External Validation of the International IgA Nephropathy Prediction Tool in Older Adult Patients.

Purpose: The International IgA Nephropathy Prediction Tool (IIgAN-PT) can predict the risk of End-stage renal disease (ESRD) or estimated glomerular filtration rate (eGFR) decline ≥ 50% for adult IgAN patients. Considering the differential progression between older adult and adult patients, this study aims to externally validate its performance in the older adult cohort. Patients and Methods: We analyzed 165 IgAN patients aged 60 and above from six medical centers, categorizing them by their predicted risk. The primary outcome was a ≥50% reduction in estimated glomerular filtration rate (eGFR) or kidney failure. Evaluation of both models involved concordance statistics (C-statistics), time-dependent receiver operating characteristic (ROC) curves, Kaplan-Meier survival curves, and calibration plots. Comparative reclassification was conducted using net reclassification improvement (NRI) and integrated discrimination improvement (IDI). Results: The study included 165 Chinese patients (median age 64, 60% male), with a median follow-up of 5.1 years. Of these, 21% reached the primary outcome. Both models with or without race demonstrated good discrimination (C-statistics 0.788 and 0.790, respectively). Survival curves for risk groups were well-separated. The full model without race more accurately predicted 5-year risks, whereas the full model with race tended to overestimate risks after 3 years. No significant reclassification improvement was noted in the full model without race (NRI 0.09, 95% CI: -0.27 to 0.34; IDI 0.003, 95% CI: -0.009 to 0.019). Conclusion: : Both models exhibited excellent discrimination among older adult IgAN patients. The full model without race demonstrated superior calibration in predicting the 5-year risk.

Carbon coated K(0.8)Ti(1.73)Li(0.27)O4: a novel anode material for sodium-ion batteries with a long cycle life.

Carbon coated K0.8Ti1.73Li0.27O4 (KTLO) has been synthesized by a facile flux method followed by ball-milling and gaseous carbon coating. The carbon coated KTLO delivers a reversible specific capacity of 119.6 mA h g(-1) at 20 mA g(-1) with no capacity loss after 250 cycles as an anode material in sodium ion batteries, exhibiting an improved rate capability of 66 mA h g(-1) at 200 mA g(-1). It was found that carbon coating of KTLO not only enhances its electronic conductivity, but also improves the structure stability, proving that the carbon coated KTLO is a promising anode material for sodium ion batteries.

Sonographic measurement of renal size in patients undergoing chronic hemodialysis: Correlation with residual renal function.

Previous studies have reported that renal size may change when the function is compromised. However, it is not known whether sonographically measured renal size reflects the residual renal function (RRF) in patients undergoing chronic hemodialysis. A total of 140 patients undergoing chronic hemodialysis (≥3 months) were investigated in the present study. The patients were divided into two groups according to the daily urine volume: Individuals with RRF (RRF+ group; ≥200 ml; n=65) and without RRF (RRF- group; <200 ml; n=75). Renal sizes were measured using sonography and renal volumes were calculated with the ellipsoid formula. Univariable and multivariable stepwise forward logistic regression analyses were performed to examine the correlation between the presence of RRF and various variables. The results indicated that there were statistically significant differences (P<0.001) between the RRF+ and RRF- groups with regard to renal length, width, thickness and volume of the left (length, 7.9±1.2 vs. 6.8±1.2 cm; volume, 60.0±26.7 vs. 40.2±18.1 ml, respectively) and right (length, 7.6±1.2 vs. 6.7±1.2 cm; volume, 50.2±26.5 vs. 33.9±15.3 ml, respectively) sides of the kidney. Multivariable stepwise forward logistic regression analyses showed that the mean renal length or volume and hemodialysis duration were independent predictors of the presence of RRF. Therefore, renal size assessment by ultrasonography may be useful for RRF evaluation in patients undergoing chronic hemodialysis.

Andrographolide induced acute kidney injury: analysis of 26 cases reported in Chinese Literature.

AIM: Some Chinese herbs have been known for their kidney toxicity. Andrographolide, the primary component of a traditional medicinal herb, Andrographis paniculata, is widely used in China for the treatment of upper and lower respiratory tract infection, and dysentery etc. The aim of the study was to identify and summarize any case of kidney injury attributed to its use in the Chinese literature. METHODS: A systemic analysis of the Chinese literature from January 1978 to August 2013 was conducted of case reports of andrographolide induced acute kidney injury (AKI). RESULTS: We identified 26 cases of andrographolide induced AKI (22 males and four females), with an average age of 31.3 years (range: 21 months to 47 years). 100-750 mg (58% 500 mg) of andrographolide was administered in 100-500 mL 5% glucose solution or normal saline by intravenous drip once a day. The adverse event appeared after one to six doses (19 [73.1%] patients got only one dose; cumulative dose 690 ± 670 mg) of andrographolide was given, or 0-96 h (median 1 h) after andrographolide was given. The symptoms included flank pain in 23 cases (88.5%), decreased urine volume in five cases (19.2%), and nausea or vomiting in six cases (23.1%). Laboratory tests showed maximum creatinine 352.8 ± 184.1 (158-889) µmol/L and blood urea nitrogen 12.1 ± 7.6 (4.0-40.6) mmol/L. Urine analysis showed proteinuria in 10 (38.5%) cases and occult blood in eight (30.8%) cases. Kidney biopsy was carried out in two cases and both revealed acute tubular necrosis. Management of this adverse event included withdrawal of the culprit drug, conservative therapy, and renal replacement therapy (six cases, 23.1%). All the patients recovered and were discharged with a normal or close to normal serum creatinine. Their average length of hospital stay was 12.1 ± 4.8 days. CONCLUSIONS: Acute kidney injury may occur shortly after intravenous infusion of andrographolide, with symptoms including flank pain, decreased urine output, and nausea or vomiting. The pathological change might be acute tubular necrosis. Renal replacement therapy may be needed in some patients and with a good recovery rate. The mechanisms of andrographolide induced AKI need to be further studied.

