrence of pneumonia in peritoneal dialysis patients.

Clin Exp Nephrol 2020 Sep 25;24(9):770-778. Epub 2020 Apr 25.

Department of Nephrology, The Second Affiliated Hospital, Guangzhou Medical University, 250th, Chang Gang East Road, Guangzhou, 510260, China.

Background: Although neutrophil-to-lymphocyte ratio (NLR) is closely associated with pneumonia in the general population, its relationship is unclear in peritoneal dialysis (PD) patients.

Methods: This is a cohort study consisting of 739 PD patients and dividing into two groups. Kaplan-Meier curves were applied to observe the incidence of the first occurrence of pneumonia, competitive risk analysis was conducted to compare whether there was a significant difference in each NLR group in the presence of other competing events, multivariable COX regression analysis was used to evaluate the hazard ratios (HRs), as well as forest plot was used to analyze the relationship between NLR and the first occurrence of pneumonia in different subgroups.

Results: Of all the patients, 116 cases of first-time pneumonia were recorded. The first-time pneumonia incidence rate was 71.67/1000 patient-years in high NLR group, which was markedly higher than that of 45.81/1000 patient-years in low NLR group. Kaplan-Meier curves indicated significant differences in the incidence of the first occurrence of pneumonia between two groups (log-rank test p = 0.015). The competitive risk model suggested a significant difference in the cumulative incidence of first pneumonia between the two groups (p = 0.032). Compared to low NLR group, adjusted Cox model showed that high NLR group was associated with increased risk of pneumonia incidence (HR, 1.51; 95% CI 1.04-2.21; p = 0.031). Forest plot showed no interaction was found in subgroups.

Conclusions: The risk of pneumonia was significantly increasing in PD patients with high NLR, which may have a certain guiding significance for the clinic.
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http://dx.doi.org/10.1007/s10157-020-01894-9DOI Listing
September 2020

Effect of CKD-MBD phenotype on health-related quality of life in patients receiving maintenance hemodialysis: A cross-sectional study.

J Int Med Res 2020 Feb;48(2):300060519895844

Department of Nephrology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, P.R. China.

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http://dx.doi.org/10.1177/0300060519895844DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7105727PMC
February 2020

Triglyceride to high-density lipoprotein cholesterol ratio is associated with increased mortality in older patients on peritoneal dialysis.

Lipids Health Dis 2019 Nov 15;18(1):199. Epub 2019 Nov 15.

Department of Nephrology, The First Affiliated Hospital of Nanchang University, 17# Yongwai Street, Nanchang, 330006, China.

Background: The triglyceride (TG) to high-density lipoprotein cholesterol (HDL-C) ratio (TG/HDL-C) has been suggested as a simple method to identify unfavorable cardiovascular (CV) outcomes in the general population. The aim of this study was to investigate the association between the TG/HDL-C ratio and all-cause and CV mortality in peritoneal dialysis (PD) patients.

Methods: We retrospectively analyzed patients on PD from November 1, 2005, to February 28, 2017, with a follow-up period lasting until May 31, 2017. The main outcomes were all-cause and CV mortality.

Results: Among the 973 PD patients, the mean age was 49.67 ± 14.58 (y). During a median follow-up period of 27.2 months (IQR = 13.4-41.5 months), 229 (23.5%) patients died, with 120 (12.3%) dying as a result of CV diseases. The median serum TG/HDL-C ratio was 1.11 (IQR = 0.71-1.80). In a multivariate Cox regression analysis, patients with higher TG/HDL-C ratio levels (tertile 3) had a higher incidence of CV mortality (adjusted HR = 2.12; 95% CI: 1.21-3.72; P = 0.009) and all-cause mortality (adjusted HR = 2.08; 95% CI: 1.37-3.14; P = 0.001) compared to patients in tertile 1. These associations persisted after excluding the patients who have already taken lipid-lowering medications. For older patients (> 60 years), each 1-unit higher baseline TG/HDL-C level was associated with a 48% (95% CI: 1.06-2.07; P = 0.021) increased risk of all-cause mortality and a 59% (95% CI: 1.03-2.45; P = 0.038) increased risk of CV mortality; however, this association was not observed in patients ≤60 years of age.

Conclusions: A higher serum TG/HDL-C ratio was an independent predictor of all-cause and CV mortality in PD patients. Furthermore, an elevated TG/HDL-C ratio was significantly associated with higher all-cause and CV mortality in older PD patients.
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http://dx.doi.org/10.1186/s12944-019-1147-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6858755PMC
November 2019

BRAIN FUNCTION ALTERATIONS IN PATIENTS WITH DIABETIC NEPHROPATHY COMPLICATED BY RETINOPATHY UNDER RESTING STATE CONDITIONS ASSESSED BY VOXEL-MIRRORED HOMOTOPIC CONNECTIVITY.

Endocr Pract 2020 Mar 4;26(3):291-298. Epub 2019 Nov 4.

