OBJECTIVETo evaluate the changes of the semen quality in uremia patients before renal transplantation.

METHODSThe semen of 24 patients with uremia and 12 normal volunteers was analyzed.

RESULTSThe semen volume, sperm motility, survival rate, density and morphological normality percentage were (2.5 +/- 0.4) ml, (13.4 +/- 3.9)%, (25.4 +/- 5.6)%, (20.6 +/- 4.5) x 10(6)/ml and (16.8 +/- 2.1)%, respectively, significantly lower than those of the normal group (P < 0.01).

CONCLUSIONSemen qualities were lowered significantly and spermatogenesis severely affected in patients with uremia.

Adolescent ; Adult ; Case-Control Studies ; Female ; Humans ; Male ; Middle Aged ; Semen ; physiology ; Sperm Count ; Sperm Motility ; Spermatogenesis ; physiology ; Uremia ; physiopathology

OBJECTIVETo investigate the expression of aquaporin-1 (AQP1) in the human peritoneum and to evaluate the effect of peritoneal dialysis (PD) on its expression.

METHODSPeritoneal biopsies were obtained from normal subjects (n = 10), uremic nondialysis patients (n = 12) at catheter insertion and PD patients (n = 10) at the time of catheter removal, reinsertion or renal transplantation. Western blot, immuno-histochemical staining and reverse transcript-polymerase chain reaction (RT-PCR) techniques were used to investigate AQP1 expression.

RESULTSAll peritoneal samples expressed AQP1 at both mRNA and protein levels. Western blot revealed a major band at 28 kD as well as more diffuse bands between 35 and 50 kD. The 28 kD band represents the nonglycosylated form of the protein while the 35 - 50 kD bands correspond to glycosylated AQP1. Immunohistochemical staining found the positive deposits were distributed in the mesothelial cells, endothelial cells of capillaries, venules and small veins, whereas no signal was detected in the arterioles. Semi-quantitative analysis showed that AQP1 expression was remarkably stable in all samples, whatever their origin (P > 0.05).

CONCLUSIONSOur findings suggested that AQP1 is the molecular counterpart of an ultra small pore during PD. Secondly, the peritoneal mesothelial cell might also be involved in peritoneal transcellular water transport. As regards whether or not the structural or distributional alterations of AQP1 in the peritoneum may be more obviously expressed during PD, further study is needed.

Adult ; Aquaporin 1 ; Aquaporins ; analysis ; Blood Group Antigens ; Female ; Humans ; Male ; Middle Aged ; Peritoneal Dialysis ; Peritoneum ; chemistry ; physiology ; Uremia ; physiopathology

OBJECTIVETo study the changes of testicular spermatogenic function after kidney transplantation.

METHODSThirty male patients with uremia underwent kidney transplantation. Semen analyses were made and sperm ultrastructural changes were studied before and after the operation.

RESULTSSperm viability, motility and movement velocity were significantly higher in the postoperative group than in the preoperative group [(70.08 +/- 2.86 vs (36.04 +/- 8.01)], [(76.15 +/- 3.75)% vs (39.27 +/- 4.14)%], [(16.80 +/- 1.11) microm/s vs (8.43 +/- 2.01)] micro/s, respectively (P < 0.01). Sertoli cell, acrosome and mitochondria structures inclined to normal after kidney transplantation.

CONCLUSIONKidney transplantation can significantly improve spermatogenic function in patients with uremia.

Adult ; Humans ; Kidney Transplantation ; physiology ; Male ; Middle Aged ; Sperm Motility ; Spermatogenesis ; physiology ; Spermatozoa ; ultrastructure ; Uremia ; physiopathology ; surgery

OBJECTIVETo assess left ventricular (LV) geometry, LV diastolic and systolic function in maintenance hemodialysis uremic patients.

