Chinese Journal of Nephrology

Select

Study on the thickness of glomerular basement membrane in adult kidney tissue and the standard of thin glomerular basement membrane

LIU Lin-chang;ZHANG You-kang;WANG Su-xia;ZHENG Xin;E Jie;CAI Li-jun;JIN Jie;TIAN Ye;ZOU Wan-zhong

2011, 27(5): 313-315.

Abstract ( ) PDF ( )

Knowledge map

Save

Objective To elucidate the thickness of glomerular basement membrane (GBM) in adult kidney tissue and to establish the standard of GBM thickness for thin basement membrane nephropathy (TBMN) in China. Methods Kidney cortex tissue samples apart from cancer focus were collected from 29 patients undergoing nephrectomy. Clinical data of patients were analyzed. Light, immunofluorescence and electron microscope examinations were performed on these 29 samples to measure the thickness of GBM and the distribution of collagen Ⅳα3, α5 chains. Results There were fifteen male and fourteen female cases with age (55.9±14.9) (20-80) years old. No familial history of renal disease or other diseases was found in these cases. The GBM thickness of these samples was (363.6±46.8) nm, which was associated with gender. GBM thickness was (384.0±41.7) nm in male, and (335.0±39.2) nm in female, which was significantly different (P=0.008). The standard to diagnose thin GBM should be the mean minus double standard deviation. So the standard of GBM thickness for TBMN should be <270 nm. Conclusions The GBM thickness of adults is (363.6±46.8) nm. GBM thickness is associated with gender, which is thicker in males with significant difference. It is suggested that the standard of GBM thickness for TBMN in adult should be <270 nm, and the difference of GBM thickness between male and female should be considered too.

Select

Applications of renal biopsy in living-related kidney transplantation and the influences of the marginal donor on the recipient prognosis

ZHAO Ji-qiang;CHEN Li-zhong;WANG Chang-xi;QIU Jiang;FEI Ji-guang;LI Jun

2011, 27(5): 316-321.

Abstract ( ) PDF ( )

Knowledge map

Save

Objective To analyze diagnostic value of renal biopsy in living-related kidney transplantation and the influence of kidneys from marginal donors on the early prognosis of recipients. Methods According to donors age and risks of donors, 142 living-related kidney transplant recipients from February 2004 to July 2008 were divided into marginal donor group (51 cases) and non-marginal donor group (91 cases). Renal biopsy was performed on 49 kidneys Postsurgical serum creatinine (Scr), the lowest Scr and post-transplant complications were analyzed between the two groups. Results Pathological changes were detected in 13 cases. The Scr at 4 weeks, 12 weeks, 6 months post-transplant and the lowest level of Scr in marginal donor group were higher than those in non-marginal donor group (all P<0.05). There were no significant differences of Scr levels at 12 months, 24 months, 36 months post-transplant, the time required to return to the lowest Scr, and post-transplant complications between two groups (all P>0.05). Conclusions The early clinical efficacy of the marginal donor is ideal, but the baseline of Scr of recipients is higher than that of recipients with kidneys from non-marginal donors. Renal biopsy has an important diagnostic and therapeutic value for both donors and recipients.

Select

Correlation between renal function and arterial stiffness of Uighur population over 35 years in Xinjiang area

PAN Shuo;LI Xiao-mei;MA Yi-tong;YANG Yi-ning;XIE Xiang;LIU Fen;HUANG Ding;HUANG Ying;TANG Qi;CHEN Bang-dang;MA Xiang;DU Lei;GAO Xia;WANG Ying-hong;GULINAER·Baituola;YU Zi-xiang

2011, 27(5): 322-326.

