Renal cell carcinoma is a heterogeneous group of renal tumors characterized by several histological subtypes.Herein,we discuss an unusual case of a 55-year-old male who presented as a consultation to our urology clini...Renal cell carcinoma is a heterogeneous group of renal tumors characterized by several histological subtypes.Herein,we discuss an unusual case of a 55-year-old male who presented as a consultation to our urology clinic with an incidentally found renal mass.After shared decision making patient proceeded with a Robotic Assisted Laparoscopy(RAL)left sided partial nephrectomy.Final pathology confirmed the presence of high nuclear grade mixed clear cell and papillary renal cell carcinoma(RCC)of the left kidney(pT3aN0M0).This case elucidates a very rare incidence of a patient seen to have a collision tumor,and furthermore demonstrates guideline-based treatment.展开更多
BACKGROUND Post-streptococcal acute glomerular nephritis(PSAGN)is mostly a benign condition.The usual sequelae of PSAGN include hypertension,its complications,and acute kidney injury.Severe PSAGN is associated with si...BACKGROUND Post-streptococcal acute glomerular nephritis(PSAGN)is mostly a benign condition.The usual sequelae of PSAGN include hypertension,its complications,and acute kidney injury.Severe PSAGN is associated with significant long-term morbidity,and histological abnormalities such as crescentic glomerulonephritis are infrequently reported.PSAGN has also been linked to late-onset chronic kidney disease in some populations due to high levels of proteinuria.METHODS This prospective observational study was conducted at Lady Ridgeway Hospital(Colombo,Sri Lanka)over 15 months.Children with PSAGN were enrolled based on clinical and laboratory criteria.Persistent proteinuria≥2+for 2 weeks and serum creatinine>100μmol/L warranted renal biopsy,assessed via light microscopy and immunofluorescence.Normalization of complement 3(C3)within 6 to 8 weeks was required for inclusion.Data on clinical features,urine protein levels,and renal function were collected from patient records,and potential associations were analysed using Statistical Package for the Social Sciences and R language for statistical computing.Ethical approval was obtained from the Ethical Review Committee,Lady Ridgeway Hospital for Children(Ref No:LRH/ERC/2021/60).RESULTS Forty-four patients were recruited.There were 27(61.4%)male patients and 17(38.6%)female patients.Thirty-seven(84%)of them were above 5 years of age.Twenty(45%)patients had a history of skin sepsis,and eighteen(41%)had a history of throat infection.Among patients with proteinuria≥2+,53%had serum creatinine>100µmol/L,while among those with proteinuria<2+,7%had serum creatinine>100µmol/L.The association of high-degree proteinuria with elevated serum creatinine was significant(χ²=7.8,P=0.005)in PSAGN.The odds ratio of the logistic regression model was 1.049(95%confidence interval:1.003-1.098),indicating a positive direction with statistically significant association(P=0.037).There was no significant association between proteinuria and the degree of hypertension or estimated creatinine clearance.Ten children underwent renal biopsy.Crescents(less than 50%)were demonstrated in five children,while three children had typical diffuse proliferative glomer-ulonephritis.One child had severe acute tubular necrosis,and another had crescentic glomerulonephritis(crescents>50%).The immunofluorescence studies revealed deposition of immunoglobulin G and C3 in all biopsy specimens.CONCLUSION High-degree proteinuria was significantly associated with elevated serum creatinine(>100μmol/L)in children with PSAGN.The majority of children with persistent proteinuria≥2+for more than 2 weeks and the highest recorded serum creatinine>100μmol/L had atypical renal histological findings.展开更多
BACKGROUND Metastasis of renal cell carcinoma(RCC)to the skeletal muscle and small bowel is an exceedingly rare occurrence.Both of these sites are unusual sites for RCC to metastasize to and to occur simultaneously is...BACKGROUND Metastasis of renal cell carcinoma(RCC)to the skeletal muscle and small bowel is an exceedingly rare occurrence.Both of these sites are unusual sites for RCC to metastasize to and to occur simultaneously is even less common.CASE SUMMARY A 58-year-old male with known history of RCC presented with a recurrence that was diagnosed through imaging and biopsies.Mucosa abnormalities of small bowel noted during endoscopy were biopsied as well as lesion in the psoas muscle that was noted.CONCLUSION This case report emphasizes that RCC can not only recur but can do so even decades later and present as metastatic foci at atypical sites.展开更多
Diabetic kidney disease(DKD)has emerged as one of the leading causes of chronic kidney disease and end-stage renal disease worldwide.In the progression of DKD,renal tubular injury plays a pivotal role,with stress-indu...Diabetic kidney disease(DKD)has emerged as one of the leading causes of chronic kidney disease and end-stage renal disease worldwide.In the progression of DKD,renal tubular injury plays a pivotal role,with stress-induced senescence of renal tubular epithelial cells(RTECs)being a critical cellular event contributing to tubular damage in DKD.Recent studies have revealed that multiple mechanisms,including oxidative stress,mitochondrial autophagy,endoplasmic reticulum stress,and epigenetic modifications,can induce stress-induced senescence in RTECs,thereby driving the progression of DKD.In recent years,research has demonstrated that traditional Chinese medicine(TCM)can regulate these mechanisms through multiple targets and key pathways,inhibiting stress-induced senescence in RTECs and ameliorating the progression of DKD.TCM has been widely applied in clinical practice with proven efficacy.This article systematically summarizes the concept of cellular senescence,delves into the relationship between stress-induced senescence of RTECs and DKD,analyzes the mechanisms underlying the formation of stress-induced senescence in RTECs within the context of DKD,and reviews the research progress of TCM in anti-senescence treatment for DKD.The aim is to provide a reference for future research and the development of novel therapeutic strategies.展开更多
Renal cell carcinoma(RCC)is an aggressive tumor known for its propensity to invade the inferior vena cava(IVC)into the heart.Cardiac metastasis of RCC without IVC involvement is rare.Even rarer is ventricular arrhythm...Renal cell carcinoma(RCC)is an aggressive tumor known for its propensity to invade the inferior vena cava(IVC)into the heart.Cardiac metastasis of RCC without IVC involvement is rare.Even rarer is ventricular arrhythmia as the primary manifestation of cardiac metastasis of RCC with only two cases reported.[1,2]We add to the literature the third case,the diagnosis of which was only possible with cardiac magnetic resonance(CMR).展开更多
BACKGROUND Acute kidney injury(AKI)is a frequent complication after liver transplantation(LT).How to realize the early diagnosis of AKI,perform active intervention,and reduce the mortality of post-LT patients is an ur...BACKGROUND Acute kidney injury(AKI)is a frequent complication after liver transplantation(LT).How to realize the early diagnosis of AKI,perform active intervention,and reduce the mortality of post-LT patients is an urgent problem to be solved.AIM To investigate the accuracy of hepatorenal index(HRI)and renal resistive index(RRI)in monitoring of early AKI after LT.METHODS This observational study included adult deceased-donor LT recipients at our center between February 2022 and February 2023 with no preoperative renal dysfunction.The HRI and RRI were recorded once per day in the postoperative period through to postoperative day(POD)7.We followed up with the patients at 1 month after LT.The patients were divided into the AKI and non-AKI groups according to the Kidney Disease Improving Global Outcomes criteria.RESULTS Of 121 patients were included in the study(mean age:50.18±8.88years;female:17.36%).AKI developed in 53 patients(43.80%).The AKI and non-AKI groups were similar in terms of their baseline characteristics.An HRI of≤1.12 on POD 1 detected AKI with a sensitivity of 62.30%and a specificity of 87.80%[area under the receiver operating characteristic curve(AUC)=0.801,P<0.01].An RRI of≥0.65 on POD 1 detected AKI with a sensitivity of 87.80%and a specificity of 67.60%(AUC=0.825,P<0.01).The HRI combined with the RRI was more effective at detecting AKI than either the HRI or RRI alone(AUC=0.890,P<0.01).The HRI increased as AKI resolved while the RRI decreased as AKI resolved.CONCLUSION The HRI and RRI are non-invasive bedside indices that can identify the occurrence and recovery of early AKI after LT.展开更多
