Evaluation of malnutrition and inflammation after total parathyroidectomy in patients on maintenance dialysis.

PURPOSE: To evaluate the effect of total parathyroidectomy (tPTx) on malnutrition and inflammation in patients on maintenance dialysis (MHD) having secondary hyperparathyroidism (SHPT). METHODS: Twenty-five patients on MHD having SHPT who were being treated with tPTx were selected, and changes in their general condition (dry body mass), parathyroid hormone (PTH) and calcium levels, nutrition state (hemoglobin, hematocrit, serum albumin, and total iron binding capacity), and inflammatory status [serum C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor (TNF-α), and the malnutrition-inflammation score (MIS)] were observed at 12, 24, and 36 months postoperatively. RESULTS: Compared with the preoperative period, the dry body mass increased at 12, 24, and 36 months postoperatively (P < 0.01), hemoglobin, hematocrit, and serum albumin increased significantly (P < 0.01), whereas calcium, phosphorus, and PTH levels decreased significantly (P < 0.01). Serum CRP, IL-6, and TNF-α levels were significantly decreased at 12, 24, and 36 months after surgery (P < 0.01). Furthermore, MIS was reduced as well but to a lesser extent (P < 0.01). CONCLUSION: tPTx effectively reduced MIS in maintenance dialysis patients, and the alleviated malnutrition and improved inflammatory status may contributed to improving the quality of life of patients on MHD with SHPT.

Meta-Analysis Treatment Hyperphosphatemia Chronic Renal Failure Based on Nano Lanthanum Hydroxide.

In this study, our aim is to investigate the effect of lanthanum carbonate in chronic treatment renal failure complicated with hyperphosphatemia. Using methods with lanthanum carbonate, hyperphosphatemia, placebos, calcium carbonate, end-stage renal disease as keywords, we searched the Chinese Journal Full-text Database, Chinese sci-tech journal database, Wanfang Data knowledge service platform, web of science, PubMed, and other databases for literature quality; meta analysis was carried out after a subsequent evaluation. The meta analysis results showed a significant difference in the control of the blood phosphorus level between weighted mean difference WMD = -0.60, 95% CI: -0.75~-0.45, lanthanum carbonate and placebo; WMD = -0.01, 95% CI: -0.07~-0.05; the lanthanum carbonate and placebo had no significant difference in the control of the blood calcium levels after treatment; WMD = -29.75, 95% CI: -39.22 for the control of blood PIH level after treatment, indicating that the difference between lanthanum carbonate and placebo in the control of the parathyroid hormone (PTH) level was statistically significant. WMD=0.41, 95% CI: -0.48~0.34; the difference between the lanthanum carbonate and calcium carbonate in the control of the blood phosphorus level was statistically significant; WMD = 0.19, 95% CI: -0.25~0.13, lanthanum carbonate and calcium carbonate were statistically significant in blood control calcium level; WMD = 174.66, 95% CI: -150.86~150.46, lanthanum carbonate and calcium carbonate were statistically significant in the control of blood PIH level; the difference was statistically significant. Conclusion: Lanthanum carbonate can significantly reduce blood phosphorus and PIH complicated hyperphosphatemia, and has no significant effect on blood calcium, which is superior to calcium carbonate in effectiveness.

[Correlation Study on Pathological Characteristics of Target Organs and Excess Evil Syndrome in IgA Nephropathy].

OBJECTIVE: To explore the correlation between pathological characteristics of target organs and excess evil syndrome in IgA nephropathy. METHODS: Data were collected in multicenter cooperation. Totally 266 IgA nephropathy patients were typed into exogenous wind-heat affection syndrome (49 cases), lower energizer damp-heat syndrome (100 cases), damp-phlegm syndrome (43 cases), and blood stasis syndrome (74 cases). Meanwhile, percutaneous renal biopsy was performed in all patients for Hass classification, Oxford classification, Katafuchi integral, and Jiang's classification methods. The correlation between excess evil syndrome and pathological index was analyzed. RESULTS: Four syndrome types were correlated with their Hass levels (r = 0. 341, P <0. 01). Affection of exogenous wind-heat syndrome was correlated with segmental proliferation of endothelial cells and damaged active lesions of segmental capillary loops. Lower-energizer damp-heat syndrome was associated with Hass III level, destroying active lesions of capillary loops, segmental proliferation of endothelial cells, glomerular segmental lesions, focal interstitial infiltration of inflammatory cells, focal interstitial fibrosis and tubular atrophy. Blood stasis syndrome was associated with Hass IV level, glomerular sclerosis, segmental glomerulosclerosis (S)/adhesion, mesangial hypercellularity (M), angiohyalinosis, multi-foci interstitial infiltration of inflammatory cells, multi-foci interstitial fibrosis and tubular atrophy. Phlegm-damp syndrome had higher proportions of Hass I and III levels, but with no association with other pathological parameters. CONCLUSIONS: Excess evil syndrome was associated with partial pathological characteristics of IgA nephropathy. It could reflect pathological damage degree of target organs, activities, chronic lesions, and prognosis of IgA nephropathy to certain extent. Correlated pathological characteristics and its evolution could indicate excess evil syndrome types and their evolution rules.