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Relationship between acute kidney injury before thoracic endovascular aneurysm repair and in-hospital outcomes in patients with type B acute aortic dissection

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Journal of Geriatric Cardiology 2015年第3期12卷 232-238页

作者： Hong-Mei REN Xiao WANG Chun-Yan HU Bin QUE Hui AI Chun-Mei WANG Li-Zhong SUN Shao-Ping NIE Emergency & Critical Care Center Beijing Anzhen Hospital Capital Medical University and Beijing Institute of Heart Lung and Blood Vessel Diseases Beijing China State Key Laboratory of Pathogen and Biosecurity Beijing Institute of Microbiology and Epidemiology Beijing China Department of Cardiovascular Surgery Beo'ing Anzhen Hospital Capital Medical University and Beijing Institute of Heart Lung and Blood Vessel Diseases Beijing China

Objective Acute kidney injury （AKI） frequently occurs after catheter-based interventional procedures and increases mortality. However, the implications of AKI before thoracic endovascular aneurysm repair （TEVAR） of type B acute aortic dissection （AAD） remain unclear. This study evaluated the incidence, predictors, and in-hospital outcomes of AKI before TEVAR in patients with type B AAD. Methods Between 2009 and 2013, 76 patients were retrospectively evaluated who received TEVAR for type B AAD within 36 h from symptom onset. The patients were classified into no-AKI vs. AKI groups, and the severity of AKI was further staged according to kidney disease： im- proving global outcomes criteria before TEVAR. Results The incidence of preoperative AKI was 36.8%. In-hospital complications was significantly higher in patients with preoperative AKI compared with no-AKI （50.0% vs. 4.2%, respectively; P 〈 0.001）, including acute renal failure （21.4% vs. O, respectively; P 〈 0.001）, and they increased with severity of AKI （P 〈 0.001）. The maximum levels of body tem- perature and white blood cell count were significantly related to maximum serum creatinine level before TEVAR. Multivariate analysis showed that systolic blood pressure on admission （OR： 1.023; 95% CI： 1.003-1.044; P ： 0.0238） and bilateral renal artery involvement （OR： 19.076; 95% CI： 1.914 190.164; P = 0.0120） were strong predictors of preoperative AKI. Conclusions Preoperative AKI frequently occurred in patients with type B AAD, and correlated with higher in-hospital complications and enhanced inflammatory reaction. Systolic blood pressure on admission and bilateral renal artery involvement were major risk factors for AKI before TEVAR.

关键词： Acute aortic dissection kidney injury Renal failure Thoracic endovascular aneurysm repair

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T cell infiltration is associated with kidney injury in patients with anti-glomerular basement membrane disease

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Science China(Life Sciences) 2016年第12期59卷 1282-1289页

作者： Shui-Yi Hu Xiao-Yu Jia Jian-Nan Li Xin Zheng Jie Ao Gang Liu Zhao Cui Ming-Hui Zhao Renal Division Department of Medicine Peking University First HospitalInstitute of Nephrology Peking UniversityKey Laboratory of Renal Disease Ministry of Health of China Key Laboratory of CKD Prevention and Treatment Ministry of Education of China Beijing 100034 China Peking-Tsinghua Center for Life Sciences Beijing 100871 China Department of Nephrology Tianjin Medical University General Hospital Tianjin 300052 China

Cell-mediated autoimmunity, particularly that involving autoreactive T cells, participates in mediating anti-glomerular basement membrane(GBM) disease. However, direct kidney injury mediated by renal infiltrated T cells has not been clearly elucidated in humans. The T cell profile(CD3, CD4, CD8, IL-17, and foxp3) and macrophage(CD68) were examined by immunohistochemistry on renal biopsy tissues from 13 patients with anti-GBM disease. The correlation between cell infiltration and clinical data was also analyzed. We found that the distribution of T cell infiltration was predominant in the peri-glomerular and interstitial areas. CD3^+ T cell infiltratrion around the glomeruli with cellular crescent formations was significantly higher than that around the glomeruli with mild mesangial proliferation. CD8^+ T cells significantly accumulated around the glomeruli with cellular crescents without Ig G deposits compared to those with Ig G deposits. The prevalence of infiltrating CD8^+ T cells was correlated with the percentage of ruptured Bowman's capsules. In conclusion, cellular immunity may play a crucial role in the inflammatory kidney injury in anti-GBM patients. The periglomerular infiltration of T cells, especially CD8^+ T cells, may participate in the pathogenic mechanism of glomerular damage.

