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Efficacy and safety of Yiqi Peiyuan granules for improving the short-term prognosis of patients with acute kidney injury:A multicenter,double-blind,placebo-controlled,randomized trial

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Journal of Integrative Medicine 2024年第3期22卷 279-285页

作者： Jia-jia Wu Tian-yi Zhang Ying-hui Qi Min-yan Zhu Yan Fang Chao-jun Qi Li-ou Cao Ji-fang Lu Bo-han Lu Lu-min Tang Jian-xiao Shen Shan Mou Department of nephrology Molecular Cell Lab for Kidney DiseaseShanghai Peritoneal Dialysis Research CenterUremia Diagnosis and Treatment CenterRenji Hospital Affiliated to Shanghai Jiaotong University School of MedicineShanghai 200127China Department of nephrology Shanghai Pudong New Area Punan HospitalShanghai 200125China Department of nephrology Ningbo Hangzhou Bay HospitalNingbo 315336Zhejiang ProvinceChina

Background:Yiqi Peiyuan(YQPY)prescription,a composite prescription of traditional Chinese medicine,has been used to prevent or delay the continued deterioration of renal function after acute kidney injury(AKI)in some institutions and has shown considerable ***:This is the first randomized controlled trial to assess efficacy and safety of YQPY for improving short-term prognosis in adult patients with ***,setting,participants and interventions:This is a prospective,double-blind,multicenter,randomized,and placebo-controlled clinical trial.A total of 144 enrolled participants were randomly allocated to two groups according to a randomization ***,caregivers and investigators assessing the outcomes were blinded to group *** in the YQPY group received 36 g YQPY granules twice a day for 28 *** in the placebo group received a placebo in the same dose as the YQPY *** outcome measures:The primary outcome was the change in the estimated glomerular filtration rate(eGFR)between baseline and after 4 and 24 weeks of *** secondary outcomes were the change of serum creatinine(Scr)level between baseline and after treatment,and the incidence of endpoint events,defined as eGFR increasing by more than 25%above baseline,eGFR>75 mL/min per1.73 m2or the composite endpoint,which was defined as the sum of patients meeting either of the above ***:Data from a total of 114 patients(59 in the YQPY group and 55 in the control group)were *** mean changes in eGFR and Scr in weeks 4 and 24 had no difference between the two *** further subgroup analysis(22 in the YQPY group and 31 in the control group),the mean change in eGFR after treatment for 4 weeks was 27.39 mL/min per 1.73 m2in the YQPY group and 5.78 mL/min per1.73 m2in the placebo group,and the mean difference between groups was 21.61 mL/min per 1.73 m2(Pgroup and 5(16.1%)in the placebo g

关键词： Chinese herbal medicine Randomized controlled trial Acute kidney injury Renal function

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Effect of Jianpi Shengxue Tablet on Iron Metabolism and Nutritional Status in Patients with Renal Anemia:A Prospective,Randomized,Open,Parallel Controlled and Multicenter Clinical Study

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Current Medical Science 2024年第3期44卷 603-610页

作者： Juan YANG Meng-yuan LIANG Yu LI Hao ZHANG Wei LI Jing LV Li-ping DONG Jing-song JIN Cheng YANG Qing-hong ZHANG Li LONG Rong ZOU Yi GAO Dan SONG Chun-qin PAN Ying YAO Xiao-lin ZHAN Xiao-hui WANG Department of nephrology Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan430030China Department of nephrology The First People’s Hospital of GuiyangGuiyang550000China Department of nephrology The Third Xiangya HospitalCentral South UniversityChangsha410000China Department of nephrology The First Affiliated Hospital of Xi’an Jiaotong UniversityXi’an710061China Department of nephrology Wuhan No. 4 HospitalWuhan430033China Department of nephrology Hubei Provincial Hospital of Traditional Chinese MedicineWuhan430060China Department of nephrology Central Theater General Hospital of PLAWuhan430064China Department of nephrology Taihe HospitalShiyan442000China Department of nephrology Third People’s Hospital of Hubei ProvinceWuhan430033China Department of nephrology Hubei Province Integrated Traditional Chinese and Western Medicine Hospital of Hubei provinceWuhan430024China Department of nephrology Xi’an No.3 HospitalAffiliated Hospital of Northwest UniversityXi’an710000China Department of nephrology Shenzhen Guangming District People’s HospitalShenzhen518000China Department of nephrology Xiantao First People’s HospitalXiantao433000China Department of Nutrition Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan430030China Department of nephrology Huangshi Central HospitalHuangshi435000China Department of nephrology The Fifth Hospital of WuhanWuhan430050China