The kidneys play a critical role in maintaining glucose homeostasis.Under normal renal tubular function,most of the glucose filtered from the glomeruli is re-absorbed in the proximal tubules,leaving only trace amounts...The kidneys play a critical role in maintaining glucose homeostasis.Under normal renal tubular function,most of the glucose filtered from the glomeruli is re-absorbed in the proximal tubules,leaving only trace amounts in the urine.Glycosuria can occur as a symptom of generalized proximal tubular dysfunction or when the reabsorption threshold is exceeded or the glucose threshold is reduced,as seen in familial renal glycosuria(FRG).FRG is characterized by persistent glycosuria despite normal blood glucose levels and tubular function and is primarily associated with mutations in the sodium/glucose cotransporter 5A2 gene,which encodes the sodium-glucose cotransporter(SGLT)2.Inhibiting SGLTs has been proposed as a novel treatment strategy for diabetes,and since FRG is often considered an asymptomatic and benign condition,it has inspired preclinical and clinical studies using SGLT2 inhibitors in type 2 diabetes.However,patients with FRG may exhibit clinical features such as lower body weight or height,altered systemic blood pressure,diaper dermatitis,amino-aciduria,decreased serum uric acid levels,and hypercalciuria.Further research is needed to fully understand the pathophysiology,molecular genetics,and clinical manifestations of renal glucosuria.展开更多
BACKGROUND Research examining the relationships among anxiety,depression,self-perceived burden(SPB),and psychological resilience(PR),along with the determinants of PR,in patients with chronic renal failure(CRF)receivi...BACKGROUND Research examining the relationships among anxiety,depression,self-perceived burden(SPB),and psychological resilience(PR),along with the determinants of PR,in patients with chronic renal failure(CRF)receiving maintenance hemodia-lysis(MHD)is limited.AIM To investigate the correlation between anxiety,depression,SPB,and PR in pati-ents with CRF on MHD.METHODS This study included 225 patients with CRF on MHD who were admitted between June 2021 and June 2024.The anxiety level was evaluated using the Self-Rating Anxiety Scale(SAS);the depression status was assessed using the Self-Rating Depression Scale(SDS);the SPB was measured using the SPB Scale(SPBS);and the PR was determined using the Connor–Davidson Resilience Scale(CD-RISC).The correlations among the SAS,SDS,SPB,and CD-RISC were analyzed using Pearson’s correlation coefficients.Univariate and multivariate analyses were performed to identify the factors that influence the PR of patients with CRF on MHD.RESULTS The SAS,SDS,SPB,and CD-RISC scores of the 225 patients were 45.25±15.36,54.81±14.68,32.31±11.52,and 66.48±9.18,respectively.Significant negative correlations were observed between SAS,SDS,SPB,and CD-RISC.Furthermore,longer dialysis vintage(P=0.015),the absence of religious beliefs(P=0.020),lower monthly income(P=0.008),higher SAS score(P=0.013),and higher SDS score(P=0.006)were all independent factors that adversely affected the PR of patients with CRF on MHD.CONCLUSION Patients with CRF on MHD present with varying degrees of anxiety,depression,and SPB,all of which exhibit a significant negative correlation with their PR.Moreover,longer dialysis vintage,the absence of religious beliefs,lower monthly income,higher SAS score,and higher SDS score were factors that negatively affected the PR of patients with CRF on MHD.展开更多
BACKGROUND Nocardiosis is a rare bacterial infection with unclear epidemiology,pathogenesis,and characteristics.Its clinical manifestations are diverse and nonspecific,making diagnosis prone to errors,including misdia...BACKGROUND Nocardiosis is a rare bacterial infection with unclear epidemiology,pathogenesis,and characteristics.Its clinical manifestations are diverse and nonspecific,making diagnosis prone to errors,including misdiagnosis and missed diagnosis.Additionally,this disease is difficult to treat,often requiring months or even years of antibacterial therapy,and can be fatal in patients with underlying conditions.CASE SUMMARY A 93-year-old male patient with chronic renal insufficiency sustained a skin injury at the tip of his right thumb.As a result of an initial misdiagnosis and inadequate treatment,the infection progressed,resulting in multiple rashes on his right upper limb.Local incision and drainage of pus,combined with oral antibiotics administered at a different hospital,yielded no significant improvement.Upon hospitalization,the patient’s immune function was assessed,and further local incision and drainage were performed.Cultures of the pus identified Nocardia brasiliensis.Treatment involved intravenous infusion of piperacillin-tazobactam sodium and oral administration of sulfamethoxazole-trimethoprim,leading to the patient’s recovery.After discharge,the patient continued to take sulfamethoxazole tablets for 6 months,with complete healing of the skin lesions and no recurrence.CONCLUSION Nocardiosis should be considered in patients with underlying conditions and compromised immunity.Prompt and accurate diagnosis is crucial.展开更多
Renal anastomotic hemangioma(AH)is a rare,benign vascular tumor with unique histopathological features,a disease that is clinically rare,and existing clinical cases offer different treatment options.As reported in the...Renal anastomotic hemangioma(AH)is a rare,benign vascular tumor with unique histopathological features,a disease that is clinically rare,and existing clinical cases offer different treatment options.As reported in the text,this is a very unusual case of renal AH with AH secondary to residual renal tissue after renal clear cell carcinoma,describing a rare renal AH and a history of renal clear cell carcinoma,including ultrasound,computed tomography and magnetic re-sonance imaging.However,the available imaging data and the literature do not provide an effective basis for the diagnosis of the disease,raising the lack of un-derstanding and misdiagnosis,where the patient eventually underwent neph-rectomy,but the author is not the most appropriate surgical treatment.The po-stoperative pathological results of the patient are benign lesions,and it is unde-niable that nephrectomy is suspected to be overtreated.By reading the literature,we provide different insights into the treatment of the patient,and we hope that this paper can provide some help for the future clinical diagnosis and treatment.展开更多