关键词： anti-GBM disease T cell IL-17 CD8 kidney injury

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The alarming link between neonicotinoid insecticides and kidney injury

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Emerging Contaminants 2024年第3期10卷 318-328页

作者： Zhanpeng Zhang Longbin Shen Mei Chen Biao Huang Zhuoqi Wei Weiguo Xu Hua Zhang Department of Metabolic and Bariatric Surgery The First Affiliated Hospital of Jinan UniversityGuangzhou510632China Department of Dermatology The First Affiliated Hospital of Jinan UniversityGuangzhouGuangdong510632China Department of Rehabilitation Medicine The First Affiliated Hospital of Jinan UniversityGuangzhou510632China Department of Interventional The First Affiliated Hospital of Guangzhou University of Traditional Chinese MedicineGuangzhou510400China Zhuhai Interventional Medical Center Zhuhai Precision Medical CenterZhuhai People's HospitalZhuhai Hospital Affiliated with Jinan UniversityZhuhaiGuangdong519000China

Neonicotinoid insecticides(NEOs)have been extensively approved for application in agricultural production both in China and *** studies indicated that human exposure to NEOs would have adverse health ***,studies on occurrences of NEOs in kidney injury patients and their association with nephrotoxicity are *** study investigates the potential correlation between exposure to NEOs and kidney injury within a subset(n=224)of the population residing in South *** of 8 NEOs and 5 metabolites were quantified in blood samples obtained from both the 110 healthy and 114 kidney injury cohorts in South *** found that target analytes were frequently detected in samples from the healthy and kidney injury cohorts(61%-100%).Dinotefuran is the predominant NEO in the healthy(42.3%)and kidney injury cohort(49.6%).Significantly positive(pkidney injury were found,indicating that these pollutants may increase the odds of human kidney injury *** multilinear regression analysis,it was observed that the concentrations of various NEOs exhibited a significant association(pkidney injury,thereby offering novel insights into the nephrotoxicity associated with these *** discovery carries significant implications for public health policies and environmental conservation practices.

关键词： Neonicotinoid insecticides Metabolites Human exposure kidney injury

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Clinical characteristics and treatment compounds of obesity-related kidney injury

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World Journal of Diabetes 2024年第6期15卷 1091-1110页

作者： Tuo-Hua Mao Han-Qi Huang Chuan-Hai Zhang Department of Endocrinology Renmin Hospital of Wuhan UniversityWuhan 430060Hubei ProvinceChina Department of Endocrinology Hubei No.3 People’s Hospital of Jianghan UniversityWuhan 430033Hubei ProvinceChina Department of Physiology UT Southwestern Medical CenterDallasTX 75390United States

Disorders in energy homeostasis can lead to various metabolic diseases,particularly *** obesity epidemic has led to an increased incidence of obesityrelated nephropathy(ORN),a distinct entity characterized by proteinuria,glomerulomegaly,progressive glomerulosclerosis,and renal function *** and its associated renal damage are common in clinical practice,and their incidence is increasing and attracting great *** is a great need to identify safe and effective therapeutic modalities,and therapeutics using chemical compounds and natural products are receiving increasing ***,the summary is lacking about the specific effects and mechanisms of action of compounds in the treatment of *** this review,we summarize the important clinical features and compound treatment strategies for obesity and obesityinduced kidney *** also summarize the pathologic and clinical features of ORN as well as its pathogenesis and potential therapeutics targeting renal inflammation,oxidative stress,insulin resistance,fibrosis,kidney lipid accumulation,and dysregulated *** addition,detailed information on natural and synthetic compounds used for the treatment of obesity-related kidney disease is *** synthesis of detailed information aims to contribute to a deeper understanding of the clinical treatment modalities for obesity-related kidney diseases,fostering the anticipation of novel insights in this domain.

