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Renal glucosuria in children

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World Journal of Clinical pediatrics 2025年第1期14卷 46-54页

作者： Meral Torun Bayram Salih Kavukcu division of nephrology Department of PediatricsDokuz Eylül UniversitySchool of MedicineInciralti-Balcova 35340IzmirTürkiye

The kidneys play a critical role in maintaining glucose *** normal renal tubular function,most of the glucose filtered from the glomeruli is re-absorbed in the proximal tubules,leaving only trace amounts in the *** can occur as a symptom of generalized proximal tubular dysfunction or when the reabsorption threshold is exceeded or the glucose threshold is reduced,as seen in familial renal glycosuria(FRG).FRG is characterized by persistent glycosuria despite normal blood glucose levels and tubular function and is primarily associated with mutations in the sodium/glucose cotransporter 5A2 gene,which encodes the sodium-glucose cotransporter(SGLT)*** SGLTs has been proposed as a novel treatment strategy for diabetes,and since FRG is often considered an asymptomatic and benign condition,it has inspired preclinical and clinical studies using SGLT2 inhibitors in type 2 ***,patients with FRG may exhibit clinical features such as lower body weight or height,altered systemic blood pressure,diaper dermatitis,amino-aciduria,decreased serum uric acid levels,and *** research is needed to fully understand the pathophysiology,molecular genetics,and clinical manifestations of renal glucosuria.

关键词： Sodium-glucose cotransporters Basolateral glucose transporters Familial renal glucosuria Intestinal glucose-galactose malabsorption Fanconi-Bickel syndrome Sodium-glucose cotransporter 2 inhibitors

Machine learning in solid organ transplantation:Charting the evolving landscape

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World Journal of Transplantation 2025年第1期15卷 165-177页

作者： Badi Rawashdeh Haneen Al-abdallat Emre Arpali Beje Thomas Ty B Dunn Matthew Cooper division of Transplant Surgery Medical College of WisconsinMilwaukeeWI 53202United States Department of Medicine Jordan University HospitalAmman 11263Jordan Department of nephrology Medical College of WisconsinMilwaukeeWI 53226United States

BACKGROUND Machine learning(ML),a major branch of artificial intelligence,has not only demonstrated the potential to significantly improve numerous sectors of healthcare but has also made significant contributions to the field of solid organ *** provides revolutionary opportunities in areas such as donorrecipient matching,post-transplant monitoring,and patient care by automatically analyzing large amounts of data,identifying patterns,and forecasting *** To conduct a comprehensive bibliometric analysis of publications on the use of ML in transplantation to understand current research trends and their *** On July 18,a thorough search strategy was used with the Web of Science *** and transplantation-related keywords were *** the aid of the VOS viewer application,the identified articles were subjected to bibliometric variable analysis in order to determine publication counts,citation counts,contributing countries,and institutions,among other *** Of the 529 articles that were first identified,427 were deemed relevant for bibliometric analysis.A surge in publications was observed over the last four years,especially after 2018,signifying growing interest in this *** 209 publications,the United States emerged as the top ***,the"Journal of Heart and Lung Transplantation"and the"American Journal of Transplantation"emerged as the leading journals,publishing the highest number of relevant *** keyword searches revealed that patient survival,mortality,outcomes,allocation,and risk assessment were significant themes of *** The growing body of pertinent publications highlights ML's growing presence in the field of solid organ *** bibliometric analysis highlights the growing importance of ML in transplant research and highlights its exciting potential to change medical practices and enhance patient *** collaboration between signific

关键词： Machine learning Artificial Intelligence Solid organ transplantation Bibliometric analysis

Age-adjusted NT-proBNP could help in the early identification and follow-up of children at risk for severe multisystem inflammatory syndrome associated with COVID-19(MIS-C)

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World Journal of Clinical Cases 2022年第29期10卷 10435-10450页

作者： Moises Rodriguez-Gonzalez Ana Castellano-Martinez division of pediatric Cardiology Puerta del Mar University HospitalCadiz 11009Spain division of pediatric nephrology Puerta del Mar University HospitalCadiz 11009Spain

