Hyperreactio luteinalis associated with chronic renal failure

Hyperreactio luteinalis is a rare benign condition characterized by bilateral ovarian enlargement associated with pregnancies where high concentrations of maternal serum human chorionic gonadotrophins are present. This condition may mimic the ovarian hyperstimulation syndrome. We report a case of a 34 year old woman with a history of chronic renal failure on haemodialysis who presented at 10 weeks' gestational age with hyperreactio luteinalis which was treated conservatively. Because of chronic renal failure, the presentation and course of the disease was different from that which has been previously reported.     

慢性肾衰竭大鼠肾细胞外基质变化

目的:分析慢性肾衰竭大鼠肾去细胞组织结构特点,探讨慢肾衰大鼠肾细胞外基质的病理变化。方法:SD大鼠实验组腺嘌呤灌胃,行去细胞处理后,H-E、Masson染色及电镜观察慢肾衰大鼠肾形态学结构变化及去细胞支架的生物学特性,免疫荧光分析其细胞外基质成分的变化。结果:腺嘌呤灌胃造模组慢肾衰血尿素氮、血肌酐明显增高,肾大体显示透明度降低,且随灌胃时间延长,H-E染色整体支架更加粗大,同时细胞数目以及小管区结晶数目明显增多;Masson三色染色显示实验组肾支架可见大量蓝色的胶原纤维沉积;扫描电镜显示2组肾细胞外基质三维结构紊乱,细胞外胶原纤维更加致密且有不同程度的增生;进一步免疫荧光检测,显示实验组支架的层黏连蛋白、胶原蛋白Ⅰ及Ⅳ都有明显的绿色荧光表达。结论:慢性肾衰肾支架病理形态结构改变及细胞外基质增生,为进一步研究慢肾衰肾支架是否可作为复细胞支架提供依据。     

限盐对慢性肾衰大鼠的心脏蛋白质组的影响

目的构建低盐饮食条件下慢性肾衰大鼠的心脏蛋白质谱,探索限盐对慢性肾衰大鼠的心脏蛋白质组的影响。方法采用5／6肾切建立慢性肾衰大鼠模型,设为假手术组（Sham组,6只）和慢性肾衰组（CRF组,6只）,术后第10周低盐（0．02％NaCl）饮食干预14d,然后取心脏左室游离壁进行蛋白提取及酶解和肽段同位素标记相对和绝对定量技术（iTRAQ）标记,最后经毛细管高效液相色谱分离后用Q—Exactive质谱仪进行蛋白质质谱分析。结果运用iTRAQ技术对低盐饮食条件下慢性肾衰大鼠的心脏蛋白质组进行了研究,共鉴定了1833种蛋白,构建了心脏蛋白质谱;其中226种蛋白发生了差异性改变,主要具有结合、催化活性等生物功能,涉及代谢、转运、生物过程的调节、应激等。结论成功构建了低盐饮食条件下慢性肾衰大鼠的心脏蛋白质谱。     

Review article--involvement of gastric APUD cells in chronic renal failure

Uremia leads to a number of metabolic and hormonal disorders induced by renal failure with definite biological and clinical sequels. Most frequently, alimentary disorders are the first to appear, followed by symptoms from other organs and systems. The gastrointestinal tract is a site of synthesis of many compounds that have hormonal or hormonal-like biological activity. These substances are produced by highly-specialised receptor-effector cells, that are dispersed in the gastrointestinal mucosa and classified as APUD cells. The present review is an attempt to make a synthesis of current opinions and views concerning the effect of homeostatic dysfunction of the kidneys on the morphology and action of APUD cells in the stomach.     

Citrate attenuates vascular calcification in chronic renal failure rats

Vascular calcification (VC) is a major contributor of cardiovascular dysfunction in chronic renal failure (CRF). Citrate binds calcium and inhibits the growth of calcium crystals. This present study intends to evaluate the effect of citrate on VC in adenine‐induced CRF rats. The rats were randomly divided into five groups: the control group, the citrate control group, model group, model rats with low‐dose treatment of citrate (216 mg/kg) and model rats with high‐dose treatment of citrate (746 mg/kg). The rats were euthanized at 5 weeks with their blood and aorta in detection. The results showed that serum level of blood urea nitrogen, serum creatinine, phosphorus, calcium, and related renal failure function marker were elevated in the model group. Furthermore, the aortic calcium accumulation and alkaline phosphatase activity were significantly increased in the model group compared with control groups. Additionally, hematoxylin–eosin staining results demonstrated that the vascular calcification in aorta is significantly increased in the model group. Finally, the expression of VC‐related proteins including bone morphogenetic protein and osteocalcin were increased in the model group, whereas alpha‐smooth muscle actin was decreased in the model group compared with the control group. However, treatment with citrate caused a reversal effect of all the above events in a dose‐dependent manner. In conclusion, citrate may attenuate vascular calcification in adenine‐induced CRF rats.     

