Atherosclerosis and arterial plaque are common and severe complications in patients with chronic kidney disease (CKD), particularly in advanced stages (CKD 3–5). Identifying reliable predictors for cardiovascular risk in this population is crucial. The Advanced Lung Cancer Inflammation Index (ALI), a marker that integrates body mass index (BMI), albumin, and the neutrophil-to-lymphocyte ratio (NLR), has shown promise as a predictor of inflammation and nutritional status. However, its association with carotid plaque in non-dialysis CKD patients remains unexplored. This retrospective cross-sectional study included 204 non-dialysis CKD stage 3–5 patients admitted between April and July 2019. ALI was calculated as BMI × albumin/NLR, and carotid plaque was assessed using ultrasound. Multivariable logistic regression models were employed to evaluate the association between logarithm-transformed ALI (LnALI) and carotid plaque, adjusting for relevant covariates. Restricted cubic spline (RCS) analyses were conducted to assess the potential non-linear relationship between ALI and carotid plaque formation. Patients with carotid plaques were older (67 [57–74] vs. 51 [40–61] years, P < 0.001) and had a higher prevalence of diabetes mellitus (51.2

Phage therapy is emerging as a promising alternative to antibiotics for treating various infections. However, there have been no prior studies on using bacteriophages for peritonitis in patients undergoing peritoneal dialysis. This report presents the successful treatment of refractory peritonitis in a 71-year-old male peritoneal dialysis patient using bacteriophages combined with antibiotics. The patient has a history of refractory and repeat peritonitis caused by Staphylococcus haemolyticus, which was resolved through simultaneous catheter replacement (SCR). Subsequently, the patient experiences another episode of refractory peritonitis due to Klebsiella pneumoniae. Although this strain is found to be susceptible to amikacin and imipenem, a 14-day course of treatment with these antibiotics in the abdominal cavity fails to resolve the peritonitis. Combined with antibiotic therapy, the patient is successfully treated with intraperitoneal phage therapy targeting his bacterial isolate. We monitor the longitudinal progression of phage loads, phage-neutralizing antibodies, interleukin-6 levels, and lipopolysaccharide concentrations in the dialysate effluent during the bacteriophage therapy. The combination of a phage cocktail and imipenem (IPM) demonstrates a greater effect in killing bacteria than either treatment alone, which indicates that a synergistic effect exists between the phage cocktail and IPM. Intraperitoneal IPM is discontinued after a 3-week course of treatment. At the same time, oral fluconazole is given to prevent fungal infections. The patient is discharged without any antibiotics. After this round of treatment, the patient remains healthy during the one-month follow-up. Our study suggests that personalized phage therapy combined with sensitive antibiotics can play a significant role in managing refractory peritonitis in patients undergoing peritoneal dialysis, showing promise for future applications.

Left ventricular hypertrophy (LVH) is a common cardiovascular complication in chronic kidney disease (CKD), associated with increased morbidity and mortality. Systemic inflammation may contribute to LVH, but evidence remains limited in non-dialysis CKD populations. The neutrophil-to-lymphocyte ratio (NLR), a readily accessible inflammatory marker, may serve as a predictor of LVH. In this cross-sectional study, 514 hospitalized CKD patients were enrolled. LVH was defined by echocardiographic criteria based on left ventricular mass index. NLR was calculated from complete blood counts. Logistic regression models were used to evaluate the association between NLR and LVH after adjusting for potential confounders. Subgroup and restricted cubic spline (RCS) analyses were conducted to assess consistency and non-linear relationships. Mediation analysis was performed to explore whether NLR mediated the relationship between CKD and LVH. Patients with LVH had significantly higher NLR levels than those without (3.14 vs. 2.20, p < 0.001). After full adjustment, standardized NLR remained independently associated with LVH (adjusted OR: 1.34, 95