BACKGROUND Multisystem inflammatory syndrome in children(MIS-C) has emerged as a new disease associated with COVID-19 that presents in acute critically ill children with acute cardiovascular *** To determine whether the age-adjusted N-terminal pro-brain natriuretic peptide(NT-proBNP) value(Z-log-NT-proBNP) is associated with severe MIS-C and myocardial *** A retrospective study was conducted which included children with MIS-C managed at our institution between April 1,2020,and February 28,*** divided the population into groups depending on severity based on pediatric intensive care unit(PICU) *** compared Z-log-NT-proBNP values across these groups and analyzed Z-log-NT-proBNP dynamics during the onemonth *** We included 17 participants [median age 3(2-9) years] and seven(41%) required PICU ***(100%) of these cases presented very high(Z-log > 4) levels of NT-proBNP at the time of admission compared to only 5(50%) patients with non-severe MIS-C(P = 0.025).NT-proBNP was significantly correlated with highsensitive Troponin I levels(P = 0.045),Ross modified score(P = 0.003) and left ventricle ejection fraction(P = 0.021).CONCLUSION Raised NT-proBNP,specifically very high values(Z-log-NT-proBNP > 4) could help in the early identification of MIS-C patients with myocardial dysfunction requiring inotropic support and PICU admission.

关键词： Multisystem inflammatory syndrome associated with COVID-19 COVID-19 SARS-CoV-2 NT-proBNP Echocardiography Myocardial dysfunction Children

Synthetic data as an investigative tool in hypertension and renal diseases research

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World Journal of Methodology 2025年第1期15卷 9-13页

作者： Aleena Jamal Som Singh Fawad Qureshi Sidney Kimmel Medical College Thomas Jefferson UniversityPhiladelphiaPA 19107United States School of Medicine University of Missouri Kansas CityKansasMO 64106United States division of nephrology and Hypertension Mayo ClinicRochesterMN 55905United States

There is a growing body of clinical research on the utility of synthetic data derivatives,an emerging research tool in *** nephrology,clinicians can use machine learning and artificial intelligence as powerful aids in their clinical decision-making while also preserving patient *** is especially important given the epidemiology of chronic kidney disease,renal oncology,and hypertension ***,there remains a need to create a framework for guidance regarding how to better utilize synthetic data as a practical application in this research.

关键词： Synthetic data Artificial intelligence nephrology Blood pressure Research Editorial

Influence of HbA1c on short-term blood pressure variability in type 2 diabetic patients with diabetic nephropathy

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2013年第11期14卷 1033-1040页

作者： Fang LIU Min WU Yan-huan FENG Hui ZHONG Tian-lei CUI You-qun HUANG Ya-ping LIANG Yong-shu DIAO Li ZANG Ling LI Jing ZANG Hong-yu QIU Song-min HUANG Ping FU division of nephrology West China Hospital of Sichuan University

The aim of this study was to understand the characteristics of blood pressure （BP） variability in subjects with diabetic nephropathy （DN）, and identify the probable predictors affecting BP variability. Fifty-one chronic kidney disease （CKD）-hypertensive patients without diabetes （NDN group） and sixty type 2 diabetic patients with overt DN （DN group） were enrolled in this study. The values of short-term BP variability were obtained from 24 h ambulatory BP monitoring （ABPM）. Variance analysis or nonparametric analysis revealed that 24-h systolic BP variability and night- time systolic BP variability of the DN group were significantly higher than those of the NDN group [（12.23±3.66） vs. （10.74±3.83） mmHg, P〈0.05; （11.23±4.82） vs. （9.48±3.69） mmHg, P〈0.05]. Then the patients of the DN group were divided into two groups according to glycated hemoglobin （HbAlc） level： Group A （HbA1c〈7%） and Group B （HbA1c〉7%）, and the t-test showed that patients in Group B had larger 24-h diastolic, daytime diastolic, and nighttime systolic/diastolic BP variability compared with Group A. In the DN group, partial correlation analysis revealed that HbAlc exhibited a strong association with 24-h diastolic, daytime diastolic, nighttime systolic and diastolic BP vari- ability （P〈0.001, P〈0.001, P〈0.05, and P〈0.001, respectively）. Taken together, larger short-term BP variability was detected in hypertensive type 2 diabetic patients with overt nephropathy and renal insufficiency. It may imply that the optimal BP variability level could benefit from a better glycaemic control.

