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Objective:To investigate the incidence and clinical characteristics of renal involvement with Omicron coronavirus infection in age-based stratified patients.Methods:The first batch of 430 convalescent patients with Omicron coronavirus treated in Tianjin First Central Hospital from January 21, 2022 to March 7, 2022 were enrolled in this study. The baseline information, vaccination status and laboratory examination information of patients were extracted in order to analyze the incidence of renal involvement in age-based stratified patients. Multivariate Logistic regression analysis was conducted to determine the risk factors of renal involvement in different age groups.Results:Excluding those younger than 1 year old and those with a history of chronic kidney disease, a total of 421 patients were included. There were 184 males and 237 females with an average age of (36.65±21.28) years. The types of renal involvement included pathological tubular urine (28.9%), proteinuria (16.9%), renal hematuria (14.7%), a slight decrease of estimated glomerular filtration rate (eGFR, 9.3%), renal glycosuria (0.5%). According to their age, all patients were divided into three groups: 113 cases of ≤ 18 years old, 244 cases of 19-59 years old and 64 cases of ≥ 60 years old. Significant difference was founded in the incidence of renal involvement among the three groups. The incidence of proteinuria, pathological tubular urine and slight decline of eGFR in the ≥ 60 years old group were significantly higher than those in the ≤ 18 years old group [28.1% (18/64) vs. 8.0% (9/112), 42.2% (27/64) vs. 19.6% (22/112), 34.9% (22/63) vs. 6.2% (7/113), respectively, all P < 0.01]. The incidence of slight decline of eGFR was significantly higher than that in 19-59 years old group [34.9% (22/63) vs. 4.1% (10/243), P < 0.01]. Multivariate Logistic regression analysis showed that age was significantly correlated with renal involvement after adjusting for the baseline situation, serological indexes and Omicron infection related indexes [odds ratio ( OR) = 1.059, 95% confidence interval (95% CI) was 1.021-1.097, P = 0.002]. Compared with the group ≤ 18 years old, the risk of renal involvement in the group ≥ 60 years old was significantly increased ( OR = 26.245, 95% CI was 1.357-507.458, P = 0.031). Age ≥ 60 years old was an independent risk factor for renal involvement with Omicron coronavirus infection. Conclusions:Although a low incidence of severe cases in Tianjin first batch of 430 patients with Omicron coronavirus infection, there is still a high incidence of renal involvement. Advanced age is the risk factor of renal involvement. We should pay more attention to the renal involvement of elderly with Omicron coronavirus infection.
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Objective@#To compare the survival rates difference between diabetic kidney disease (DKD) and non-DKD maintenance hemodialysis patients.@*Methods@#The eligible patients who started hemodialysis treatment in Dalian Municipal Central Hospital from January 1, 2010 to December 31, 2016 were enrolled. The endpoint was all-cause death. Patients were divided into two groups according to the primary disease: DKD group and non-DKD group. Survival between two groups was compared by Kaplan-Meier plots and log-rank test. Survival was timed from the start of dialysis until the date of death and was censored for the date of end of the study period (December 31, 2016). SPSS 13.0 software was used for statistical analysis. Univariate COX regression analysis was used for risk assessment. Independent analysis was performed by multivariate COX regression. P < 0.05 indicated that the difference was statistically significant.@*Results@#A total of 769 patients were enrolled, including 305 patients with DKD (39.7%) and 464 patients with non-DKD (60.3%). There were 465 males, accounting for 60.5%, and 304 females, accounting for 39.5%. The mean age of starting dialysis was (56.2 ± 14.9) years. The median follow-up time was 21 months. One hundred and seventy patients died due to all causes, accounting for 21.7%. The 1-, 2-, 3-, 4-, 5-, 6- and 7-year survival rates in the diabetic kidney disease group were 94%, 77%, 68%, 56%, 44%, 31% and 26%. The 1-, 2-, 3-, 4-, 5-, 6- and 7-year survival rates in the non-diabetic kidney disease group were 94%, 87%, 81%, 77%, 69%, 65% and 60%. The survival rate of DKD group was significantly lower than that of non-DKD group (χ2=23.656, P < 0.01). Multivariate Cox regression analysis showed that age of onset of dialysis, primary disease, low density lipoprotein, serum potassium, ejection fraction (EF), coronary heart disease and stroke were independent risk factors of mortality (P < 0.05).@*Conclusions@#The survival rate of patients with diabetic kidney disease is significantly lower than that of patients with non-diabetic kidney disease in the maintenance hemodialysis patients in our center. Age, primary disease, low density lipoprotein, EF, coronary heart disease, and stroke are independent predictors of death.