Introduction: Chronic kidney disease (CKD) is associated with a high prevalence of cardiovascular complications, including left ventricular hypertrophy (LVH), which significantly increases morbidity and mortality. LVH in CKD results from a complex interplay of hemodynamic, neurohormonal, and metabolic factors. The uric acid-to-high density lipoprotein cholesterol ratio (UHR) has recently been proposed as a potential marker for cardiovascular outcomes, combining the effects of uric acid and HDL-C on inflammation and cardiovascular risk. However, the relationship between UHR and LVH in CKD patients remains unexplored. This study aimed to investigate the association between UHR and LVH in patients with CKD. Methods: This cross-sectional study included CKD patients admitted to the Division of Nephrology between April 2019 and October 2019. CKD was staged according to the Kidney Disease: Improving Global Outcomes (KDIGO) guidelines. LVH was assessed using transthoracic echocardiography, and left ventricular mass index (LVMI) was calculated. LVH was defined as an LVMI >115 g/m2 for men and >95 g/m2 for women. UHR was calculated by dividing serum uric acid levels (µmol/L) by HDL-C levels (mmol/L). Multivariable logistic regression models were used to assess the association between UHR and LVH, adjusting for covariates including age, gender, BMI, and other relevant clinical factors. Results: A total of 466 patients were included, of whom 56 had LVH. Patients with LVH had significantly higher UHR levels compared to those without LVH. In multivariable regression analysis, the natural logarithm of UHR (LnUHR) was significantly associated with an increased risk of LVH (OR: 2.04, 95% CI: 1.05–4.12, p = 0.035) after full adjustment for confounders. Further analysis using restricted cubic splines revealed a non-linear relationship between UHR and LVH, with an inflection point at UHR = 0.60. Below this threshold, each increase of one standard deviation in UHR was associated with a 2.11-fold increase in LVH risk (OR: 2.11, 95% CI: 1.51–3.03, p < 0.001), while above this threshold, the association was not significant (OR: 0.82, 95% CI: 0.39–1.47, p = 0.54). Conclusion: This study provides the first evidence of an association between UHR and LVH in CKD patients, particularly at lower UHR levels. The findings suggest that UHR could serve as a novel marker for cardiovascular risk stratification in CKD, reflecting the balance between pro-inflammatory and protective cardiovascular factors. These results highlight the potential of UHR as a cost-effective tool for identifying CKD patients at increased risk of LVH, warranting further investigation in longitudinal studies to establish causality and explore targeted interventions.

INTRODUCTION:Peritoneal dialysis (PD)-associated peritonitis is a major complication in PD patients, leading to increased morbidity and technique failure. Identifying reliable biomarkers for predicting peritonitis risk is crucial for early intervention. Monocyte-to-lymphocyte ratio (MLR) is an emerging inflammatory marker associated with adverse outcomes in end-stage renal disease, but its predictive value for peritonitis remains unclear. METHODS:This retrospective cohort study included PD patients from a single center who had undergone PD for at least 3 months. MLR was assessed at the time of PD catheter insertion, and patients were followed for 36 months. Peritonitis was defined according to the International Society for Peritoneal Dialysis criteria. Cox proportional hazards models were used to analyze the association between MLR (continuous and tertile-based) and peritonitis, adjusting for demographic, clinical, and laboratory factors. Restricted cubic spline (RCS) regression was applied to evaluate nonlinearity, and subgroup analysis was conducted to examine whether the association between MLR and peritonitis was consistent across different subgroups. RESULTS:A total of 108 patients were included, with 33 (30.6%) developing peritonitis. MLR was significantly higher in the peritonitis group (p = 0.032). Cox regression showed that higher MLR was independently associated with an increased risk of peritonitis (adjusted hazard ratio = 1.85, 95% confidence interval: 1.01-3.40, p = 0.048). Patients in the highest MLR tertile had a sixfold increased peritonitis risk compared to those in the lowest tertile (p for trend = 0.002). RCS analysis revealed a nonlinear association, with a threshold at natural logarithm-transformed MLR = -0.9. Subgroup analysis suggested a stronger association in patients with lower body mass index (<24 kg/m2). CONCLUSION:Higher MLR at PD initiation is an independent predictor of long-term peritonitis risk. MLR may serve as a simple, cost-effective biomarker for early peritonitis risk stratification, particularly in leaner patients.