The voxel-mirrored homologous connection (VHMC) technique was applied to detect resting brain function alterations in patients with diabetic nephropathy and retinopathy (DNR), and their relationships with clinical manifestations in the kidneys and eyes are discussed. Twenty-two patients with DNR and 22 healthy controls (HCs) similarly matched in age, sex, and educational background were recruited. Resting-state functional magnetic resonance imaging scans were performed for all subjects. Retinal fundus photography and renal biopsy were employed to observe the clinical features of the kidney and retina. Pearson correlation analysis was used to analyze the relationship between clinical manifestations and experimental results. Compared with the HCs, patients with DNR showed decreased mean VMHC values in the bilateral middle temporal gyrus, bilateral middle occipital gyrus (BMOG), and bilateral medial frontal gyrus. The receiver operating characteristic curve analysis of each brain region confirmed that the accuracy of the area under the curve was excellent. The results showed that the average VHMC value of BMOG signals was positively correlated with the urinary protein to creatinine ratio in female subjects ( = 0.626; <.05). Nonetheless, no such correlation was noted among the male subjects. There were significant changes in brain function in DNR patients compared to the control group. Changes in the central nervous system in patients with DNR were mainly due to the dual negative effects of kidney function and diabetes mellitus. = albumin/creatinine ratio; = bilateral medial frontal gyrus; = bilateral middle occipital gyrus; = bilateral middle temporal gyrus; = diabetic nephropathy; = diabetic nephropathy complicated by retinopathy; = diabetic retinopathy; = functional magnetic resonance imaging; = healthy control; = magnetic resonance imaging; = protein to creatinine ratio; = receiver operating characteristic; = voxel-mirrored homologous connection.
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http://dx.doi.org/10.4158/EP-2019-0355DOI Listing
March 2020

Serum alkaline phosphatase levels correlate with long-term mortality solely in peritoneal dialysis patients with residual renal function.

Ren Fail 2019 Nov;41(1):718-725

a Department of Nephrology, The First Affiliated Hospital of Nanchang University , Nanchang , China.

Increased serum alkaline phosphatase (ALP) is predictive of a higher mortality in patients with end-stage renal disease. However, it remains unknown whether residual renal function (RRF) influences the outcome-association of serum ALP among peritoneal dialysis (PD) patients. A total of 650 incident PD patients receiving PD catheter implantation in an institute between 1 November 2005 and 28 February 2017 were retrospectively enrolled. These patients were divided into groups with and without RRF (RRF and non-RRF groups) and those with serum ALP levels in tertiles. The Kaplan-Meier method and multivariate Cox proportional hazard models were used to analyze their outcomes based on RRF and serum ALP levels. These 650 patients had a mean age of 49.4 ± 14.0 years old, their median ALP level was 74 U/L (interquartile range (IQR): 59-98). After 28-month (IQR: 14-41) follow-up, 80 patients in RRF group and 40 patients in non-RRF group died. PD patients with the highest serum ALP tertile had significant lower survival ( = .014), when compared to other patients in the RRF group. However, this relationship was not observed in patients in the non-RRF group. After multivariate adjustment, in the RRF group, patients with the highest ALP tertile had a significantly higher risk of mortality (hazard ratio (HR): 2.26, 95% confidence interval (CI): 1.06-4.82,  = .034). Each 10-U/L increase in ALP level was associated with a 4% (HR: 1.04, 95% CI: 1.00-1.08,  = .045) higher mortality risk. Higher serum ALP level is associated with increased mortality solely in PD patients with RRF.
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http://dx.doi.org/10.1080/0886022X.2019.1646662DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6713195PMC
November 2019

Relationship between serum bilirubin levels and mortality in patients on peritoneal dialysis.

Ren Fail 2019 Nov;41(1):532-539

a Department of Nephrology , The First Affiliated Hospital of Nanchang University , Nanchang , Jiangxi , China.

Studies have shown that the serum total bilirubin (TBil) is associated with the mortality of the general population and of hemodialysis patients. However, few studies have examined the associations of the direct bilirubin (DBil) and indirect bilirubin (IBil) with the mortality of peritoneal dialysis (PD) patients. This was a retrospective cohort study. Clinical and laboratory data were collected from 740 PD patients. The primary endpoint was 5-year all-cause mortality. Survival analysis was performed using the Kaplan-Meier method with the log-rank test. The mortality hazard ratio was evaluated using Cox regression models. Among the 740 PD patients, the mean age was 49.9 ± 15.0 years, 54.9% were men, and 20.3% had diabetes. During the median follow-up period of 28 months (interquartile range, 14-41 months), 178 patients died. Kaplan-Meier analysis revealed that all-cause mortality was higher in the patients in the higher TBil group than in the lower TBil group (25.6% vs. 18.3%,  = .017) and in patients in the higher IBil group than in the lower IBil group (24.3% vs. 19%,  = .026). Multivariate analysis showed that compared with the lower TBil group, the 5-year mortality risk was higher in the higher TBil group (HR = 1.69, 95% CI: 1.11-2.56,  = .014). Similarly, there was a 56% higher risk of 5-year mortality in the higher IBil group than in the lower IBil group (HR = 1.56, 95% CI: 1.04-2.34,  = .032). However, no such associations were observed between the DBil and the mortality risk. The baseline serum TBil and IBil levels were significantly associated with 5-year all-cause mortality among PD patients.
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http://dx.doi.org/10.1080/0886022X.2019.1628062DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6598530PMC
November 2019

Effects of Sustained-Release Beraprost in Patients With Primary Glomerular Disease or Nephrosclerosis: CASSIOPEIR Study Results.

