Outcome of Early Initiation of Peritoneal Dialysis in Patients with End-Stage Renal Failure

Recent studies reported that early initiation of hemodialysis may increase mortality. However, studies that assessed the influence of early initiation of peritoneal dialysis (PD) yielded controversial results. In the present study, we evaluated the prognosis of early initiation of PD on the various outcomes of end stage renal failure patients by using propensity-score matching methods. Incident PD patients (n = 491) who started PD at SNU Hospital were enrolled. The patients were divided into 'early starters (n = 244)' and 'late starters (n = 247)' on the basis of the estimated glomerular filtration rate (eGFR) at the start of dialysis. The calculated propensity-score was used for one-to-one matching. After propensity-score-based matching (n = 136, for each group), no significant differences were observed in terms of all-cause mortality (P = 0.17), technique failure (P = 0.62), cardiovascular event (P = 0.96) and composite event (P = 0.86) between the early and late starters. Stratification analysis in the propensity-score quartiles (n = 491) exhibited no trend toward better or poorer survival in terms of all-cause mortality. In conclusion, early commencement of PD does not reduce the mortality risk and other outcomes. Although the recent guidelines suggest that initiation of dialysis at higher eGFR, physicians should not determine the time to initiate PD therapy simply rely on the eGFR alone.

Protective efficacy of vaccination with Neospora caninum multiple recombinant antigens against experimental Neospora caninum infection

Protective efficacy of vaccination with Neospora caninum multiple recombinant antigens against N. caninum infection was evaluated in vitro and in vivo. Two major immunodominant surface antigens (NcSAG1 and NcSRS2) and two dense granule proteins (NcDG1 and NcDG2) of N. caninum tachyzoites were expressed in E. coli, respectively. An in vitro neutralization assay using polyclonal antisera raised against each recombinant antigen showed inhibitory effects on the invasion of N. caninum tachyzoites into host cells. Separate groups of gerbils were immunized with the purified recombinant proteins singly or in combinations and animals were then challenged with N. caninum. Following these experimental challenges, the protective efficacy of each vaccination was determined by assessing animal survival rate. All experimental groups showed protective effects of different degrees against experimental infection. The highest protection efficacy was observed for combined vaccination with NcSRS2 and NcDG1. Our results indicate that combined vaccination with the N. caninum recombinant antigens, NcSRS2 and NcDG1, induces the highest protective effect against N. caninum infection in vitro and in vivo.

Effects of Fructooligosaccharide and Fructooligosaccharide Containing Sponge Cake on Blood Lipids, Intestinal Function and Short Chain Fatty Acid Production in Rats

The purpose of this study was to elucidate effects of fructooligosaccharide on gastrointestinal tract and blood lipids of rats when this was supplied as purchased condition or oligosaccharide containing sponge cake. Male Sprague-Dawley rats were assigned to one of 3 treatments 1) control diet 2) 7.5% fructooligosaccharide containing diet (FOS diet) 3) lyophilized sponge cake powder containing diet (FOS-C diet). The sponge cake was made with fractooligosaccharide which replaced 40% of its surose, and the final concentration of fructooligosaccharide in FOS-C diet was 7.5%. Cecal and fecal water contents, amount of cecal content, and cecal wall weight were higher from fructooligosaccharide consumption, whereas total gut transit time was longer in rats consuming fructooligosaccharide compared with those fed control diet. Cecal and fecal pH were lower in FOS and FOS-C groups than in control group. Total cecal SCFA pools were higher from ingesting fructooligosaccharide containing diets compared with control diet. Serum triglyceride levels were lower in rats fed FOS and FOS-C diet than those fed control diet, while serum cholesterol levels were unaffected by treatment. Therefore the effects of fructooligosaccharide in sponge cake on serum lipids and gastrointestinal tract were similar to those of intact fructooligosaccharide. Also, adding 7.5% of FOS accompanied diarrhea symptom which suggests some precaution are needed when using FOS.