RESUMO
Objective:To investigate the effects of aerobic combined stretching exercise during dialysis on the severity of restless legs syndrome(RLS), quality of life and sleep quality in hemodialysis (HD) patients.Methods:A total of 63 HD patients with RLS who were admitted to the Hemodialysis Center, Renmin Hospital of Wuhan University from March 2018 to March 2019 were selected as research objects. According to the random number table method, they were divided into the observation group (32 cases) and the control group (31 cases). Patients in the control group were given conventional nursing methods while patients in the observation group were given the aerobic combined stretching exercise during dialysis. The International Restless Legs Syndrome Rating Scale (IRLS) Kidney Disease Quality of Life, (KDQOL-36 TM), Pittsburgh Sleep Quality Index(PSQI) and blood chemistry were used to evaluate the effect of exercise on HD patients with RLS. Results:After intervention, the observation group ′s IRLS scores was 12.19±4.48, lower than the control group (17.87±3.91), the difference was statistically significant ( t value was 3.021, P<0.05). The scores of physical health, mental health, kidney burden, symptoms and discomfort, effects of kidney disease in KDQOL-36 TM of the observation group were 44.56±6.64, 46.12±4.95, 19.92±15.91, 87.59±5.65, 64.55±13.20, higher than the control group (37.43±4.81, 41.81±4.87,12.10±14.87, 78.83±7.96, 55.45±15.52), the differences were statistically significant ( t values were -5.027--2.015, P<0.05). The PSQI total score was 8.94±2.54, lower than that of the control group (13.13±1.31), the difference was statistically significant ( t value was 8.271, P<0.05). The blood phosphorus was (1.80±0.48) mmol/L in the observation group, lower than (2.04±0.34) mmol/L in the control group, and hemoglobin, blood calcium [(105.31±13.58) g/L, (2.26±0.20) mg/L] were higher than those in the control group[(99.52±8.21) g/L, (2.05±0.29) mg/L], the differences were statistically significant ( t values were 2.275, -2.042, -3.325, P<0.05). Conclusions:The aerobic combined stretching exercise during dialysis relieves the symptom of RLS, improves the sleeping quality and quality of life.
RESUMO
Objective:To observe the expression of sirtuin 3 (Sirt3) and mitochondrial damage-associated proteins in lipopolysaccharide (LPS)-induced acute kidney injury mouse model and renal tubular epithelial cells, and to explore the role of Sirt3 in LPS-induced abnormal mitochondrial dynamics in renal tubular epithelial cells.Methods:Eighteen specific pathogen free (SPF) male C57BL/6 mice were randomly assigned to control group, LPS 24 h group and LPS 48 h group. The control group was intraperitoneally injected with physiological saline (0.1 ml/10 g), and LPS 24 h group and LPS 48 h group were intraperitoneally injected with LPS (10 mg/kg) solution. Renal functional indexes of mice were analyzed by automatic biochemical analyzer. The pathological change of the kidney was observed by HE staining, and the expressions of dynamin-related protein-1 (Drp1), optic atrophy type 1 (Opa1) and Sirt3 were evaluated by Western blotting. Expression and distribution of Sirt3 in kidney was assessed by immunohistochemistry. Human renal tubular epithelial cells (HK-2) were exposed to 10 μg/ml LPS for 24 h, and the expression of Drp1, Opa1 and Sirt3 were detected by Western blotting. Cell apoptosis was assessed by Hoechst-33342 staining. After transfection to HK-2 cells with pcDNA3.1-Sirt3 recombinant plasmid, the expressions of Sirt3, Drp1, Opa1 and cell apoptosis were detected by the same methods as above.Results:(1) The levels of blood urea nitrogen and serum creatinine in LPS group were significantly higher than those in control group (both P<0.05), and the pathological changes of kidney were obvious. (2) Compared with the control group, the expression of mitochondrial fission-associated protein Drp1 in renal tissue of LPS group was significantly higher ( P<0.05), and the expression of mitochondrial fusion associated protein Opa1 was significantly lower ( P<0.05). (3) Compared with the control group, the expression of Sirt3 in LPS group was significantly lower ( P<0.05), and immunohistochemistry results showed that Sirt3 was mainly expressed in glomerular vascular endothelial cells and renal tubular epithelial cells. (4) In vitro, LPS stimulation induced increased Drp1 expression in HK-2 cells ( P<0.05), decreased Opa1 and Sirt3 expression (both P<0.05), and increased apoptosis ( P<0.05). (5) LPS-induced mitochondrial dynamics disturbance and apoptosis were alleviated by pcDNA3.1-Sirt3 recombinant plasmid transfection. Conclusions:LPS can induce down-regulation of Sirt3 expression and disturbance of mitochondrial dynamics, and Sirt3 may play a protective role in LPS-induced acute kidney injury by regulating mitochondrial dynamics.