Amlodipine-induced gingival hyperplasia in chronic renal failure: a case report

Amlodipine is a dihydropyridine calcium channel blocker that is used in the management of both hypertension and angina. Amlodipine induced side effects are headache, dizziness, edema, flushing, palpitations, and rarely gingival hyperplasia. The exact reason of amlodipine-induced gingival hyperplasia is not known. We presented a case with chronic renal failure (CRF) that developed gingival hyperplasia due to amlodipine use, which improved after ceasing the drug.     

Upregulation of the brain renin-angiotensin system in rats with chronic renal failure

Aim: We investigated how the brain renin–angiotensin system is involved in regulation of the sympathetic activity and arterial pressure in rats with chronic renal failure. Methods: Systolic arterial pressure, heart rate and diurnal urinary noradrenaline excretion were measured for 12 weeks in spontaneously hypertensive rats (SHR) with or without subtotal nephrectomy. Expression of mRNAs related to the brain renin–angiotensin system was measured using polymerase chain reaction. Effects of a 6‐day intracerebroventricular infusion of a type 1 angiotensin II receptor antagonist (candesartan) or bilateral dorsal rhizotomy on these variables were also investigated. Results: Systolic arterial pressure and urinary excretion of noradrenaline were consistently higher in subtotally nephrectomized SHR than in sham‐operated SHR (262 ± 5 vs. 220 ± 3 mmHg, P < 0.001; 2.71 ± 0.22 vs. 1.69 ±0.19 ng g^?1 body weight day^?1, P < 0.001). Expression of renin, angiotensin‐converting enzyme and type 1 angiotensin II receptor mRNAs in the hypothalamus and lower brainstem was greater in subtotally nephrectomized SHR than in sham‐operated SHR. Continuous intracerebroventricular infusion of candesartan attenuated hypertension and the increase in urinary noradrenaline excretion in subtotally nephrectomized SHR. Dorsal rhizotomy decreased arterial pressure, urinary excretion of noradrenaline and expression of renin–angiotensin system‐related mRNAs in brains of subtotally nephrectomized SHR. Conclusion: The brain renin–angiotensin system in subtotally nephrectomized SHR appears to be activated via afferent nerves from the remnant kidney, resulting in sympathetic overactivity and hypertension in this chronic renal failure model.     

慢性肾功能衰竭患者血液透析发生院内感染的临床分析

目的分析慢性肾功能衰竭患者血液透析发生院内感染的临床特点以及相关危险因素。方法回顾性分析2005年5月至2010年5月期间在我院长期行血液透析的383例患者的相关临床资料,将其中160例患者出现了不同程度的院内感染设为感染组,223例患者未出现院内感染为未感染组。结果血液透析患者发生院内感染的发生率为41.78%,其中以肺部感染最为常见;感染组与未感染组患者之间的相关临床指标相比较,年龄、住院天数、是否左心衰、是否有糖尿病、是否存在低蛋白血症、插管时间以及C反应蛋白具有统计学差异（P〈0.05或0.01）,而性别、血肌酐、甘油三脂不具有统计学差异（P〉0.05）。结论对于长期血液透析患者,我们应该控制好各个危险因素,规范化管理防治院内感染的相关制度,对患者采取正规的营养支持、纠正贫血、抗感染等支持治疗,及时的作相关病原学检查,严防滥用抗生素。     

Dietary protein restriction in chronic renal failure: An update

Summary In recent years dietary protein restriction (DPR) to slow down the progression rate of chronic renal disease has been a major field in nephrological science. In this update a brief historical overview is given, as well as a critical review regarding the now available data from clinical trials. Furthermore, the theoretical backgrounds of DPR are discussed. It is concluded that DPR has profound effects on the kidney. In certain diseases, especially primary glomerular disease, the beneficial effect seems proven. However, many questions remain to be answered, e.g. how to apply reliable statistics in chronic renal failure, how to obtain and monitor patient compliance, and the definition of the exact target group since the diet has a selective effect.Most of these questions will be answered in the coming years when data becomes available from large scale multicenter trials.Awaiting these results, proposals for the treatment with diet are made, based on the facts that are now to our knowledge.     