Carotid atherosclerosis is a major cardiovascular complication in patients with chronic kidney disease (CKD). The hemoglobin glycation index (HGI) has been linked to glycation stress and vascular inflammation, which may contribute to atherosclerosis. However, its relationship with carotid plaque in patients with CKD remains unclear. This study aimed to investigate the association between HGI and carotid plaques in non-dialysis CKD stage 3–5 patients. This retrospective cross-sectional study included 195 non-dialysis CKD stage 3–5 patients. HGI was calculated as the difference between observed glycated hemoglobin (HbA1c) and predicted HbA1c, which was derived from fasting blood glucose. Carotid plaques were assessed via ultrasound. Multivariable logistic regression models were used to examine the association between HGI and carotid plaques, adjusting for cardiovascular risk factors (age, sex, body mass index, smoking, drinking, hypertension, cholesterol), CKD-related variables (estimated glomerular filtration rate, hemoglobin, intact parathyroid hormone) and medications (statins, sodium-glucose cotransporter-2 inhibitor, and glucagon-like peptide-1 receptor agonist). Restricted cubic spline (RCS) analysis was conducted to explore nonlinear relationships, and a threshold effect analysis was performed using piecewise logistic regression. Subgroup analyses were conducted to examine consistency across different subgroups. Causal mediation analysis was used to assess the potential mediating roles of age and diabetes mellitus. Among 195 non-dialysis CKD stage 3–5 patients, higher HGI was independently associated with carotid plaque (OR 1.76, 95

Objective To analyze the differences of free and esterified oxo-eicosatetraenoic acids(oxo-ETEs)in blood cells and plasma from arterial and venous blood in hemodialysis(HD)patients.Methods Arterial and venous blood samples from 12 patients with end-stage renal disease(ESRD)before and after HD treatment at Charité-Universitätsmedizin Berlin,Germany,from June to December 2020 were collected.The esterified and free oxo-ETEs derived from arachidonic acid in blood cells and plasma were measured by high performance liquid chromatography-tandem mass spectrometry(HPLC-MS/MS).Results Neither esterified nor free oxo-ETEs in blood cells displayed significant arteriovenous differences before and after HD.HD predominantly affected the metabolic levels of esterified and free oxo-ETEs in plasma.HD reduced the arteriovenous differences of esterified 12-oxo-ETE,free 15-oxo-ETE,and free 5-oxo-ETE in plasma,while raised the arteriovenous differences of esterified 15-oxo-ETE.Conclusions The oxo-ETEs in blood cells are relatively well-stabilized responding to HD treatment,whereas arteriovenous differences of free and esterified oxo-ETEs in plasma are present and active in response to HD treatment,potentially contributing to the cardiovascular disease.

Chronic kidney disease (CKD) is a significant public health concern associated with a high prevalence of carotid plaques, which are indicators of atherosclerosis and predictors of adverse cardiovascular outcomes. Inflammation is a hallmark of CKD, contributing to both renal dysfunction and cardiovascular complications. This study aims to investigate the association between inflammatory markers—systemic inflammatory response index (SIRI), systemic immune-inflammation index (SII), aggregate inflammatory status index (AISI), monocyte to high-density lipoprotein cholesterol ratio (MHR), neutrophil to high-density lipoprotein cholesterol ratio (NHR), neutrophil to lymphocyte ratio (NLR), and monocyte to lymphocyte ratio (MLR)—and carotid plaques in CKD patients, and to explore the potential mediating role of estimated glomerular filtration rate (eGFR) in this relationship. A cross-sectional analysis was conducted on patients admitted to the Division of Nephrology between January 2023 and June 2023. The primary endpoint was the presence of carotid plaques assessed using ultrasound imaging. Multivariable logistic regression models were used to examine the associations between inflammatory markers and carotid plaques, and trend tests were performed to evaluate the trending association of carotid plaques risk and inflammatory markers in tertiles. Restricted cubic spline (RCS) analysis was used to assess potential non-linear relationships, and subgroup analyses were conducted to examine consistency across different strata. Mediation analysis was performed to explore the role of eGFR. Of the 609 participants, 387 were included in the final analysis after applying exclusion criteria. Elevated levels of LnSIRI (OR = 1.87, 95