Objective This study aimed to analyze the clinical efficacy of the Jianpi Shengxue tablet for treating renal *** A total of 200 patients with renal anemia from December 2020 to December 2022 were enrolled and randomly divided into two *** in the control group were treated with polysaccharide-iron complex,and those in the experimental group were administered Jianpi Shengxue *** 8 weeks of continuous treatment,the therapeutic outcomes regarding anemia were compared between the two *** After treatment,the red blood cell(RBC)count,hematocrit(HCT),reticulocyte percentage(RET),ferritin(SF),serum iron(SI),transferrin saturation(TSAT),and serum albumin(ALB)all increased(Pgroup were significantly greater than those in the control group(Pgroup than in the control group(P<0.01).Conclusion The Jianpi Shengxue tablet demonstrates efficacy in treating renal anemia,leading to significant improvements in the laboratory examination results and clinical symptoms of patients with renal anemia.

关键词： Jianpi Shengxue tablet renal anemia randomized open parallel control multicenter clinical study

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Individualized Traditional Chinese Medicine treatment vs antibiotics for recurrent urinary tract infections: a multicenter, randomized controlled study

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Journal of Traditional Chinese Medicine 2024年第3期44卷 524-529页

作者： GU Xiangchen QIU Meisi XIE Lin CHEN Min DENG Yueyi ZHANG Changming JIAN Guihua WANG Chen WANG Yi Department of nephrology Yueyang Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Shanghai University of Traditional Chinese MedicineShanghai 200437China Department of nephrology Rizhao Hospital of Traditional Chinese MedicineShanghai 200437China Department of nephrology Longhua Hospital Affiliated to Shanghai University of Traditional Chinese MedicineShanghai200032China Department of nephrology Shanghai Municipal Traditional Chinese Medicine Hospital Affiliated to Shanghai University of Traditional Chinese MedicineShanghai 200071China Department of nephrology the Sixth People's Hospital Affiliated Shanghai Jiaotong UniversityShanghai 200233China Department of nephrology Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese MedicineShanghai 201203China

OBJECTIVE: To systematically assess the effects of individualized Chinese medicines on recurrent urinary tract infections(rUTIs).METHODS: This study recruited 230 adult female patients in the remission phase of rUTIs from five hospitals in China. The patients were randomly allocated to two groups: an individualized Chinese medicine group(n = 114) and a control group(n = 116). Patients in the Chinese medicine group received individualized Chinese herbs, which were evaluated for syndrome *** in the control group received antibiotic treatment combined with a Chinese medicine placebo. The duration of treatment was three courses of four weeks each, with a three-month subsequent follow-up. UTI recurrence rate,Traditional Chinese Medicine(TCM) syndrome scores,36-item Short Form Survey(SF-36) score, and urine secretory immunoglobulin A(SIgA) were measured and analyzed before and after treatment in each group. RESULTS: Patients from the Chinese medicine group exhibited significant decreases in both short-and longterm UTI recurrence rates compared with the control group(P groups were significant(P group were also significantly higher than those in the control group after treatment(P group also demonstrated a significant increase in urine SIg A expression. CONCLUSION: Taken together, compared to the oftenused long-term antimicrobial prophylaxis during the remission stage of r UTIs, treating patients with an individualized Chinese medicine decoction by syndrome differentiation could effectively reduce the recurrence rate, improve the patients' TCM syndrome scores and quality of life, and enhance immunity, which in turn helps to prevent antibiotic resistance.

关键词： urinary tract infections medicine Chinese traditional syndrome differentiation quality of life immunoglobulin A secretory randomized controlled trial

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Cholesterol business:lifeor death byrust

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Signal Transduction and Targeted Therapy 2024年第4期9卷 1247-1248页

作者： Shubhangi Gavalil Francesca Maremonti Andreas Linkermann Division of nephrology Department of Internal Medicine 3University Hospital Carl Gustav Carus at the Technische Universitat DresdenDresdenGermany Division of nephrology Department of MedicineAlbert Einstein College of MedicineBronxNYUSA

In two recent manuscripts published in Nature,the cholesterol-synthesis pathway was identified as a master regulator of ferroptosis sensitivity and therefore as a novel therapeutic target.1,2 Ferroptosis does not only represent one way to eliminate cancer cells,but also contributes to acute organ damage in the kidney,heart,brain,and liver,and it kills tissues during the process of organ *** term“ferroptosis”should be defined as a cellular process of iron-catalyzed lipid peroxidation-mediated rupture of the plasma membrane.

