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The brain communicates with the metabolic dependent pathway and the immune pathway of the sympathetic nervous system(SNS), and participates in the Brain-Kidney axis to a certain extent. In the course of chronic kidney disease,nervous system diseases,such as cerebrovascular disease, cognitive impairment and neuropathy,occur frequently, which indicates that there are a lot of crosstalk between kidney and brain. In this paper, the pathophysiological mechanism of BrainKidney dialogues in chronic kidney diseases is discussed from the point of nutrient metabolism in patients with chronic kidney diseases, and the two-way regulation mechanism of humral and non-humoral pathays was also studied,which is affected by microvascular and white matter lesions, homocysteinemia, disturbance of hormone and neurotransmitter regulation, immune inflammation and sympathetic nervous system,in order to provide more effective strategies for optimizing protein nutrition and improving prognosis by further understanding the causes and pathogenesis of nutritional metabolic disorders in patients with chronic kidney disease and end-stage renal disease.
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OBJECTIVE: To investigate the effect of probiotic on protein energy wasting and micro-inflammation in peritoneal dialysis patients. METHODS: One hundred and twelve patients who underwent peritoneal dialysis at the nephrology department of Guizhou provincial people's hospital in 2017, were randomly divided into intervention group(n=56) and control group(n=56), which were treated probiotic and placebo respectively two months, and collected biochemical, inflammatory, physical measurement and bioelectrical impedance index before and after treatment. RESULTS: The prevalence of protein-energy wasting was 64.29% and 60.71%in intervention group and control group, respectively. Compared with control group, patients in intervention group had lower urea nitrogen, triglyceride, low density lipoprotein, high-sensitivity C-reactive protein and interleukin-6 and higher serum albumin levels, and these differences were statistically significant(P<0.05). Physical measurement results showed that the upper arm muscle circumference of intervention group was increased compared to control group, and the change was statistically significant(P<0.05). Biological resistance testing results showed that the fat percentage of intervention group was significantly higher than that of control group(P<0.05).CONCLUSION: The treatment of probiotic could improve protein energy wasting and micro-inflammation in continuous peritoneal dialysis patients.
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AIM:To observe the expression of Snail1 and insulin-like growth factor-1 (IGF-1) in NRK-52E cells induced by high glucose,and to investigate the relationship of Snail1 and IGF-1 in the mechanism of epithelial to mesenchymal transition (EMT) in diabetic kidney disease (DKD).METHODS:The NRK-52E cells were treated with Snail1 siRNA and IGF-1 siRNA after cultured with high glucose medium for 72 h,and divided into control group,high glucose group,non-targeting (NT) siRNA group,Snail1 RNAi group and IGF-1 RNAi group.The cells were harvested at 48 h and 72 h.Real-time PCR was used to detect the mRNA expression of Snail1,IGF-1,E-cadherin and fibronectin (FN),and the protein levels were determined by immunofluorescence staining.RESULTS:Compared with control group,the expression of E-cadherin at mRNA and protein levels declined after stimulation with high glucose (P ＜ 0.01),while that of FN was elevated (P ＜0.01).Meanwhile,the mRNA and protein levels of Snail1 and IGF-1 were markedly increased (P ＜0.01).The expression of E-cadherin at mRNA and protein levels was improved in Snail1 RNAi group as compared with high glucose group (P ＜ 0.01),while that of FN,IGF-l and Snail1 was significantly down-regulated (P ＜ 0.01).The same changes were observed in IGF-1 RNAi group (P ＜0.01).The protein expression of each factor in NT group had no significant change as compared with high glucose group (P ＞ 0.05).Pearson correlation analysis showed a close positive relationship between the expression of Snail1 and IGF-1 protein (r =0.852,P ＜ 0.01).CONCLUSION:Snail1 may facilitate DKD development by regulating IGF-1 in the process of EMT.
RESUMEN
AIM:To observe the expression of Snail1 and insulin-like growth factor-1 (IGF-1) in NRK-52E cells induced by high glucose,and to investigate the relationship of Snail1 and IGF-1 in the mechanism of epithelial to mesenchymal transition (EMT) in diabetic kidney disease (DKD).METHODS:The NRK-52E cells were treated with Snail1 siRNA and IGF-1 siRNA after cultured with high glucose medium for 72 h,and divided into control group,high glucose group,non-targeting (NT) siRNA group,Snail1 RNAi group and IGF-1 RNAi group.The cells were harvested at 48 h and 72 h.Real-time PCR was used to detect the mRNA expression of Snail1,IGF-1,E-cadherin and fibronectin (FN),and the protein levels were determined by immunofluorescence staining.RESULTS:Compared with control group,the expression of E-cadherin at mRNA and protein levels declined after stimulation with high glucose (P ＜ 0.01),while that of FN was elevated (P ＜0.01).Meanwhile,the mRNA and protein levels of Snail1 and IGF-1 were markedly increased (P ＜0.01).The expression of E-cadherin at mRNA and protein levels was improved in Snail1 RNAi group as compared with high glucose group (P ＜ 0.01),while that of FN,IGF-l and Snail1 was significantly down-regulated (P ＜ 0.01).The same changes were observed in IGF-1 RNAi group (P ＜0.01).The protein expression of each factor in NT group had no significant change as compared with high glucose group (P ＞ 0.05).Pearson correlation analysis showed a close positive relationship between the expression of Snail1 and IGF-1 protein (r =0.852,P ＜ 0.01).CONCLUSION:Snail1 may facilitate DKD development by regulating IGF-1 in the process of EMT.