Objective To assess the efficacy and adverse reaction of Lanthanum carbonate in patients with hyperphosphatemia and high calcium times phosphate product receiving maintenance hemodialysis.Methods Twenty-three hemodialysis patients with serum phosphate ≥ 2.0 mmol/L and/or the serum calcium times phosphate product ≥ 4.52 mmol2/L2 were prescribed Lanthanum carbonate chewed with meals for 4 weeks.Blood (Hb), serum albumin (ALB), alanine amino shift enzyme (ALT), aspartic acid transaminase (AST) ,calcium(CA), phosphorus (P) calculated the product of calcium and phosphorus (Ca×P) and intact parathyroid hormone (iPTH) level were checked before and after Lantharum carbonate therapy.The adverse reactions were recorded concomitantly.Results Serum phosphate and the serum calcium time phosphate product significantly decreased after 1 month Lanthanum carbonate therapy((2.48±0.55) mmol/L vs.(1.83 ±0.37) mmol/L, (5.21 ± 1.35) mmol2/L2 vs.(4.10±0.96) mmol2/L2;t =2.742,2.936;P＜0.05).Serum calcium, iPTH level and blood cells count remained no change(P＞0.05), while serum ALT, AST concentration within normal range.Five patients complained affordable abdomen discomfort or upset.Conclusion Lantharum carbonate show to effectively and quickly control serum phosphorus levels and calcium time phosphate product in hemodialysis patients without inducing changes in serum calcium and should be considered an ideal phosphate binder.

Objective To investigate the cardioprotective effect of losartan o n subtotal nephrectomy renal failure rats. Methods Renal failure rats were estab lished by subtotal nephrectomy, and then divided into RF group with subtotal nep hrectomy,RF+Los group with additional losartan(10 mg?kg-1?d-1) gavage. Rats underwent sham operation(sham group) with normal saline gavage as control. Hear t changes of experimental rats were observed 12 weeks after operation. Results T he RF group developed hypertension of arterial systolic blood pressure(SBP) and myocardiac myocytes hypertrophy. The levels of collagen type Ⅰ,type Ⅲ,and fi bronectin in endocardium and surrounding intracardial coronary arteries adventit ia of the RF group were significantly increased as compared to those of the sham group. The SBP and the levels of collagen type Ⅰ,Ⅲand fibronectin were marked ly decreased in the RF+Los group as compared to those of the RF group.Expressio n of angiotensin Ⅱsubtype 1 receptor (AT1R) mRNA in the myocardium of the RF+L os group was significantly down regulated as compared to that of RF group. Concl usions Losartan can prevent the cardiac ventricular remodeling with left ventric ular hypertrophy (LVH) and myocardial interstitial fibrosis by the depression of renin-angiotensin system through the down-regulation of myocardiac AT1R mRNA.

Objective To observe the effect of fleabane injection on serum level of D-dimer, fibrinogen and hypersensitive C-reactive protein in patients with IgA nephropathy and to explore the mechanism of fleabane injection for treating IgA nephropathy. Methods 29 patients with IgA nephropathy were given fleabane injection together with routine treatment. Another group of 28 patients with IgA nephropathy were only treated with routine treatment as con-trol. Determinations of 24 hours urine protein output(24HPQ), serum level of D-dimer(D-D), Fibrinogen(Fib) and hypersensitive C-reactive protein (hsCRP) were carried out pre- and post-study. Results Significant decrease in 24HPQ , serum level of D-D, Fib and hsCRP were observed in both treatment group and control group(P <0. 01 ～0. 05), but more significant in treatment group as compared with control group ( P < 0. 05). Conclusion Flea-bane Injection plus routine treatment could significantly decrease 24HPQ in patients with IgA nephropathy, and this maybe contribute to regulation of D-D, Fib and hsCRP by fleabane injection.

Objective To explore mRNA and protein expression of PAl-1 in kidney tissue of mice with IgA nephropathy (IgAN) and the effects of YiShen Decoction. Methods The IgAN model was built by the method of oral intake of bovine serum albumin(BSA)together with the injection of staphylococcus enterotoxin B(SEB)through caudal vein. The mRNA expression of PAI-1 was measured by fluorescent quantitative polymerase chain reaction (FQ-PER)and the expression of PAI-1 protein was measured by immunohistochemistry. Results No significant difference of mRNA and protein expression of PAI-1 was found between the low concentration and high concentration Yishen Decoction group. But the secretion and mRNA expression of PAI-1 in the low and hiigh concentration Yishen Decoction group was decreased more than that in the IgAN model group. Conclusion The abnormal expression of PAI-1 mRNA and protein played an important role in the onset and development of IgAN. The TCM Yishen Decoction could reduce the abnormal expression of the mRNA and protein of PAI-1 in kidney tissue of mice with IgA nephropathy.

OBJECTIVE To investigate the infection episode and related risk factors in continuous hemodialysis patients. METHODS The relationship among infection and etiologies of infection,nutritional status,pathogens and causes of chronic renal failure(CRF) were retrospectively analyzed in 180 continuous hemodialysis patients. RESULTS Totally 113 times infections were observed among the 86 inpatients under continuous hemodialysis.The main infectious site in hemodialysis patients was lungs.Thirty eight times were positive in 50 times of etiologic detection,Gram-negative germ was the most common(60.3%).Hemoglobin and serum albumin decreased obviously in infectious patients.Diabetes and systemic lupus erythematosus patients were more susceptible to infection.The hepatitis virus infections rate in hemodialysis patients was relatively high. CONCLUSIONS There is higher infections rate in continuous hemodialysis patients.Diabetes and systemic lupus erythematosus patients are more susceptible to infection.Anemia,lower serum albumin,old age and bad compliance are the susceptible factors.