ABSTRACT
(Pro)renin receptor(PRR)was organically identified as a specific receptor for prorenin and renin to regulate the activity of renin-angiotensin system(RAS). Increasing evidence suggests that PRR plays a multitude functions in a RAS-dependent and independent manner. The extracellular domain of PRR is cleaved by furin or ADAM19 to produce a 28-ku soluble PRR(sPRR) while the intracellular domain,M8.9,is a subunit of vacuolar H+-ATPase that mediates H+transport. PRR is critically involved in embryogenesis in low vertebrates and mammals. In recent years ,a significant progress has been made in identifying the physiological and pathophysiological functions of renal PRR. PRR has been identified as an important regulator of urine concentrating capability mostly due to its ability to upregulate to aquaporin-2(AQP2)in the collecting duct and Na+,K+,2Cl-cotransporter(NKCC2)in the thick ascending limb. PRR also promotes K+ secretion in response to K+loading through extra-adrenal aldosterone(Aldo)produc?tion. Overactivation of renal PRR contributes to the pathogenesis of hypertension induced by angiotensin Ⅱ infusion and fructose/salt. Overall,PRR has emerged as a new regulator of physiological and pathophysiological processes in the kidney.
ABSTRACT
Objective To investigate the clinical characteristics of elderly patients with multiple myeloma and their prognostic factors.Methods 100 multiple myeloma patients with age≥ 60 years and 100 multiple myeloma patients with age <60 years who admitted in our hospital from December 2007 to December 2015 were collected as research subjects.100 patients with age ≥60 years were divided into elderly multiple myeloma group,100 cases with aged <60 years were divided into non -elderly multiple myeloma group.The clinical data and laboratory results of two groups were compared,the prognosis factors in elderly patients with multiple myeloma were analyzed.Results The incidence rate of ISS stage Ⅰ -Ⅱ in elderly multiple myeloma group (45.0%)was lower than non -elderly multiple myeloma group (60.0%),the incidence rate of stage Ⅲ was higher than non -elderly multiple myeloma group (χ2 =4.511,P <0.05).The infection incidence of elderly multiple myeloma group(30.0%)was higher than non -elderly multiple myeloma group(15.0%)(χ2 =10.452,P <0.05 ).The hemoglobin,serum albumin contents of elderly multiple myeloma group [(83.7 ±19.8)g/L,(27.89 ±6.87)g/L]were less than non -elderly multiple myeloma group[(92.1 ±22.5)g/L,(33.15 ±7.69)g/L](t =4.297,4.426,all P <0.05).The calcium content,the propor-tion of bone marrow plasma cells,serum creatinine and blood β-microspheres protein levels of elderly multiple mye-loma group [(2.51 ±0.41)mmol/L,(39.43 ±18.64)%,(182.24 ±125.47)μmol/L,(9.02 ±6.24)mg/L]were higher than non -elderly multiple myeloma group [(2.36 ±0.48)mmol/L,(37.45 ±19.86)%,(143.25 ± 116.43)μmol/L,(5.87 ±3.41)mg/L](t =5.945,4.196,4.375,4.264,all P <0.05).The median survival time of elderly multiple myeloma patients were significantly correlated with the patients'age,the proportion of plasma cells in bone marrow,blood β2 -microglobulin,albumin,and ISS staging (χ2 =4.125,3.254,8.542,5.748,9.244,all P <0.05).Conclusion The condition of elderly myeloma patients is more serious,age,proportion of plasma cells in bone marrow,blood β2 -microglobulin,albumin and ISS stage affect myeloma patients prognosis.