METHODSForty uremic patients and forty-five normal subjects were included in this study. LV volume, LV mass index (LVMI), relative wall thickness (RWT), LV mass and diastolic volume ratio (LVM/EDV) were measured. Mitral flow E velocity and A velocity ratio, deceleration time, mitral flow E velocity and mitral annulus Ea velocity ratio (E/Ea), pulmonary vein flow S velocity and D velocity ratio, atrial flow reversal velocity of pulmonary vein flow, mitral inflow propagation velocity, left atrium volume (LAV) and pulmonary artery systolic pressure (PASP) were determined for diastolic function evaluation. LV ejection fraction (LVEF) and single volume (SV) were derived from 3D echocardiography, systolic velocity of mitral valve annulus (Sa) by pulse tissue Doppler imaging (TDI) were used to evaluate systolic function. The time to peak systolic velocity (Ts) and early diastole velocity (Td) of LV 12 segments were measured using TDI. The maximal difference of Ts and Td (Ts-Dif and Td-Dif) were calculated to assess LV systolic and diastolic asynchrony.

RESULTSRWT, LVMI and LVM/EDV were significantly increased in uremic patients. There were 50% concentric, 17.5% eccentric hypertrophy and 17.5%concentric remodeling, respectively in uremic patients. The indices for LV diastolic function (E/Ea, LAV and PASP) were significantly higher in uremic patients than those in control subjects (P < 0.01). About 85% of the diastolic dysfunction in uremic patients presented as impaired relaxation pattern and 32.5% as increased filling pressure. LVEF and SV were similar between uremic patients and control subjects. Sa was significantly lower in uremic group than that in controls (P < 0.05). Ts-Dif was similar between the 2 groups while Td-Dif was significantly higher in uremic patients than control subjects (P < 0.05).

CONCLUSIONLV hypertrophy, LV mass increase and LV diastolic dysfunction were the major characteristic of myocardial injury in uremia patients.

Adult ; Aged ; Case-Control Studies ; Echocardiography ; Female ; Humans ; Male ; Middle Aged ; Renal Dialysis ; Uremia ; diagnostic imaging ; physiopathology ; therapy ; Ventricular Remodeling

OBJECTIVETo evaluate the left ventricular systolic asynchrony in patients with uremic myocardiopathy (UM) using tissue synchronization imaging (TSI).

METHODSUltrasound system with TSI and Q-analyze software were used. Thirty-five patients with UM were enrolled in the study,and thirty normal subjects were included as the control group.

RESULTThe total and mean time to peak velocity (Tc) corrected by the heart rate of all segments in UM group were longer than those in the control group (P<0.05), and the time to peak velocity of most segments in UM group was also longer (P<0.05). Delayed time to peak velocity was found in 175 (175/420) segments in UM group and left ventricular systolic asynchrony was detected in 65.7% (23/35).

CONCLUSIONTSI can detect the ventricular systolic asynchrony in patients with uremic myocardiopathy and provide reliable parameters for clinical management.

Adult ; Cardiomyopathies ; etiology ; physiopathology ; Case-Control Studies ; Echocardiography ; methods ; Female ; Humans ; Male ; Middle Aged ; Systole ; physiology ; Uremia ; complications ; Ventricular Dysfunction, Left ; diagnostic imaging ; physiopathology

Colonic necrosis is known as a rare complication following the administration of Kayexalate (sodium polystryrene sulfonate) in sorbitol. We report a rare case of colonic mucosal necrosis following Kalimate (calcium polystryrene sulfonate), an analogue of Kayexalate without sorbitol in a 34-yr-old man. He had a history of hypertension and uremia. During the management of intracranial hemorrhage, hyperkalemia developed. Kalimate was administered orally and as an enema suspended in 20% dextrose water to treat hyperkalemia. Two days after administration of Kalimate enema, he had profuse hematochezia, and a sigmoidoscopy showed diffuse colonic mucosal necrosis in the rectum and sigmoid colon. Microscopic examination of random colonic biopsies by two consecutive sigmoidoscopies revealed angulated crystals with a characteristic crystalline mosaic pattern on the ulcerated mucosa, which were consistent with Kayexalate crystals. Hematochezia subsided with conservative treatment after a discontinuance of Kalimate administration.
Adult ; Colon/*pathology ; Gastrointestinal Hemorrhage/etiology ; Humans ; Hyperkalemia/drug therapy ; Intestinal Mucosa/*pathology ; Male ; Necrosis/*chemically induced/complications/pathology ; Polystyrenes/*adverse effects/therapeutic use ; Uremia/*physiopathology