Abstract Background Gut dysbiosis in peritoneal dialysis (PD) patients causes chronic inflammation and metabolic disorders which result in a series of complications, probably playing an important role in PD technique failure. The reduction in gut microbial diversity was a common feature of gut dysbiosis. The objective was to explore the relationship between gut microbial diversity and technique failure in PD patients. Methods The gut microbiota was analyzed by 16s ribosomal RNA gene amplicon sequencing. Cox proportional hazards models were used to identify association between gut microbial diversity and technique failure in PD patients. Results In this study, a total of 101 PD patients were enrolled. During a median follow-up of 38 months, we found that lower diversity was independently associated with a higher risk of technique failure (hazard ratio [HR], 2.682; 95% confidence interval [CI], 1.319–5.456; p = 0.006). In addition, older age (HR, 1.034; 95% CI, 1.005–1.063; p = 0.020) and the history of diabetes (HR, 5.547; 95% CI, 2.218–13.876; p < 0.001) were also independent predictors for technique failure of PD patients. The prediction model constructed on the basis of three independent risk factors above performed well in predicting technique failure at 36 and 48 months (36 months: area under the curve [AUC] = 0.861; 95% CI, 0.836–0.886; 48 months: AUC = 0.815; 95% CI, 0.774–0.857). Conclusion Gut microbial diversity was independently correlated with technique failure in PD patients, and some specific microbial taxa may serve as a potential therapeutic target for decreasing PD technique failure.

Peritoneal dialysis (PD) is a renal replacement therapy for end-stage renal disease. Gut microbiota-derived uremic solutes, indoxyl sulfate (IS), p-cresyl sulfate (PCS), and trimethylamine-N-oxide (TMAO) accumulate in PD patients. The objective was to explore the gut microbiota and their influence on uremic toxins in PD patients and healthy controls (HC). Fecal samples were collected from PD patients (n = 105) and HC (n = 102). 16S rRNA gene regions were sequenced for gut microbiota analysis. IS, PCS, and TMAO levels were measured using HPLC-MS. PD patients exhibited lower alpha diversity and altered gut microbiota composition compared to HC. At the genus level, PD patients showed increased abundance of opportunistic pathogenic bacteria, and decreased abundance of beneficial bacteria. Three Operational Taxonomic Units discriminated PD patients from HC. Phenylalanine metabolism increased in PD, whereas tryptophan metabolism was unaltered. Low serum PCS did not necessarily mean healthier due to the loss of alpha diversity, increased Proteobacteria and opportunistic pathogenic bacteria. High serum PCS was mainly caused by elevated p-cresol-producing bacteria, enriched amino acid related enzymes, and enhanced sulfur metabolism, rather than declined residual renal function. In patients with different urine volumes, the gut microbiota alpha diversity and composition were unaltered, but serum IS and TMAO were significantly elevated in anuric patients. In conclusion, the gut microbiota abundance, composition, and function were altered in PD patients, which increased the PCS levels. We provided a better understanding of the microbiota-metabolite-kidney axis in PD patients. Targeting certain bacteria could decrease the PCS levels, whereas preserving the residual renal function could reduce the IS and TMAO levels.

Introduction: The immune senescence marked by the inflation of memory T cell is established in end-stage renal disease (ESRD) patients with peritoneal dialysis (PD). These patients suffer high incidence of infectious disease, which has been relevant to immune dysfunction. However the association of immune senescence with infection in PD patients is not clear. This prospective study aimed to investigate the relationship between proportion of T cell subsets and infection event in patients on PD. Methods: We enrolled patients on PD >6 months from January 1, 2016 to December 30, 2016 and followed them until April 30, 2020. Baseline T cell subsets from blood were collected at the time of recruitment. The primary end point was infection event including peritonitis, exit site infection, pneumonia, urinary tract infection, and other infection. Results: There were 94 patients (46 male) with a mean age of 56.1 ± 14.9 years old enrolled during the follow-up period, and 26 patients suffered infection events. A higher proportion of effector memory (EM) CD8+ T cells was found in patients with infection than in those without infection. There was no difference in the distribution of EM CD8+ T cells between PD-related and non-dialysis infection. Increased level of EM CD8+ T cells was risk factor for first infection event in PD patients. Conclusion: High level of EM CD8+ T cells could be a significant predictor of infection event in patients on PD.

对于腹膜透析(peritoneal dialysis,PD)(简称腹透)患者的难治性腹膜炎,国际腹膜透析协会(International Society for Peritoneal Dialysis,ISPD)腹膜炎诊治指南建议早期拔管,期间给予血液透析(简称血透)过渡,而何时进行腹透管重置目前尚缺乏明确的循证医学证据.本文报道1例PD患者拔管与置管同时进行成功治疗复发性合并难治性腹膜炎,避免血透过渡时新建血管通路以及血透相关风险,结合其诊治过程,加深对复发性及难治性腹膜炎的认识,为PD相关腹膜炎的预防和治疗提供可借鉴的经验.

