Prevalence, awareness, treatment, and control of hypertension in the non-dialysis chronic kidney disease patients / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Data on the epidemiology of hypertension in Chinese non-dialysis chronic kidney disease (CKD) patients are limited. The aim of the present study was to investigate the prevalence, awareness, treatment, and control of hypertension in the non-dialysis CKD patients through a nationwide, multicenter study in China.</p><p><b>METHODS</b>The survey was performed in 61 tertiary hospitals in 31 provinces, municipalities, and autonomous regions in China (except Hong Kong, Macao, and Taiwan). Trained physicians collected demographic and clinical data and measured blood pressure (BP) using a standardized protocol. Hypertension was defined as systolic BP ≥ 140 mmHg and/or diastolic BP ≥ 90 mmHg, and/or use of antihypertensive medications. BP < 140/90 mmHg and < 130/80 mmHg were used as the 2 thresholds of hypertension control. In multivariate logistic regression with adjustment for sex and age, we analyzed the association between CKD stages and uncontrolled hypertension in non-dialysis CKD patients.</p><p><b>RESULTS</b>The analysis included 8927 non-dialysis CKD patients. The prevalence, awareness, and treatment of hypertension in non-dialysis CKD patients were 67.3%, 85.8%, and 81.0%, respectively. Of hypertensive CKD patients, 33.1% and 14.1% had controlled BP to < 140/90 mmHg and < 130/80 mmHg, respectively. With successive CKD stages, the prevalence of hypertension in non-dialysis CKD patients increased, but the control of hypertension decreased (P < 0.001). When the threshold of BP < 130/80 mmHg was considered, the risk of uncontrolled hypertension in CKD 2, 3a, 3b, 4, and 5 stages increased 1.3, 1.4, 1.4, 2.5, and 4.0 times compared with CKD 1 stage, respectively (P < 0.05). Using the threshold of < 140/90 mmHg, the risk of uncontrolled hypertension increased in advanced stages (P < 0.05).</p><p><b>CONCLUSIONS</b>The prevalence of hypertension Chinese non-dialysis CKD patients was high, and the hypertension control was suboptimal. With successive CKD stages, the risk of uncontrolled hypertension increased.</p>

Effects of Salvia miltiorrhiza on oxidative stress and microinflammatory state in patients undergoing continuous hemodialysis / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To investigate the effects of Salvia miltiorrhiza (SM) on oxidative stress and microinflammatory state in patients undergoing continuous hemodialysis (CHD).</p><p><b>METHODS</b>Thirty-six patients who had received CHD for over half a year were assigned into the routine CHD group (18 cases) and the treated group treated with routine CHD plus SM (18 cases). Meanwhile, 18 healthy adults were taken as the normal control. Indexes related with oxidative stress [malondialdehyde (MDA), advanced oxidative protein products (AOPP) and superoxide dismutase (SOD)) and microinflammation C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-alpha) were detected before and after 1, 2 and 3 months of treatment.</p><p><b>RESULTS</b>The levels of AOPP, MDA, CRP, IL-6 and TNF-alpha in patients were higher and SOD was lower than those in the normal control at all the time points (P < 0.01). Compared with the baseline, the levels of AOPP and MDA in the routine CHD group significantly increased and SOD decreased after 3 months of treatment (P < 0.05), but changes of CRP, IL-6 and TNF-alpha showed no significance though there were somewhat increment (P > 0.05). The levels of AOPP and MDA were lower and SOD was higher after 1, 2 and 3 months of SM combined treatment, and CRP was lower after 3 months of treatment in the treated group than those of baselines and those at the corresponding time points in the routine CHD group (P < 0.01), but IL-6 and TNF-alpha reduced insignificantly (P > 0.05).</p><p><b>CONCLUSION</b>Hemodialysis may aggravate the oxidative stress and microinflammation in patients, which could be obviously alleviated by SM.</p>

Effects of leukocyte depletion filter on canine kidney during cardiopulmonary bypass / 中南大学学报(医学版)

OBJECTIVE@#To explore the effect of a reforming leukocyte depletion filter (LDF-1) on the functional and pathologic changes of canine kidney during cardiopulmonary bypass (CPB).@*METHODS@#Twelve Mongolian dogs were randomly allocated into a control group (no LDF-1, n = 6) or a leukocyte-depleted filter group (LDF-1 placed in venous line, n = 6). CPB of the dogs anestheitized with sodium pentobarbitone at 25 mg/kg was set up. After 10 min of CPB, aorta was clamped and St. Thomas cardioplegic solution at 20 mg/kg was immediately injected into the root of aorta. The aortic cross-clamp was released and CPB was closed at 70 min. Dogs were observed for 2 h after weaning from CPB. LDF-1 was opened at 2 min and stoped at 7 min during initially running CPB in the LDF-1 group. Circulating leukocytes, plasma L-selectin, and plasma IL-8 were respectively counted before CPB, at 10 minutes, 40 min, and 75 min during CPB, the end of CPB, and 2 h after CPB. The urine analysis and renal pathology, which were obtained before CPB and 2 h after CPB, were observed.@*RESULTS@#The number of leukocytes significantly decreased by 55% - 68% in the LDF-1 group compared with the baseline during CPB. The value at 10 min of CPB in the LDF-1 group was lower than that in the control group (P < 0.05). Plasma levels of L-selectin and IL-8 obviously increased in the 2 groups compared with the baseline during CPB, but both levels at 2 h after CPB in the LDF-1 group were lower than those in the control group (P <0. 05). No statistic difference was found in plasma levels of urea and creatinine, but hematuria was observed in the 2 groups at 2 hours after CPB. The pathologic changes of kidney, which was mainly renal tubule swelling accompanied partly with vacuolar degeneration, were similar under the light microscope in the 2 groups at 2 h after CPB. Obvious glomerular damage was not found.@*CONCLUSION@#LDF-1 can effectively decrease leukocyte counts and the inflammatory reaction, but it can not bring about excellent protective effect on kidney during CPB when used alone. Attention to should be paid the renal protection in the postoperative CPB.