Infection is a common, serious and costly complication in patients with chronic renal failure (CRF) and has been the major cause of high mortality in these patients. Increased evidences suggest that prophylaxis can significantly decrease the prevalence of infections in CRF patients, such as tuberculosis, S. aureus infection and hepatitis virus induced liver diseases. It remains an important issue for clinical nephrologists to investigate and to provide strategies for prevention and treatment of various infections in CRF patients.

Objective To evaluate the relationship between NK cytotoxicity and anemia in uremia. Methods The effect of rHuEPO on natural killer (NK) cell cytotoxic activity was studied in 12 hemodialysis(HD) patients. Results The levels of hemoglobin (Hb) and NK cell activity were significantly lower in HID patients than that in healthy controls. After two months of the treatment with rHuEPO, the levels of Hb in these patients rose significantly with a parallel rise in NK cell activity. NK cell activity was not increased when they were incubated with rHuEOP but was increased with red blcxxl cells. Conclusion Improved NK cell cytotoxicity in HD patients after treatment with rHuEPO was achieved through the rise in R15C rather than through rHuEPO itself.

Objective To test the hypothesis that attachment of synovial cell to &?2-microglobulin modified with advanced glycation end products (ACE-?2m) would affect cell adhesion, spreading and proliferation.Methods Normal human synovial cells (type B cells) were isolated and plated in culture dishes coated with AGE-?2m or with normal extracellular matrix proteins (EMP). Adhesion was analyzed by counting the isotope-labelled cells. Spreading was tested using a light microscope and proliferation determined by 3H-TdR incorporation and counting the number of cells. Results Synovial cells adhered less effectively to AGE-?2m, ?2m and AGE-collagen than to the normal EMP (collagen and fibronectin). Cells interacting with AGE-?2m, ?2m or AGE-collagen also demonstrated less extensive spreading throughout the examined time intervals (60-120 minutes after plating), and decreased 3H-TdR incorporation and cell numbers after 72 hours of plating when compared to cells interacting with normal EMP. Conchusion AGE-?2m in amyloid may alter synovial cell behavior in situ in ways which cods contribute to the development of dialysis-related amyloidodsis(DRA).

Objective To determine the expression of advanced glycation end products(AGE) binding proteins on human joint synovial cells for elucidating the pathobiological effects of ?2m modified with AGE(AGE-?2m) on joint resident cells. Methods Type A and type B synovial cells were isolated and cultured in vitro. The expression of AGE receptor 1 (ACE-R1 ), AGE receptor 2 (AGE-R2), AGE receptor 3 (AGE-R3) and 35 KD receptor for AGE(RAGE) on synoviocytes were detected by immunofluorescent staining using specific antibodies and flow cytometric analyses. mRNA of AGE receptors was examined by RT-PCR techniques.-Results RAGE and AGE-R3, but not AGE-R1 and AGE-R2, were constitutively expressed on the membrane surface of both type A and type B synovial cells. These two types of synovial cell also expressed mRNA of RAGE and AGE-R3. Conclusion Human joint synovial cells express specific AGE binding proteins, RAGE and AGE-R3, suggesting that these cells may be involved in AGE metabolism and might be the target of the biological effects of AGEs in dialysis-related amyloidosis.

The rats were fed on low salt diet for seven days,and then were randomly divided into five groups: control (n=7), CsA treated (n=7), CsA+Verapamil (n=7), CsA+Enalapril (n=7) and CsA+Losartan (n=7).CsA was given by subcutaneous injection (15mg?kg -1?d -1) for four weeks. The apoptosis of tubular and interstitial cells was detected by TUNEL assay. The proliferating cell nuclear antigen and Fas antigen expression were examined by immunohistochemical staining. Apoptosis of tubular and interstitial cells increased in CsA treated rats. CsA+Losartan and CsA+Enalapril treated rats had a statistically significant decrease in apoptosis when compared to CsA treated rats (7.3?1.1 and 6.6?0.8 vs 13.9?1.2 respectively, P