Background: In recent years, studies have shown that liraglutide may delay the progression of renal fibrosis by inhibiting renal fibrosis signaling pathways and reducing collagen deposition. TGF-β1 and E-Cadherin pla...Background: In recent years, studies have shown that liraglutide may delay the progression of renal fibrosis by inhibiting renal fibrosis signaling pathways and reducing collagen deposition. TGF-β1 and E-Cadherin play crucial roles in renal fibrosis. Objective: To explore the protective effect of liraglutide on early renal fibrosis in diabetes mice. Methods: Twenty-four 8-week-old healthy male C57BL/6J mice were randomly divided into a normal diet feeding group (NG, n = 8) and a high-fat diet feeding group (HG, n = 16) using a simple random sampling method. Four weeks later, the high-fat diet feeding group received a one-time intraperitoneal injection of STZ diluted with 0.1 mol/L sodium citrate buffer (50 mg/Kg). The diabetes model was established after 7 days of continuous injection. The diabetes model mice were randomly divided into 2 groups, each containing 8 mice. One group received liraglutide (400 ug per kilogram per day, subcutaneous injection), named Liraglutide Intervention Group (LDG);the other group received an equal dose of saline subcutaneously, named the Diabetes Model Non-intervention Group (NDG). NG also received an equal dose of saline subcutaneously, named Normal Control Group (NCG). Renal tissue pathological changes were observed by HE and Masson staining;TGF-βl and E-Cadherin protein expressions were detected by immunohistochemistry;E-Cadherin protein expression was detected by Western blotting. Results: The degree of kidney tissue damage and fibrosis in liraglutide intervention group was milder than that in non-intervention group, and the expression of TGF-β1 and E-Cadherin protein tended to be similar to that in normal control group. Conclusion: Liraglutide can significantly reduce early renal fibrosis in diabetes mice, and its mechanism may be related to the reduction of TGF-β1 expression to induce EMT changes in epithelial cells (for example, up regulation of E-Cadherin).展开更多
Primary renal cell carcinoma (RCC) with metastasis is common with an estimated 30% of patients with RCC having metastases at the time of diagnosis. Evidence of metastatic RCC without a primary renal tumor is extremely...Primary renal cell carcinoma (RCC) with metastasis is common with an estimated 30% of patients with RCC having metastases at the time of diagnosis. Evidence of metastatic RCC without a primary renal tumor is extremely rare with only a handful of cases citing this occurrence. Occasionally an unclear patient presentation requires thoughtful consideration of all the possibilities and results in a clinician reexamining the data to expand a differential, thus arriving at a diagnosis. This is the case of a 22-year-old who presented with diffuse lymphadenopathy, fever, cough, lower abdominal pain following a trip to India where the patient was hospitalized, initially believed to be tuberculosis. After multiple needle biopsies of lymph nodes and a retroperitoneal mass that were insufficient for a diagnosis, a wide excisional biopsy was performed that led to a diagnosis in our patient. The patient was diagnosed with metastatic TFE3-rearranged (MiT translocation) renal cell carcinoma and subsequently started on pembrolizumab and Lenvatinib followed by debulking surgery.展开更多
BACKGROUND Renal cell carcinoma(RCC)is treated with surgical resection as the gold standard,as it is notoriously resistant to systemic therapy.Advancements with targeted therapies contribute to declining mortality,but...BACKGROUND Renal cell carcinoma(RCC)is treated with surgical resection as the gold standard,as it is notoriously resistant to systemic therapy.Advancements with targeted therapies contribute to declining mortality,but metastatic RCC(mRCC)survival remains poor.One possible factor is treatment at academic centers,which employ advanced providers and novel therapies.This study compared outcomes of mRCC in patients treated at academic/research facilities compared to those treated at non-academic centers.AIM To compare survival outcomes of mRCC and their various etiologies between academic and non-academic centers.METHODS The National Cancer Database was used to identify mRCC patients including all histology subtypes and stage IV disease.Descriptive statistics and Kaplan-Meier curves measured survival outcomes for user file facility types sorted into a binary academic/research and non-academic research variable.Multivariate logistic regression and Cox proportional hazard testing generated odds ratio and hazard ratio.Data was analyzed using Statistical Package for the Social Sciences version 29.0 using a significance level of P<0.05.RESULTS Overall,academic facility patients experienced greater 5-year and 10-year overall survival than non-academic facility patients.Treatment at non-academic facilities was associated with increased odds of death that persisted even after controlling for age,tumor size,sex,and distance traveled to treatment center.In comparison,nonacademic facility patients also experienced greater risk of hazard.CONCLUSION Patients with mRCC treated at academic/research facilities experienced increased survival compared to patients treated at non-academic facilities,were more likely to be younger,carry private insurance,and come from a large metropolitan area.They also were significantly more likely to receive surgery and adjuvant immunotherapy.展开更多
BACKGROUND Atrial fibrillation(AF)is a prevalent cardiac arrhythmia associated with significant morbidity and mortality,particularly in patients with concomitant renal dysfunction.Anticoagulation therapy reduces the r...BACKGROUND Atrial fibrillation(AF)is a prevalent cardiac arrhythmia associated with significant morbidity and mortality,particularly in patients with concomitant renal dysfunction.Anticoagulation therapy reduces the risk of thromboembolic complications in AF but presents challenges in patients with renal impairment due to altered pharmacokinetics and increased bleeding risk.AIM To support clinicians in navigating the complexities of anticoagulation in this high-risk population,ensuring optimal outcomes.METHODS The present review followed PRISMA guidelines.Data extraction was conducted using a standardized template that captured key study characteristics:Population demographics,renal function metrics,anticoagulant dosing strategies,and primary and secondary outcomes.For quality assessment,we employed the Cochrane Risk of Bias 2.0 tool for randomized controlled trials.Observational studies were appraised using the Newcastle-Ottawa Scale.RESULTS We analyze data from 16 studies to provide recommendations on optimal anticoagulation strategies,balancing thrombotic and bleeding risks.Current evidence supports the preferential use of apixaban in moderate chronic kidney disease and cautiously in end-stage renal disease,emphasizing the importance of individualized therapy.CONCLUSION The management of anticoagulation in AF patients with renal dysfunction is challenging but critical for reducing stroke risk.展开更多
Background:Renal cell carcinoma(RCC)is a prevalent malignancy characterized by a rising incidence and significant mortality.Interleukins(ILs)are crucial in regulating immune cell trafficking and exhibit anti-tumor pro...Background:Renal cell carcinoma(RCC)is a prevalent malignancy characterized by a rising incidence and significant mortality.Interleukins(ILs)are crucial in regulating immune cell trafficking and exhibit anti-tumor properties.However,limited research has explored the expression levels and prognostic significance of interleukins in RCC.Methods:In this comprehensive study,we performed a detailed analysis of interleukins in RCC patients using multiple bioinformatics tools,including Oncomine,UALCAN,GEPIA,Kaplan-Meier plotter,cBioPortal,GeneMANIA,TRRUST,STRING,and Linked Omics.Results:Our analysis demonstrated a significant upregulation in the transcriptional levels of IL4,IL7,IL15,IL16,IL23A,IL26,and IL32 were significantly upregulated in RCC tissues,indicating their potential involvement in the pathogenesis of this malignancy.In contrast,IL1A,IL11,and IL27 were downregulated,indicating their potential function as tumor suppressors.Significant correlations were identified between the expression levels of IL11,IL23A,IL27,IL32,and the pathological stage of RCC patients.The expression levels of IL1A,IL4,IL11,IL15,IL16,IL23A,IL26,IL27,and IL32 were significantly correlated with improved prognosis.The differentially expressed interleukins primarily function in cytokine-cytokine receptor interactions and immune response-regulating signaling pathways.homeobox A10(HOXA10),v-myb myeloblastosis viral oncogene homolog(avian)(MYB),v-rel reticuloendotheliosis viral oncogene homolog A(avian)(RELA),and nuclear factor of kappa light polypeptide gene enhancer in B-cells 1(NFKB1)are key transcription factors for ILs,while LCK proto-oncogene(LCK),LYN proto-oncogene(LYN),spleen associated tyrosine kinase(SYK),Janus kinase 3(JAK3),and FER tyrosine kinase(FER)are IL targets.IL expression significantly correlated with the infiltration of six distinct immune cell types.IL1A potentially exerts an anti-tumor effect in RCC prognosis by inducing neutrophil extracellular traps(NETs).Additionally,NFKB1 may positively regulate IL1A,providing a rationale for further in vivo and clinical studies.Conclusion:In conclusion,our study demonstrates the potential role of IL 1A in the prognosis of RCC and establishes a theoretical foundation for subsequent in vivo and clinical investigations.展开更多