Abstract ( ) PDF ( )

Knowledge map

Save

Objective To study the correlation between renal function and arterial stiffness of Uighur population over 35 years old in Xinjiang area. Methods From October 2007 to March 2010, four-stage stratified random sampling method was applied to collect a total of 4312 Uighur people over 35 years old in Urumqi, Karamay, Fukang, Turpan area, Hotan prefecture, Yili Kazak autonomous prefecture and Altai prefecture. The data of these 4312 general urban and rural Uygur residents were complete. Simplified MDRD formula was used to calculate the estimate glomerular filtration rate (eGFR). Arm-ankle pulse wave velocity (b-aPWV) of both sides was measured and the average value was used in correlation analysis with eGFR, and then the associated risk factors were adjusted. Results The eGFR was negatively correlated with b-aPWV (r=-0.174, P<0.01). Multiple linear regression showed that after adjusting some risk factors such as age, sex, body mass index, systolic blood pressure, diastolic blood pressure, waist circumference, hip circumference, uric acid，fasting blood glucose, total cholesterol, triglycerides, low density lipoprotein, eGFR was still negatively correlated with b-aPWV (P=0.012). Conclusions In Uygur population over 35 years old in Xinjiang, the glomerular filtration rate is negatively correlated with arterial stiffness.

Select

Correlation between urinary angiotensinogen and intrarenal renin-angiotensin system activity in chronic kidney disease patients

ZHANG Xiao-yan;LV Wen-lv;TENG Jie;ZHONG Yi-hong;DING Xiao-qiang

2011, 27(5): 327-332.

Abstract ( ) PDF ( )

Knowledge map

Save

Objective To analyze the correlation of urinary angiotensinogen (AGT) with clinical index of kidney injury and intrarenal renin-angiotensin system(RAS) activity in chronic kidney disease(CKD) patients. Methods Urinary or plasma renin activity, AGT, angiotensin Ⅱ(AngⅡ), aldosterone were measured by RIA or ELISA in 129 CKD patients. Expression of intrarenal renin, AGT, AngⅡ and angiotensin Ⅱ receptor was examined by immunohistochemistry staining (IHCS) in 73 CKD patients undergoing renal biopsy. Correlation of urinary AGT with other indexes was performed. Results Average urinary AGT in 129 CKD patients was (159.08±125.18) μg/g Cr, Scr was (113.20±105.05) μmol/L, and urinary AGT was positively correlated with Scr (r＝0.51, P<0.01). Average estimated glomerular filtration rate (eGFR) was (58.52±27.15) ml·min-1·(1.73 m2)-1, which was negatively correlated with urinary AGT (r＝-0.55， P<0.01). Average urinary protein was (2.03±2.65) g/24 h, which was positively correlated with urinary AGT (r＝0.30, P<0.01). Average urinary AngⅡ was (164.71±139.25) ng/g Cr, which was positively correlated with urinary AGT (r＝0.20, P<0.05). Average urinary type Ⅳ collagen was (447.60±800.66) μg/g Cr, which was positively correlated with urinary AGT (r＝0.47, P<0.01). Average urinary soduim was (162.17±81.61) mmol/24 h, which was negatively correlated with urinary AGT (r＝-0.20, P<0.05). Multiple regression analysis indicated that low eGFR (P<0.01), high Scr (P<0.01), high urinary protein (P<0.05), high urinary Ang Ⅱ (P<0.05) and high urinary type Ⅳ collagen (P<0.01) were significantly correlated with high urinary AGT. In renal tissues of CKD patients, there was positive correlation of urinary AGT with positive IHCS area of AGT (r＝0.45, P<0.01), AngⅡ (r＝0.52, P<0.01) and angiotensin Ⅱ type 1 receptor(r＝0.28, P<0.05). Conclusions Urinary AGT level may indicate the kidney injury severity, especially in chronic kidney injury, and may be used as a non-invasive marker of intrarenal Ang Ⅱ activity in CKD patients.

Select

Clinicopathological analysis of mercury poisoning-associated glomerulonephropathy

SU Tao;LIU Xiao-ling;ZHANG Yi-miao;MAO Wei-bo;LIU Gang;WANG Su-xia;WANG Han-bin;ZHOU Fu-de

2011, 27(5): 333-336.

