ObjectiveTo assess the effects of short-term (2-7 d) high-dose (80 mg/d) statins in the prevention of contrast-induced nephropathy ( CIN).MethodsWe searched PubMed, Embase,ScienceDirect,Scopus,Ovid andWileyInterScience with the key wordsof “ statins/statin/HMG-CoA reductaseinhibitor” ,“contrast ” and“ nephropathy/nephrosis/nephrotoxicity/kidneyfailure”inall languages from 1996 t0 2010 for RCT that assessed the preventive effect of short-term (2-7 d)high-dose( 80 mg/d) statins on CIN.ResultsFive trials with a total of 1009 patients were identifiedTwo studies were conducted in patients with CKD 3-5 stages ( GFR≤60 ml/min or serum creatinine≥97.2 μmol/L) and the remaining 3 studies were conducted in patients with CKD l and 2 stages.Analysis of the data in patients with CKD 3-5 stages did not reveal a statistically significant difference in CIN incidence between the statins and placebo groups (6.50％vs 7.2％ ).The relative risk ( RR)was 0.89 without evidence of heterogeneity (12 =Oqo,P=O.79).Analysis of the data in patients with CKD I and 2 stages revealed a significantly lower CIN incidence in the statins group( 3.60-/o )than that in the placebo group( 11.9％ ).The RR was 0.28 without evidence of heterogeneity( I2=0%, P =0.87 ). Conclusion Short-termhigh-dosestatins treatment may be benefical in reducing the incidence of CIN in patients with CKD l and 2 stages,while nobenefit has been shown in the patients with CKD 3-5 stages.

Objective To explore the role of hemoglobin (Hb) level in mortality and morbidity of chronic kidney disease (CKD)patients,aiming to give some evidence for therapy of anemia.Methods Randomized,clinical trials (RCTs) were identified by searching Medline,Embase and the Cochrane library.All the analyses were performed using the Revman software available free from the Cochrane collaboration.Results Twenty-three trials involving 10 204 patients were identified.Overall,the high Hb target was associated with increased risk of all-cause mortality (RR=1.10,95％ CI 1.00 to 1.21),hypertension (RR=1.40,95％ CI 1.12 to 1.75),stroke and hospitalization (RR=1.07,95％ CI 1.00 to 1.14) compared with low Hb target (P＜0.05).No significant difference was found in the risks of non-fatal mycardial infarction (RR=1.13,95％ CI 0.79 to 1.62) and renal replacement therapy (RR =1.00,95％ CI 0.85 to 1.18).Conclusions Targeting low Hb target is beneficial to CKD patients based on reduced risk of hypertension,hospitalization,stroke and all-cause mortality.However,no significant difference is found in non-fatal mycardial infarction and renal replacement therapy.

Asymmetric dimethylarginine(ADMA)is a natural L-arginine analogue that reduces the bioavailability of nitric oxide in plasma and various types of tissues,acting as an endogenous NO synthase inhibitor in vivo.ADMA is considered a common pathway mediating the adverse vascular effects of traditional and nontraditional risk factors.These preclinical findings are thought to be of major importance as ADMA predicts cardiovascular events and mortality in patients with chronic kidney disease(CKD).Also,ADMA uniformly predicts the progression of moderate and severe CKD.The present study summarizes the latest developments in this field.

OBJECTIVE:To evaluate the effects of compound amino acids capsul es on hypoalbuminemia in patients with chronic renal failure undergoing hemodialysis.METHODS:30hemodialysis patients were selected to orally take2compound amino acids capsules(0.35g per capsule)twice daily for12weeks,renal and liver function and levels of serum albumin and pre-albumin were measured before and after the experiment.RESULTS:The levels of serum albumin and pre-albumin were increased significantly after the treatment,it were(30.5?4.6)g/L vs(35.9?7.1)g/L,and(213.0?46.9)mg/L vs(275.8?52.3)mg/L respectively(P