Ther Apher Dial 2020 Feb 28;24(1):42-55. Epub 2019 Jul 28.

The University of Tokyo, Tokyo, Japan.

TRK-100STP, a sustained-release preparation of the orally active prostacyclin analogue beraprost sodium, targets renal hypoxia. This study aimed to show the superiority of TRK-100STP over placebos in patients with chronic kidney disease (with either primary glomerular disease or nephrosclerosis) to determine the recommended dose. CASSIOPEIR (Chronic Renal Failure Asian Study with Oral PGI Derivative for Evaluating Improvement of Renal Function) was a randomized, double-blind, placebo-controlled study conducted at 160 sites in seven Asia-Pacific countries and regions. Eligible patients (n = 892) were randomized to TRK-100STP 120, 240 μg, or placebo for a treatment period of up to 4 years. The primary efficacy endpoint was time to first occurrence of a renal composite: doubling of serum creatinine or occurrence of end-stage renal disease. No significant differences were observed in composite endpoints between TRK-100STP and placebo (P = 0.5674). Hazard ratios (95% CI) in the TRK-100STP 120 and 240 μg vs. placebo groups were 0.98 (0.78, 1.22) and 0.91 (0.72, 1.14), respectively. The overall incidence of adverse events and adverse drug reactions was comparable between treatment arms.
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http://dx.doi.org/10.1111/1744-9987.12840DOI Listing
February 2020

Novel long non-coding RNA AV310809 promotes TGF-β1 induced epithelial-mesenchymal transition of human peritoneal mesothelial cells via activation of the Wnt2/β-catenin signaling pathway.

Biochem Biophys Res Commun 2019 05 30;513(1):119-126. Epub 2019 Mar 30.

Department of Nephrology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, 330006, China. Electronic address:

Peritoneal fibrosis (PF) is a crucial cause of the loss of peritoneal function in patients with peritoneal dialysis. To better understand the underlying mechanism of PF, we selected AV310809, which is one of the most highly upregulated lncRNA in fibrotic peritoneal tissue, for functional analysis. We used co-expression analysis to explore the potential relationship between AV310809 and coding genes. qPCR, WB and IF were applied to evaluate the expression and localization of AV310809, epithelial markers and proteins involved in the Wnt2/β-catenin signaling pathway. The interaction between AV310809 and β-catenin was examined using an RNA pulldown assay. The expression level of AV310809 was upregulated in fibrotic peritoneum and TGF-β1 induced EMT in HPMCs. Ectopic overexpression of AV310809 promoted EMT and activated the Wnt2/β-catenin signaling pathway. Furthermore, we demonstrated that AV310809 could interact with β-catenin and blocking β-catenin inhibited the augmentation of EMT by AV310809. These findings indicated that AV310809 promoted TGF-β1-induced EMT in HPMCs through the activation of the Wnt2/β-catenin signaling pathway, possibly by targeting β-catenin. We suggest that AV310809 may be a new therapeutic target for the management of peritoneal dialysis-associated PF.
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http://dx.doi.org/10.1016/j.bbrc.2019.03.071DOI Listing
May 2019

MiR-200a ameliorates peritoneal fibrosis and functional deterioration in a rat model of peritoneal dialysis.

Int Urol Nephrol 2019 May 19;51(5):889-896. Epub 2019 Mar 19.

Department of Nephrology, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi, China.

Peritoneal fibrosis is recognised as the main cause of the technical failure of peritoneal dialysis (PD), and currently, there are no specific and effective anti-fibrosis therapies. We have found that miR-200a is down-regulated in a rat model of PD-related peritoneal fibrosis (PF) and could inhibit transforming growth factor beta 1 (TGF-β1)-induced epithelial-mesenchymal transition (EMT) in peritoneal mesothelial cells by target ZEB1/2. However, its treatment role in vivo is still largely unclear. In this study, we examined the therapeutic potential for miR-200a on PD-related PF in a rat model of PD induced by daily infusion of 4.25% dextrose-containing dialysate. Male Sprague-Dawley rats were divided into four groups: control group, PD group, PD + miR-agomir-NC group, and PD + miR-200a-agomir group (n = 5 in each group). MiR-200a agomir was delivered into the peritoneum by intra-peritoneal injection on days 10 and 20 after PD. We found that treatment with miR-200a agomir significantly reduced the collagen volume fraction (CVF) of the peritoneum and prevented peritoneal dysfunction. The up-regulation of the EMT marker (decreased E-cadherin and increased α-smooth muscle actin) and extracellular matrix (fibronectin and collagen I) was significantly ameliorated by miR-200a in the PD + miR-200a-agomir group. Furthermore, we demonstrated that miR-200a inhibition of PF in vivo was associated with the suppression of ZEB1 and 2, which were proved to be the target of miR-200a in our previous study. In conclusion, results from the present study suggest that treatment with miR-200a may represent a novel and effective therapy for PD-related PF.
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http://dx.doi.org/10.1007/s11255-019-02122-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6499761PMC
May 2019

Celastrol antagonizes high glucose-evoked podocyte injury, inflammation and insulin resistance by restoring the HO-1-mediated autophagy pathway.