关键词： rupture death damage

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Functional gastrointestinal disorders,mental health,genetic susceptibility,and incident chronic kidney disease

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Chinese Medical Journal 2024年第9期137卷 1088-1094页

作者： Mengyi Liu Panpan He Ziliang Ye Sisi Yang Yanjun Zhang Qimeng Wu Chun Zhou Yuanyuan Zhang Fan Fan Hou Xianhui Qin Division of nephrology Nanfang HospitalSouthern Medical UniversityNational Clinical Research Center for Kidney DiseaseState Key Laboratory of Organ Failure ResearchGuangdong Provincial Institute of NephrologyGuangdong Provincial Key Laboratory of Renal Failure ResearchGuangzhouGuangdong 510515China

Background:Whether functional gastrointestinal disorders(FGIDs)are associated with the long-term risk of chronic kidney disease(CKD)remains *** aimed to investigate the prospective association of FGIDs with CKD and examine whether mental health mediated the ***:About 416,258 participants without a prior CKD diagnosis enrolled in the UK Biobank between 2006 and 2010 were *** with FGIDs(including irritable bowel syndrome[IBS],dyspepsia,and other functional intestinal disorders[FIDs;mainly composed of constipation])were the exposure group,and non-FGID participants were the non-exposure *** primary outcome was incident CKD,ascertained from hospital admission and death registry records.A Cox proportional hazard regression model was used to investigate the association between FGIDs and CKD,and the mediation analysis was performed to investigate the mediation proportions of mental ***:At baseline,33,156(8.0%)participants were diagnosed with FGIDs,including 21,060(5.1%),8262(2.0%),and 6437(1.6%)cases of IBS,dyspepsia,and other FIDs,*** a mean follow-up period of 12.1 years,11,001(2.6%)participants developed *** were significantly associated with a higher risk of incident CKD compared to the absence of FGIDs(hazard ratio[HR],1.36;95%confidence interval[CI],1.28-1.44).Similar results were observed for IBS(HR,1.27;95%CI,1.17-1.38),dyspepsia(HR,1.30;95%CI,1.17-1.44),and other FIDs(HR,1.60;95%CI,1.43-1.79).Mediation analyses suggested that the mental health score significantly mediated 9.05%of the association of FGIDs with incident CKD and 5.63-13.97%of the associations of FGID subtypes with ***,the positive associations of FGIDs and FGID subtypes with CKD were more pronounced in participants with a high genetic risk of ***:Participants with FGIDs had a higher risk of incident CKD,which was partly explained by mental health scores and was more pronounced in those with high gen

关键词： Functional gastrointestinal disorders Chronic kidney diseases Genetic susceptibility Mental health

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The burden of depression,anxiety and schizophrenia among the older population in ageing and aged countries:an analysis of the Global Burden of Disease Study 2019

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General Psychiatry 2024年第1期37卷 83-93页

作者： Ying Cheng Yu Fang Jinxin Zheng shiyang Guan Meiti Wang Wu Hong Shanghai Mental Health Center Shanghai Jiao Tong University School of MedicineShanghaiChina Department of nephrology Rujin HospitalInstitute of NephrologyInstitute of NephrologyShanghai Jiao Tong University School of MedicineShanghaiChina School of Global Health Chinese Center for Tropical Diseases ResearchShanghai Jiao Tong University School of MedicineShanghaiChina Department of Epidemiology and Biostatistics School of Public HealthAnhui Medical UniversityHefeiAnhuiChina

Background Depression,anxiety and schizophrenia among older persons have become global public health ***,the burden of these disorders in ageing and aged countries has not been *** To investigate the burden of depression,anxiety and schizophrenia among older adults in ageing and aged *** Using data from the Global Burden of Disease Study 2019,we calculated the estimated annual percentage change(EAPC)in the age-standardised incidence rates(ASiR)and age-standardised disability-adjusted life years(DALYs)rates(ASDR)for depression,anxiety and schizophrenia of older people in ageing countries(China,India,Indonesia)and aged countries(Japan,Italy,Portugal)between 1990 and *** in incidence and DALYs were analysed by gender and *** In 2019,the highest incidence of depression,anxiety and schizophrenia in the older population in aged countries was in Japan(927271.3(752552.3-1125796.5),51498.2(37625.7-70487.3)and 126.0(61.0-223.2),respectively),while the highest incidence in ageing countries was in China(5797556.9(4599403.4-7133006.5),330256.1(246448.9-445987.4)and 1067.7(556.2-1775.9),respectively).DALYs for these disorders were similar,with the highest in Japan and *** 1990 to 2019,the ASIR for depressive disorders decreased in aged countries but increased in ageing countries;the ASIR for anxiety disorders and schizophrenia declined in both ageing and aged *** ASDR for depressive disorders was consistent with the ASIR but not for anxiety disorders and *** ASIR for depressive disorders was higher in older women,while the opposite was observed in anxiety disorders and ***,the conditions of burden of depressive disorders,anxiety disorders and schizophrenia in the 65-70-year-old age group were the most *** The incidence and DALYs of these three mental disorders increased while exhibiting differences between ageing and aged *** awareness about for