Peritoneal dialysis (PD) is a replacement therapy for end-stage renal disease patients. In the first 4-8 weeks of PD, the patients were given an empirical dialysis prescription due to unknown peritoneal transport characteristics. Proteomic analysis could be used to identify serum biomarkers. In a discovery set, patients were divided into three groups according to the peritoneal equilibration test (PET) results: high (H), high average (HA), low average and low (LA&L) groups. A total of 1051 identified proteins were screened by Nano HPLC-MS/MS. The top two proteins among different peritoneal transport characteristics were Orosomucoid 2 (ORM2) and Creactive protein (CRP). In a validation set, CRP was significantly elevated in H group than LA&L group, consistent with proteomic analysis. Serum ORM2 was enhanced in LA&L group compared with H and HA group. The expression of ORM2 in peritoneum was also enriched in LA&L group. At last, supplying exogenous ORM could reduce peritoneal proteins loss, without causing a pro-inflammatory response in mice. ORM2 and CRP could be used as biomarkers to predict the baseline peritoneal transport characteristics, and guide the early PD treatment. ORM may serve as a novel therapeutic target for decreasing peritoneal proteins loss in PD patients. Significance: Peritoneal dialysis (PD) is associated with the functional alterations of the peritoneum. PD patients were often given an empirical dialysis prescription due to the unknown peritoneal transport characteristics in the first 4-8 weeks since PD started. Therefore, it is urgently needed to find biomarkers to predict the baseline peritoneal transport characteristics. In this study, we employed a proteomic analysis to identify serum biomarkers in a training set and verified the screened biomarkers in a validation set. We also found that Orosomucoid (ORM) has the potential to decrease peritoneal proteins loss in PD therapy.

Neuronal intranuclear inclusion disease (NIID) is neurodegenerative disease characterized by widespread inclusions. Despite the identification of GGC repeat expansion in 5'UTR of NOTCH2NLC gene in adult-onset NIIDs, its pathogenic mechanism remains unclear. Gain-of-function poly-amino-acid proteins generated by unconventional translation have been revealed in nucleotide repeat expansion disorders, inspiring us to explore the possibility of unconventional translation in NIID. Here we demonstrated that NOTCH2NLC 5'UTR triggers the translation of a polyglycine (polyG)-containing protein, N2NLCpolyG. N2NLCpolyG accumulates in p62-positive inclusions in cultured cells, mouse models, and NIID patient tissues with NOTCH2NLC GGC expansion. Translation of N2NLCpolyG is initiated by an upstream open reading frame (uORF) embedding the GGC repeats. N2NLCpolyG tends to aggregate with the increase of GGC repeat units, and displays phase separation properties. N2NLCpolyG aggregation impairs nuclear lamina and nucleocytoplasmic transport but does not necessarily cause acute death on neuronal cells. Our study suggests a similarity of pathogenic mechanisms between NIID and another GGC-repeat disease, fragile X-associated tremor ataxia syndrome. These findings expand our knowledge of protein gain-of-function in NIID, and further highlight evidence for a novel spectrum of diseases caused by aberrant polyG protein aggregation, namely the polyG diseases.

Introduction: The mortality of peritoneal dialysis (PD) patients remains high. The neutrophil to lymphocyte ratio (NLR), as an indicator of systemic inflammation, has been considered to be a predictor of cardiovascular and all-cause mortality in hemodialysis patients. The present study aims to investigate the relationship between NLR and long-term outcome in PD patients. Materials and Methods: The study included patients who initiated PD for at least 3 months between January 1, 2013, and December 31, 2015. All the patients were followed up until death, cessation of PD, or to the end of the study (June 31, 2018). NLR was calculated as the ratio of neutrophils to lymphocytes. Results: A total of 140 patients were included in this study. The median NLR reported was 2.87. Patients with lower NLR showed a higher survival rate than patients with higher NLR (log rank 6.886, p = 0.009). Furthermore, patients with higher NLR had a significantly higher cardiovascular mortality (log rank 5.221, p = 0.022). Multivariate Cox proportional hazards model showed that older age (HR 1.054, 95% CI 1.017–1.092, p = 0.004), higher Ca × P (HR 1.689, 95% CI 1.131–2.523, p = 0.010), and higher NLR (HR 2.603, 95% CI 1.037–6.535, p = 0.042) were independent predictors of increased all-cause mortality. NLR was also independently associated with cardiovascular mortality (HR 2.886, 95% CI 1.005–8.283, p = 0.039). Higher NLR (HR 2.667, 95% CI 1.333–5.337, p = 0.006), older age (HR 1.028, 95% CI 1.005–1.052, p = 0.016), and history of cardiovascular disease (HR 1.426, 95% CI 1.195–3.927, p = 0.031) were significantly independently associated with poor peritonitis-free survival in this study. Conclusions: NLR could be a strong predictor of long-term outcome in PD patients.