关键词： Short-term blood pressure variability Diabetic nephropathy Glycated hemoglobin (HbAlc) Hypertension Glycaemic control

Applicability of various estimation formulas to assess renal function in Chinese children

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World Journal of pediatrics 2015年第4期11卷 346-351页

作者： Yue Du Ting-Ting Sun Ling Hou Jin-Jie Guo Xiu-Li Wang Yu-Bin Wu pediatric nephrology Shengjing Hospital of China Medical UniversityShenyangLiaoning 110004China

Background:This study was to evaluate the relative applicability of the most commonly used estimation formulas for renal glomerular filtration rate(GFR)of Chinese children with chronic kidney disease(CKD).Methods:One hundred CKD patients of less than 17 years old were divided into two groups by sex which was further categorized intofi ve subgroups based on CKD staging according to the"reference"GFR(rGFR)determined by Tc-99m-DTPA renal dynamic *** GFR markers including serum cystatin C(CysC),β2-microglobulin,creatinine,and blood urea nitrogen were ***:Among all four markers,CysC best refl ected the extent of glomerular damages for CKD stage *** value for estimation of GFR(eGFR)was derived from five different formulas either over-estimated or under-estimated GFR as referenced to rGFR,and the extent of deviations was dependent on gender,age and CKD *** Counahan-Barratt formula and the Schwartz formula gave the most accurate estimations of GFR for CKD stages 1 and 2-3,respectively regardless of gender and age *** operating characteristic analyses indicated that the Counahan-Barratt formula has the highest diagnostic ***:The Counahan-Barratt formula provides the best approximation to rGFR,thereby the highest applicability to Chinese children with CKD of different genders,ages and CKD stages.

关键词： chronic kidney disease Counahan-Barratt formula cystatin C renal glomerularfi ltration rate Schwartz formula

Effect of high glucose levels on the calcification of vascular smooth muscle cells by inducing osteoblastic differentiation and intracellular calcium deposition via BMP-2/Cbfα-1 pathway

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2010年第12期11卷 905-911页

作者： Fang LIU Hui ZHONG Jing-yuan LIANG Ping FU Zhi-juan LUO Li ZHOU Rong GOU Jun HUANG division of nephrology West China Hospital Sichuan University Chengdu 610041 China

In this paper, we investigate the effect and the possible mechanism of high glucose levels on the calcification of human aortic smooth muscle cells （HASMCs）. HASMCs were divided into four groups： normal glucose group （NG）, osmolality control group （OC）, high glucose group （HG, HASMCs culture medium containing 30 mmol/L glucose）, and high glucose plus recombinant human Noggin protein （bone morphogenetic protein-2 （BMP-2） antagonist） group （HN）. The mRNA levels and the protein expressions of BMP-2 and core binding factor alpha-1 （Cbfa-1） were measured by real-time quantitative polymerase chain reaction （PCR） and Western blot. After induced by 10 mmol/L β-glycerol phosphoric acid, cells were had＇vested for assessments of alkaline phosphatase （ALP） activities at Days 1,2, and 3, and intracellular calcium contents at Days 7 and 14, respectively. High glucose levels increased the mRNA levels and the protein expressions of BMP-2 and Cbfa-1 （P〈0.05）. The expression of Cbfa-1 was partially blocked by Noggin protein （P〈0.05）, while BMP-2 was not （P〉0.05）. After being induced by β-glycerol phosphoric acid, high glucose levels increased the ALP activity [（48.63±1.03） vs. （41.42±2.28） U/mg protein, Day 3; P〈0.05] and the intracellular calcium content [（2.76±0.09） vs. （1.75±0.07） μmol/mg protein, Day 14; P〈0.05] in a time-dependent manner when compared with the NG group, while the ALP activity could not be blocked by Noggin protein [（48.63±1.03） vs. （47.37±0.97） U/mg protein, Day 3; P〉0.05]. These results show that high glucose levels can evoke the calcification of HASMCs by inducing osteoblastic trans-differentiation and intracellular calcium deposition via the BMP-2/Cbfa-1 pathway, which can be partially blocked by Noggin protein.