Abstract ( ) PDF ( )

Knowledge map

Save

Objective To elucidate the clinical and pathological characteristics of patients with mercury poisoning-associated glomerulonephropathy. Methods Seven patients with mercury poisoning-associated glomerulonephropathy were enrolled in this study. The pattern of mercury exposure, feature of mercury toxicity, and clinicopathological presentation of the kidneys were investigated. Results They were all female, averaged (28.9±8.1) years old. Skin-whitening cream was the only cause of mercury poisoning. Proteinuria occurred 5 to 8 months after exposure. Serum mercury were 27.0 to 98.0 μg/L, and spot urinary mercury were 34.4 to 204.0 μg/L. The presentation of all the patients was mild to moderate edema with proteinuria and decreased serum albumin level. Five patients (5/7) were diagnosed as nephrotic syndrome. Six patients underwent renal biopsy: 3 cases with minimal change disease, 2 cases with membranous nephropathy and 1 case with focal segmental glomerular sclerosis. All the patients were administrated chelation therapy with sodium dimercaptopropanal sulfonate or sodium dimercaptosuccinic acid for 3 to 7 courses. They got complete remission by 3 to 5 weeks treatment. Conclusions Patients in this study with glomerulonephropathy induced by mercury poisoning are all from skin-whitening cream exposure. Mild to moderate edema and proteinuria are the common clinical pattern. Minimal change disease, membranous nephropathy and focal segmental glomerular sclerosis are found pathologically. Chelation therapy is effective.

Select

Correlation between food intolerance and Henoch-Schonlein purpura in children

ZHANG Jian-jiang;SHI Pei-pei;ZHANG Li-guo;LU Feng-xia;ZHAO Li-li

2011, 27(5): 337-340.

Abstract ( ) PDF ( )

Knowledge map

Save

Objective To investigate the correlation between food intolerance and Henoch-Schonlein purpura (HSP) in children and the efficacy of food forbidden or alternative therapy. Methods The levels of IgG against several common food in serum obtained from 40 children with HSP were measured by ELISA. The efficacy of food forbidden or alternative food therapy was assessed after 3 months. Results Total positive rate of serum food-intolerant IgG antibodies in HSP children was 92.5%. Among these 14 intolerant foods, the positive percentage of egg was the highest (33.8%), followed by tomato (14.9%), milk (13.5%) and morrhua (12.2%). Significant differences of the sort and degree of food intolerance existed among different age groups (t=2.257, P=0.045), but not between boys and girls(t=1.053, P=0.315), city and countryside(t=1.388, P=0.193). There was no linear correlation between total food intolerance and serum IgG level (t=0.793, P=0.445). Food intolerance had no direct relation to immune complex deposition in kidneys of HSP nephritis(r=-0.262, P=0.387). The efficacy of adjusting diet was 95%. Conclusions HSP is closely related to food intolerance. Egg is the most common intolerant food. Food forbidden or alternative therapy shows acceptable efficacy in the treatment of most Henoch-Schonlein purpura children.

Select

Comparison of diagnostic value in early diabetic nephropathy among three kinds of glomerular filtration rate estimation equations

ZHANG Hong-xia;YUAN Jie;LIU Jie;JIA Wei-ping

2011, 27(5): 341-345.

