Monocyte counts are negatively associated with ankle-brachial index values in non-dialysis-dependent chronic kidney disease patients.

Our aim was to determine which leukocyte subtypes are most relevant to ankle-brachial index (ABI) values in patients with non-dialysis-dependent chronic kidney disease (NDD-CKD). The study included 79 NDD-CKD patients aged 62.84 ± 12.09 years (63.33% men; 26.67% patients with diabetes) and 21 age-matched normal controls. According to the estimated glomerular filtration rate (eGFR) calculated by the CKD-Epidemiology Collaboration equation (CKD-EPI), we classified the study population into 2 groups (21 subjects with NDD-CKD with an eGFR 60-89 mL/min/1.73m2, 58 subjects with NDD-CKD with eGFR <60 mL/min/1.73 m2). ABI was calculated as the ratio of the ankle systolic BP divided by the arm systolic BP using an ABI-form device. An automated hematologic analyzer was used to measure total and differential leukocyte counts. Monocyte counts and monocyte-to-total leukocyte count ratios (MTR) in patients with an ABI value <1.10 were significantly higher than those in patients with an ABI value ≥1.10, respectively. Univariate analyses revealed that mean ABI values were negatively correlated with monocyte count (r= -0.341; p = 0.044), MTR (r= -0.346, p = 0.031). Multivariate linear regression analyses showed that monocyte count was negatively associated with ABI values (ß ± SE = -1.825 ± 0.341, p = 0.013). The area under the curve of monocyte counts was 0.695 (95% confidence interval 0.586-0.804, p = 0.002) in predicting an ABI value <1.10. Monocyte counts are negatively associated with ABI values in patients with NDD-CKD without apparent peripheral arterial occlusive disorder (PAOD).

Multicenter Adherence Study of Asthma Medication for Children in Korea.

PURPOSE: Adherence is a major component of successful medical treatment. However, non-adherence remains a barrier to effective delivery of healthcare worldwide. METHODS: Twenty healthcare facilities (secondary or tertiary hospitals) belonging to the Korean Academy of Pediatric Allergy and Respiratory Diseases (KAPARD) participated. Questionnaires were given to patients currently receiving treatment in the form of inhalant useor oral intake or transdermal patch for mild to moderate asthma. RESULTS: A total of 1,838 patients responded to the questionnaire. Mean age was 5.98 ± 3.79 years (range: 0-18 years). With help from their caregivers, the percentage of patients that answered "taking as prescribed" was 38.04% for inhalant users, 50.09% for oral medication users and 67.42% for transdermal users. Transdermal patch users had significantly greater adherence compared to the other 2 groups (P < 0.001). The 34.15% of inhalant users, 70.33% of oral medication users and 93.00% of transdermal patch users felt that their medication delivery system was "Easy" or "Very easy" to use (P < 0.001). "Method of administration" was deemed to be the most difficult part of the treatment regimen to follow, and 76.7% of patients preferred once-daily administration (i.e., "Frequency of administration"). CONCLUSIONS: Asthma medication adherence in young children was found to be better in the transdermal patch group. This may be due to requiring fewer doses and easy to follow instructions. From an adherence point of view, the transdermal patch seems more useful for long-term asthma control in children compared to oral or inhaled medicine.

Erratum To: Spontaneous rupture of a renal artery pseudoaneurysm in a previously hypertensive patient.

[This corrects the article DOI: 10.1186/s40885-014-0011-4.].

Spontaneous rupture of a renal artery pseudoaneurysm in a previously hypertensive patient.

Previously, renal artery pseudoaneurysms were thought to be extremely uncommon. However, these lesions are now being detected more frequently as incidental findings on computed tomography, magnetic resonance imaging, and the extensive use of angiography. The incidence of ruptured renal artery pseudoaneurysms is very low. We report a case of a giant renal artery pseudoaneurysm (9.4-cm diameter) with severe left flank pain and a syncopal attack in a young woman who did not control high blood pressure for a couple of years.

Effects of suppressing intrarenal angiotensinogen on renal transforming growth factor-beta1 expression in acute ureteral obstruction.

BACKGROUND: Angiotensin II (Ang II) mediates the up-regulation of fibrogenic factors such as transforming growth factor-beta1 (TGF-beta1) in chronic renal diseases. In addition, it has been proposed that the intrarenal renin-angiotensin system (RAS) is as important as the systemic RAS in kidney disease progression. METHODS: We suppressed angiotensinogen (AGT) gene expression in the kidney by transferring recombinant adenoviral vectors carrying a transgene expressing AGT antisense mRNA, and determined the effect of the local inhibition of the RAS on TGF-beta1 synthesis in the kidneys of rats with unilateral ureteral obstruction (UUO). Immediately after UUO, recombinant adenovirus vectors were injected intraparenchymally into the cortex of obstructed kidneys. RESULTS: beta-galactosidase (beta-gal)-stained kidney sections revealed the efficient transduction of the recombinant adenoviral vectors into tubular epithelial cells. Kidney cortex injected with AGT antisense showed significantly lower native AGT mRNA and protein expressions than control UUO kidneys at 24 hours and 5 days post-UUO. TGF-beta1 was significantly up-regulated in the renal cortex 24 hours and 5 days post-UUO, whereas AGT antisense-injected UUO rats showed significantly reduced TGF-beta1 expression compared to control UUO rats. Both fibronectin and collagen type I expressions were increased 24 hours and 5 days post-UUO, and these augmentations were considerably reduced by AGT antisense RNA treatment. CONCLUSION: This study demonstrates that the suppression of intrarenal RAS prevents the formation of renal cortical TGF-beta1, and of related fibrogenic factors, in early UUO.