Acute kidney injury in patients with idiopathic membranous nephropathy: influencing factors and prognosis.

AIM: Idiopathic membranous nephropathy (IMN) is a common type of nephrotic syndrome, and is associated with acute kidney injury (AKI). We investigated the association of multiple variables with AKI in patients with IMN. METHODS: The data of 187 patients with biopsy-proven IMN were examined. Renal outcome was defined as progression to end-stage renal disease (ESRD). Binary logistic regression and Kaplan-Meier's analysis were used for statistical analysis. RESULTS: During follow-up, 46 (24.6%) patients developed AKI. The incidence of AKI was greater in males than females (p < .01). The AKI group had higher uric acid, lower serum PLA2R antibody positive, and worse baseline kidney function (all p < .01). Most patients in the AKI group had stage I (71.74%) or stage II (21.74%). The AKI group had higher renal tubular injury score and chronicity index (both p < .05). Binary logistic regression indicated that uric acid and baseline estimated glomerular filtration rate (eGFR) were independent risk factors for AKI in patients with IMN (p < .05). The optimal cutoff value of serum uric acid for predicting AKI was 402.50 µmol/L and the baseline eGFR was 96.83 mL/min/1.73 m2. Kaplan-Meier's analysis showed that the cumulative renal survival rate was lower in the AKI group (p = .047). CONCLUSIONS: AKI increases the risk of poor prognosis in IMN patients and the high uric acid and low baseline eGFR were considered independent predictors for developing AKI in patients with IMN.

Effects of microbial community structure and its co-occurrence on the dynamic changes of physicochemical properties and free amino acids in the Cantonese soy sauce fermentation process.

The soy sauce produced by Cantonese fermentation has a unique flavor, among which brine fermentation plays an important role. In this fermentation process, 61 volatile compounds, including 19 esters, 10 aldehydes, 9 alcohols, 5 phenols, and 18 others, were identified by headspace solid-phase microextraction-gas chromatography-mass spectrometry. Seventeen kinds of free amino acids were detected by high-performance liquid chromatography. Results showed that Touyou, which comprised 1.5 g/100 g total nitrogen, 1.0 g/100 mL amino acid nitrogen, 3.66 g/100 g reducing sugar, 1.44 g/100 mL total acid, 17.04 g/100 mL salt content, and 27.3% umami free amino acids, had excellent quality. High-throughput sequencing was used to identify microorganisms. The top 3 of bacteria were Weissella, Staphylococcus, and Lactobacillus, and the top 3 fungi were Aspergillus, Zygosaccharomyces, and Candida. The co-occurrence network analysis of microorganisms showed that the top-ranked microorganisms were Plectosphaerella, Aureobasidium, unidentified_Mortierellales_sp, Glutinomyces, Faecalibacterium, and Cladophialophora. Then, eight microorganisms (VIP[pred] > 1) were obtained by two-way orthogonal partial least squares model, namely, Staphylococcus, Candida, Weissella, Aspergillus, Zygosaccharomyces, Lactobacillus, Monilinia, and Clavispora. Correlation analysis showed that these microorganisms were strongly related to flavor metabolites. This study explored the dynamics of traditional Cantonese fermentation, which has positive implications for optimizing this traditional fermentation process.