scholarly journals Elevated Serum Chloride Levels Contribute to a Poor Prognosis in Patients with IgA Nephropathy

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Yaling Zhai ◽  
Xingchen Yao ◽  
Yuanyuan Qi ◽  
Jingge Gao ◽  
Yazhuo Chen ◽  
...  
Keyword(s):  
Risk Factor ◽  
Predictive Model ◽  
Iga Nephropathy ◽  
Independent Risk Factor ◽  
Interstitial Fibrosis ◽  
Elevated Serum ◽  
Prognostic Indicators ◽  
Endothelial Cell Proliferation ◽  
Serum Chloride ◽  
High Chloride

Introduction. The identification of reliable prognostic factors is a crucial requirement for patients with IgA nephropathy (IgAN). Here, we explored the relationship between serum chloride levels and prognosis in patients with IgAN. Methods. We recruited all patients with primary IgAN, as diagnosed by renal biopsy, between 1st January 2015 and 1st April 2019. Patients were divided two groups (high chloride group and low chloride group) based on the best cut-off values from survival receiver operating characteristic (ROC) curves. The baseline clinicopathological characteristics of two groups were then compared. Cox proportional hazard models were used to determine the prognostic value of serum chloride levels in patients with IgAN. Finally, we screened reliable prognostic indicators and built a clinical prediction model and validated the performance of the model. Results. Compared with patients in the high chloride group, patients in the low chloride group had significantly lower levels of 24-hour urinary total protein (24 h-UTP), serum creatinine (sCr), and higher levels of hemoglobin (Hb), albumin (all p < 0.05 ), and less proportion of Oxford classification grade E1 (endothelial cell proliferation) and T2 (renal tubule atrophy or renal interstitial fibrosis). Cox analysis revealed that serum   chloride   level ≥ 105.4   mmol / L was a significant and independent risk factor for prognosis in patients with IgAN ( p < 0.05 ). Serum chloride, sCr, T, hypertension, and Hb were used to generate a predictive model for prognosis. The c -indices of our predictive model were 0.80, 0.86, and 0.78, for 1, 2, and 3 years, respectively; Brier scores were 0.06, 0.09, and 0.16, respectively. Conclusions. A serum   chloride   level ≥ 105.4   mmol / l was identified as a significant and independent risk factor for the prognosis of patients with IgAN. A predictive prognosis model was generated using serum chloride, sCr, T, hypertension, and Hb; this model exhibited a good predictive effect.

scholarly journals Elevated Serum Chloride Level Contributes to the Poor Prognosis of IgA Nephropathy

2020 ◽  
Author(s):  
Yaling Zhai ◽  
Xingchen Yao ◽  
Yuanyuan Qi ◽  
Jingge Gao ◽  
Yazhuo Chen ◽  
...  
Keyword(s):  
Risk Factor ◽  
Independent Risk Factor ◽  
Cox Regression ◽  
Elevated Serum ◽  
Endothelial Cell Proliferation ◽  
Good Prediction ◽  
Operating Characteristics ◽  
Serum Chloride ◽  
Prognosis Model ◽  
Lower Group