Adolescent ; Adult ; Aged ; Blood Urea Nitrogen ; Creatinine ; blood ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Kidney ; physiopathology ; Kidney Function Tests ; Male ; Middle Aged ; Phytotherapy ; Renal Dialysis ; Uremia ; physiopathology ; therapy

To investigate the role of glucose transporter 1 (GLUT1) and sodium-glucose cotransporter 1 (SGLT1) in high glucose dialysate-induced peritoneal fibrosis.Thirty six male SD rats were randomly divided into 6 groups (6 in each):normal control group, sham operation group, peritoneal dialysis group (PD group), PD+phloretin group (PD+T group), PD+phlorizin group (PD+Z group), PD+phloretin+phlorizin group (PD+T+Z group). Rat model of uraemia was established using 5/6 nephrotomy, and 2.5% dextrose peritoneal dialysis solution was used in peritoneal dialysis. Peritoneal equilibration test was performed 24 h after dialysis to evaluate transport function of peritoneum in rats; HE staining was used to observe the morphology of peritoneal tissue; and immunohistochemistry was used to detect the expression of GLUT1, SGLT1, TGF-β1 and connective tissue growth factor (CTGF) in peritoneum. Human peritoneal microvascular endothelial cells (HPECs) were divided into 5 groups:normal control group, peritoneal dialysis group (PD group), PD+phloretin group (PD+T group), PD+phlorezin group (PD+Z group), and PD+phloretin+phlorezin group (PD+T+Z group). Real time PCR and Western blotting were used to detect mRNA and protein expressions of GLUT1, SGLT1, TGF-β1, CTGF in peritoneal membrane and HPECs., compared with sham operation group, rats in PD group had thickened peritoneum, higher ultrafiltration volume, and the mRNA and protein expressions of GLUT1, SGLT1, CTGF, TGF-β1 were significantly increased (all<0.05); compared with PD group, thickened peritoneum was attenuated, and the mRNA and protein expressions of GLUT1, SGLT1, CTGF, TGF-β1 were significantly decreased in PD+T, PD+Z and PD+T+Z groups (all<0.05). Pearson's correlation analysis showed that the expressions of GLUT1, SGLT1 in peritoneum were positively correlated with the expressions of TGF-β1 and CTGF (all<0.05)., the mRNA and protein expressions of GLUT1, SGLT1, TGF-β1, CTGF were significantly increased in HPECs of peritoneal dialysis group (all<0.05), and those in PD+T, PD+Z, and PD+T+Z groups were decreased (all<0.05). Pearson's correlation analysis showed that the expressions of GLUT1, SGLT1 in HPECs were positively correlated with the expressions of TGF-β1 and CTGF (all<0.05).High glucose peritoneal dialysis fluid may promote peritoneal fibrosis by upregulating the expressions of GLUT1 and SGLT1.
Animals ; Cells, Cultured ; Connective Tissue Growth Factor ; analysis ; drug effects ; Dialysis Solutions ; adverse effects ; chemistry ; pharmacology ; Gene Expression Regulation ; drug effects ; Glucose ; adverse effects ; pharmacology ; Glucose Transporter Type 1 ; analysis ; drug effects ; physiology ; Hemodiafiltration ; adverse effects ; methods ; Humans ; Male ; Peritoneal Dialysis ; adverse effects ; methods ; Peritoneal Fibrosis ; chemically induced ; genetics ; physiopathology ; Peritoneum ; chemistry ; drug effects ; pathology ; Phloretin ; Phlorhizin ; RNA, Messenger ; Rats ; Rats, Sprague-Dawley ; Sodium-Glucose Transporter 1 ; analysis ; drug effects ; physiology ; Transforming Growth Factor beta1 ; analysis ; drug effects ; Uremia ; chemically induced