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.

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 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

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 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. [

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 Our study aimed at the role of p27 on the hypertrophy of mesangial cell (MC) cultured in high glucose. Methods The p27 protein of MC lysate was detected with western blotting analysis. The degree of cultured MC hypertrophy was estimated through [3H]-thymidine incorporation and [3H]-leucine incorporation. The effect of reducing p27 expression on cell hypertrophy was analysed with p27 antisense oligodeoxynucleotide (ODN) phosphorothioate. Results in MC cultured in high glucose (450mg/dl) serum-free DMEM compared with MC cultured in normal glucose (100mg/dl) serum-free DMEM, p27 increased, [3H]-leucine incorporation increased and[3H]-thymidine incorporation decreased;p27 antisense ODN transfection reduced [3H]leucine incorporation, increased [3H] thymidine incorporation of MC cultured in high glucose senumfree DMEM. Increasing medium osmolarity with D-mannitol failed to induce p27 expression of MC. Conclusion p27 protein increased in MC cultured in high glucose. High level of p27 played an important role in MC hypertrophy induced by high glucose. Because the cell cycle is controlled by the interaction between the positive cell cycle regulatory proteins(CCRP) and negative CCRP, further research is needed to study the expression of the positive and negative CCRP in MC in order to better understand the role of CCRP in MC hypertrophy.