Abstract ( ) PDF ( )

Knowledge map

Save

Objective To investigate the value of CysC-based GFR in comparison with creatinine-based GFR (CG-GFR and MDRD-GFR) as an accurate serum marker in the prediction of early diabetic nephropathy. Methods A tatal of 133 type 2 diabetic patients (74 males and 59 females, aged 58.1±12.3) were enrolled. The level of diabetic nephropathy (normoalbuminuric, microalbuminuric and macroalbuminuric) was staged and estimated GFR based on serum creatinine and cystatin C(CysC) was calculated. The plasma clearance of 99mTc-DTPA, serum CysC, creatinine, BMI, HbA1c, serum lipid and blood pressure were measured. Results 99mTc-DTPA-GFR was used as golden standard. At 90 and 75 ml·min-1·（1.73 m2）-1 cut-points, diagnostic efficiencies of CysC-GFR(89% and 92%) were better than those of CG-GFR (79%=86%, P=0.004, 0.04) and MDRD-GFR (80%-86%, P=0.02, 0.04). At 60 ml·min-1·（1.73 m2）-1 cut-point, diagnostic efficiencies of CysC-GFR,CG-GFR and MDRD-GFR were 92%, 90% and 92% respectively(P=0.49, P=0.71). The Logistic regression analyses showed that retinopathy, HbA1c, CysC, diabetic duration, and CysC-GFR were indicators to predict the development of microalbuminuria. Conclusion CysC-GFR is more valuable than CG-GFR and MDRD-GFR in the prediction of early diabetic nephropathy and should be applied clinically.

Select

Impact of the new CKD-EPI equation on the staging of patients with chronic kidney disease based on abbreviated MDRD equation

LI Jiang-tao;XU Chen;CUI Chun-li;WANG Hui-fang;WU Yi-tai;YUAN Ai-hong;JIANG Xiao-feng;MA Jun

2011, 27(5): 346-350.

Abstract ( ) PDF ( )

Knowledge map

Save

Objective To compare the estimated GFR (eGFR) values using the new chronic kidney disease epidemiology collaboration (CKD-EPI) equation with those from the abbreviated MDRD equation in a Chinese cohort with chronic kidney disease (CKD) and to analyze the impact of the new CKD-EPI equation on the staging of CKD. Methods A total of 450 Chinese patients (239 female and 211 male) with CKD were enrolled. eGFRs obtained by the CKD-EPI equation and the abbreviated MDRD equation were compared with the Bland and Altman method. The agreement between two equations in CKD staging was assessed by Kappa test. Results Mean eGFR was 2.4 ml·（min）-1·（1.73 m2）-1 higher with the CKD-EPI equation as compared to the abbreviated MDRD equation. The percentage of CKD staging concordance between equations for stage 1, 2, 3A, 3B, 4, and 5 was 97.10% (n=67), 80.77% (n=105), 6 0.86% (n=48), 87.69%(n=57), 90.38% (n=47) and 98.18% (n=54) respectively. Kappa index was 0.913 (95%CI: 0.881-0.945). The CKD-EPI equation reclassified 19.23% (n=25) and 39.24% (n=31) of patients with CKD stage 2 and 3A,upward to a higher eGFR category. Conclusions The new CKD-EPI equation reclassifies a number of patients to higher CKD stages, especially those classified as CKD stage 2 or 3A by the abbreviated MDRD equation.

Select

The expression and function of Erbin protein in renal interstitial fibrosis

ZHOU Qiao-dan;KOU Pei;XU Chu-ou;ZENG Rui;BAI Shou-jun;PEI Guang-chang;ZHANG Ya-min;HAN Min;LIU Li-li;XU Gang

2011, 27(5): 351-356.

Abstract ( ) PDF ( )

