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Objective To investigate the expression of connective tissue growth factor (CTGF) and heat shock protein 47 (HSP47) in peritoneum fibrosis rats,and the mechanism of 1,25-dihydroxyvitamin D3 [1,25-(OH)2-VitD3] in inhibiting the peritoneum fibrosis.Methods Adult male Sprague-Dawley rats were randomly divided into 3 groups:control group (n=8),model group (n=8) and 1,25-dihydroxyvitamin D3 group (VitD3,n=8).The model of peritoneum fibrosis rats were induced by daily intraperitoneally injection of 15％ chlorhexidine gluconate (CHX) 0.2 ml/d with 0.1％ glucose for 4 weeks.Rats in VitD3 group were also treated with 1,25-(OH)2-VitD3 [i.p.6 ng· (100 g) 1 · d-1].Peritoneal transport function,renal function,peritoneum thickness and serum level of 25hydroxyvitamin D3 were detected.In vitro,primary cultured peritoneal mesothelial cells were divided into control group,high glucose group (HG,2.5％),CTGF siRNA intervention group (CTGF siRNA+HG),VitD3 intervention group (VitD3+HG) and combined intervention group (CTGF siRNA+VitD3+HG).Real-time PCR,Western blotting and immunofluorescence were applied to measure the expression of CTGF and HSP47,also ELISA was used to detect the protein level of FN in peritoneum and peritoneal mesothelial cells.Results Compared with control group,the peritoneal ultrafiltration in peritoneum fibrosis rats were significantly decreased (P ＜ 0.05),the absorbance level of peritoneal fibrosis,peritoneum thickness,the rate of dialysate urea nitrogen and blood urea nitrogen (DUN/BUN) and the expressions of CTGF and HSP47 were increased (all P＜0.05).After application of 1,25-dihydroxyvitamin D3,peritoneal fibrosis lesion was significantly improved,the peritoneum thickness,the expressions of CTGF and HSP47 were decreased (all P ＜ 0.05).In vitro,2.5％ high glucose induced-peritoneal mesothelial cells were respectively treated by CTGF siRNA,1,25-(OH)2-VitD3 and combined interventions,the expression of FN,CTGF and HSP47 was significantly lower than that in high glucose group (all P ＜ 0.05).Conclusions The expression of CTGF and HSP47 is significantly increased in peritoneal fibrosis rats.1,25-(OH)2-VitD3 may ameliorate the progression of peritoneal fibrosis via reducing the expression of CTGF,decreasing the expression of HSP47 and FN.
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Objective To explore the feasibility of bioelectrical impedance analysis in assessing resting energy metabolism(REM)and the association of REM with anthropometry in hemodialysis patients.Methods Adult hemodialysis patients from 11 hemodialysis facilities in Guizhou Province were enrolled in this study.Bioelectrical impedance analysis was used to measure the rest metabolic rate(RMR)and body composition of 765 patients undergoing regular dialysis.A standard method was used to measure their height,weight,upper arm circumference,triceps skinfold thickness,left calf circumference and grip strength.The upper arm muscle circumference was also calculated.The level of RMR and body composition in hemodialysis patients were compared by gender grouping.The patients were then divided into four groups according to the RMR quartile.Spearman correlation analysis and multiple linear regression analysis were derived to analyze the relationship between RMR and anthropometry.Results The level of RMR in male patients was significantly higher than that in female patients[1591(1444,1764)Rcal/d and 1226(1104,1354)Rcal/d,P ＜ 0.001].Compared with the first quartile of RMR group,upper arm circumference,upper arm muscle circumference,left calf circumference and grip strength in the fourth quartile group were increased significantly(all P ＜ 0.05).Multiple linear regression analysis showed that height(β=0.572),left calf circumference(β=0.273),upper ann muscle circumference(β=0.092)and suffering from protein energy wasting(PEW,β=-0.184)were independent influential factors of RMR(all P ＜ 0.05).Conclusions RMR levels in patients with maintenance hemodialysis are associated with left calf circumference and upper ann muscle circumference,which may become a new index to evaluate energy consumption and malnutrition in MHD patients.
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Objective To explore the blood pressure variability (BPV) in pediatric patients undergoing maintenance hemodialysis (MHD) and to assess the factors associated with pre-dialysis BPV (pre-HD BPV).Methods The pediatric patients who undergone regular dialysis for more than twelve months from Oct 2005 to Oct 2011 in hemo dialysis center of Guizhou Provincial People's Hospital were divided into high pre-HD BPV group and low pre-HD BPV group.Baseline characteristics,biochemical indexes and cardiac function parameters measured by echocardiography were collected in both groups and multiple linear regression analysis was performed.Results Pediatric patients in high pre-HD BPV group demonstrated significantly higher inter-dialytic weight growth rate (IDWG),pre-dialysis systolic blood pressure and average amount of dehydration than those in low pre-HD BPV group (P ＜ 0.05),while significantly lower hemoglobin and albumin levels than those in low pre-HD BPV group (P ＜ 0.05).Comparison among laboratory indicators,serum phosphorus and parathyroid hormone demonstrated significant difference between groups (P ＜ 0.05).For all pediatric patients,pre-HD BPV was positively correlated with IDWG (β=0.165),pre-dialysis systolicblood pressure (β=0.259),and iPTH (β=0.187),while negatively correlated with hemoglobin level (β=-0.199).Conclusions Increasing IDWG,higher pre-dialysis systolic blood pressure,anemia and secondary hyperparathyroidism influence BPV in pediatric patients on MHD.