Five previously undescribed diterpenoids,named succipenoids D‒H(1‒5),along with four undescribed lignans,named succignans A‒D(6‒9),were isolated from the dichloromethane extract of Chinese medicinal succinum.Compounds...Five previously undescribed diterpenoids,named succipenoids D‒H(1‒5),along with four undescribed lignans,named succignans A‒D(6‒9),were isolated from the dichloromethane extract of Chinese medicinal succinum.Compounds 1‒5 were characterized as nor-abietane diterpenoids,while compounds 6‒9 were identified as lignans polymerized from two groups of phenylpropanoid units.The structures of these novel compounds,including their absolute configurations,were determined through spectroscopic and computational methods.Biological assessments of renal fibrosis demonstrated that compounds 6 and 7 effectively reduce the expression of proteins associated with renal fibrosis,includingα-smooth muscle actin(α-SMA),collagen I,and fibronectin in transforming growth factor-β1(TGF-β1)induced normal rat kidney proximal tubular epithelial cells(NRK-52e).展开更多
Background:Chiglitazar is a novel pan-agonist that can activate all three subtypes of peroxisome proliferator-activated receptor.It was approved for the treatment of type 2 diabetes mellitus as monotherapy on October ...Background:Chiglitazar is a novel pan-agonist that can activate all three subtypes of peroxisome proliferator-activated receptor.It was approved for the treatment of type 2 diabetes mellitus as monotherapy on October 19,2021,and as combination therapy with metformin when using metformin alone failed in blood glucose control on July 16,2024,by the National Medical Products Administration(NMPA)in China.However,pharmacokinetic(PK)study of this product in patients with renal impairment have not yet been conducted.The purpose of this study is to evaluate the effects of renal impairment on the PK and safety after a single oral dose of Chiglitazar.Methods:This multicenter,open-label,parallel-controlled,single-dose Phase I clinical trial(NCT 05515458)enrolled 24 participants(12/group)with severe renal impairment(SRI)or normal renal function(NRF).All participants received a single oral dose of 48 mg chiglitazar after breakfast and the PK and safety was evaluated.Results:The median Tmax was similar in both SRI and NRF groups(5.01 vs.5.02 hours).The geometric mean ratios(GMR)for Cmax,AUC0-t,and AUC0-∞were 0.807(90%confidence interval[CI]:0.697–0.935),0.853(90%CI:0.713–1.02),and 0.855(90%CI:0.716–1.02),respectively,indicating that SRI did not significantly affect the exposure of chiglitazar.The Cmax was weakly positively correlated with eGFR(r=0.4798,P=0.0177)and creatinine clearance rate(r=0.4667,P=0.0215).Urinary excretion of chiglitazar was negligible in the SRI group,with average values of Ae0-t=2,900 ng,Fe0-t=0.0060%,and CLR=0.323 mL/h within 0–72 hours post-dose.The treatment-emergent adverse event(TEAE)incidence in the SRI group(16.7%,2/12)was comparable to that in the NRF group(25%,3/12).All TEAEs were of mild severity and were adjudicated by the investigators to be unrelated to chiglitazar.No serious AE were reported.Chiglitazar exhibits a favorable safety profile.Conclusion:Severe renal impairment does not significantly affect the PK and safety of chiglitazar,and no dose adjustment for mild,moderate,and severe renal impairments is required.展开更多
Paediatric renal tumors are rare and accounts for about 7%of all paediatric malignant tumors.The spectrum of paediatric renal tumors ranges from benign to malignant.Benign tumors include cystic nephroma,metanephric tu...Paediatric renal tumors are rare and accounts for about 7%of all paediatric malignant tumors.The spectrum of paediatric renal tumors ranges from benign to malignant.Benign tumors include cystic nephroma,metanephric tumors and ossifying renal tumor of infancy.Tumor with low grade malignancy includes mesoblastic nephroma.Malignant tumors are nephroblastoma,clear cell sarcoma,malignant rhabdoid tumor,anaplastic sarcoma and Ewing sarcoma.Additionally,there are molecularly defined renal tumors,which includes renal cell carcinoma(RCC)with MiT translocations,ALK-rearranged RCC,eosinophilic solid and cystic RCC and SMARCB1-deficient renal medullary carcinoma.These tumors apart from having characteristic clinical presentation and histomorphology,also carry typical molecular mutations and translocations.Certain renal tumors have association with various genetic syndromes such as Beckwith-Weidmann syndrome,Wilm’s tumor,aniridia,genitourinary anomalies and mental retardation syndrome,Denys-Drash syndrome,rhabdoid tumor predisposition syndrome and DICER syndrome.This review article focusses on molecular characteristics,histomorphology and syndromic association of pediatric renal tumors,their immunohistochemical approach to diagnosis with recent updates in molecularly defined renal tumors.展开更多
[Objectives]To investigate differences in BMI and renal function across constitution types and influencing factors of blood pressure.[Methods]92 college student volunteers aged 18-25 from January 2023 to December 2024...[Objectives]To investigate differences in BMI and renal function across constitution types and influencing factors of blood pressure.[Methods]92 college student volunteers aged 18-25 from January 2023 to December 2024 were selected.BMI,blood pressure,and renal function markers—blood urea nitrogen(BUN),creatinine(Cr),uric acid(UA),were compared across constitution types.Multiple stepwise regression analysis was applied to identify the influencing factors of blood pressure.[Results]Among 92 healthy participants aged 18-25,Shar-predominant constitution accounted for 50%,Khii-predominant for 25%,and Badgan-predominant for 20.65%.Significant differences existed in mean systolic and diastolic blood pressure across constitution types(systolic:F=4.56,P=0.001;diastolic:F=3.78,P=0.005).Shar-predominant group showed significantly higher systolic blood pressure than other types(P<0.05),while Khii-predominant group had higher diastolic pressure.Shar-predominant constitution demonstrated significantly greater height,weight,and BMI compared to other types(P<0.05).Males exhibited significantly higher height,weight,and BMI than females(P<0.05).Shar-predominant group showed significantly elevated urea,uric acid,and creatinine levels compared to other constitution types(P<0.05).Males had significantly higher mean urea,uric acid,and creatinine levels than females(P<0.05).Correlation analysis revealed stronger associations between BMI,renal function,and blood pressure in Shar-predominant group(r>0.50,P<0.05).Multiple regression analysis identified BMI as the primary influencing factor for blood pressure,followed by urea and uric acid.In Shar-predominant group,BMI exerted the strongest effect on blood pressure(β=0.60-0.65,P<0.001).[Conclusions]This study provides important evidence for health management in populations with different constitution types.展开更多
文摘Renal cell carcinoma is a heterogeneous group of renal tumors characterized by several histological subtypes.Herein,we discuss an unusual case of a 55-year-old male who presented as a consultation to our urology clinic with an incidentally found renal mass.After shared decision making patient proceeded with a Robotic Assisted Laparoscopy(RAL)left sided partial nephrectomy.Final pathology confirmed the presence of high nuclear grade mixed clear cell and papillary renal cell carcinoma(RCC)of the left kidney(pT3aN0M0).This case elucidates a very rare incidence of a patient seen to have a collision tumor,and furthermore demonstrates guideline-based treatment.