Knowledge map

Save

Objective To investigate the expression of Erbin in renal interstitial fibrosis (RIF) and the effect of over-expression of Erbin on transforming growth factor β1 (TGF-β1)-induced epithelial-mesenchymal transition (EMT) in NRK52E cells. Methods In vivo, the model of renal fibrosis was induced by 5/6 subtotal nephrectomy in rat. Scr and BUN was detected and Masson staining was used to evaluate the level of renal tissue fibrosis. The location and expression of Erbin in renal tissue were detected by immunohistochemistry and Western blotting. In vitro, after NRK52E cells were treated by TGF-β1 (10 μg/L) for 72 h, immunofluorescence and Western blotting were used to obverse the expression and distribution of E-cadherin and α-SMA. The expression of Erbin mRNA and protein were detected by RT-PCR and Western blotting respectively. NRK52E cells were transiently transfected with Prk5-myc-Erbin plasmid via lipofectamine 2000, then the expressions of Erbin, E-cadherin and α-SMA were detected by Western blotting. Results (1)Compared to sham group with Scr (33.96±7.28) μmol/L and BUN (8.11±2.55) mmol/L, rats in 5/6 nephrectomy model with Scr (140.52±61.11) μmol/L and BUN (34.23±7.66) mmol/L revealed renal dysfunction. Masson staining indicated kidney interstitial fibrosis, and the expression of Erbin was significantly increased in renal tissue(2.9 folds), especially in tubular epithelia. (2)In vitro, the expressions of Erbin and α-SMA were markedly increased (2.3 folds and 2.1 folds, P<0.05, respectively) and the expression of E-cadherin was dramatically decreased in NRK52E cells stimulated by TGF-β1, which were consistent with immunofluorescence results. TGF-β1-induced E-cadherin suppression and α-SMA induction could be efficiently blocked by over-expression of Erbin (all P<0.05). Conclusions Erbin is up-regulated in renal interstitial fibrosis, and over-expression of Erbin can partly inhibit renal EMT induced by TGF-β1, which indicates Erbin playing an protective role in renal fibrosis.

Select

Endoplasmic reticulum stress-related apoptosis pathway is involved in unilateral ureteral obstruction-induced renal interstitial fibrosis in rats

RUAN Ying-xin;ZHANG Peng-yu;LIN Shan;LI Chun-mei;LIU Su-yan

2011, 27(5): 357-362.

Abstract ( ) PDF ( )

Knowledge map

Save

Objective To investigate the effect of endoplasmic reticulum stress (ERS)-associated apoptosis on renal interstitial fibrosis induced by unilateral ureteral obstruction(UUO) in rats. Methods Eighteen healthy male Wistar rats undergoing UUO were sacrificed at 3,7,14 days after operation. Additional seven rats underwent sham operation. Histological changes were observed by HE and Masson staining. Immunohistochemistry was performed on renal tissue for α-smooth muscle actin (α-SMA). Chromatometry was used to detect the content of hydroxyproline. Apoptosis cells were determined by terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) and the electrophoresis analysis of genome DNA. The mRNA expression of glucose-regulated protein 78 (GRP78), which are important markers of ERS, were detected by RT-PCR. Western blotting was used to assess the protein level of GRP78 and cysteinyl aspartate specific proteinase-3 (caspase-3). Results Compared with sham operation group, the degree of renal interstitial and the level of hydroxyproline content of UUO group increased significantly(P<0.05). Immunohistochemistry staining indicated that α-SMA extensively expressed in renal tubular and interstitial cells. The apoptotic cells in the renal tubular and interstitium were continuously increased from day 3 to the end of experiment of UUO group. As early as 3 days after surgery, the mRNA level of GRP78 in UUO group increased compared with sham operation group(P<0.01), while the protein expression increased on day 7 after surgery(P<0.01). Prolonged ERS triggered apoptosis, the protein expression of caspase-3 increased significantly on day 3 after surgery(P<0.05), and the expression sustained high level during the experiment afterwards. There was a positive correlation between GRP78 protein expression and hydroxyproline content (r=0.657, P<0.01) as well as caspase-3 protein expression (r=0.714, P<0.01). Conclusions UUO induces a significant up-regulation in endoplasmic reticulum molecular chaperones at early stage, indicating that ERS response is activated in the rat kidney. Prolonged ERS can lead to renal tubular and interstitial cell apoptosis, and caspase-3-mediated ERS associated apoptosis may contribute to the fibrosis.