关键词： Compounds Obesity kidney injury Obesity-related nephropathy Clinical features and treatment

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Ketamine Abuse-Induced Obstructive Nephropathy and kidney injury

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Chinese Medical Sciences Journal 2014年第2期29卷 122-124页

作者： Jun Wang Hua-lin Qi Feng Liu Hai-dong Yan Department of Nephrology East Hospital Tongji Univesity School of Medicine

KETAMINE is an anaesthetic agent characterized by a rapid onset and short duration of action, but it has increasingly been abused as a ＂clubdrug＂ since the late 1980s. It can causeinflammation and contraction of the bladder, leading to possibly irreversible kidney damage. Since 2007, case reports are appearing in the medical literature describing severe bladder dysfunction and kidney injury in ketamine abusers. In this article, we report a case of obstructive nephropathy and kidney injury in a ketamine abuser.

关键词： ketamine kidney injury hydronephrosis

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Intravenous injection of Xuebijing attenuates acute kidney injury in rats with paraquat intoxication

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World Journal of Emergency Medicine 2017年第1期8卷 61-64页

作者： Jia-jun Xu Jian-tao Zhen Li Tang Qing-ming Lin Department of Emergency Medicine Quanzhou First Hospital Affiiated Fujian Medical University Department of Emergency Medicine Fujian Provincial Hospital Shengli Clinical Medical College of Fujian Medical University

BACKGROUND: The study aimed to investigate the therapeutic benefits of intravenous Xuebijing on acute kidney injury(AKI) in rats with paraquat ***: Male Sprague-Dawley rats were randomly divided equally into three groups: sham group(n=8), paraquat group(n=8) and Xuebijing-treated group(n=8) using a random number table. The rats were intraperitoneally injected with 50 mg/kg of paraquat. One hour after paraquat administration, the rats were treated intravenously with Xuebijing(8 mL /kg). At 12 hours after paraquat administration, serum was collected to evaluate kidney function, then the rats were sacrificed and kidney samples were immediately harvested. AKI scores were evaluated by renal histopathology and pro-in? ammatory cytokines mR NA levels in kidney were assayed using real-time ***: Serum urea nitrogen, creatinine and AKI scores were significantly higher in the paraquat group, compared with the sham group(P<0.05, respectively). Moreover, interleukin(IL)-1β, IL-6 and TNF-α m RNA levels were signi? cantly higher in the paraquat group(P<0.01, respectively). However, intravenous Xuebijing signi? cantly decreased serum urea nitrogen, creatinine, AKI scores and IL-1β, IL-6 and TNF-α m RNA levels, compared with the paraquat group(P<0.05, respectively).CONCLUSION: Intravenous Xuebijing attenuates AKI following paraquat poisoning by suppressing in? ammatory response.

关键词： Paraquat Xuebijing kidney injury Inflammation

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Imaging and spatial omics of kidney injury:significance,challenges,advances and perspectives

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Medical Review 2023年第6期3卷 514-520页

作者： Zehua Li Yao Lu Li Yang Renal Division Peking University Institute of NephrologyPeking University First HospitalBeijingChina Key Laboratory of Renal Disease-Ministry of Health of China Key Laboratory of CKD Prevention and Treatment(Peking University)-Ministry of Education of ChinaPeking University First HospitalBeijingChina Research Units of Diagnosis and Treatment of Immune-mediated kidney Diseases-Chinese Academy of Medical Sciences Peking University First HospitalBeijingChina Renal Division Peking University Institute of NephrologyPeking University First HospitalBeijing 100034China Key Laboratory of Renal Disease-Ministry of Health of China Key Laboratory of CKD Prevention and Treatment(Peking University)-Ministry of Education of ChinaPeking University First HospitalBeijing 100034China Research Units of Diagnosis and Treatment of Immunemediated kidney Diseases-Chinese Academy of Medical Sciences Peking University First HospitalXishiku Street#8Beijing 100034China