文摘BACKGROUND Post-streptococcal acute glomerular nephritis(PSAGN)is mostly a benign condition.The usual sequelae of PSAGN include hypertension,its complications,and acute kidney injury.Severe PSAGN is associated with significant long-term morbidity,and histological abnormalities such as crescentic glomerulonephritis are infrequently reported.PSAGN has also been linked to late-onset chronic kidney disease in some populations due to high levels of proteinuria.METHODS This prospective observational study was conducted at Lady Ridgeway Hospital(Colombo,Sri Lanka)over 15 months.Children with PSAGN were enrolled based on clinical and laboratory criteria.Persistent proteinuria≥2+for 2 weeks and serum creatinine>100μmol/L warranted renal biopsy,assessed via light microscopy and immunofluorescence.Normalization of complement 3(C3)within 6 to 8 weeks was required for inclusion.Data on clinical features,urine protein levels,and renal function were collected from patient records,and potential associations were analysed using Statistical Package for the Social Sciences and R language for statistical computing.Ethical approval was obtained from the Ethical Review Committee,Lady Ridgeway Hospital for Children(Ref No:LRH/ERC/2021/60).RESULTS Forty-four patients were recruited.There were 27(61.4%)male patients and 17(38.6%)female patients.Thirty-seven(84%)of them were above 5 years of age.Twenty(45%)patients had a history of skin sepsis,and eighteen(41%)had a history of throat infection.Among patients with proteinuria≥2+,53%had serum creatinine>100µmol/L,while among those with proteinuria<2+,7%had serum creatinine>100µmol/L.The association of high-degree proteinuria with elevated serum creatinine was significant(χ²=7.8,P=0.005)in PSAGN.The odds ratio of the logistic regression model was 1.049(95%confidence interval:1.003-1.098),indicating a positive direction with statistically significant association(P=0.037).There was no significant association between proteinuria and the degree of hypertension or estimated creatinine clearance.Ten children underwent renal biopsy.Crescents(less than 50%)were demonstrated in five children,while three children had typical diffuse proliferative glomer-ulonephritis.One child had severe acute tubular necrosis,and another had crescentic glomerulonephritis(crescents>50%).The immunofluorescence studies revealed deposition of immunoglobulin G and C3 in all biopsy specimens.CONCLUSION High-degree proteinuria was significantly associated with elevated serum creatinine(>100μmol/L)in children with PSAGN.The majority of children with persistent proteinuria≥2+for more than 2 weeks and the highest recorded serum creatinine>100μmol/L had atypical renal histological findings.
文摘BACKGROUND Metastasis of renal cell carcinoma(RCC)to the skeletal muscle and small bowel is an exceedingly rare occurrence.Both of these sites are unusual sites for RCC to metastasize to and to occur simultaneously is even less common.CASE SUMMARY A 58-year-old male with known history of RCC presented with a recurrence that was diagnosed through imaging and biopsies.Mucosa abnormalities of small bowel noted during endoscopy were biopsied as well as lesion in the psoas muscle that was noted.CONCLUSION This case report emphasizes that RCC can not only recur but can do so even decades later and present as metastatic foci at atypical sites.
基金supported by the Hebei Natural Science Foundation(Grant No.H2022110019).
文摘Diabetic kidney disease(DKD)has emerged as one of the leading causes of chronic kidney disease and end-stage renal disease worldwide.In the progression of DKD,renal tubular injury plays a pivotal role,with stress-induced senescence of renal tubular epithelial cells(RTECs)being a critical cellular event contributing to tubular damage in DKD.Recent studies have revealed that multiple mechanisms,including oxidative stress,mitochondrial autophagy,endoplasmic reticulum stress,and epigenetic modifications,can induce stress-induced senescence in RTECs,thereby driving the progression of DKD.In recent years,research has demonstrated that traditional Chinese medicine(TCM)can regulate these mechanisms through multiple targets and key pathways,inhibiting stress-induced senescence in RTECs and ameliorating the progression of DKD.TCM has been widely applied in clinical practice with proven efficacy.This article systematically summarizes the concept of cellular senescence,delves into the relationship between stress-induced senescence of RTECs and DKD,analyzes the mechanisms underlying the formation of stress-induced senescence in RTECs within the context of DKD,and reviews the research progress of TCM in anti-senescence treatment for DKD.The aim is to provide a reference for future research and the development of novel therapeutic strategies.
文摘Renal cell carcinoma(RCC)is an aggressive tumor known for its propensity to invade the inferior vena cava(IVC)into the heart.Cardiac metastasis of RCC without IVC involvement is rare.Even rarer is ventricular arrhythmia as the primary manifestation of cardiac metastasis of RCC with only two cases reported.[1,2]We add to the literature the third case,the diagnosis of which was only possible with cardiac magnetic resonance(CMR).
基金Supported by the Clinical+X Scientific Research Project of Affiliated Hospital of Qingdao University,No.QYFY+X202101060Natural Science Foundation of Shandong Province,No.ZR2023MH240.
