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Objective:To explore any effect of regular aerobic exercise on renal fibrosis and apoptosis in rats with spontaneous hypertension.Methods:Thirty 6-week-old male spontaneously hypertensive rats were randomly divided into a sedentary group (group HS) and an exercise group (group HE). Ten age- and sex-matched Wistar-Kyoto rats formed a control group. The rats in group HE underwent 12 weeks of swimming exercise lasting 60 minutes, five times a week, while the other two groups were kept quiet in their cages. Before and after the training, the tail artery blood pressure of each rat was measured. Renal function was evaluated after the experiment by measuring 24h urine protein, blood urea nitrogen and serum creatinine levels, while the degree of renal interstitial fibrosis was measured using Masson staining and the collagen volume fraction was calculated. The number of apoptotic cells in the renal tubular epithelial tissue was recorded by TUNEL staining and the apoptosis rate was calculated. The expression of renal transforming growth factor β1 (TGF-β1), Smad2/3, Smad7, Bax and Bcl-2 protein were detected using western blotting.Results:After the intervention, the average systolic and diastolic blood pressure and mean arterial pressure of group HS had increased significantly, while those of group HE had decreased significantly, with no significant changes in those measurements among the control group. Compared with the control group, after the intervention, the average blood pressure, 24h urinary protein, blood urea nitrogen and serum creatinine, as well as the cell apoptosis rate and expression of TGF-β1, Smad2/3 and Bax had increased significantly, and that of Smad7 and Bcl-2 had decreased significantly in group HS. And compared with group HS, in group HE the average blood pressure, 24h urinary protein, blood urea nitrogen, serum creatinine and the cell apoptosis rate had decreased significantly, together with the expression of TGF-β1, Smad2/3 and Bax, but the average expression of Smad7 and Bcl-2 had increased significantly.Conclusion:Regular aerobic exercise can relieve the renal dysfunction seen in spontaneous hypertension, at least in rats, by inhibiting renal fibrosis and apoptosis.
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Objective To investigate the effects of combination therapy with ACEI and aldosterone receptor antagonist on Cys-C and urinary microprotein regulation.Methods Patients were randomly divided into two groups.The control group received benazepine hydrochloride only.The experimental group received benazepine and spironolactone treatment.The blood pressure,renal function,24 h urinary protein,Cys-C,GFR,urinary microprotein and the correlation of GFR with Cys-C and urinary microprotein were recorded.Results There was no statistically significant difference between two groups in blood pressure(P>0.05).After treatment,the renal function of the experimental group was significantly improved compared to that of the control group.The 24 h urine protein,Cys-C and urinary microprotein were significantly lower in the experimental group than the control group(P<0.05).GFR was negatively correlated with Cys-C and urinary microprotein.Conclusion The com-bination therapy of ACEI and aldosterone receptor antagonist can improve renal function and reduce 24 h hematuria.GFR fil-tration ability was significantly improved with the reduction of Cys-C and urinary microprotein.
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Objective:To probe the effect of intermittent aerobic exercise on adrenomedullin secretion of kidney in hypertensive nephropathy rat (HNR),and investigate the renal mechanism for exercise in the prevention and treatment of hypertension.Method:Thirty-two HNRs were divided into two groups:intermittent exercise group (Group IAE) and control group (Group C).The IAE group performed intermittent treadmill exercise for 8 weeks and their blood pressure was measured before and after exercise by tail pressure of HNR,and serum ADM was detected by enzyme linked immunosorbent assay.Adrenomedullin (ADM) was expressed in kidney by immunohistochemistry.Quantification of specific receptor RAMP2 and CRLR in kidney ADM was detected by immunoblotting.Result:The blood pressure in the Group IAE was significantly lower than that in the Group C(P＜ 0.05).The expression of ADM of kidney and serum in the Group IAE was obviously higher than that in the Group C.The quantity of RAMP2 and CRLR in kidney was obviously increased(P ＜ 0.05).Conclusion:Intermittent aerobic exercise increases serum ADM of HNR with the up-regulated expression of ADM in kidney and their specific receptor CRLR and RAMP2.The increase of serum ADM induced by intermittent aerobic exercise may be related to the change of ADM and the regulation of its specific receptor which may be one of the mechanisms for intermittent aerobic exercise in the prevention and treatment of hypertension.
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We investigated the risk factors for pulmonary hypertension (PH) in patients receiving maintenance peritoneal dialysis (MPD). A group of 180 end-stage renal disease patients (124 men and 56 women; mean age: 56.43±8.36) were enrolled in our study, which was conducted between January 2009 and June 2014. All of the patients received MPD treatment in the Dialysis Center of the Second Affiliated Hospital of Soochow University. Clinical data, laboratory indices, and echocardiographic data from these patients were collected, and follow-ups were scheduled bi-monthly. The incidence and relevant risk factors of PH were analyzed. The differences in measurement data were compared by t-test and enumeration data were compared with the χ2 test. Among the 180 patients receiving MPD, 60 were diagnosed with PH. The remaining 120 were regarded as the non-PH group. Significant differences were observed in the clinical data, laboratory indices, and echocardiographic data between the PH and non-PH patients (all P<0.05). Furthermore, hypertensive nephropathy patients on MPD showed a significantly higher incidence of PH compared with non-hypertensive nephropathy patients (P<0.05). Logistic regression analysis showed that the proportion of internal arteriovenous fistula, C-reactive protein levels, and ejection fraction were the highest risk factors for PH in patients receiving MPD. Our study shows that there is a high incidence of PH in patients receiving MPD and hypertensive nephropathy patients have an increased susceptibility to PH.