Objective To elucidate the clinical characteristics and the outcome of acute renal failure (ARF) in the elderly. Methods Clinical data of 109 elderly patients(≥60 years) with ARF were analysed and compared with that of 175 younger adult ARF patients(18 40 years) in the same period. Results 109 out of 422 patients(25 8%) with ARF were more than 60 years. The mortality rate of ARF in these patients was 58 7%. ARF was induced mainly by prerenal factors (20 2%) and sepsis (15 6%). Complications such as infections (52 3% vs 29 7%), cardiovascular events (64 2% vs 38 3%), respiratory failure (43 1% vs 20 0%) and hyperkalemia (29 4% vs 15 4%) were more prevalent in elderly patient than that in the younger adult ARF patients ( P

To elucidate the effects of pro inflammatory mediators on mRNA expression of AGE receptors in type B synovial cells, type B synovial cells from normal subjects were isolated and cultured in vitro with human serum albumin modified with advanced glycation end products (AGE HSA), tumor necrosis factor ?(TNF ?)and interleukin 1?(IL 1?). The expression of RAGE mRNA and AGE R3 mRNA was examined by RT PCR techniques. TNF ?, AGE HSA and IL 1? up regulated the expression of AGE R3 mRNA in type B synovial cells in a dose and time dependent manner. In contrast, TNF ? and AGE HSA down regulated the expression of RAGE mRNA in a dose and time dependent manner. IL 1? had no effect on RAGE mRNA expression. The regulatory responses induced by AGE HSA were blocked by a neutralizing polyclonal anti human TNF ? antibody, suggesting that the effects of AGE HSA were mediated by TNF ?. The proinflammatory mediators may regulate the gene expression of AGE receptors in type B synovial cells, and the regulatory role of these receptors is different in response to the proinflammatory mediators.

To investigate the clinical characteristics of patients with post traumatic acute renal failure (ARF)effect of early renal replacement therapy on their propnosis, a case control study was carried out in 71 cases of post traumatic ARF and 40 cases of post operative ARF. The effect of early renal replacement therapy on prognosis was evaluated. The incidence of post traumatic ARF in traumatic patients was 1 06%, and 16 21% in ARF. Rhabomyolysis and hypovolemia were the most common causes of ARF. Respiratory failure and coma were the predisposing factors of ARF. The incidence of multiple organ failure was 85 9% and the mortality was 70 4%. Early renal replacement therapy might improve the prognosis. The mortality of patients with Post traumatic ARF remains high, renal replacement therapy should be given as early as possible.

Objective To evaluate the clinical characteristics and prognostic factors in patients with acute renal failure (ARF) due to sepsis. Methods A case-control retrospective study was carried out in patients with acute renal failure due to sepsis and non-sepsis. Univariate and multivariate logistic regression analysis was performed to find the correlation among prognosis, clinico-biochemical parameters and scoring indexes of APACHE II and ATN-ISI. Results The incidence of septic ARF was 15. 6% in all ARF patients. Multiple organ failure was most common (87.9% ) in these patients with a high mortality (69. 7% ). Single-variable analysis showed that surgery, respiratory failure, hepatic failure, mechanical ventilation, oliguria, coma, multiple organ failure, ARF occurred during ICU stay and chronic health points were factors influencing prognosis. Multivariate logistic regression analysis showed that oliguria, ARF occurred during ICU stay, chronic health points, and multiple organ failure were the independent predictors of hospital mortality. Conclusion Outcome of septic ARF is correlated with factors including oliguria, ARF occurred during ICU stay, chronic health points and multiple organ failure.

The aim of this study was to investigate the effect of patients isolation,paying careful attention to hygienic measure and strict sterilization on prevention of hepatitis C infection in hemodialysis(HD) unit. Patients in our HD unit from May 1994 to May 1998 were isolated and strict sterilization of dialysis apparatuses were performed, while patients from April 1990 to April 1994 were not isolated. The rate of HCV infection in these two groups of patients were 18 20% and 26 72%, respectively ( P