Fatores sociodemográficos e clínicos dos pacientes que tiveram perda do enxerto renal / Sociodemographic and clinical factors of patients who have lost kidney grafting

Introdução: O transplante renal é uma terapia renal substitu-tiva que proporciona resultados mais expressivos na qualidade de vida do paciente dialítico. A sobrevida do enxerto depende do tipo de doador (falecido ou vivo), se houve complicações no pós-operatório e se adquiriu infecções (trato urinário, do trato respiratório, das sondas e da ferida operatória). Objeti-vos: Caracterizar os fatores sociodemográficos e clínicos dos transplantados renais que tiveram perda do enxerto renal; cor-relacionar a causa da perda do enxerto com o tempo e a idade do transplantado renal. Material e Métodos: estudo retrospec-tivo, descritivo, de natureza quantitativa realizado na unidade de transplante renal de um hospital do interior paulista, com 63 pacientes transplantados renais que tiveram a perda do enxerto, no período de janeiro de 2010 a dezembro de 2015. Resulta-dos: Entre os 63 pacientes, a média de idade foi de 42,4±12,4 anos, sexo masculino (60,3%), casados (57,1%) e escolaridade entre 05 e 08 anos de estudo (54%). O serviço mais utilizado foi o Sistema Único de Saúde (74,6%). A doença de base foi a Hipertensão Arterial (85,7%). A duração do transplante variou de zero dia a 53,8 meses, média de 10,9 meses. Analisando a idade e a causa da perda do enxerto, nos menores de 60 anos prevaleceu a glomerulonefrite. Ao se comparar a causa da per-da do enxerto, em pacientes submetidos ao transplante renal, verificou-se que houve correlação com a idade(coeficiente = 0,30; p = 0,01). Conclusão: Os resultados possibilitaram ca-racterizar que os transplantados renais que tiveram perda do enxerto no período do estudo eram homens, de idade produti-va, casados, com baixa escolaridade, usuários do sistema único de saúde e com doença de base hipertensão arterial. Verificou-se que houve correlação da causa da perda do enxerto com a idade do transplantado.

Introduction: Kidney transplantation is a renal replacement therapy that provides more expressive results in the dialysis patient's quality of life. The survival rate of the graft depends on the type of donor (deceased or living), whether he/she had complications in the postoperative period, and whether he/she acquired infections (urinary tract, respiratory tract, probes and surgical wound). Material and Methods: We carried out a retrospective, descriptive study using a quantitative approach at the renal transplant unit of a hospital in the inland of São Paulo State, Brazil, with 63 renal transplant patients who had graft loss from January 2010 to December 2015. Results:Among the 63 patients, the mean age was 42.4 ± 12.4 years, the majority was male (60.3%), married (57.1%), and they had a length of study between 05 and 08 years of schooling (54%). The most used health care service was the Unified Health System (74.6%). The underlying disease was Arterial Hypertension (85.7%). The length of transplantation time ranged from zero days to 53.8 months, mean of 10.9 months. Analyzing the age and cause of graft loss, glomerulonephritis prevailed in those aged 60 and younger. When comparing the cause of graft loss, there was a correlation with age (coefficient = 0.30, p = 0.01) in patients undergoing kidney transplantation. Conclusion: The results allowed characterizing the renal transplant recipients who had graft loss in the study period. They were men of a productive age, married, with low level of education, and users of the unified health system. They also had arterial hypertension as the underlying disease. It was verified that there was correlation between the cause of the graft loss and the age of transplant recipients

Protective effect of rhein on aristolochic acid-induced renal injury in zebrafish / 中国药理学通报

Aim To study the effect of rhein on renal damage induced by aristolochic acid. Methods Ze-brafish model of aristolochic acid nephropathy, genera-ted by treating zebrafish larvae with aristolochic acid for 24 h, was treated with rhein simultaneously . Mor-pholigical changes were observed and the creatinine level in larvae tissue was measured. And mRNA ex-pression levels of inflammatory factor cox2 a and fibrosis factor TGF-β1 in larvae tissue were detected using qPCR. Results Some larvae show periocular edema and circulation system defection e. g. weak heart beat, narrow cardiac vesicle, decreased blood flow and even blockage , with a dose-response relationship after expo-sure to aristolochic acid for 24 h. The creatinine level in larvae tissue of the treated group was significantly higher than that of the control larvae. And the expres-sion levels of cox2 a and TGF-β1 in larvae tissue of the treated group were also significantly increased. Per-centage of abnormal larvae and creatinine level in lar-vae tissue were decreased when treated with rhein sim-ultaneously. And the expression levels of cox2a was down-regulated by rhein compared with the aristolochic acid treated group. But rhein had no effect on TGF-β1 expression. Conclusion To some extent rhein can protect renal from damage induced by aristolochic acid.