文摘BACKGROUND Acute kidney injury(AKI)is a frequent complication after liver transplantation(LT).How to realize the early diagnosis of AKI,perform active intervention,and reduce the mortality of post-LT patients is an urgent problem to be solved.AIM To investigate the accuracy of hepatorenal index(HRI)and renal resistive index(RRI)in monitoring of early AKI after LT.METHODS This observational study included adult deceased-donor LT recipients at our center between February 2022 and February 2023 with no preoperative renal dysfunction.The HRI and RRI were recorded once per day in the postoperative period through to postoperative day(POD)7.We followed up with the patients at 1 month after LT.The patients were divided into the AKI and non-AKI groups according to the Kidney Disease Improving Global Outcomes criteria.RESULTS Of 121 patients were included in the study(mean age:50.18±8.88years;female:17.36%).AKI developed in 53 patients(43.80%).The AKI and non-AKI groups were similar in terms of their baseline characteristics.An HRI of≤1.12 on POD 1 detected AKI with a sensitivity of 62.30%and a specificity of 87.80%[area under the receiver operating characteristic curve(AUC)=0.801,P<0.01].An RRI of≥0.65 on POD 1 detected AKI with a sensitivity of 87.80%and a specificity of 67.60%(AUC=0.825,P<0.01).The HRI combined with the RRI was more effective at detecting AKI than either the HRI or RRI alone(AUC=0.890,P<0.01).The HRI increased as AKI resolved while the RRI decreased as AKI resolved.CONCLUSION The HRI and RRI are non-invasive bedside indices that can identify the occurrence and recovery of early AKI after LT.
文摘The kidneys play a critical role in maintaining glucose homeostasis.Under normal renal tubular function,most of the glucose filtered from the glomeruli is re-absorbed in the proximal tubules,leaving only trace amounts in the urine.Glycosuria can occur as a symptom of generalized proximal tubular dysfunction or when the reabsorption threshold is exceeded or the glucose threshold is reduced,as seen in familial renal glycosuria(FRG).FRG is characterized by persistent glycosuria despite normal blood glucose levels and tubular function and is primarily associated with mutations in the sodium/glucose cotransporter 5A2 gene,which encodes the sodium-glucose cotransporter(SGLT)2.Inhibiting SGLTs has been proposed as a novel treatment strategy for diabetes,and since FRG is often considered an asymptomatic and benign condition,it has inspired preclinical and clinical studies using SGLT2 inhibitors in type 2 diabetes.However,patients with FRG may exhibit clinical features such as lower body weight or height,altered systemic blood pressure,diaper dermatitis,amino-aciduria,decreased serum uric acid levels,and hypercalciuria.Further research is needed to fully understand the pathophysiology,molecular genetics,and clinical manifestations of renal glucosuria.
基金Supported by Key Research Fund of Wannan Medical College,No.WK2021ZF15Research Foundation for Advanced Talents of Wannan Medical College,No.YR202213+3 种基金Foundation of Anhui Educational Committee,No.2023AH051759Excellent Youth Research Project of Anhui UniversitiesNo.2023AH030107Horizontal Project of Wannan Medical College,No.622202504003 and No.662202404013.
文摘BACKGROUND Research examining the relationships among anxiety,depression,self-perceived burden(SPB),and psychological resilience(PR),along with the determinants of PR,in patients with chronic renal failure(CRF)receiving maintenance hemodia-lysis(MHD)is limited.AIM To investigate the correlation between anxiety,depression,SPB,and PR in pati-ents with CRF on MHD.METHODS This study included 225 patients with CRF on MHD who were admitted between June 2021 and June 2024.The anxiety level was evaluated using the Self-Rating Anxiety Scale(SAS);the depression status was assessed using the Self-Rating Depression Scale(SDS);the SPB was measured using the SPB Scale(SPBS);and the PR was determined using the Connor–Davidson Resilience Scale(CD-RISC).The correlations among the SAS,SDS,SPB,and CD-RISC were analyzed using Pearson’s correlation coefficients.Univariate and multivariate analyses were performed to identify the factors that influence the PR of patients with CRF on MHD.RESULTS The SAS,SDS,SPB,and CD-RISC scores of the 225 patients were 45.25±15.36,54.81±14.68,32.31±11.52,and 66.48±9.18,respectively.Significant negative correlations were observed between SAS,SDS,SPB,and CD-RISC.Furthermore,longer dialysis vintage(P=0.015),the absence of religious beliefs(P=0.020),lower monthly income(P=0.008),higher SAS score(P=0.013),and higher SDS score(P=0.006)were all independent factors that adversely affected the PR of patients with CRF on MHD.CONCLUSION Patients with CRF on MHD present with varying degrees of anxiety,depression,and SPB,all of which exhibit a significant negative correlation with their PR.Moreover,longer dialysis vintage,the absence of religious beliefs,lower monthly income,higher SAS score,and higher SDS score were factors that negatively affected the PR of patients with CRF on MHD.
基金Supported by Zhejiang Provincial Traditional Chinese Medicine Science and Technology Program,No.2023ZF075.
文摘BACKGROUND Nocardiosis is a rare bacterial infection with unclear epidemiology,pathogenesis,and characteristics.Its clinical manifestations are diverse and nonspecific,making diagnosis prone to errors,including misdiagnosis and missed diagnosis.Additionally,this disease is difficult to treat,often requiring months or even years of antibacterial therapy,and can be fatal in patients with underlying conditions.CASE SUMMARY A 93-year-old male patient with chronic renal insufficiency sustained a skin injury at the tip of his right thumb.As a result of an initial misdiagnosis and inadequate treatment,the infection progressed,resulting in multiple rashes on his right upper limb.Local incision and drainage of pus,combined with oral antibiotics administered at a different hospital,yielded no significant improvement.Upon hospitalization,the patient’s immune function was assessed,and further local incision and drainage were performed.Cultures of the pus identified Nocardia brasiliensis.Treatment involved intravenous infusion of piperacillin-tazobactam sodium and oral administration of sulfamethoxazole-trimethoprim,leading to the patient’s recovery.After discharge,the patient continued to take sulfamethoxazole tablets for 6 months,with complete healing of the skin lesions and no recurrence.CONCLUSION Nocardiosis should be considered in patients with underlying conditions and compromised immunity.Prompt and accurate diagnosis is crucial.
文摘Renal anastomotic hemangioma(AH)is a rare,benign vascular tumor with unique histopathological features,a disease that is clinically rare,and existing clinical cases offer different treatment options.As reported in the text,this is a very unusual case of renal AH with AH secondary to residual renal tissue after renal clear cell carcinoma,describing a rare renal AH and a history of renal clear cell carcinoma,including ultrasound,computed tomography and magnetic re-sonance imaging.However,the available imaging data and the literature do not provide an effective basis for the diagnosis of the disease,raising the lack of un-derstanding and misdiagnosis,where the patient eventually underwent neph-rectomy,but the author is not the most appropriate surgical treatment.The po-stoperative pathological results of the patient are benign lesions,and it is unde-niable that nephrectomy is suspected to be overtreated.By reading the literature,we provide different insights into the treatment of the patient,and we hope that this paper can provide some help for the future clinical diagnosis and treatment.