Background High IS level has been demonstrated to be associated with vascular calcification and lymphocyte functional disorders, which are both risk factors of CVD. Low HDL-c level is a risk factor of CVD in CKD patients. This study was designed to explore the potential relationship between IS and HDL-c levels in early stages of CKD population. Methods Patients of CKD stage 1-3 were enrolled in this cross-sectional study. Correlations between HDL-c and IS levels were investigated among various clinicopathological variables through independent samples t test and multivariate logistic regression. Results A total of 205 CKD patients (96 men) aged 43.27 ± 13.80 years old were included in this research. There were 96 patients (46 men) in CKD stage1 and 109 (50 men) in CKD stage 2 or stage 3. IS levels were significantly higher in CKD 2 + 3 group (1.50 ± 1.74 μg/ml vs. 0.94 ± 0.66 μg/ml, p = 0.007), while HDL-c levels were lower (1.19 ± 0.39 mmol/L vs. 1.33 ± 0.45 mmol/L, p = 0.017) compared to CKD 1 group. Among all the patients, a negative correlation was observed between IS and HDL-c levels (r = −0.244, p = 0.001). IS level was an independent risk factor for low HDL-c (<1.04 mmol/L) incidence even after controlling for potential confounders including concomitant disease, age, sex, blood pressure, BMI and laboratory biochemical test including eGFR (OR = 1.63, 95% CI: 1.11–2.39, p = 0.013). IS and HDL-c were both risk factors for predicting CKD stage 3. Conclusions In early CKD stages, low HDL-c level is associated with increased IS levels, which may be an important contributor in the development of dyslipidemia in CKD patients.

Objective:To investigate the expression of Na +-dependent glucose transporter(SGLT) in human peritoneal mesothelial cells (HPMCs) and vascular endothelial cells in peritoneal tissues of peritoneal dialysis (PD) patients at different dialysis vintages, and to study the influence of high glucose treatment on the expression of SGLT1 and SGLT2 in primary HPMCs. Methods:According to the dialysis vintage, PD patients were divided into four groups: 0 year group, >0-2 years group, >2-4 years group and >4 years group. HE and Masson staining were used to observe the morphologic changes of peritoneal tissues in PD patients. Immunohistochemical staining was used to detect the expression of SGLT1 and SGLT2 in peritoneal HPMCs and vascular endothelial cells. The primary HPMCs were extracted from the peritoneal dialysis fluid, and treated with high-glucose or high-mannitol for 0 h, 12 h, 24 h, 48 h, 72 h and 96 h. Western blotting was used to investigate the SGLT1 and SGLT 2 expression in HPMCs. The cell viability was detected by using cell counting kit (CCK-8).Results:HE and Masson staining showed that the peritoneum of PD patients in 0 year group was smooth and continuous, with a flat layer of HPMCs. The number of HPMCs in>0-2 years group decreased compared with that in 0 year group. The HPMCs size increased in>2-4 years group, but the number decreased. The peritoneum of PD patients in>4 years group was significantly thickened and fibrotic, and HPMCs almost disappeared. Immunohistochemical staining showed that the expression of SGLT1 and SGLT2 in HPMCs gradually decreased with the increase of dialysis vintage ( P<0.05). The wall of peritoneal blood vessel became thicken, but the expression of SGLT1 and SGLT2 was not statistically different among four groups ( P>0.05). SGLT1 in primary HPMCs could be up-regulated (0 h, 12 h and 24 h), and then down-regulated (24 h, 48 h, 72 h, 96 h) with the treatment of 60 mmol/L glucose ( P=0.029); but there was no significant difference of SGLT2. Conclusion:High glucose and the increase of dialysis vintage can reduce the number and the viability of HPMCs, and decrease the expression of SGLT1 and SGLT2, but there was no significant influence on SGLT1 and SGLT2 in peritoneal vascular endothelial cells.