ObjectiveTo explore the relationship between the different body mass index (BMI) ranges and all cause mortality in hemodialysis (HD) patients. MethodsEligible studies assessing the effects of BMI ranges on all-cause mortality(published from 1966 to 2012 )were searched, using hemodialysis/haemodialysis and obese/body mass index/overweight andmortality/surwival/reverse epidemiology/obesity paradox in PubMed,Embase,ScienceDirect,Wilcy,Scopus and Ovid. Inclusion criteria were that trials reported mortality in HD patients according to the traditional WHO/NIH BMI classification,and BMI levels were acceptable within 2 kg/m2.The quality of the trials was evaluated using the assessing risk of bias in studies included in Cochrane reviews.The mortality rate in HD patients was the primary endpoint of the study.ResultsWith no significant heterogeneity ( I2 =0％,P =0.45 ),a fixed-effects model was used for analysis.Four studies with a total of 81 423 patients met final inclusion criteria.Compared to individuals with non-elevated BMI levels,the elevated group (BMI ≥25 kg/m2) was associated with lower all-cause mortality ( OR 0.67,95％ CI 0.65-0.68 ). In a risk-adjusted sensitivity analysis,elevated BMI levels remained protective against mortality( adjusted HR 0.94,95％ CI 0.92-0.96 ).ConclusionsHigh BMI levels are associated with lower all-cause mortality rate in HD patients.More stable hemodynamic status,cytokine and neurohormonal alternations,and nutritional status maybe contribute to the protective effects of BMI on the mortality of HD patients.There is a need for more prospective studies to elucidate underlying mechanisms.

Objective To investigate the effect of low molecular weight heparin on lipid parameters in hemodialysis patients. Methods The trial was double blind, open, controlled and randomized for one year. 35 pre-dialysis patients were divided into two groups: UFH(unfractionated heparin) group(n = 13) and LMWH(low molecular weight heparin ) group(n = 22), UFH or Fragmin according to individual dosage was infused to patients of two groups respectively. The level of serum lipid, lipoprotein, apolipoprotein and activity of lipase were measured at months 0, 6 and 12 of trial. Results Significant increases in serum concentrations of TG, LDL, VLDL, Lp(a) and apo-B were observed, whereas serum concentrations of HDL, apo-Al and activity of plasma LCAT or LDL were decreased in both groups before hemodialysis. As dialysis time went by, in LMWH group, activities of plasma LPL and LCAT elevated; TG concentration decreased; VLDL and LDL were not significantly different compared with that of pre-dialysis, but were statistically different in contrast to UFH group. Conclusion The long-term use of LMWH instead of conventional heparin for anticoagulation during dialysis has beneficial effects on the lipid profile, especially in patients with dyslipidemia.

Objective To explore the protective effects of peritoneal dialysis on tissue and organ damage induced by acute hemorrhagic necrotic pancreatitis (AHNP) . Methods Thirty-four AHNP patients were randomly divided into PD group ( n = 21) and control group (n=13). Control group was treated with conventional therapy, while PD group was treated with conventional therapy companied by intermittent peritonea] dialysis (IPD). Urinary and serum amylase, the plasma levels of TNF and IL-1, faecal occult blood test and serum leucocyte were examined. Functions of brain, kidney , liver and heart were observed. Results The protective effect was better in PD group than that in normal group (P

Objective To investigate the effects of arteriovenous fistula on structure and function of left ventricle in patients with maintained hemodialysis. Methods Levels of hemoglobin, inter-hemodialysis weight increase, blood pressure, diameter and blood flow of the fistula, structure and function of left ventricle were examined before and 12, 24 months after hemodialysis treatment in 44 patients who were divided into group A(low flow group, 900 ml/min) based on the fistula flow at the 24th month. Results Left ventricular end-diastolic diameter (LVDd), interventriculare septal thickness (IVST) and left ventricular mass index (LVMI) increased gradually as the time of hemodialysis going on. The cardio-cheat proportion also increased as well as ejection fraction (EF) and the peak velocity ratio of early and late diastolic period(E/A), especially significantly increased in group B. Cardio-chest proportion , LVDd and LVMI were higher and E/A lower in patients with severe sodium retention than those with mild sodium retention in both groups. The fistula flow was positively related to LVDd and LVMI( P

Erythropoietin is a critical growth factor in development of erythrocyte. After binding to its receptor, eryhropoietin produces biological action through consequent activation of intracellular signal transduction systems, including JAK2-STAT5, sos-Ras-MAPK, IRS-2- PI 3-K + and Ca 2+ channel.

Objective: To investigate the function and IL 1ra gene expression of neutrophils in hemodialysis (HD) patients. Methods: Gene expression was studied by reverse transcribe polymerase chain reaction (RT PCR) from untreated neutrophils in healthy controls and HD patients. Phagocytosis and bactericidal assays decreased in the number of viable extracellular and intracellular bacteria by colony counts. Results: Freshly isolated neutrophils spontaneously expressed icIL 1ra, sIL 1ra mRNA in HD patients. Phagocytosis and intracellular killing of neutrophils in HD patients impaired obviously when exposed to staphylococcus aureus in comparison with healthy controls. Conclusion: Untreated neutrophils in HD patients spontaneously express icIL 1ra and sIL 1ra mRNA, which is consistent with the suppressed phagocytosis and intracellular killing capacity. [