关键词： Bone morphogenetic protein (BMP) Core binding factor alpha-1 (Cbfa-1) Vascular smooth muscle cell,Noggin protein

Dynamics of circulating microparticles in chronic kidney disease and transplantation:Is it really reliable marker?

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World Journal of Transplantation 2015年第4期5卷 267-275页

作者： Ismail Dursun Sibel Yel Emel Unsur division of pediatric nephrology Erciyes UniversityFaculty of Medicine division of pediatric nephrology Emel Mehmet Tarman Children HospitalKayseri Teaching and Training Hospital

The deterioration of endothelial structure plays a very important role in the development of vascular diseases. It is believed that endothelial dysfunction starts in the early stage of kidney disease and is a risk factor of an unfavorable cardiovascular prognosis. Because a direct assessment of biological states in endothelial cells is not applicable, the measurement of endothelial microparticles(EMPs) detached from endothelium during activation or apoptosis is thought to be a marker of early vascular disease and endothelial dysfunction in children with chronic kidney disease(CKD). Few studies have shown increased circulating EMPs and its relationship with cardiovascular risk factors in patients with *** contain membrane proteins and cytosolic material derived from the cell from which they originate. EMPs having CD144, CD 146, CD31+/CD41-, CD51 and CD105 may be used to evaluate the vascular endothelial cell damage and determine asymptomatic patients who might be at higher risk of developing cardiovascular disease in CKD and renal transplant.

关键词： Endothelial dysfunction Endothelial microparticles Kidney transplantation Chronic kidney disease

Indications and results of renal biopsy in children:a 36-year experience

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World Journal of pediatrics 2018年第2期14卷 127-133页

作者： Luisa Santangelo Giuseppe Stefano Netti Paolo Giordano Vincenza Carbone Marida Martino Diletta Domenica Torres Michele Rossini Anna Maria Di Palma Loreto Gesualdo Mario Giordano Unit of pediatric nephrology and Dialysis Pediatric Hospital"GiovanniⅩⅩⅢ"BariItaly Clinical Pathology Department of Medical and Surgical SciencesUniversity of FoggiaFoggiaItaly Unit of nephrology Dialysis and TransplantationDepartment of Emergency and OrganTransplantationUniversity"Aldo Moro"BariItaly

Background This study was conducted to investigate retrospectively the indications for renal biopsy(RB)in native kidneys and to analyze pathological findings in a single tertiary pediatric hospital in Southern Italy for the last 36 *** All patients who underwent RB at our hospital from 1979 to 2014 were *** renal tissue specimens were studied under light and immunofluorescent microscopy,while electron microscopy was performed only for specific clinical *** The study group included 213 patients(female 43.2%)who underwent 225 percutaneous native kidney *** age was 10.4 years(range 0.6-24 years).The most frequent indication for RB was nephrotic syndrome(44.4%),fol-lowed by proteinuria(27.6%),asymptomatic hematuria(17.3%)and acute kidney injury(9.8%).Gross hematuria appeared after biopsy in less than 5%of the patients,but none of them needed blood *** renal tissue sample was obtained in 95.5%of the renal *** glomerulonephritis(GN)was the most common finding(61.4%),followed by secondary GN(21.4%),tubulointerstitial diseases(3.7%)and hereditary nephropathy(2.8%),while in 10.7%of the cases,normal renal tissues were *** to histopathological diagnosis,the most common causes of primary GN were IgA nephropathy(20.9%),followed by minimal change disease(18.1%)and focal segmental glomerulosclerosis(11.6%).Conclusions The epidemiology of glomerular disease in our single-center cohort is similar to that shown in other national and international ***,our study shows that percutaneous ultrasound-guided RB is a safe,reliable and effec-tive technique in children.

关键词： Epidemiology Glomerular diseases Nephropathy pediatric patients Renal biopsy