Abstract IntroductionFinding reliable prognostic factors is crucial for IgA nephropathy (IgAN). Here, we determined the relationship between prognosis of IgAN with serum chloride.MethodsPrimary IgAN diagnosed by renal biopsy from January 1, 2015 to April 1, 2019 were recruited. Patients were divided into lower group and higher group based on the best cut-off value of survival receiver operating characteristics (ROC) curves. The baseline clinicopathological characteristics were retrospectively compared. Cox proportional hazard models were used to demonstrate the prognostic value of serum chloride in IgAN. Prognosis prediction model was built by multivariate Cox regression. ResultsCompared to higher group , age、24-hour urinary protein and serum creatinine(Cr) in the lower group were significantly lower, hemoglobin(Hb)、albumin were significantly higher(all P<0.05),the degree of endothelial cell proliferation (E) and renal tubule atrophy or renal interstitial fibrosis (T) were significantly lighter (all P<0.05). Univariate and multivariate Cox analysis revealed that serum chloride ≥105.4 mmol/l was an independent risk factor for the prognosis of IgAN(P<0.05). Serum chloride, Cr, T, hypertension, and Hb were screened out as features in predictive prognosis model. The c-index of the model was 0.85、0.82 and 0.77 for 1、2 and 3 years respectively, and brier scores were 0.06 、0.09 and 0.16 respectively. ConclusionsSerum chloride ≥105.4 mmol/l was an independent risk factor for the prognosis of IgAN. A predictive prognosis model including serum chloride, Cr, T, hypertension and Hb exhibited a relatively good prediction effect.

scholarly journals Elevated serum fibrinogen level is an independent risk factor for IgA nephropathy

Oncotarget ◽  
2017 ◽  
Vol 8 (58) ◽  
pp. 99125-99135 ◽  
Author(s):  
Ji Zhang ◽  
Chaosheng Chen ◽  
Qiongxiu Zhou ◽  
Shubei Zheng ◽  
Yinqiu Lv ◽  
...  
Keyword(s):  
Risk Factor ◽  
Iga Nephropathy ◽  
Independent Risk Factor ◽  
Fibrinogen Level ◽  
Elevated Serum

Mechanistic Insights of Soluble Uric Acid-related Kidney Disease

2020 ◽  
Vol 27 (30) ◽  
pp. 5056-5066 ◽  
Author(s):  
Pan Jing ◽  
Min Shi ◽  
Liang Ma ◽  
Ping Fu
Keyword(s):  
Uric Acid ◽  
Risk Factor ◽  
Kidney Disease ◽  
Serum Uric Acid ◽  
Independent Risk Factor ◽  
Elevated Serum ◽  
Tubulointerstitial Fibrosis ◽  
Renal Diseases ◽  
Glomerular Hypertrophy ◽  
Progression Of Kidney Disease

Hyperuricemia, defined as the presence of elevated serum uric acid (sUA), could lead to urate deposit in joints, tendons, kidney and other tissues. Hyperuricemia as an independent risk factor was common in patients during the causation and progression of kidney disease. Uric acid is a soluble final product of endogenous and dietary purine metabolism, which is freely filtered in kidney glomeruli where approximately 90% of filtered uric acid is reabsorbed. Considerable studies have demonstrated that soluble uric acid was involved in the pathophysiology of renal arteriolopathy, tubule injury, tubulointerstitial fibrosis, as well as glomerular hypertrophy and glomerulosclerosis. In the review, we summarized the mechanistic insights of soluble uric acid related renal diseases.

scholarly journals P1174STUDY ON THE RELATIONSHIP BETWEEN HYPOCHLOREMIA AND ALL-CAUSE DEATH IN PATIENTS RECEIVING CONTINUOUS AMBULATORY PERITONEAL DIALYSIS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Tao Xu ◽  
Niansong Wang ◽  
Cheng Qiao
Keyword(s):  
Logistic Regression ◽  
Risk Factor ◽  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Roc Curve ◽  
Independent Risk Factor ◽  
Chloride Level ◽  
Kaplan Meier ◽  
Serum Chloride ◽  
The Relationship