Mol Immunol 2018 12 12;104:61-68. Epub 2018 Nov 12.

Department of Nephrology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, 330006, China. Electronic address:

Diabetic nephropathy (DN) contributes to end-stage renal disease and kidney dysfunction with a proverbial feature of podocyte injury. Inflammation and insulin resistance is recently implicated in the pathogenesis of diabetic kidney injury. Celastrol exerts critical roles in inflammatory diseases and injury progression. However, its function and mechanism in DN remains elusive. Here, celastrol dose-dependently restored podocyte viability under high glucose (HG) conditions, but with little cytotoxicity in podocyte. Preconditioning with celastrol counteracted HG-evoked cell apoptosis, LDH release, ROS production and podocyte depletion. Additionally, HG-elevated high transcripts and secretions of pro-inflammatory cytokines were reversed following celastrol treatment, including IL-1β, TNF-α, IL-6. Simultaneously, the inhibitory effects of HG on insulin-triggered glucose uptake and nephrin expression were overturned after celastrol exposure. Intriguingly, celastrol restored HG-induced deficiency of autophagy pathway. Nevertheless, blocking the autophagy signaling by its antagonist 3-MA muted celastrol-protected against HG-evoked cell injury, inflammation and insulin resistance. Importantly, celastrol enhanced heme oxygenase-1 (HO-1) expression in HG-stimulated podocytes. Notably, HO-1 cessation depressed autophagy pathway activation and subsequently blunted beneficial effects of celastrol on HG-exposed podocytes. These finding suggest that celastrol may protect against HG-induced podocyte injury, inflammation and insulin resistance by restoring HO-1-mediated autophagy pathway, implying a promising therapeutic strategy against DN.
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http://dx.doi.org/10.1016/j.molimm.2018.10.021DOI Listing
December 2018

Leflunomide versus cyclophosphamide in the induction treatment of proliferative lupus nephritis in Chinese patients: a randomized trial.

Clin Rheumatol 2019 Mar 13;38(3):859-867. Epub 2018 Nov 13.

Department of Nephrology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.

Objectives: A prospective, multi-center, randomized controlled study was conducted to evaluate the efficacy and safety of a 24-week course low-dose leflunomide combined with prednisone in the induction treatment of proliferative lupus nephritis in Chinese patients.

Method: Patients (n = 100) with biopsy-proved proliferative lupus nephritis were enrolled in this study. They were randomized into two groups and received either leflunomide or cyclophosphamide in conjunction with prednisone for 24 weeks. Leflunomide was given orally with a loading dose of 40 mg/day for 3 days followed by 20 mg/day. Intravenous cyclophosphamide was administered monthly at a dosage of 0.8-1.0 g. The primary efficacy outcome was the frequency of complete remission and partial remission at week 24. The secondary outcomes included changes of urinary protein excretion, serum albumin, complement 3, anti-dsDNA antibody level, and systemic lupus erythematosus disease activity index (SLEDAI) after 24-week therapy.

Results: Of 100 patients, 48 received leflunomide combined with prednisone and other 52 received cyclophosphamide with concomitant prednisone. There were no statistically significant differences between groups in complete remission rate and partial remission rate. At week 24, 23% of patients in the leflunomide group and 27% of patients in the cyclophosphamide group achieved complete remission (P = 0.64), while 56% of patients in the leflunomide group and 42% of patients in the cyclophosphamide group achieved partial remission at week 24 (P = 0.16). SLEDAI, serum albumin, complement 3, anti-dsDNA antibody level, and urinary protein excretion improved significantly in both groups. No significant difference was seen in the changes of clinical parameters after therapy between the two groups. There was no significant difference in side effects in both groups.

Conclusions: Compared with cyclophosphamide, low-dose leflunomide in combination with prednisone showed both effectiveness and safety in the induction therapy of proliferative lupus nephritis in Chinese patients.
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http://dx.doi.org/10.1007/s10067-018-4348-zDOI Listing
March 2019

Association of Preoperative Mean Arterial Pressure With the Primary Failure of Brescia-Cimino Arteriovenous Fistula Within the First 7 Days Following Surgery in Hemodialysis Patients.

Ther Apher Dial 2018 Oct 20;22(5):539-543. Epub 2018 Jun 20.

Department of Nephrology, First Affiliated Hospital of Nanchang University, Nanchang, China.