The kidneys are susceptible to a range of insults that can cause damage to *** diagnosis,timely prevention,and proper treatment are crucial for improving the outcome of kidney ***,the complexity of renal structure and function makes it difficult to reach the demand of early detection and comprehensive evaluation of kidney *** successful drug therapy caused by the elaborate pathogenesis mechanism network of kidney injury calls for a systematical interpretation in mechanism *** advances in renal imaging and omics studies have provided novel views and deeper insights into kidney injury,but also raise challenges in reaching a comprehensive cellular and molecular atlas of kidney *** in imaging and omics of kidney injury are being made in various directions,with the initiative of construction a high-resolution structural atlas of kidney,dynamic and non-invasive evaluation of renal function,and systematic establishment of spatially resolved molecular atlas by transcriptomics and *** the limitations of a single modality,novel multimodal integration technologies of imaging and omics are being attempted to achieve a systematic description of nephropathy *** extensive efforts in renal multimodal imaging and omics studies are extremely required to deepen our understanding on kidney injury in the context of diagnostic,mechanistic and therapeutic perspectives.

关键词： kidney injury imaging omics multi-modalities Introduction

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Low-molecular-weight dextran for optical coherence tomography may not be protective against kidney injury in patients with renal insufficiency

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World Journal of Nephrology 2021年第2期10卷 8-20页

作者： Toru Misawa Tomoyo Sugiyama Yoshihisa Kanaji Masahiro Hoshino Masao Yamaguchi Masahiro Hada Tatsuhiro Nagamine Kai Nogami Yumi Yasui Eisuke Usui Tetsumin Lee Taishi Yonetsu Tetsuo Sasano Tsunekazu Kakuta Department of Cardiovascular Medicine Tsuchiura Kyodo General HospitalIbaraki 300-0028Japan Department of Interventional Cardiology Tokyo Medical and Dental UniversityTokyo 113-8519Japan Department of Cardiovascular Medicine Tokyo Medical and Dental UniversityTokyo 113-8519Japan

BACKGROUND Low-molecular-weight dextran(LMWD)is considered a safe alternative to contrast media for blood displacement during optical coherence tomography(OCT)*** To investigate whether the use of LMWD for OCT is protective against kidney injury in patients with advanced renal *** In this retrospective cohort study,we identified 421 patients with advanced renal insufficiency(estimated glomerular filtration rate<45 mL/min/1.73 m2)who underwent coronary angiography or percutaneous coronary intervention;79 patients who used additional LMWD for OCT imaging(LMWD group)and 342 patients who used contrast medium exclusively(control group).We evaluated the differences between these two groups and performed a propensity score-matched subgroup *** The median total volume of contrast medium was 133.0 mL in the control group vs 140.0 mL in the LMWD *** baseline renal function was not statistically different between these two groups,the LMWD group demonstrated a strong trend toward the progression of renal insufficiency as indicated by the greater change in serum creatinine level during the 1-year follow-up compared with the control *** in the LMWD group experienced worsening renal function more frequently than patients in the control *** score matching adjusted for total contrast media volume consistently indicated a trend toward worsening renal function in the LMWD group at the 1-year *** serum creatinine at 1-year follow-up was significantly greater in the LMWD group than that in the control group[0.06(-0.06,0.29)vs-0.04(-0.23,0.08)mg/dL,P=0.001],despite using similar contrast *** OCT using LMWD may not be protective against worsening renal function in patients with advanced renal insufficiency.