关键词： schizophrenia burden ageing

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The role of innate immunity in diabetic nephropathy and their therapeutic consequences

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Journal of Pharmaceutical Analysis 2024年第1期14卷 39-51页

作者： Min Yang Chun Zhang Department of nephrology Union HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan430022China

Diabetic nephropathy (DN) is an enduring condition that leads to inflammation and affects a substantial number of individuals with diabetes worldwide. A gradual reduction in glomerular filtration and emergence of proteins in the urine are typical aspects of DN, ultimately resulting in renal failure. Mounting evidence suggests that immunological and inflammatory factors are crucial for the development of DN. Therefore, the activation of innate immunity by resident renal and immune cells is critical for initiating and perpetuating inflammation. Toll-like receptors (TLRs) are an important group of receptors that identify patterns and activate immune responses and inflammation. Meanwhile, inflammatory responses in the liver, pancreatic islets, and kidneys involve inflammasomes and chemokines that generate pro-inflammatory cytokines. Moreover, the activation of the complement cascade can be triggered by glycated proteins. This review highlights recent findings elucidating how the innate immune system contributes to tissue fibrosis and organ dysfunction, ultimately leading to renal failure. This review also discusses innovative approaches that can be utilized to modulate the innate immune responses in DN for therapeutic purposes.

关键词： Innate immunity Diabetic nephropathy Inflammation Toll-like receptor Inflammasomes

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Clinical study of different prediction models in predicting diabetic nephropathy in patients with type 2 diabetes mellitus

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World Journal of Diabetes 2024年第1期15卷 43-52页

作者： Sha-Sha Cai Teng-Ye Zheng Kang-Yao Wang Hui-Ping Zhu Department of nephrology The First People’s Hospital of WenlingWenling 317500Zhejiang ProvinceChina

BACKGROUND Among older adults,type 2 diabetes mellitus(T2DM)is widely recognized as one of the most prevalent *** nephropathy(DN)is a frequent com-plication of DM,mainly characterized by renal microvascular *** detection,aggressive prevention,and cure of DN are key to improving *** a diagnostic and predictive model for DN is crucial in auxiliary *** To investigate the factors that impact T2DM complicated with DN and utilize this information to develop a predictive *** The clinical data of 210 patients diagnosed with T2DM and admitted to the First People’s Hospital of Wenling between August 2019 and August 2022 were retrospectively *** to whether the patients had DN,they were divided into the DN group(complicated with DN)and the non-DN group(without DN).Multivariate logistic regression analysis was used to explore factors affecting DN in patients with *** data were randomly split into a training set(n=147)and a test set(n=63)in a 7:3 ratio using a random *** training set was used to construct the nomogram,decision tree,and random forest models,and the test set was used to evaluate the prediction performance of the model by comparing the sensitivity,specificity,accuracy,recall,precision,and area under the receiver operating characteristic *** Among the 210 patients with T2DM,74(35.34%)had *** validation dataset showed that the accuracies of the nomogram,decision tree,and random forest models in predicting DN in patients with T2DM were 0.746,0.714,and 0.730,*** sensitivities were 0.710,0.710,and 0.806,respectively;the specificities were 0.844,0.875,and 0.844,respectively;the area under the receiver operating characteristic curve(AUC)of the patients were 0.811,0.735,and 0.850,*** Delong test results revealed that the AUC values of the decision tree model were lower than those of the random forest and nomogram models(P<0.05),whereas the differ

关键词： Type 2 diabetes mellitus Diabetic nephropathy Random forest Decision-making tree Nomogram Forecast

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A Chinese Multi-Specialty Delphi Consensus to Optimize RAASi Usage and Hyperkalaemia Management in Patients with Chronic Kidney Disease and Heart Failure

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Chinese Medical Sciences Journal 2024年第2期39卷 79-90页