Effects of flavonoids from Prinsepia utilis Royle on the histomorphology of kidney in alloxan-induced diabetic mice / 中国药理学通报

Aim To investigate the effect of flavonoids from Prinsepia utilis Royle( FPR) on the histomorphol-ogy of kidney in diabetic mice, and to investigate its protective mechanism. Methods Diabetic mice in-duced by alloxan were given FPR orally each day for four weeks. After the administration for two and four weeks, ten mice in each group were randomly sacri-ficed. The kidneys were removed and weighed. The extracted renal tissue was embedded with paraffin and sectioned, the sections were stained with Hematoxylin and Eosin(HE)、Periodic acid Schiff(PAS) and Go-mori, and then observed under the microscopy. 1mm3 of renal cortex fixed with glutaral in four centi-degree , and then the ultrastructure of each group was observed under the electron microscope respectively after four weeks′ treatment. Results Compared with the model control group, in the treatment group, observation un-der the microscopy showed that glomerular volume and mesangial cells reduced, FPR could relieve thickening of the glomerular basement membrane ( GBM ) , little inflammatory cells infiltrated in the interstitium,tubular epithelial cells almost became normal, renal tubule had little glucogen, fiber decreased in the interstitium of renal tubule. Observation under the electron micro-scope indicated that foot process in podocytes lined up in order, mitochondria of the renal tubule’ s epithelial cell almost recovered. Conclusion FPR can relieve the changes of renal pathology,improve renal function, and delay the progression of pathologic changes of kid-ney in diabetic mice partly through reducing the blood glucose and the blood lipid.

Anti-HLA and anti-MICA antibodies are positively correlated with transplanted kidney dysfunction / 中华微生物学和免疫学杂志

Objective To study the correlation between transplanted kidney dysfunction and oc-currence of the panel reactive antibody ( PRA, also referred as anti-HLA antibody ) and anti-Major-Histo-compatibility-Complex class Ⅰrelated chain A (MICA) antibody.Methods The tests for detecting PRA and anti-MICA antibody were performed on 679 renal transplant patients from December , 2009 to June, 2010 who received transplantation before 2008 in Beijing Friendship Hospital .Enzyme-Linked Immunosor-bent Assay ( ELISA) was used to detect anti-HLA antibody using LAT-1240 ( OneLambda Inc .) .MICA Ab-Scan Kit was adopted to detect anti-MICA antibody .Continuous observation of graft function was conducted . Results 108 out of 679 patients showed anti-HLA antibody and/or anti-MICA antibody positive results . Among them, 81 patients were positive only for anti-HLA antibody, 18 patients were positive only for anti-MICA antibody and other 9 patients showed anti-HLA and anti-MICA antibodies double positive .Among all of the kidney transplant patients with a failed or decreased renal function , 71 patients were positive for anti-HLA antibody;16 patients were positive for anti-MICA antibody;and other 9 patients were positive for both anti-HLA and anti-MICA antibodies .The results demonstrated that anti-HLA and anti-MICA antibodies af-fected the renal functions in patient with renal transplantation (χ2 =353.92, P <0.001).Conclusion Anti-HLA and MICA antibodies showed significant positive correlations with chronic allograft failure in the patients with renal transplantation .

Serum adiponectin levels and inflammatory markers in patients with end-stage renal disease / 中国医师杂志

Objective To examine the levels of serum adipunectin (ADPN)in patients with end-stage renal disease (ESRD), and identify the relationship between serum ADPN and tumor necrosis factor (TNF)-α, high sensitivity C-reactive protein(hs-CRP) and renal function. Methods Sixty ESRD patients and twenty normal healthy persons were involved in this study. The patients were divided into three groups: patients with chronic renal failure (CRF, 18 cases), patients with hemodialysis (HD,22 cases) and patients with peritoneal dialysis (PD,20 cases). The levels of serum ADPN, TNF-α and hs-CRP were detected by means of ELISA. Differences in continuous variables be-tween the three groups were evaluated. Results The levels of serum ADPN, TNF-α and hs-CRP in CRF, HD and PD patients were signifi-cantly higher than those in control group ( P<0.01 ). Serum ADPN levels in ESRD patients were positive related to serum TNF-α( r≥0.478, P<0.01 ), and negative related to GFR ( r≥-0.582, P<0.01 ). Conclusion The level of serum ADPN was markedly in-creased in patients with ESRD, and correlated with serum TNF-α level and.renal function.