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Objective To compare the survival rates difference between diabetic kidney disease (DKD) and non-DKD maintenance hemodialysis patients. Methods The eligible patients who started hemodialysis treatment in Dalian Municipal Central Hospital from January 1, 2010 to December 31, 2016 were enrolled. The endpoint was all-cause death. Patients were divided into two groups according to the primary disease: DKD group and non-DKD group. Survival between two groups was compared by Kaplan-Meier plots and log-rank test. Survival was timed from the start of dialysis until the date of death and was censored for the date of end of the study period (December 31, 2016). SPSS 13.0 software was used for statistical analysis. Univariate COX regression analysis was used for risk assessment. Independent analysis was performed by multivariate COX regression. P < 0.05 indicated that the difference was statistically significant. Results A total of 769 patients were enrolled, including 305 patients with DKD (39.7%) and 464 patients with non-DKD (60.3%). There were 465 males, accounting for 60.5%, and 304 females, accounting for 39.5% . The mean age of starting dialysis was (56.2 ± 14.9) years. The median follow-up time was 21 months. One hundred and seventy patients died due to all causes, accounting for 21.7%. The 1-, 2-, 3-, 4-, 5-, 6-and 7-year survival rates in the diabetic kidney disease group were 94%, 77%, 68%, 56%, 44%, 31% and 26%. The 1-, 2-, 3-, 4-, 5-, 6-and 7-year survival rates in the non- diabetic kidney disease group were 94%, 87%, 81%, 77%, 69%, 65% and 60%. The survival rate of DKD group was significantly lower than that of non-DKD group (χ2＝23.656, P < 0.01). Multivariate Cox regression analysis showed that age of onset of dialysis, primary disease, low density lipoprotein, serum potassium, ejection fraction (EF), coronary heart disease and stroke were independent risk factors of mortality (P < 0.05). Conclusions The survival rate of patients with diabetic kidney disease is significantly lower than that of patients with non-diabetic kidney disease in the maintenance hemodialysis patients in our center. Age, primary disease, low density lipoprotein, EF, coronary heart disease, and stroke are independent predictors of death.
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Objective To explore whether the change of S phase kinase-associated protein 2 (Skp2) expression could regulate mesangial cell proliferation. Methods Skp2 siRNA and control siRNA, pIRES-GFP-Skp2 plasmid and pIRES-GFP plasmid were designed and synthesized. Cell transfection was performed by Lipofectamine 2000. Skp2 mRNA and protein levels were detected by semiquantitative PCR and Western blotting respectively. Primary culture rat mesangial cells were divided into 6 groups: 0%FCS, 20%FCS, 10%FCS+pIRES-GFP plasmid, 10%FCS+pIRES-GFP-Skp2 plasmid, 20%FCS+control siRNA, 20%FCS+Skp2 siRNA. Cell number was detected by MTT. S phase entry was measured by BrdU labeling. Cell cycle profile was determined by flow cytometric analysis. Results Skp2 mRNA level was significantly down-regulated by Skp2 siRNA compared to control siRNA. Skp2 protein level increased after pIRES-GFP-Skp2plasmid transfection compared to pIRES-GFP plasmid. MTT, BrdU labeling and cell cycle profile demonstrated that cell number (A: 0.419±0.088 vs 0.305±0.036, P＜0.01) and S-phase cells (BrdU labeling positive cell: 0.21±0.04 vs 0.15±0.03, P＜0.01;S-phase cell number:20.18±0.64vs 14.33±0.37, P＜0.01) obviously increased after Skp2 plasmid transfection, while decreased after Skp2 siRNA transfection compared to control groups (A: 0.328±0.069 vs 0.482±0.133, P＜0.01;BrdU labeling positive cell: 0.17±0.01 vs 0.24±0.00, P＜0.01; S-phase cell number: 16.52±0.75vs 23.81 ±1.25, P＜0.01). Conclusion Over-expression of Skp2 stimulates mesangial cell proliferation while down-regulated expression of Skp2 inhibits mesangial cell proliferation.
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Objective To detect the levels of 25-hydroxyvitamin D3 and analyse the related clinical factors in patients with chronic kidney disease (CKD).Methods Patients with CKD in our department from March 1st to July 1st were enrolled continuously.The level of 25-hydroxyvitamin D3 and intact parathyroid hormone(iPTH) were detected by electrochemiluminescence and immunochemiluminescent respectively.Serum calcium,phosphorus and albumin were measured by automatic biochemical instrument.Results 127 patients were selected and the average age was (60.9?15.3).The mean level of 25-hydroxyvitamin D3 was (12.06?6.41)?g/L.82.6% patients had vitamin D deficiency and 96.9% patients had vitamin D insufficiency.The level of 25-hydroxyvitamin had no statistics difference D3 between stage 1,2 and 3 CKD patients but was much hihger than that of stage 4 and non-haemodialysis stage 5 patients.The level of 25-hydroxyvitamin D3 was not related to serum calcium,phosphorus and iPTH,while positively related to albumin and eGFR and negatively related to serum creatinine and total cholesterol.Conclusion Vitamin D deficiency and insufficiency are frequent in CKD patients and deteriorate with the progress of kidney function impairment.The level of 25-hydroxyvitamin D3 is not related to the traditional CKD-MBD index such as serum calcium,phosphorus and iPTH.