Clinical outcomes between elderly ESKD patients under peritoneal dialysis and hemodialysis: a national cohort study.

With ageing populations, new elderly end-stage kidney disease (ESKD) cases rise. Unlike younger patients, elderly ESKD patients are less likely to undergo kidney transplant, and therefore the decision of receiving peritoneal dialysis (PD) and hemodialysis (HD) is more crucial. A total of 36,852 patients, aged more than 65, who were newly diagnosed with ESKD and initiated renal replacement therapy between 2013 and 2019 were identified. These patients were categorized into two groups: the PD group and the HD group according to their long-term renal replacement treatment. After propensity score matching, the PD group (n = 1628) displayed a lower incidence of major adverse cardiac and cerebrovascular events (MACCE) (10.09% vs. 13.03%, hazard ratio (HR): 0.74, 95% confidence interval (CI): 0.66-0.83), malignancy (1.23% vs. 2.14%, HR: 0.55, 95% CI: 0.40-0.76), and MACCE-associated mortality (1.35% vs. 2.25%, HR: 0.62, 95% CI: 0.46-0.84) compared to the HD group (n = 6512). However, the PD group demonstrated a higher rate of infection (34.09% vs. 24.14%, HR: 1.28, 95% CI: 1.20-1.37). The risks of all-cause mortality and infection-associated mortality were not different. This study may provide valuable clinical information to assist elderly ESKD patients to choose HD or PD as their renal replacement therapy.

Positive effects of selenized-oligochitosan on zearalenone-induced intestinal dysfunction in piglets.

This paper assessed the positive effects of selenized-oligochitosan (SOC) on zearalenone(ZEN)-induced intestinal dysfunction in piglets. Sixty piglets were randomly divided into 4 groups. Group C was fed the basal diet as a control and Group Z was supplemented with 2 µg/g ZEN in the basal diet; Group ZS1 and ZS2 were supplemented with 0.3 or 0.5 µg/g SOC (calculated by selenium), in addition to 2 µg/g ZEN in the basal diet. After 42 days, ileal mucosal structure, digestive enzyme activities, tight junction protein mRNA expressions, plasma D-lactate and D-xylose contents, and plasma diamine oxidase activities were determined. Compare with Group C, ileal villus height, value of villus height/crypt depth, trypsin, lipase and α-amylase activities, occluding, claudin-1 and ZO-1 mRNA expressions, and plasma D-xylose levels were significantly decreased (p < 0.01) in piglets of group Z; while compare to Group C, ileal crypt depth, plasma D-lactate contents and diamine oxidase activities were significantly increased in piglets of group Z (p < 0.01 or p < 0.05). Compare with Group Z, ileal villus height, lipase and α-amylase activities, occluding, claudin-1 and ZO-1 mRNA expressions, and plasma D-xylose levels were significantly elevated in piglets of group ZS1 and ZS2 (p < 0.01); while compare to Group Z, plasma D-lactate and diamine oxidase contents were significantly reduced in piglets of group ZS1 and ZS2 (p < 0.01 or p < 0.05). Compare with Group Z, value of villus height/crypt depth and trypsin activity were significantly promoted in piglets of group ZS2 (p < 0.01); whereas ileal crypt depth was significantly reduced in piglets of group ZS2 (p <0.01).Thus, SOC can mitigate ZEN-induced intestinal dysfunction in piglets.