This retrospective study included 1051 patients with end-stage kidney disease and Brescia-Cimino arteriovenous fistula (AVF) (excluding pre-dialysis patients), and aimed to investigate the role of blood pressure in AVF primary failure. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured twice daily for 3 days before surgery. The success (N = 1010) and failure (N = 41) groups were based on AVF primary failure within 7 days of surgery. The cephalic vein was larger and the preoperative mean arterial pressure (MAP) was higher in the success group compared with the failure group (P < 0.05). Cephalic vein diameter and preoperative MAP independently predicted AVF primary failure within 7 days after surgery. In conclusion, small cephalic vein diameter and low preoperative MAP were associated with AVF primary failure within 7 days of surgery.
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http://dx.doi.org/10.1111/1744-9987.12670DOI Listing
October 2018

Apolipoprotein B/apolipoprotein A1 ratio and mortality among incident peritoneal dialysis patients.

Lipids Health Dis 2018 May 17;17(1):117. Epub 2018 May 17.

Department of Nephrology, The First Affiliated Hospital of Nanchang University, 17# yongwai street, Nanchang, 330006, Jiangxi, China.

Background: To investigate the association between the ratio of apolipoprotein B (apo B) / apolipoprotein A1 (apo A1) with all-cause mortality and cardiovascular events in peritoneal dialysis (PD) patients.

Methods: Eight hundred and sixty incident PD patients were enrolled from November 1, 2005, to February 28, 2017, and followed until May 31, 2017. Outcomes were all-cause mortality and cardiovascular events. Associations between the apo B/apo A1 ratio with all-cause mortality and cardiovascular events were evaluated using multivariable-adjusted Cox models.

Results: Of the 860 patients, the mean age was 49.9 ± 14.5 years, 57.6% were men, and 19.3% were diabetic patients. The median apo B/apo A1 ratio was 0.65 (range: 0.22-2.24). During a median follow-up period of 27 months (interquartile range, 13 - 41 months), 202 deaths, and 145 cardiovascular events were recorded. After adjustment for age, sex, body mass index, diabetes, cardiovascular disease, systolic blood pressure, total Kt/V, estimated glomerular filtration rate, hemoglobin level, neutrophil to lymphocyte ratio and albumin, triglyceride, and cholesterol, as well as the use of lipid-lowering agents, the highest apo B/apo A1 ratio tertile was significantly associated with a hazard ratio for all-cause mortality of 1.60 (95% CI: 1.02 to 2.49, P = 0.040) and for cardiovascular events of 2.04 (95% CI: 1.21 to 3.44, P = 0.008).

Conclusion: An increased apo B/apo A1 ratio was independently associated with all-cause mortality and cardiovascular events in PD patients.
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http://dx.doi.org/10.1186/s12944-018-0771-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5960196PMC
May 2018

A meta-analysis of the association between diabetic patients and AVF failure in dialysis.

Ren Fail 2018 Nov;40(1):379-383

a Department of Nephrology , The First Affiliated Hospital, Nanchang University , Nanchang , Jiangxi , People's Republic of China.

Purpose: The most preferable vascular access for patients with end-stage renal failure needing hemodialysis is native arteriovenous fistula (AVF) on account of its access longevity, patient morbidity, hospitalization costs, lower risks of infection and fewer incidence of thrombotic complications. Meanwhile, according to National Kidney Foundation (NKF)̸Dialysis Out-comes Quality Initiative (DOQI) guidelines, AVF is more used than before. However, a significant percentage of AVF fails to support dialysis therapy due to lack of adequate maturity. Among all factors, the presence of diabetes mellitus was shown to be one of the risk factors for the development of vascular access failure by some authors. Therefore, this review evaluates the current evidence concerning the correlation of diabetes and AVF failure.

Methods: A search was conducted using MEDLINE, SCIENCE DIRECT, SPRINGER, WILEY-BLACKWELL, KARGER, EMbase, CNKI and WanFang Data from the establishment time of databases to January 2016. The analysis involved studies that contained subgroups of diabetic patients and compared their outcomes with those of non-diabetic adults. In total, 23 articles were retrieved and included in the review.

Results: The meta-analysis revealed a statistically significantly higher rate of AVF failure in diabetic patients compared with non-diabetic patients (OR = 1.682; 95% CI, 1.429-1.981, Test of OR = 1: z = 6.25, p <.001).

Conclusions: This review found an increased risk of AVF failure in diabetes patients. If confirmed by further prospective studies, preventive measure should be considered when planning AVF in diabetic patients.
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http://dx.doi.org/10.1080/0886022X.2018.1456464DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6014481PMC
November 2018

Differential expression profile of long non-coding RNA in the stenosis tissue of arteriovenous fistula.

Gene 2018 Jul 12;664:127-138. Epub 2018 Apr 12.

Department of Urology, First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People's Republic of China. Electronic address:

Objective: To analyze and preliminarily validate the lncRNA expression profiles in the stenosis tissue of arteriovenous fistula (AVF).