RESUMO
Objective@#To investigate the clinic-pathological features and prognostic risk factors of IgA nephropathy (IgAN) with hypertension (HTN).@*Methods@#Primary IgAN patients diagnosed with biopsy from January 2016 to December 2017 were recruited. Patients were divided into IgAN with normal blood pressure (IgAN-NTN) group and IgAN with hypertension (IgAN-HTN) group based on the pressure value when performing the kidney biopsy. The clinical and pathological data were collected and compared between the two groups. Kaplan-Meier method was conducted for renal results, whereas the Cox regression model was exploited to analyze the prognostic factors in the progression of IgAN-HTN patients.@*Results@#The total number of enrolled patients was 275 cases, 170 (61.82%) of which had normal pressure and 105 individuals (38.18%) resulted in hypertension. The IgAN-HTN group in terms of male proportion, age, systolic pressure, diastolic pressure, serum urea nitrogen, serum creatinine, serum uric acid, 24 h urinary protein, triacylglycerol, complement C4 and so on were higher than those in the IgAN-NTN group (all P<0.05). The incidence of gross hematuria and the level of estimated glomerular filtration rate (eGFR) were significantly lower than those in the NTN group (all P<0.001). For the aspect of light microscope pathological manifestations, IgAN-HTN group exhibited more severe histological lesions including glomerular sclerosis, renal tubular atrophy or renal interstitial fibrosis, interstitial vascular injury than IgAN-NTN group (all P<0.05). Immunofluorescence examination results showed that the deposition ratio of C1q in IgAN-HTN group was higher than that in IgAN-NTN group (P=0.015). By employing Kaplan-Meier method, the cumulative renal survival rate in the HTN group was much lower than that in the NTN group (Log-rank test: χ2=6.456, P=0.011). For the patients in IgAN-HTN group, the cumulative renal survival rate in the dyslipidemia group was much lower than that in the ortholiposis group (Log-rank test: χ2=5.093, P=0.024). There was no significant difference in the cumulative renal survival rate between the blood pressure control group and the unqualified group (Log-rank test: χ2=1.036, P=0.309). As a result of univariate and multivariable Cox regression analysis, total cholesterol, eGFR and 24 h urinary protein were risk factors for renal progression of IgAN patients with hypertension.@*Conclusions@#The clinical manifestations and renal pathological changes in patients with IgAN-HTN are more serious than those in IgAN-NTN patients, which result in worse prognosis. IgAN-HTN patients should be paid more attention to the management of serum lipid level during treatment and follow-up.