Select

Murine double minute 2: a novel mineralocorticoid-responsive gene involved in aldosterone-induced human mesangial cells line proliferation

WANG Hai-yun;LI Xue-mei;CHEN Li-meng;DUAN Lin;LI Yan;LI Xue-wang

2011, 27(5): 363-368.

Abstract ( ) PDF ( )

Knowledge map

Save

Objective To investigate whether and how murine double minute 2(MDM2) was involved in aldosterone (ALD)-induced human mesangial cells line (HMCLs) proliferation. Methods RT-PCR and immunofluorescence were used to confirm the expression of MDM2 in HMCLs. Western blotting was used to estimate the relationship between ALD dose and MDM2 expression. Spironolactone, a mineralocorticoid receptor (MR) blocker, was used to estimate the role of MR on the up-regulation of MDM2 induced by ALD. Cycloheximide(CHX), a protein synthesis inhibitor, was used to estimate whether the rapid nongenomic mechanism was involved in the up-regulation. To confirm the relationship among ALD, MDM2 expression and proliferation of HMCLs, small interference RNA of MDM2 was applied. Results Both MR and 11β-hydroxysteroid dehydrogenase type 2 (11β-HSD2) mRNAs were detected in HMCLs. MDM2 protein expression was also detected in both the nucleus and the cytoplasm. ALD significantly stimulated MDM2 expression, which implied that MDM2 was a novel mineralocorticoid-responsive gene in HMCLs. MR was involved in this process as spironolactone did not promote the expression of MDM2 mRNA or protein. ALD with CHX did not increase the expression of MDM2 protein, which indicated it was not directly regulated by the rapid nongenomic mechanisms. MDM2 protein was decreased by using the transfection of MDM2 siRNA and ALD did not promote the cell proliferation of HMCLs under the same conditions. All of which implied that MDM2 participated in ALD-induced HMCLs proliferation. Conclusions MDM2 is a novel mineralocorticoid-responsive gene in HMCLs. MR is involved in ALD-induced MDM2 expression which is inhibited by spironolactone. The increased expression of MDM2 protein induced by ALD is not directly regulated by the rapid nongenomic mechanisms. MDM2 participates in ALD induced HMCLs proliferation.

Select

Intestinal permeability and injury change in chronic renal failure rats

LI Fang-fei;JIANG Zong-pei;HU Wen-xue;ZHANG Yu;LI Ya-fang;PENG Wen-xing;HU Xu-chu;YU Xue-qing

2011, 27(5): 369-373.

Abstract ( ) PDF ( )

Knowledge map

Save

Objective To observe the histopathologic injury of small intestine and intestinal permeability in chronic renal failure(CRF) rats. Methods Twenty male Sprague-Dawley rats were randomly assigned to CRF group (n=10) and control group (n=10). 5/6 nephrectomy was used to establish CRF rats, while sham operation for control. Blood biochemistry was regularly monitored until CRF model was successfully established. The model rats were fed with lactulose (L) and mannitol (M) through intragastric administration. Urine was collected after 6 hours, and the concentration of lactulose and mannitol in urine was measured using high pressure liquid chromatograph with refractive index detector (HPLC-RID), and the ratio of urinary excretion of L/M was calculated to evaluate intestinal permeability. Small intestinal mucosa were stained by hematoxylin-eosin (HE) and observed with light microscope (villus height, thickness of muscle layer and villus count), histological damage score was used to evaluate intestinal injury. Results The L/M ratio of CRF group was higher than that of control group (1.75±0.11 vs 1.20±0.06, P<0.01). The small intestinal mucosal villus height and thickness of muscle layer in CRF group were higher (P<0.01), and the number of villi was lower compared to control group (P<0.01). The score of histopathologic intestine damage of CRF group was higher than that of control group (1.00±0.71 vs 0, P<0.01). Conclusion The intestinal permeability of CRF rats is increased with varying degrees of intestinal damage.

Please choose a citation manager

Content to export

Archive

临床研究

基础研究

临床研究

基础研究