基于血清蛋白组学的慢性肾衰预测模型探讨

 目的 通过比较慢性肾衰（CRF）患者与正常人血清蛋白表达谱的差异,筛选血清蛋白标志物并建立诊断模型,探讨其在慢性肾衰血清学诊断中的意义。方法 收集62例CRF患者和28例正常人的血清,经表面增强激光解析离子化飞行时间质谱(SELDI-TOF-MS)检验并筛选血清蛋白标志物。经生物信息学分析建立预测模型并进行验证。结果 在质荷比(m/z)1500～30000范围内,检测到51个有效蛋白峰,发现有19个峰有显著差异 (P<0.001),其中18个峰呈低表达,1个峰呈高表达;且CRF组和正常组的聚类性质明显不同;组内样本彼此靠近,组间样本彼此分开。构建的"慢性肾衰组－正常组"诊断决策树模型,预测正确率为87.8%,灵敏度为87.1%,特异度为89.3%。结论 该决策树模型能对慢性肾衰做出较为准确的预测判断,为慢性肾衰的临床早期发现提供一定的实验依据     

Assessment of erythropoietin levels and some iron indices in chronic renal failure and liver cirrhosis patients

This study was constructed to investigate the relationship between renal anaemia and erythropoietin (EPO) concentrations in chronic renal failure (CRF) patients and to evaluate the possible role of the liver. Serum EPO levels were measured in blood samples from 20 CRF patients on hemodialysis (HD), 20 liver cirrhosis (LC) patients, 20 patients having both CRF and LC and undergoing HD, and 20 normal control subjects. Blood cell counts, iron indices (iron, total iron-binding capacity (TIBC) and ferritin), renal function (blood urea nitrogen (BUN) and creatinine), hepatic function (ALT, AST, ALP and bilirubin) investigations were carried out for all the subjects enrolled in this study. CRF patients without LC had serum EPO concentration of 6.21 +/- 0.53 mU/ml (mean +/- SE), which was significantly higher than that in patients having both CRF and LC (4.32 +/- 0.52) (p < 0.01). Both groups showed significantly lower values than the controls (12.75 +/- 0.70) (p < 0.001). LC patients with intact kidneys had significantly higher EPO level (22.70 +/- 1.70) (p < 0.001). No correlation was found between EPO level and any of the hematologic or iron indices.     

慢性心力衰竭大鼠肾组织中血小板源性生长因子及结缔组织生长因子的表达

目的:探讨血小板源性生长因子BB(PDGF-BB)及结缔组织生长因子(CTGF)在慢性心力衰竭大鼠肾组织的表达及意义。方法:采用肾上腹主动脉缩窄法制作Wistar大鼠慢性心力衰竭模型,随机分为假手术组,心衰10 d、20 d、30 d组。观察及比较各组大鼠的血流动力学数值;Masson染色方法观察大鼠慢性心衰时肾组织结构变化;免疫组织化学方法检测各组大鼠肾组织的PDGF-BB及CTGF的表达部位;免疫印迹半定量检测各组大鼠肾组织的PDGF-BB、CTGF的表达水平。结果:心衰模型各组大鼠PDGF-BB、CTGF的蛋白表达均较假手术组高,且随心衰程度的加重而表达升高。结论:慢性心衰可引起肾间质纤维化,其发生发展与心衰的严重程度密切相关。     