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Humans , Male , Female , Middle Aged , Aged , Arteriovenous Fistula/complications , Hypertension, Pulmonary/etiology , Peritoneal Dialysis/adverse effects , C-Reactive Protein/analysis , China/epidemiology , Hypertension, Pulmonary/epidemiology , Incidence , Kidney Failure, Chronic/complications , Kidney Failure, Chronic/therapy , Natriuretic Peptide, Brain/blood , Phosphorus/blood , Prospective Studies , Risk FactorsABSTRACT
OBJECTIVE:To investigate the effect of prostaglandin E1 combined with atorvastatin on related indicators in elderly patients with hypertensive nephropathy. METHODS:70 elderly patients with hypertensive nephropathy were randomly divided into control group and observation group. Control group was orally given 10 mg Atorvastatin calcium tablet,once a day;observation group was additionally given 10 μg Prostaglandin E1 injection,adding into 250 ml 0.9% Sodium chloride injection by intravenous infusion,once a day. The treatment course for both groups was 2 weeks. All patients were given quality low-protein,low-salt and low cholesterol diet,depressurization,lipid-lowering and other conventional treatment. Heart rate (HR),systolic blood pressure (SBP),diastolic blood pressure(DBP),triglyceride(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C), low-density lipoprotein cholesterol(LDL-C),serum creatinine(Scr),24h urinary protein(TP/24 h),microalbuminuria(mAlb),uri-nary β2-microglobulin (β2-MG),blood urea nitrogen (BUN) before and after treatment,and incidence of adverse reactions in 2 groups were observed. RESULTS:After treatment,HR,SBP,DBP,TG,TC and LDL-C in 2 groups were significantly lower than before,and difference was statistically significant(P0.05);Scr,TP/24 h,mAlb,β2-MG and BUN were signifi-cantly lower than before,and observation group was lower than control group,the differences were statistically significant(P0.05). CONCLUSIONS:Based on the con-ventional treatment,prostaglandin E1 combined with atorvastatin can effectively improve the HR,blood pressure and blood lipid of elderly patients with hypertensive nephropathy;however,prostaglandin E1 combined with atorvastatin is better than atorvastatin alone in aspect of protecting renal function,with similar safety.
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Objective To investigate the serum and urine levels of neutrophil gelatinase‐associated lipocalin(NGAL) in patients with primary hypertension and related clinical significance .Methods A total of 107 patients with primary hypertension and 100 healthy subjects were enrolled ,and detected for serum and urine levels of NGAL and urinary micro‐albumin .Results Serum and u‐rine levels of NGAL in hypertension patients were (1 .98 ± 1 .49) and (1 .29 ± 0 .54)μg/L ,higher than the (0 .69 ± 1 .02) and (0 .55 ± 0 .35)μg/L in healthy subjects(P< 0 .05) .Urinary micro‐albumin level in hypertension patients was also higher than healthy subjects (P<0 .05) .Conclusion Serum and urine levels of NGAL in patients with primary hypertension could be signifi‐cantly increased ,which might be with important clinical significance in diagnosis ,treatment and prognosis of hypertensive nephropa‐thy .
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OBJECTIVE:To observe the clinical efficacy and safety of Enalapril folic acid tablet combined with Shenkang injec-tion in the treatment of hypertensive nephropathy. METHODS:90 patients with hypertensive nephropathy were randomly divided in-to control group and observation group. All patients were given anti-infection,regulating electrolyte balance,supplying amino acids and other conventional treatment. Based on it,control group was orally given Maleic acid enalaprilat folic acid tablet 1 tablet in the morning,once a day;observation group was additionally given 100 ml Shenkang injection adding into 300 ml 10% Glucose injec-tion by intravenous infusion,20-30 drops/min,once a day. The treatment course for both groups was 4 weeks. The clinical effica-cy,and clearance rate of creatinine(Ccr),serum creatinine (Scr),morning urine test urine protein (Up)/urine creatinine (Ucr), serum malondialdehyde(MDA),superoxide dismutase(SOD),total antioxidant capacity(T-AOC)before and after treatment and incidence of adverse reactions in 2 groups were observed. RESULTS:The total effective rate in observation group was significantly higher than control group,the difference was statistically significant(P0.05). And there was no significant difference in the incidence of adverse reactions(P>0.05). CONCLUSIONS:Based on the conventional treat-ment,Enalapril folic acid tablet combined with Shenkang injection has better efficacy than only Enalapril folic acid tablet in the treatment of hypertensive nephropathy,with similar safety.