Impaired T cell immune function exists in end-stage renal disease (ESRD) patients. Dialysis treatment may lead to changes in T cell subsets. In the present study, we aimed to identify alterations of T cell phenotypes in ESRD patients, especially in those receiving peritoneal dialysis (PD), and analyze the potential associated factors. In the present study, 110 PD patients and 110 age/gender-matched hemodialysis (HD) patients who met the inclusion criteria were studied. Pre-dialysis blood samples were obtained and analyzed by flow cytometry to detect the expression of CD45RO and CCR7. Univariate and multivariate regression analyses were used to determine the factors associated with the alteration of T cell phenotypes. In all dialysis patients, age was associated with the frequencies of both CD4+ and CD8+ naïve T cells, effector memory (EM) T cells and effector memory RA (EMRA) T cells but not central memory (CM) T cells. Dialysis modality was also associated with T cell subsets. Compared with HD patients, PD patients showed an increase in both CD4+ and CD8+ CM T cells and a reduction in both CD4+ and CD8+ EM and EMRA T cells. However, the number of CD4+ naïve T cells was lower and the number of CD8+ naïve T cells was higher in PD patients than those in HD patients. In PD patients, further multivariate analysis revealed that the frequency of CD4+ naïve T cells was positively associated with nPCR, while the frequency of CD8+ naïve T cells was negatively associated with age. In dialysis patients, the dialysis modality and age influence T cell subsets. There is a progression from naïve to effector T cells in HD patients compared with PD patients. In PD patients, different factors may influence the frequencies of CD4+ and CD8+ naïve T cells.

布氏菌病简称布病 ,是布氏菌感染引起的一种人畜共患的传染病 ,属自然疫源性疾病.布病临床表现主要为发热、多汗、关节痛 ,以及肝脾、淋巴结肿大等 ,病情轻重不一.中国报告病例最多的省(自治区)为新疆、内蒙古、山西和黑龙江 ,集中于北方.疫区布病患者诊断并不困难 ,但非疫区出现的非典型症状患者常易被误诊.本文报告1例在慢性肾脏病基础上以发热伴腰椎疼痛为主要症状的布氏菌病的诊治经过及体会.

目的 腹膜透析(peritoneal dialysis,PD)患者血清硫酸吲哚酚(indoxyl sulfate,IS)浓度显著低于血液透析患者,进一步分析PD患者血清IS浓度的影响因素.方法 研究对象为在复旦大学附属中山医院腹透中心定期评估、病情稳定的持续不卧床PD(continuous ambulatory PD,CAPD)患者,收集患者一般人口统计学资料,检测血清IS浓度及各项实验室检查指标,进行腹膜平衡试验和透析充分性检查.结果 共纳入CAPD患者169例,有尿和无尿患者的性别、年龄、肾脏基础疾病、贫血、营养等一般情况差异均无统计学意义;有尿患者血清IS浓度更低[(18.74±11.30) μg/mL vs.(28.05±13.98) μg/mL,P＜0.001],透析充分性更好[tKt/v:2.20±0.60vs.1.84±0.43,P＜0.001;tCcr:(71.68±22.84) L/wk vs.(53.66±11.16) L/wk,P＜0.001].依据tKt/v分组,无论有尿还是无尿,透析充分与不充分患者IS浓度差异均无统计学意义;而依据tCcr分组则发现,透析充分的有尿患者血清IS浓度显著低于透析不充分的有尿患者.不同腹膜转运特性患者间血清IS浓度无统计学意义,高转运患者微炎症状态、营养不良情况更明显.单因素及多因素分析均提示透析龄、硫酸对甲酚、尿量、tCcr、前白蛋白、血肌酐与IS浓度具有显著相关性,且校正透析龄及尿量后tCcr与IS仍显著相关.结论 CAPD患者残余肾功能对IS清除极为重要,腹膜转运特性对血清IS浓度无显著影响;透析龄、硫酸对甲酚、尿量、tCcr、前白蛋白、血肌酐与血清IS浓度具有显著相关性.对于有尿CAPD患者,tCcr能够在一定程度上反映血清IS水平.