Evaluation of Ca3Co2O6 as cathode material for high-performance solid-oxide fuel cell.

A cobalt-based thermoelectric compound Ca(3)Co(2)O(6) (CCO) has been developed as new cathode material with superior performance for intermediate-temperature (IT) solid-oxide fuel cell (SOFC). Systematic evaluation has been carried out. Measurement of thermal expansion coefficient (TEC), thermal-stress (σ) and interfacial shearing stress (τ) with the electrolyte show that CCO matches well with several commonly-used IT electrolytes. Maximum power density as high as 1.47 W cm(-2) is attained at 800°C, and an additional thermoelectric voltage of 11.7 mV is detected. The superior electrochemical performance, thermoelectric effect, and comparable thermal and mechanical behaviors with the electrolytes make CCO to be a promising cathode material for SOFC.

Controllable synthesis of hollow bipyramid ß-MnO(2) and its high electrochemical performance for lithium storage.

Three types of MnO2 nanostructures, viz., α-MnO2 nanotubes, hollow ß-MnO2 bipyramids, and solid ß-MnO2 bipyramids, have been synthesized via a simple template-free hydrothermal method. Cyclic voltammetry and galvanostatic charge/discharge measurements demonstrate that the hollow ß-MnO2 bipyramids exhibit the highest specific capacity and the best cyclability; the capacity retains 213 mAh g(-1) at a current density of 100 mA g(-1) after 150 cycles. XRD patterns of the lithiated ß-MnO2 electrodes clearly show the expansion of lattice volume caused by lithiation, but the structure keeps stable during lithium insertion/extraction process. We suggest that the excellent performance for ß-MnO2 can be attributed to its unique electrochemical reaction, compact tunnel-structure and hollow architecture. The hollow architecture can accommodate the volume change during charge/discharge process and improve effective diffusion paths for both lithium ions and electrons.

Nitrogen-doped porous carbon nanofiber webs as anodes for lithium ion batteries with a superhigh capacity and rate capability.

Nitrogen-doped carbon nanofiber webs (CNFWs) with high surface areas are successfully prepared by carbonization-activation of polypyrrole nanofiber webs with KOH. The as-obtained CNFWs exhibit a superhigh reversible capacity of 943 mAh g(-1) at a current density of 2 A g(-1) even after 600 cycles, which is ascribed to the novel porous nanostructure and high-level nitrogen doping.

Interstitial lung diseases after leflunomide use in nephropathy: an analysis of reported cases in Chinese literature.

BACKGROUND: Leflunomide (LEF)-induced interstitial lung disease (ILD) has been reported in patients with rheumatoid arthritis. In China, LEF is used off-label for the treatment of nephropathy. METHODS: Systemic review of the Chinese literature from 1999 to June 2010 for case reports and case series of LEF-induced ILD in nephropathy patients. RESULTS: We identified seven cases of LEF-induced ILD (three males and four females), with an average age of 45.9 years (range: 9-69 years). Six cases had primary nephrotic syndrome and one had Henoch-Schoenlein purpura. Four cases had diagnoses of renal pathology. Five patients were given loading doses of LEF, followed by a maintenance dose of 10-30 mg/day. The mean duration of LEF use was 62.9 ± 33.0 days (range: 20-120 days). The mean accumulated dose of LEF was 1192.5 mg (range: 830-1800 mg). LEF therapy was considered effective in four patients. Four patients died (57.1%), three of whom had developed fevers. All three male patients died and both of the young patients died. The mean duration of LEF treatment was 83 days for patients who died and 37 days for survivors. CONCLUSIONS: LEF-induced ILD in patients with nephropathy usually occurred after ∼2 months of treatment and an accumulated dose of 1192.5 mg. Duration of LEF use, male sex, young age and fever seemed to increase the risk of mortality.

[Curative machanism of Shenle capsule on 5/6 nephrectomy rats].

OBJECTIVE: To explore curative machanism of Shenle capsule on the 5/6 nephrectomy rats. METHOD: Fibrin plate method was applied to examine activity of urinary plasminogen activator(PA). Semi-quantitative analysis was used to observe stained intensity and area of tissue-type plasminogen activator, urokinas-type plasminogen activator/ plasminogen activator inhibitor(tPA, uPA/PAI-1)in remnant renal tissue. Northern blot was employed to analyze the expression of transforming growth factor (TGF-beta) mRNA. RESULT: In model control group, the urinary PA activity and protein expression of tPA, uPA were down-regulated, but protein expression of PAI-1, TGF-beta mRNA was up-regulated in remnant renal tissue. In each treated group, the urinary PA activity and protein expression of tPA/uPA were enhanced,but the protein expression of PAI-1, TGF-beta mRNA decreased simultaneously. CONCLUSION: Shenle capsule can delay glomerulosclersis and tubulointerstitial fibrotic lesions of remnant kidney by improving the activity of urinary PA and modulating the expression of tPA, uPA/PAI-1 and TGF-beta mRNA.