Methods: A total of 54 uremic patients administered in the department of nephrology in the First Affiliated Hospital of Nanchang University between February 2017 and March 2017 were included in the study and subsequently categorized as experimental group, which included 12 patients with confirmed diagnosis of AVF, and control group which included 42 patients with no vascular stenosis. The experimental group inclusion criteria include: AVF used >3 months; The blood flow of AVF <200 mL/min; the degree of the stenosis was >50%, excluded obvious thrombosis; The ultrasonographic data of AVF stenosis is complete. The controls were randomly selected from uremic patients who were primary AVF operation, excluded obvious vascular stenosis and vascular diseases. Among them, 4 sample in the experimental group and 4 controls were used in LncRNA sequencing. RNA in vascular tissue was extracted by Trizol and IncRNA sequencing was used to establish the expression profiles of lncRNA in the stenosis tissue of AVF.9 difference expression lncRNA were collected for validating in AVF stenosis cases by using quantitative real-time polymerase chain reaction (qRT-PCR). Moreover, Cluster analysis, gene functional analysis and pathway analysis were used to explore the function of difference expression lncRNA.

Results: Among the 27,692 lncRNA transcripts examined, 247 lncRNAs were found to be significantly differentially expressed (P < 0.05, fold change ≥2) in the experimental group and control group, with 141 being up-regulated and 106 down-regulated. The expression levels of 9 lncRNAs validated by subsequent qRT-PCR were shown to be highly consistent with the sequencing data.

Conclusion: Our study revealed lncRNAs expression profiles in the stenosis tissue of AVF by LncRNA sequencing. These lncRNAs and its related signaling pathways may play a key role in the occurrence and progression of AVF stenosis.
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http://dx.doi.org/10.1016/j.gene.2018.04.028DOI Listing
July 2018

MiR-200a negatively regulates TGF-β-induced epithelial-mesenchymal transition of peritoneal mesothelial cells by targeting ZEB1/2 expression.

Am J Physiol Renal Physiol 2018 06 10;314(6):F1087-F1095. Epub 2018 Jan 10.

Department of Nephrology, The First Affiliated Hospital of Nanchang University , Nanchang, Jiangxi , China.

Although epithelial-mesenchymal transition (EMT) of peritoneal mesothelial cells was recognized as the key process of peritoneal fibrosis, which is a major cause of peritoneal failure related to peritoneal dialysis (PD), mechanisms underlying these processes remain largely unknown. In this study, we found that miR-200a was significantly downregulated in peritoneal tissues with fibrosis in a rat model of PD. In vitro, transforming growth factor (TGF)-β-induced EMT, identified by de novo expression of α-smooth muscle actin and a loss of E-cadherin in human peritoneal mesothelial cells (HPMCs), was associated with downregulation of miR-200a but upregulation of zinc finger E-box-binding homeobox 1/2 (ZEB1/2), suggesting a close link between miR-200a and ZEB1/2 in TGF-β-induced EMT. It was further demonstrated that miR-200a was able to bind to the 3'UTR of ZEB1/2, and overexpression of miR-200a blocked TGF-β-induced upregulation of ZEB1/2 and, therefore, inhibited EMT and collagen expression. In contrast, overexpression ZEB1/2 blocked miR-200a inhibition of EMT and collagen expression in HMPCs. In conclusion, miR-200a could negatively regulate TGF-β-induced EMT by targeting ZEB1/2 in peritoneal mesothelial cells. Blockade of EMT in HPMCS indicates the therapeutic potential of miR-200a as a treatment for peritoneal fibrosis associated with PD.
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http://dx.doi.org/10.1152/ajprenal.00566.2016DOI Listing
June 2018

TGF-β1 mimics the effect of IL-4 on the glycosylation of IgA1 by downregulating core 1 β1, 3-galactosyltransferase and Cosmc.

Mol Med Rep 2017 Feb 29;15(2):969-974. Epub 2016 Dec 29.

Department of Nephrology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China.

The aberrant glycosylation of IgA1 is pivotal in the pathogenesis of IgA nephropathy (IgAN). The aim of the present study was to investigate the effect of transforming growth factor‑β1 (TGF‑β1) on the glycosylation of IgA1 and the associated mechanism. The mRNA levels of core1 β1, 3-galactosyltransferase (C1GalT1) and its molecular chaperone, Cosmc, were analyzed, as was the subsequent O-glycosylation of IgA1, in a human B‑cell line stimulated with TGF‑β1. The IgA1‑positive human B‑cell line was cultured with different concentrations of recombinant human TGF‑β1 (5, 10, 15 and 30 ng/ml). The production and glycosylation of IgA1 were assayed using sandwich ELISA and enzyme‑linked lectin binding assays, respectively, and the mRNA levels of C1GalT1 and Cosmc were quantified using reverse transcription‑quantitative polymerase chain reaction analysis. The results showed that the production of IgA1 was stimulated by low concentrations of TGF‑β1 (5 or 10 ng/ml) and was suppressed by high concentrations (15 or 30 ng/ml). The terminal glycosylation of secreted IgA1 was altered in response to TGF‑β1. TGF‑β1 stimulation significantly decreased the mRNA levels of C1GalT1 and Cosmc. TGF‑β1 may be key in controlling the glycosylation of IgA1, in part via the downregulation of C1GalT1 and Cosmc.
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http://dx.doi.org/10.3892/mmr.2016.6084DOI Listing
February 2017

A nationwide cross-sectional survey on prevalence, management and pharmacoepidemiology patterns on hypertension in Chinese patients with chronic kidney disease.