文摘Background: In recent years, studies have shown that liraglutide may delay the progression of renal fibrosis by inhibiting renal fibrosis signaling pathways and reducing collagen deposition. TGF-β1 and E-Cadherin play crucial roles in renal fibrosis. Objective: To explore the protective effect of liraglutide on early renal fibrosis in diabetes mice. Methods: Twenty-four 8-week-old healthy male C57BL/6J mice were randomly divided into a normal diet feeding group (NG, n = 8) and a high-fat diet feeding group (HG, n = 16) using a simple random sampling method. Four weeks later, the high-fat diet feeding group received a one-time intraperitoneal injection of STZ diluted with 0.1 mol/L sodium citrate buffer (50 mg/Kg). The diabetes model was established after 7 days of continuous injection. The diabetes model mice were randomly divided into 2 groups, each containing 8 mice. One group received liraglutide (400 ug per kilogram per day, subcutaneous injection), named Liraglutide Intervention Group (LDG);the other group received an equal dose of saline subcutaneously, named the Diabetes Model Non-intervention Group (NDG). NG also received an equal dose of saline subcutaneously, named Normal Control Group (NCG). Renal tissue pathological changes were observed by HE and Masson staining;TGF-βl and E-Cadherin protein expressions were detected by immunohistochemistry;E-Cadherin protein expression was detected by Western blotting. Results: The degree of kidney tissue damage and fibrosis in liraglutide intervention group was milder than that in non-intervention group, and the expression of TGF-β1 and E-Cadherin protein tended to be similar to that in normal control group. Conclusion: Liraglutide can significantly reduce early renal fibrosis in diabetes mice, and its mechanism may be related to the reduction of TGF-β1 expression to induce EMT changes in epithelial cells (for example, up regulation of E-Cadherin).
文摘Primary renal cell carcinoma (RCC) with metastasis is common with an estimated 30% of patients with RCC having metastases at the time of diagnosis. Evidence of metastatic RCC without a primary renal tumor is extremely rare with only a handful of cases citing this occurrence. Occasionally an unclear patient presentation requires thoughtful consideration of all the possibilities and results in a clinician reexamining the data to expand a differential, thus arriving at a diagnosis. This is the case of a 22-year-old who presented with diffuse lymphadenopathy, fever, cough, lower abdominal pain following a trip to India where the patient was hospitalized, initially believed to be tuberculosis. After multiple needle biopsies of lymph nodes and a retroperitoneal mass that were insufficient for a diagnosis, a wide excisional biopsy was performed that led to a diagnosis in our patient. The patient was diagnosed with metastatic TFE3-rearranged (MiT translocation) renal cell carcinoma and subsequently started on pembrolizumab and Lenvatinib followed by debulking surgery.
文摘BACKGROUND Renal cell carcinoma(RCC)is treated with surgical resection as the gold standard,as it is notoriously resistant to systemic therapy.Advancements with targeted therapies contribute to declining mortality,but metastatic RCC(mRCC)survival remains poor.One possible factor is treatment at academic centers,which employ advanced providers and novel therapies.This study compared outcomes of mRCC in patients treated at academic/research facilities compared to those treated at non-academic centers.AIM To compare survival outcomes of mRCC and their various etiologies between academic and non-academic centers.METHODS The National Cancer Database was used to identify mRCC patients including all histology subtypes and stage IV disease.Descriptive statistics and Kaplan-Meier curves measured survival outcomes for user file facility types sorted into a binary academic/research and non-academic research variable.Multivariate logistic regression and Cox proportional hazard testing generated odds ratio and hazard ratio.Data was analyzed using Statistical Package for the Social Sciences version 29.0 using a significance level of P<0.05.RESULTS Overall,academic facility patients experienced greater 5-year and 10-year overall survival than non-academic facility patients.Treatment at non-academic facilities was associated with increased odds of death that persisted even after controlling for age,tumor size,sex,and distance traveled to treatment center.In comparison,nonacademic facility patients also experienced greater risk of hazard.CONCLUSION Patients with mRCC treated at academic/research facilities experienced increased survival compared to patients treated at non-academic facilities,were more likely to be younger,carry private insurance,and come from a large metropolitan area.They also were significantly more likely to receive surgery and adjuvant immunotherapy.
文摘BACKGROUND Atrial fibrillation(AF)is a prevalent cardiac arrhythmia associated with significant morbidity and mortality,particularly in patients with concomitant renal dysfunction.Anticoagulation therapy reduces the risk of thromboembolic complications in AF but presents challenges in patients with renal impairment due to altered pharmacokinetics and increased bleeding risk.AIM To support clinicians in navigating the complexities of anticoagulation in this high-risk population,ensuring optimal outcomes.METHODS The present review followed PRISMA guidelines.Data extraction was conducted using a standardized template that captured key study characteristics:Population demographics,renal function metrics,anticoagulant dosing strategies,and primary and secondary outcomes.For quality assessment,we employed the Cochrane Risk of Bias 2.0 tool for randomized controlled trials.Observational studies were appraised using the Newcastle-Ottawa Scale.RESULTS We analyze data from 16 studies to provide recommendations on optimal anticoagulation strategies,balancing thrombotic and bleeding risks.Current evidence supports the preferential use of apixaban in moderate chronic kidney disease and cautiously in end-stage renal disease,emphasizing the importance of individualized therapy.CONCLUSION The management of anticoagulation in AF patients with renal dysfunction is challenging but critical for reducing stroke risk.
基金supported by Natural Science Foundation of Anhui Province(2008085MH273)Anhui Fund for Distinguished Young Scholars(2022AH020050)+3 种基金the Scientific Research Platform Improvement Project of Anhui Medical University(2022xkjT045)the Natural Science Foundation of Anhui Province(No.2108085MH278)Graduate Research and Practice Innovation Project of Anhui Medical University(YJS20230110)the Science and Technology Program of Ma’anshan City(No.YL-2022-8)。
文摘Background:Renal cell carcinoma(RCC)is a prevalent malignancy characterized by a rising incidence and significant mortality.Interleukins(ILs)are crucial in regulating immune cell trafficking and exhibit anti-tumor properties.However,limited research has explored the expression levels and prognostic significance of interleukins in RCC.Methods:In this comprehensive study,we performed a detailed analysis of interleukins in RCC patients using multiple bioinformatics tools,including Oncomine,UALCAN,GEPIA,Kaplan-Meier plotter,cBioPortal,GeneMANIA,TRRUST,STRING,and Linked Omics.Results:Our analysis demonstrated a significant upregulation in the transcriptional levels of IL4,IL7,IL15,IL16,IL23A,IL26,and IL32 were significantly upregulated in RCC tissues,indicating their potential involvement in the pathogenesis of this malignancy.In contrast,IL1A,IL11,and IL27 were downregulated,indicating their potential function as tumor suppressors.Significant correlations were identified between the expression levels of IL11,IL23A,IL27,IL32,and the pathological stage of RCC patients.The expression levels of IL1A,IL4,IL11,IL15,IL16,IL23A,IL26,IL27,and IL32 were significantly correlated with improved prognosis.The differentially expressed interleukins primarily function in cytokine-cytokine receptor interactions and immune response-regulating signaling pathways.homeobox A10(HOXA10),v-myb myeloblastosis viral oncogene homolog(avian)(MYB),v-rel reticuloendotheliosis viral oncogene homolog A(avian)(RELA),and nuclear factor of kappa light polypeptide gene enhancer in B-cells 1(NFKB1)are key transcription factors for ILs,while LCK proto-oncogene(LCK),LYN proto-oncogene(LYN),spleen associated tyrosine kinase(SYK),Janus kinase 3(JAK3),and FER tyrosine kinase(FER)are IL targets.IL expression significantly correlated with the infiltration of six distinct immune cell types.IL1A potentially exerts an anti-tumor effect in RCC prognosis by inducing neutrophil extracellular traps(NETs).Additionally,NFKB1 may positively regulate IL1A,providing a rationale for further in vivo and clinical studies.Conclusion:In conclusion,our study demonstrates the potential role of IL 1A in the prognosis of RCC and establishes a theoretical foundation for subsequent in vivo and clinical investigations.