关键词： Coronary artery disease kidney injury Contrast media Dextran Optical coherence tomography Renal insufficiency

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Risk factors for acute kidney injury after partial hepatectomy

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World Journal of Hepatology 2017年第18期9卷 815-822页

作者： Luis Cesar Bredt Luis Alberto Batista Peres Department of Surgical Oncology and Hepa- tobiliary Surgery University Hospital of Western Paraná State University of Western Paraná Department of Nephrology University Hospital of Western Paraná State University of Western Paraná

To identify risk factors for the occurrence of acute kidney injury (AKI) in the postoperative period of partial hepatectomies. METHODSRetrospective analysis of 446 consecutive resections in 405 patients, analyzing clinical characteristics, preoperative laboratory data, intraoperative data, and postoperative laboratory data and clinical evolution. Adopting the International Club of Ascites criteria for the definition of AKI, potential predictors of AKI by logistic regression were identified. RESULTSOf the total 446 partial liver resections, postoperative AKI occurred in 80 cases (17.9%). Identified predictors of AKI were: Non-dialytic chronic kidney injury (CKI), biliary obstruction, the Model for End-Stage Liver Disease (MELD) score, the extent of hepatic resection, the occurrence of intraoperative hemodynamic instability, post-hepatectomy haemorrhage, and postoperative sepsis. CONCLUSIONThe MELD score, the presence of non-dialytic CKI and biliary obstruction in the preoperative period, and perioperative hemodynamics instability, bleeding, and sepsis are risk factors for the occurrence of AKI in patients that underwent partial hepatectomy.

关键词： kidney injury Hepatectomy Postoperative Liver Resection

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Timely renal replacement therapy linked to better outcome in patients with sepsis-associated acute kidney injury

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Journal of Intensive Medicine 2022年第3期2卷 173-182页

作者： Yiwen Fan Liang Chen Shaowei Jiang Yingying Huang Yuxin Leng Chengjin Gao Department of Emergency Shanghai Jiao Tong University School of MedicineShanghai 200092China Department of Pathology and Medical Biology University of GroningenUniversity Medical Center GroningenGronigen 9713GZthe Netherlands Department of Intensive Care Unit Peking University Third HospitalBeijing 100191China

Background:Recent studies suggest that acute kidney injury(AKI)can be treated with renal replacement therapy(RRT).However,its benefits to patients with sepsis-associated AKI(SA-AKI),which is linked to high mortality and morbidity rates,remain under *** aim of this study was to compare the outcomes of different RRT strategies for patients with ***:This retrospective study evaluated patients who were admitted to the hospital with sepsis and devel-oped SA-AKI during hospitalization from 1st January 2014 to 31st January ***,renal recovery,and systemic organ function at 90 days following admission were compared between the RRT group(RG)and non-RRT group(NRG),as well as the early-RRT group(EG)and delayed-RRT group(DG).The groups were defined according to the time from admission to RRT initiation(criterion 1,EG1 and DG1)and kidney Disease Improving Global Outcomes(KDIGO)classification(criterion 2,EG2 and DG2).Categorical and continuous variables were compared using the chi-squared test or Fisher’s exact test and Student’s t-test or Wilcoxon ***-Meier curves were constructed to determine the unadjusted survival rates for the different ***:A total of 116 patients were included in this study;of those,38 received RRT and 46 expired within 90 *** different strategies of RRT,there were no significant differences found in 90-day mortality(RG ***:𝜒2=0.610,P=0.435;EG1 ***1:𝜒2=0.835,P=0.360;EG2 ***2:𝜒2=0.022,P=0.899)and renal ***,the values of change in sequential organ failure assessment(ΔSOFA)max-min of patients in the EG and RG were significantly higher than those recorded in the NRG(ΔSOFA RG=7.0,ΔSOFA NRG=3.60,ΔSOFA EG1=9.00,ΔSOFA EG2=6.30;P<0.050).Also,the 90-day renal recovery in the EG was better than that noted in the DG with criterion 1(87.5%vs.38.5%,respectively,𝜒2=10.425,P=0.032),suggesting that RRT(especially timely RRT)may be beneficial to the restoration of systemic organ function in pati

关键词： Dialysis Sepsis Renal failure kidney injury Creatinine Shock

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