Sci Rep 2016 12 20;6:38768. Epub 2016 Dec 20.

Department of Nephrology, Ruijin Hospital Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.

Limited data are available on epidemiology and drug use in Chinese hypertensive patients with chronic kidney disease (CKD). We determined the prevalence; awareness, treatment, and control rates of hypertension; anti-hypertensive use, expenditure pattern; and factors associated with hypertension prevalence and control in Chinese patients with CKD. This was one of the largest cross-sectional surveys that enrolled 6079 CKD participants (mean age, 51.0 ± 16.37 years) with or without hypertension from 22 centres across China. The prevalence, awareness, and treatment rates were 71.2%, 95.4%, and 93.7%, respectively. Control rates 1 and 2 (Blood pressure, BP <140/90 and <130/80 mmHg) were 41.1% and 15.0%, respectively. Patients were treated mostly with monotherapy (37.7%) or 2-drug anti-hypertensive combination (38.7%). Factors associated with prevalence of hypertension included age; smoking; body mass index; physical exercise; family history of hypertension; hyperuricaemia; and CKD. Control rate was associated with CKD stage, BP monitoring at home, and use of drug combinations. Despite high rates of awareness and treatment, the control rates are low. CKD stages 4 and 5 adversely affect the control rate. The results suggest the immediate need of comprehensive controlling measures to improve the control of hypertension in Chinese patients with CKD.
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http://dx.doi.org/10.1038/srep38768DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5171924PMC
December 2016

Immunosuppressive agents versus steroids in the treatment of IgA nephropathy-induced proteinuria: A meta-analysis.

Exp Ther Med 2016 01 12;11(1):49-56. Epub 2015 Nov 12.

Department of Nephrology, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi 330006, P.R. China.

Immunoglobulin A nephropathy (IgAN) is one of the most common types of primary glomerular disease. Immunosuppressive treatment for patients with IgAN remains controversial. The present meta-analysis aimed to assess the efficacy and safety of various immunosuppressive agents compared with steroids in patients with IgAN and moderate to severe proteinuria. PubMed, EMBASE, Cochrane Library, Chinese National Knowledge Infrastructure, Wanfang, Weipu, Chinese Biomedical Literature Database and Qinghuatongfang were searched for relevant randomized controlled trials (RCTs) published between 1990 and September 2013. All eligible studies (biopsy proven IgA nephropathy, use of immunosuppressive agents) measured urinary protein excretion and proteinuria remission. Data were analyzed with the random effects model using Review Manager. A total of 29 RCTs were included, involving 1,466 patients. Compared with steroids, immunosuppressive agents, including azathioprine [corrected] (AZA) [complete response (CR)/partial response (PR); relative risk (RR), 3.43; 95% confidence interval (CI) 1.92-6.12; P<0.0001], mycophenolate mofetil (MMF) (CR/PR; RR, 2.19; 95% CI, 1.25-3.85; P=0.006) and leflunomide (LET) (CR/PR; RR, 2.64; 95% CI, 1.80-3.86; P<0.00001) resulted in increased partial or complete proteinuria remission. Cyclophosphamide (CTX) resulted in a higher reduction of urinary protein excretion than steroids (SMD, 0.91; 95% CI, 0.41-1.41; P=0.0004)). Compared to CTX, LET showed higher effectiveness (CR/PR; RR, 2.01; 95% CI, 1.08-3.75; P=0.03) with a lower incidence of adverse events. The present meta-analysis, which is based on IgAN patients, suggested that AZA, MMF, LET and CTX are effective in reducing proteinuria levels, with acceptable side effects. Therefore, immunosuppressive agents may be considered promising therapeutic agents for the treatment of IgAN and should be investigated further in large sample size, high-quality studies.
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http://dx.doi.org/10.3892/etm.2015.2860DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4726883PMC
January 2016

The expression profiling and ontology analysis of noncoding RNAs in peritoneal fibrosis induced by peritoneal dialysis fluid.

Gene 2015 Jun 28;564(2):210-9. Epub 2015 Mar 28.

Department of Nephrology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, China. Electronic address:

Increasing amounts of evidence have indicated that noncoding RNAs (ncRNAs) have important regulatory potential in various biological processes. However, the contributions of ncRNAs, especially long noncoding RNAs (lncRNAs), to peritoneal fibrosis remain largely unknown. The aim of this study was to investigate miRNA, lncRNA and mRNA expression profiles and their potential roles in the process of peritoneal fibrosis. Microarray expression profiles of the miRNAs, lncRNAs and mRNAs were determined in normal control peritoneum and in a mouse model of peritoneal dialysis fluid (PDF)-induced fibrotic peritoneum. Differential expression, pathway and gene network analyses were developed to identify possible functional RNA molecules in peritoneal fibrosis. Compared to the normal control, 232 lncRNAs (127 up-regulated and 105 down-regulated), 154 mRNAs (87 up-regulated and 67 down-regulated) and 15 miRNAs (14 miRNAs up-regulated and 1 down-regulated) were differentially expressed in the fibrotic peritoneum. Among the differentially expressed ncRNAs, 9 lncRNAs and 5 miRNAs were validated by real-time RT-PCR. Pathway analysis showed that the Jak-STAT, TGF-beta and MAPK signaling pathways had a close relationship with peritoneal fibrosis. Gene co-expression network analysis identified many genes, including JunB, HSP72, and Nedd9. It also identified lncRNAs AK089579, AK080622, and ENSMUST00000053838 and miRNAs miR-182 and miR-488. All of these species potentially play a key role in peritoneal fibrosis. Our results provide a foundation and an expansive view of the roles and mechanisms of ncRNAs in PDF-induced peritoneal fibrosis.
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http://dx.doi.org/10.1016/j.gene.2015.03.050DOI Listing
June 2015