RESUMO
Objective To investigate the clinic-pathological features and prognostic risk factors of IgA nephropathy (IgAN) with hypertension (HTN). Methods Primary IgAN patients diagnosed with biopsy from January 2016 to December 2017 were recruited. Patients were divided into IgAN with normal blood pressure (IgAN-NTN) group and IgAN with hypertension (IgAN-HTN) group based on the pressure value when performing the kidney biopsy. The clinical and pathological data were collected and compared between the two groups. Kaplan-Meier method was conducted for renal results, whereas the Cox regression model was exploited to analyze the prognostic factors in the progression of IgAN-HTN patients. Results The total number of enrolled patients was 275 cases, 170 (61.82％) of which had normal pressure and 105 individuals (38.18％) resulted in hypertension.The IgAN-HTN group in terms of male proportion, age, systolic pressure, diastolic pressure, serum urea nitrogen, serum creatinine, serum uric acid, 24 h urinary protein, triacylglycerol, complement C4 and so on were higher than those in the IgAN-NTN group (all P<0.05). The incidence of gross hematuria and the level of estimated glomerular filtration rate (eGFR) were significantly lower than those in the NTN group (all P<0.001). For the aspect of light microscope pathological manifestations, IgAN-HTN group exhibited more severe histological lesions including glomerular sclerosis, renal tubular atrophy or renal interstitial fibrosis, interstitial vascular injury than IgAN - NTN group (all P<0.05). Immunofluorescence examination results showed that the deposition ratio of C1q in IgAN-HTN group was higher than that in IgAN-NTN group (P=0.015). By employing Kaplan-Meier method, the cumulative renal survival rate in the HTN group was much lower than that in the NTN group (Log-rank test:χ2=6.456, P=0.011). For the patients in IgAN-HTN group, the cumulative renal survival rate in the dyslipidemia group was much lower than that in the ortholiposis group (Log-rank test: χ2=5.093, P=0.024). There was no significant difference in the cumulative renal survival rate between the blood pressure control group and the unqualified group (Log-rank test: χ2=1.036, P=0.309). As a result of univariate and multivariable Cox regression analysis, total cholesterol, eGFR and 24 h urinary protein were risk factors for renal progression of IgAN patients with hypertension. Conclusions The clinical manifestations and renal pathological changes in patients with IgAN-HTN are more serious than those in IgAN-NTN patients, which result in worse prognosis. IgAN-HTN patients should be paid more attention to the management of serum lipid level during treatment and follow-up.
RESUMO
Objective To evaluate the effects of autophagy on oxidative stress induced by contrast media in podocytes.Methods The differentiated mouse podocytes were exposed to contrast media (Iopromide,50 mg/L)、rapamycin (Rap,autophagy enhancer,1 ng/L),3-methyladenine (3-MA,autophagy inhibitor,2 mmol/L) for 2 hours.The expression of autophagy protein LC3-Ⅱ and Beclin-1 as well as oxidative stress-related proteins Catalase,MnSOD were detected by Western blot.The formations of autophagy were observed by MDC staining,and the levels of reactive oxygen species (ROS) by CM-H2DCFDA staining.Cell activity was evaluated by CCK8 assay.Results Both the levels of oxidative stress and autophagy in podocytes increased when stimulated by contrast media,the expression of LC3-Ⅱ and Beclin-1 were enhanced,Catalase and MnSOD were inhibited (all P ＜ 0.05).Rapamycin increased the expression of Catalase,MnSOD and cell activity of podocytes,reduced the generation of ROS (all P ＜ 0.05),but in Rap group,cell activity showed no significant difference (P ＞ 0.05).3-MA decreased the expression of Catalase 、MnSOD and inhibited the cell activity of podocyte,increased the generation of ROS (all P ＜ 0.05).Conclusion Autophagy protects podocyte from contrast media by the means of reducing oxidative stress.
RESUMO
Objective To investigate the renoprotective effects of KB-R7943 on renal injury induced bycontrast media. Method Tubular epithelial cells were trested with varions cencentration of KB-B7943 (10-5,10-6 mol/L) for 12 hours before contrast media was used. After cells we, re incubated with contrast media (CM)(110 mgI/L) for 1 hour, cells injury was assessed by using LDH, and cell morphologic changes and cells apopto-sis were evaluated with inverted microscope and flow cytometry, respoelively. Intracellular Ca2+ and reactive oxy-gen species (ROS) were analyzed by using confocal microscope. The expression of Na+/Ca2+exchanger mRNAwas evaluated by RT-PCR. Mannitol with same osmolarity (20% mannitol, 770 mOsm/L) of CM was used as con-trol. One-way analysis of variance and q-test were used for comparison between groups. The simple linear correla-tion was employed to analyze the correlation. P < 0.05 was considered significant. Results Contrast media sig-nificantly induced tubular cells damage significantly and apoptosis at 1 hour after incubation, meanwhile, intracel-lular Ca2+ and ROS were inoreased progressively in CM group. KB-R7943 significantly attenuated cells damage andapoptosis in dose-dependent in association with decreased intracellular Ca2+ and ROS. Expression of Na+/Ca2+exchanger mRNA was not changed. Conclusions KB-R7943 has renoprotective effects on the contrast-media-in-duced renal tubular cyotoxicity