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Objective To analyse the clinical significance of serum homocysteine(Hcy) and neutrophil gelatinase‐associated li‐pocalin(NGAL) in patients with hypertensive nephropathy ,and explore the relationship between serum homocysteine ,NGAL con‐centration and Urinary albumin excretion rate(UAER) .Methods 103 patients with hypertension treated in renal and cardiovascular department of Huangshi Central Hospital from January 2012 to June 2014 were enrolled in the study and were divided into 3 groups :macroalbuminuria group (36 cases) ,microalbuminuria group (35 cases) and negative albuminuria group (32 cases) .In addi‐tion to that ,33 healthy people were recruited as control group .Serum homocysteine ,NGAL concentration and UAER were meas‐ured for the peple enrolled in the study .Results Serum homocysteine and NGAL concentration of macroalbuminuria group and mi‐croalbuminuria group were much higher than negative albuminuria group and control group(P0 .05) .UAER was positively correlated with serum homocysteine and NGAL concentration(r=0 .792 ,0 .658 ,P<0 .05) . Conclusion The detection of serum homocysteine and NGAL are helpful in understanding the changes of disease in patients with hypertensive nephropathy .
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Objective To investigate the clinical efficacy of vallarta combined with folic acid in treatment of elderly hypertensive nephropathy.Methods 120 patients of essential hypertension with renal failure in Weifang People’s Hospital were divided into control group and observation group according to the odd and even numbers.The observation group was given vallarta and folic acid,the control group were given vallarta.4 weeks later,the effect of two groups were evaluated.Systolic and diastolic blood pressure,serum cretonne,blood urea nitrogen and 24h urinary protein were measured before and after treatment. Results The patients after treatment systolic and diastolic pressure was significantly better than control group, the difference was statistically significant(P<0.05),serum creatinine,blood urea nitrogen and 24h urine protein test results were better than control group,the difference was statistically significance(P<0.05).The total effective rate of observation group was better than control group(P<0.05),the obvious effective rate of observation group was significantly better than control group(P<0.01).Conclusion Combination of valsartan and folic acid in treatment of elderly hypertensive nephropathy has a higher total effective rate,while significantly lower blood pressure,serum creatinine,blood urea nitrogen and 24h urinary protein.
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Objective To observe the effect of Cordceps Sinensis (CS) on the expression of intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) in the kidney of spontaneously hypertensive rats(SHR), and to investigate the mechanism of CS. Methods Male SHRs (23 week old) were randomly divided into 4 groups: a group without any treatment (Group S), a group treated with Cordceps sinensis at 4 F), and a group received daily intragastric administration of CS at 4 male WKY rats were used as normals controls. At the end of 8 weeks, all rats were sacrificed. Serum creatinine(Scr), 24 h urinary protein count, and the expression of ICAM-1 and VCAM-1 were examined by immunohistochemical technique and RT-PCR. Results Compared with the WKY rats, blood pressure, 24 h urinary protein count, Scr,and the expression of ICAM-1 andVCAM-1 in the kidney of SHR significantly increased (P＜0.05).Compared with Group S, blood pressure decreased after treatment by fosinopril (P＜0.05). Compared with Group S, the levels of Scr, 24 h urinary protein count, and glomerular lesion were significantly reduced in the CS and/or fosinopril treatment group. The expression of ICAM-1 and VCAM-1 was significantly decreased in these groups (P＜0.05).Conclusion CS may play a role in the protection and anti-fibrosis in the process of renal injury in SHR through reducing the expression of ICAM-1 and VCAM-1.
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AIM: To investingate the variety of the function of vascular endothelium in the patients with hypertensive nephropathy and the effect of Huayu Qinli Granule on (Hirudo,Rhizoma Smilacis Glabrae,Herba Leonuri,etc.) it. METHODS: This was a prospective,comparative and single-blind clinical trial.Patients in accord with the diagnosis and TCM differentiation standard were randomly divided into treatment group,united treatment group,blank control group and positive control group.Before the beginning of the trial,all patients were treated by Felodipine to lower their blood pressure to desired value.When the trial began,blank control group were treated only by Felodipine, positive control group were treated by general hypertension pills+captopril,treatment group were treated by Felodipine+Huayu Qinli Granule,united treatment group were treated by Felodipine+Huayu Qinli Granule+captopril.The course of study was for 4 weeks.The levels of urinary microalbumine(ALB),urinary ?_1-microglobulin(?_1-mg),urinary?_2-microglobulin(?_2-mg),serum nitric oxide and plasma endothelin were measured before and after the trial. RESULTS: The results showed both Huayu Qinli Granule and ACEI improved the levels of serum nitric oxide but there was slightly advantage over ACEI;both Huayu Qinli Granule and ACEI improved the levels of plasma endothelin,the improvement of Huayu Qinli Granule was(equal) to ACEI;united treatment group had the remarkable effect on serum nitric oxide and plasma endothelin. CONCLUSION: The results indicate that Huayu Qinli Granule improves the function of vascular endothelium in the patients with hypertensive nephropathy to a certain extent with the sufficiency of the treatment of depressing blood pressure.The effect of Huayu Qinli Granule is similar to that of ACEI.They cooperate with each other but mechanism of them may be different.