慢性肾衰大鼠继发甲状旁腺功能亢进时腺体钙敏感受体的观察

研究慢性肾衰 (CRF)继发性甲旁亢 (2°HPT)大鼠发病时及 1,2 5 (OH) 2 D3 治疗时甲状旁腺钙敏感受体 (PCaR)mRNA含量变化。采用肾大部分切除大鼠 2°HPT模型 ,动物分为CRF组 ,治疗组 ,假手术组。治疗组予以 1,2 5(OH) 2 D3(2 5pmol d× 10腹腔注射 ) ,31d后测定生化指标及PCaRmRNA含量 ,后者采用逆转录聚合酶链反应 (RT PCR)半定量法。(1)CRF组大鼠较假手术组血肌酐 (SCr) (6 9 30± 11 2 0vs 2 1 15± 8 2 0 μmol L ,P <0 0 5 )及甲状旁腺素 (PTH) (2 5 6± 72vs 41± 7pg mL ,P <0 0 5 )明显上升 ,治疗组PTH较CRF组明显下降 (112± 47vs 2 5 6± 72pg mL ,P <0 0 5 )。(2 )CRF组大鼠PCaRmRNA与假手术组含量无明显差异 (1 10 0± 0 15 3vs 1 0 74± 0 119) ,治疗组PCaRmRNA与CRF组含量无明显差异 (1 131± 0 10 8vs1 0 74± 0 119)。本实验 2°HPT模型PCaRmRNA表达无明显变化 ,1,2 5 (OH) 2 D3治疗肾大部切除 2°HPT大鼠对PCaRmRNA水平无显著影响     

慢性肾衰及血透中多肽生长因子与凋亡因子表达

目的 探讨慢性肾功能衰竭（ＣＲＦ）患者及血液透析（ＨＤ）过程中多肽生长因子及凋亡因子的含量变化及相互关系。方法 采用流式细胞术及放射免疫分析法分别测定ＣＲＦ及ＨＤ前后外周血单核细胞（ＰＢＭＣ）中Ｆａｓ抗原（ＣＤ９５）,线粒体膜蛋白（Ａｐｏ２．７）,抗凋亡因子（ＢＣ１－２）蛋白的阳性细胞数及血清中转化生长因子α（ＴＧＦ－α）,类胰岛素样生长因子（ＩＧＦ－Ⅱ）的含量。结果 ＣＲＦ（非透析组）ＣＤ９５、     

瞬目反射检查在慢性肾功能衰竭患者中的应用

目的：观察慢性肾功能衰竭患者瞬目反射（ＢＲ）的特点并探讨其临床意义。方法：检测１７例慢性肾功能衰竭患者及３０名健康成人ＢＲ。结果：慢性肾功能衰竭患者ＢＲ的各期反应即Ｒ１、Ｒ２、Ｒ′２的潜伏期分别为１１９３±１３２、３６０９±４２１、３６４７±４５５ｍｓ，均较对照组明显延长（Ｐ＜００５）。结论：ＢＲ检测有助于慢性肾功能衰竭患者神经系统异常的早期诊断     

Investigation of membrane-active components from blood serum of patients with chronic renal failure

Bulletin of Experimental Biology and Medicine -     

大鼠肾小体发育的生长曲线

目的：探讨大鼠肾小体发育中体积生长曲线的变化规律。方法：采用连续切片技术,光镜观察并结合体视学分析方法,对不同发育阶段大鼠肾小体的体积进行测量,定量研究肾小体体积的变化规律。结果：胚龄16 d 时逗号小体及 S 小体出现,胚龄18 d,出现了Ⅲ期和Ⅳ期肾小体,生后7 d,逗号小体及 S 小体消失,肾小体的体积从胚龄18 d 到生后40 d 大约增大86倍。结论：大鼠肾小体于胚龄16 d 发生,生后40 d 达到成年水平。     

Trabecular bone morphometry in beagles with chronic renal failure

Summary A morphometric study was performed on undecalcified sections of trabecular bone from the ribs of adult dogs that were controls (n=8), or had various degrees of renal failure as a result of perinatal irradiation (n=16). In a group identified as markedly uremic there was an increase in the proportion of surface with osteoid seams (P<0.01), osteoblasts (P<0.01) and osteoclastic resorption (P<0.01) as well as the % osteoid volume (P<0.01). Aside from a decrease in the % trabecular bone which was of unclear significance, the results agree well with those of similar studies in man. Within this group, 6 of the samples had a histologic pattern that was principally that of hyperparathyroidism and in the remaining 2 there was evidence of a mineralization defect and osteomalacic changes. These 2 dogs had the poorest renal function and one that had been biopsied 5 months earlier, when its renal function was less impaired, had had a hyperparathyroid pattern.