基金supported by Shenzhen Fundamental Research Program(No.JCYJ20200109114003921).
文摘Five previously undescribed diterpenoids,named succipenoids D‒H(1‒5),along with four undescribed lignans,named succignans A‒D(6‒9),were isolated from the dichloromethane extract of Chinese medicinal succinum.Compounds 1‒5 were characterized as nor-abietane diterpenoids,while compounds 6‒9 were identified as lignans polymerized from two groups of phenylpropanoid units.The structures of these novel compounds,including their absolute configurations,were determined through spectroscopic and computational methods.Biological assessments of renal fibrosis demonstrated that compounds 6 and 7 effectively reduce the expression of proteins associated with renal fibrosis,includingα-smooth muscle actin(α-SMA),collagen I,and fibronectin in transforming growth factor-β1(TGF-β1)induced normal rat kidney proximal tubular epithelial cells(NRK-52e).
文摘Background:Chiglitazar is a novel pan-agonist that can activate all three subtypes of peroxisome proliferator-activated receptor.It was approved for the treatment of type 2 diabetes mellitus as monotherapy on October 19,2021,and as combination therapy with metformin when using metformin alone failed in blood glucose control on July 16,2024,by the National Medical Products Administration(NMPA)in China.However,pharmacokinetic(PK)study of this product in patients with renal impairment have not yet been conducted.The purpose of this study is to evaluate the effects of renal impairment on the PK and safety after a single oral dose of Chiglitazar.Methods:This multicenter,open-label,parallel-controlled,single-dose Phase I clinical trial(NCT 05515458)enrolled 24 participants(12/group)with severe renal impairment(SRI)or normal renal function(NRF).All participants received a single oral dose of 48 mg chiglitazar after breakfast and the PK and safety was evaluated.Results:The median Tmax was similar in both SRI and NRF groups(5.01 vs.5.02 hours).The geometric mean ratios(GMR)for Cmax,AUC0-t,and AUC0-∞were 0.807(90%confidence interval[CI]:0.697–0.935),0.853(90%CI:0.713–1.02),and 0.855(90%CI:0.716–1.02),respectively,indicating that SRI did not significantly affect the exposure of chiglitazar.The Cmax was weakly positively correlated with eGFR(r=0.4798,P=0.0177)and creatinine clearance rate(r=0.4667,P=0.0215).Urinary excretion of chiglitazar was negligible in the SRI group,with average values of Ae0-t=2,900 ng,Fe0-t=0.0060%,and CLR=0.323 mL/h within 0–72 hours post-dose.The treatment-emergent adverse event(TEAE)incidence in the SRI group(16.7%,2/12)was comparable to that in the NRF group(25%,3/12).All TEAEs were of mild severity and were adjudicated by the investigators to be unrelated to chiglitazar.No serious AE were reported.Chiglitazar exhibits a favorable safety profile.Conclusion:Severe renal impairment does not significantly affect the PK and safety of chiglitazar,and no dose adjustment for mild,moderate,and severe renal impairments is required.
文摘Paediatric renal tumors are rare and accounts for about 7%of all paediatric malignant tumors.The spectrum of paediatric renal tumors ranges from benign to malignant.Benign tumors include cystic nephroma,metanephric tumors and ossifying renal tumor of infancy.Tumor with low grade malignancy includes mesoblastic nephroma.Malignant tumors are nephroblastoma,clear cell sarcoma,malignant rhabdoid tumor,anaplastic sarcoma and Ewing sarcoma.Additionally,there are molecularly defined renal tumors,which includes renal cell carcinoma(RCC)with MiT translocations,ALK-rearranged RCC,eosinophilic solid and cystic RCC and SMARCB1-deficient renal medullary carcinoma.These tumors apart from having characteristic clinical presentation and histomorphology,also carry typical molecular mutations and translocations.Certain renal tumors have association with various genetic syndromes such as Beckwith-Weidmann syndrome,Wilm’s tumor,aniridia,genitourinary anomalies and mental retardation syndrome,Denys-Drash syndrome,rhabdoid tumor predisposition syndrome and DICER syndrome.This review article focusses on molecular characteristics,histomorphology and syndromic association of pediatric renal tumors,their immunohistochemical approach to diagnosis with recent updates in molecularly defined renal tumors.
基金Supported by Project of Science and Technology Department of Inner Mongolia Autonomous Region(2021GG0117).
文摘[Objectives]To investigate differences in BMI and renal function across constitution types and influencing factors of blood pressure.[Methods]92 college student volunteers aged 18-25 from January 2023 to December 2024 were selected.BMI,blood pressure,and renal function markers—blood urea nitrogen(BUN),creatinine(Cr),uric acid(UA),were compared across constitution types.Multiple stepwise regression analysis was applied to identify the influencing factors of blood pressure.[Results]Among 92 healthy participants aged 18-25,Shar-predominant constitution accounted for 50%,Khii-predominant for 25%,and Badgan-predominant for 20.65%.Significant differences existed in mean systolic and diastolic blood pressure across constitution types(systolic:F=4.56,P=0.001;diastolic:F=3.78,P=0.005).Shar-predominant group showed significantly higher systolic blood pressure than other types(P<0.05),while Khii-predominant group had higher diastolic pressure.Shar-predominant constitution demonstrated significantly greater height,weight,and BMI compared to other types(P<0.05).Males exhibited significantly higher height,weight,and BMI than females(P<0.05).Shar-predominant group showed significantly elevated urea,uric acid,and creatinine levels compared to other constitution types(P<0.05).Males had significantly higher mean urea,uric acid,and creatinine levels than females(P<0.05).Correlation analysis revealed stronger associations between BMI,renal function,and blood pressure in Shar-predominant group(r>0.50,P<0.05).Multiple regression analysis identified BMI as the primary influencing factor for blood pressure,followed by urea and uric acid.In Shar-predominant group,BMI exerted the strongest effect on blood pressure(β=0.60-0.65,P<0.001).[Conclusions]This study provides important evidence for health management in populations with different constitution types.
