Objective To explore the expression levels and clinical significance of serum angiopoietin-like protein 8(ANGPTL8),cardiotrophin like cytokine factor 1(CLCF-1)in patients with primary nephrotic syndrome(PNS).Methods 124 patients with PNS admitted to Yulin Hospital,the First Affiliated Hospital of Xi'an Jiaotong University from January 2020 to February 2023 were selected as the PNS group,and 60 healthy individuals who underwent physical examinations during the same period were selected as the control group.Enzyme linked immunosorbent assay(ELISA)was used to detect serum levels of ANGPTL8 and CLCF-1.The correlation between serum ANGPTL8,CLCF-1 and renal function indicators were analyzed by Pearson correlation analysis.Logistic regression analysis was used to analyze the influencing factors on the prognosis of PNS patients.The evaluation value of serum ANGPTL8 and CLCF-1 was analyzed by analyzing receiver operating characteristic curve.Results The serum ANGPTL8(22.16±3.27 μg/L),CLCF-1(89.71±11.04 ng/L),24-hour urine protein(5.79±1.45g/24h),blood urea nitrogen(10.20±1.41mmol/L)and blood creatinine(191.44±21.52μmol/L)in the PNS group were higher than those in the control group(3.08±0.46μg/L,14.20±3.78ng/L,0.09±0.03 g/24h,4.88±1.21mmol/L,70.34±11.26μmol/L),while blood albumin was lower than those in the control group(25.06±2.80g/L vs 42.11±3.37g/L),and the differences were statistically significant(t=25.088～51.109,all P＜0.001).Serum ANGPTL8 and CLCF-1 were positively correlated with 24-hour urine protein,blood urea nitrogen and blood creatinine(r=0.636～0.789,all P＜0.001),while negatively correlated with blood albumin(r=-0.712,-0.689,all P＜0.001).Compared with the good outcome group,the PNS patients in the poor outcome group had higher serum ANGPTL8,CLCF-1,while lower IgA,and the differences were statistically significant(t=24.403,12.455,5.974,all P＜0.001).Serum ANGPTL8,CLCF-1 were risk factors affecting the outcome of PNS patients,while IgA was a protective factor(Wald χ2=14.354,15.666,10.847,all P＜0.001).The AUC(95%CI)of the combined evaluation of serum ANGPTL8 and CLCF-1 for the outcome of PNS patients which was higher than that of serum ANGPTL8 and CLCF-1,and the differences were statistically significant(Z=4.265,4.810,all P＜0.001).Conclusion The expression of serum ANGPTL8 and CLCF-1 are elevated in PNS patients,which are related to renal function indicators.The combination of the two has high evaluation value for evaluating the prognosis of PNS patients.

Objective To explore the expression levels and clinical significance of serum angiopoietin-like protein 8(ANGPTL8),cardiotrophin like cytokine factor 1(CLCF-1)in patients with primary nephrotic syndrome(PNS).Methods 124 patients with PNS admitted to Yulin Hospital,the First Affiliated Hospital of Xi'an Jiaotong University from January 2020 to February 2023 were selected as the PNS group,and 60 healthy individuals who underwent physical examinations during the same period were selected as the control group.Enzyme linked immunosorbent assay(ELISA)was used to detect serum levels of ANGPTL8 and CLCF-1.The correlation between serum ANGPTL8,CLCF-1 and renal function indicators were analyzed by Pearson correlation analysis.Logistic regression analysis was used to analyze the influencing factors on the prognosis of PNS patients.The evaluation value of serum ANGPTL8 and CLCF-1 was analyzed by analyzing receiver operating characteristic curve.Results The serum ANGPTL8(22.16±3.27 μg/L),CLCF-1(89.71±11.04 ng/L),24-hour urine protein(5.79±1.45g/24h),blood urea nitrogen(10.20±1.41mmol/L)and blood creatinine(191.44±21.52μmol/L)in the PNS group were higher than those in the control group(3.08±0.46μg/L,14.20±3.78ng/L,0.09±0.03 g/24h,4.88±1.21mmol/L,70.34±11.26μmol/L),while blood albumin was lower than those in the control group(25.06±2.80g/L vs 42.11±3.37g/L),and the differences were statistically significant(t=25.088～51.109,all P＜0.001).Serum ANGPTL8 and CLCF-1 were positively correlated with 24-hour urine protein,blood urea nitrogen and blood creatinine(r=0.636～0.789,all P＜0.001),while negatively correlated with blood albumin(r=-0.712,-0.689,all P＜0.001).Compared with the good outcome group,the PNS patients in the poor outcome group had higher serum ANGPTL8,CLCF-1,while lower IgA,and the differences were statistically significant(t=24.403,12.455,5.974,all P＜0.001).Serum ANGPTL8,CLCF-1 were risk factors affecting the outcome of PNS patients,while IgA was a protective factor(Wald χ2=14.354,15.666,10.847,all P＜0.001).The AUC(95%CI)of the combined evaluation of serum ANGPTL8 and CLCF-1 for the outcome of PNS patients which was higher than that of serum ANGPTL8 and CLCF-1,and the differences were statistically significant(Z=4.265,4.810,all P＜0.001).Conclusion The expression of serum ANGPTL8 and CLCF-1 are elevated in PNS patients,which are related to renal function indicators.The combination of the two has high evaluation value for evaluating the prognosis of PNS patients.

Objective To compare the therapeutic efficacy of whey protein powder in peritoneal dialysis hypoproteinemia patients.Methods From August 2019 to August 2020,100 patients with peritoneal dialysis hypoproteinemia from the Peritoneal Dialysis Center of the First Affiliated Hospital of Xi'an Jiaotong University were investigated.The patients were separated into 2 groups randomly;the study group were administered whey protein powder and the control group with high protein food.After 32 weeks of treatment,biochemical and biometric indices including hemoglobin(Hb),albumin(ALB),prealbumin(PA),triglyceride(TG),total cholesterol(TC),phosphorus(P),low density lipoprotein(LDL),high density lipoprotein(HDL),serum creatinine(Scr),blood urea nitrogen(BUN),estimated glo-merular filtration rate(eGFR),total spKt/Vurea(TKt/V),total creatinine clearance rate(TCcr),hand grip strength(HG),triceps skinfold(TSF),arm circumference(AMC),mid-arm muscle circumference(MAMC)were compared between groups.Results Compared with 0 week,at 16 and 32 weeks,ALB,PA,and HG were significantly increased in the study group(P＜0.05).Compared with the control group,ALB,PA,and HG increased significantly at 16 and 32 weeks in the study group(P＜0.05).There were no significant differences in TG,TC,HDL,LDL,eGFR,TKt/V,and TCcr at 0,8,16,and 32 weeks between the control and study groups(P＞0.05).Conclusion For patients with peritoneal dialysis hypoproteinemia caused by insufficient protein intake or excessive protein loss,the addition of whey protein during peritoneal dialysis can significantly improve the nutritional status of patients,with greater efficacy than a high protein diet alone.