作者： Ming-Hui Zhao Wei Chen Hong Cheng Bi-Cheng Liu Zhi-Guo Mao Zhuang Tian Gang Xu Jing-Min Zhou Renal Division Peking University First HospitalBeijing 100034China Department of nephrology The First Affiliated HospitalSun Yat-Sen UniversityGuangzhou 510080China Department of nephrology Capital Medical UniversityBeijing 100029China Department of nephrology Southeast University Zhongda HospitalNanjing 210009China Department of nephrology Shanghai Changzheng HospitalShanghai 200003China Department of Cardiology Peking Union Medical College HospitalBeijing 100730China Renal Division Tongji Medical College of Huazhong University of Science and TechnologyWuhan 430030China Department of Cardiology Zhongshan HospitalFudan UniversityShanghai 200032China

Objective Variations are present in common clinical practices regarding best practice in managing hyperkalaemia(HK),there is therefore a need to establish a multi-specialty approach to optimal renin angiotension-aldosterone system inhibitors(RAASi)usage and HK management in patients with chronic kidney disease(CKD)&heart failure(HF).This study aimed to establish a multi-speciality approach to the optimal use of RAASi and the management of HK in patients with CKD and *** A steering expert group of cardiology and nephrology experts across China were convened to discuss challenges to HK management through a nominal group *** group then created a list of 41 statements for a consensus questionnaire,which was distributed for a further survey in extended panel group of cardiologists and nephrologists across *** was assessed using a modified Delphi technique,with agreement defined as"strong"(≥75%andgroup,data collection,and analysis were aided by an independent *** A total of 150 responses from 21 provinces across China were recruited in the *** were comprised of an even split(n=75,50%)between cardiologists and *** 41 statements achieved the 75%consensus agreement threshold,of which 27 statements attained very strong consensus(≥90%agreement)and 14 attained strong consensus(agreement between 75%and 90%).Conclusion Based on the agreement levels from respondents,the steering group agreed a set of recommendations intended to improve patient outcomes in the use of RAASi therapy and HK management in China.

关键词： Sardiorenal syndrome chronic kidney failure heart failure hyperkalemia multidisciplinary communication RAASi

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Physico-chemical characterization of acid base disorders in patients with COVID-19:A cohort study

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World Journal of nephrology 2024年第2期13卷 16-23页

作者： Sergio Pinto de Souza Juliana R Caldas Marcelo Barreto Lopes Marcelo Augusto Duarte Silveira Fernanda Oliveira Coelho Igor Oliveira Queiroz Pedro Domingues Cury Rogério da Hora Passos Department of nephrology Hospital São RafaelSalvadorBA 41253190Brazil Department of nephrology D’Or Institute for Research and Education(IDOR)SalvadorBA 41253190Brazil Faculty of Medicine Escola Bahiana de Medicina e Saúde Pública-EBMSPSalvadorBA 40290000Brazil Department of Intensive Care D’Or Institute for Research and Education(IDOR)SalvadorBA 41253190Brazil Hospital São Rafael D’Or Institute for Research and Education(IDOR)SalvadorBA 41253190Brazil Department of Intensive Care Unit Hospital Israelita Albert EinsteinSao PauloSP 05652900Brazil

BACKGROUND Acid-base imbalance has been poorly described in patients with coronavirus disease 2019(COVID-19).Study by the quantitative acid-base approach may be able to account for minor changes in ion distribution that may have been over-looked using traditional acid-base analysis *** a cohort of critically ill COVID-19 patients,we looked for an association between metabolic acidosis surrogates and worse clinical outcomes,such as mortality,renal dialysis,and length of hospital *** To describe the acid-base disorders of critically ill COVID-19 patients using Stewart’s approach,associating its variables with poor *** This study pertained to a retrospective cohort comprised of adult patients who experienced an intensive care unit stay exceeding 4 days and who were diagnosed with severe acute respiratory syndrome coronavirus 2 infection through a positive polymerase chain reaction analysis of a nasal swab and typical pulmonary involvement observed in chest computed tomography *** and clinical data were obtained from electronic *** variables were compared using Fisher’s exact *** data were presented as median and interquartile *** Mann-Whitney U test was used for *** In total,211 patients were *** mortality rate was 13.7%.Overall,149 patients(70.6%)presented with alkalosis,28 patients(13.3%)had acidosis,and the remaining 34 patients(16.2%)had a normal arterial pondus *** those presenting with acidosis,most had a low apparent strong ion difference(SID)(20 patients,9.5%).Within the group with alkalosis,128 patients(61.0%)had respiratory *** non-survivors were older,had more comorbidities,and had higher Charlson’s and simplified acute physiology score *** did not find severe acid-base imbalance in this *** analyzed Stewart’s variables(effective SID,apparent SID,and strong ion gap and the effect of albumin,lactate,phosphorus,and chloride)were not d

关键词： COVID-19 Physicochemical approach Acid-base status Critically ill patients Acute respiratory syndrome

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