Cross-talk between angiotensin-II and toll-like receptor 4 triggers a synergetic inflammatory response in rat mesangial cells under high glucose conditions.

Biochem Biophys Res Commun 2015 Apr 28;459(2):264-269. Epub 2015 Feb 28.

Division of Nephrology and Organ Transplatation, The First Affiliated Hospital of NanChang University, China. Electronic address:

Toll-like Receptor 4 (TLR4) may play an important role in the pathogenesis of diabetic nephropathy (DN). In this study, We observed the TLR4 signal and the release of inflammation factors after angiotensin II (Ang II) stimulation in rat mesangial cells (MCs) under high glucose conditions, this revealed the innate immune mechanism of injury by Ang II in DN. Our data showed that TLR4 and MyD88 were up-regulated significantly in high glucose and AngII-induced MCs; meanwhile, NF-κB as well as MCP-1, IL-6 were also highly expressed. In cells that were transfected with TLR4 SiRNA,the parameters were greatly inhibited; similar effects were detected in cells that were treated with Irbesartan. We concluded that Ang II synergized with high glucose in the release of pro-inflammatory factors mainly through the upregulation of TLR4 signaling in MCs, Cross-talk between Ang II and TLR4 contributed to the MC inflammatory injury under high glucose conditions.
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http://dx.doi.org/10.1016/j.bbrc.2015.02.096DOI Listing
April 2015

Acute kidney injury associated with minimal change disease in systemic lupus erythematosus: a case report.

J Med Case Rep 2014 Dec 13;8:422. Epub 2014 Dec 13.

Department of Nephrology, The First Affiliated Hospital, Nan Chang University, YongWai street 17#, Nanchang city, Jiangxi province 330006, China.

Introduction: In systemic lupus erythematosus, acute kidney injury is usually associated with severe lupus nephritis and rarely associated with other glomerular diseases.

Case Presentation: We recently encountered a patient with acute kidney injury that was associated with minimal change disease in systemic lupus erythematosus. A 26-year-old Chinese woman who had a history of systemic lupus erythematosus presented with nephrotic syndrome and acute kidney injury. She fulfilled four of the American College of Rheumatology criteria for the classification of systemic lupus erythematosus. However, a renal biopsy revealed that there were no glomerular abnormalities or deposition of immune complex. Her generalized edema disappeared, and her high serum creatinine level decreased to normal after prednisolone therapy.

Conclusion: Though the relationship between lupus and minimal change disease is still not defined, the possibility of systemic lupus erythematosus combined with minimal change disease must be differentiated in patients with lupus and severe proteinuria.
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http://dx.doi.org/10.1186/1752-1947-8-422DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4301750PMC
December 2014

Correlation of Doppler parameters with renal pathology: A study of 992 patients.

Exp Ther Med 2014 Feb 10;7(2):439-442. Epub 2013 Dec 10.

Department of Nephrology, General Hospital of Guangzhou Military Command of PLA, Guangzhou, Guangdong 510010, P.R. China.

Ultrasound examination is a non-invasive diagnostic technique that is used on patients with suspected or established renal disease. The purpose of this study was to determine the role of intrarenal Doppler ultrasonography in the assessment of the renal pathology of patients with chronic kidney disease (CKD), as shown by kidney biopsy. This retrospective analysis enrolled 992 consecutive patients with CKD who underwent intrarenal Doppler ultrasonography and a kidney biopsy at the Departments of Nephrology of three hospitals between January 2006 and December 2010. Doppler parameters, including the peak systolic velocity (PSV), end-diastolic velocity and resistive index (RI) of the interlobar arteries, were compared with the renal biopsy findings. The RI of the interlobar arteries was correlated with the estimated glomerular filtration rate and the histological damage scores, demonstrating the most evident correlation with the tubulointerstitial damage (TI) score among the three histological components. The PSV of the interlobar arteries increased as the CKD stage progressed and correlated with a number of the renal histological changes, including the glomerulosclerosis and TI scores. The RI and PSV of the interlobar artery are correlated with the histopathological pattern in CKD. Thus, the RI and PSV of the interlobar artery may be potential indicators for monitoring the progression of renal damage.
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http://dx.doi.org/10.3892/etm.2013.1442DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3881055PMC
February 2014