Abstract Background and Aims To investigate the relationship between hypochloremia on all-cause death in patients receiving continuous ambulatory peritoneal dialysis (CAPD). Method 300 CAPD patients from January 2013 to December 2019 in the Sixth People's Hospital affiliated to Shanghai Jiaotong University. According to the serum chloride level, the patients were divided into two groups: hypochloremia group (serum chlorine ≤ 96mmol / L, n = 135) and normal chloride group (106mmol / L &lt; serum chlorine &gt; 96mmol / L, n = 165). The endpoint was all-cause death. We used the receiver-operating characteristic (ROC) curve to analysis the diagnostic value and logistic regression to assess the predictive value in relation to serum chloride with all-cause death in CAPD patients. Kaplan Meier curve was used to evaluate the effect of serum chloride on all-cause death survival analysis. All statistics were analyzed by SPSS 20.0 software, P &lt; 0.05, indicating significant difference. Results 114 cases of all-cause death occurred in CAPD patients during follow-up (62.1 ± 11.1 months). The results of correlation analysis showed that serum chloride was positively correlated with serum sodium and potassium (r=0.721,0.199, P=0.001) and the negative correlation between serum chloride and dialysis age and serum phosphorus (r=-0.321, - 0.300, P=0.001). ROC curve analysis showed that serum chloride was statistically significant in predicting all-cause death in CAPD patients (AUC = 0.666, 95% Cl = 0.601-0.730, sensitivity / specificity = 64.6% / 59.8%, best threshold = 95.5mmol/l). Kaplan Meier analysis of all-cause death risk curve shows that the incidence of all-cause death in the low chloride group is higher than that in the normal serum chloride group. Logistic regression analysis showed that low chloride level was an independent risk factor for all-cause death in CAPD patients. Conclusion Hypochloremia is an independent risk factor for all-cause death in CAPD patients.

scholarly journals Upregulated Expression of Intestinal Antimicrobial Peptide HD5 Associated with Renal Function in IgA Nephropathy

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Shaozhen Feng ◽  
Zhong Zhong ◽  
Jinjin Fan ◽  
Xiaoyan Li ◽  
Dianchun Shi ◽  
...  
Keyword(s):  
Renal Function ◽  
Iga Nephropathy ◽  
Cox Regression ◽  
Interstitial Fibrosis ◽  
Elevated Serum ◽  
Renal Outcome ◽  
Rank Test ◽  
Baseline Serum ◽  
Median Level ◽  
Normal Controls

Purpose. It was reported that gut-kidney axis may play an important role in IgA nephropathy (IgAN). Previous five GWASs of different populations for IgAN have discovered several genes related to intestinal immunity, including DEFA gene. However, the roles of the encoded proteins of DEFA5/6 which were called intestinal antimicrobial peptides HD5 and HD6 were not clear in kidney disease, such as IgAN. The purpose of this study was to clarify the association of HD5 and HD6 with IgAN. Methods. We measured HD5 and HD6 in serum, urine, and kidney of IgAN patients and normal controls by ELISA, Western blot, and immunofluorescence. The association of HD5 or HD6 levels with clinical and pathologic phenotypes was analyzed. Results. Serum levels of HD5 and HD6 were significantly higher in IgAN patients than those in normal controls. Baseline serum HD5 levels were significantly associated with eGFR (P=0.002) and tubular atrophy/interstitial fibrosis (P=0.004) by stepwise multivariate regression analysis. Compared to the patients with serum HD5 below the median level, patients with elevated serum HD5 above the median level had a significantly worse renal outcome (log-rank test, P=0.009) by Kaplan-Meier analysis. A Cox regression model showed that serum HD5 was an independent prognostic factor (HR=1.239, P=0.029) after adjusting for the well-known predictors of outcome in IgAN patients. In renal biopsies of IgAN patients, HD5 was significantly expressed in the damaged proximal tubules, while no immunoreactive HD6 was found. Interestingly, the serum HD6 level of IgAN patients was significantly associated with gender. Conclusions. In IgAN patients, an elevated serum HD5 level at the time of renal biopsy was associated with poor renal outcomes. HD5 rather than HD6 was probably associated with renal function of IgAN patients.

Increased lipoprotein (a) levels as an independent risk factor for venous thromboembolism

Blood ◽  
2000 ◽  
Vol 96 (10) ◽  
pp. 3364-3368 ◽  
Author(s):  
Mario von Depka ◽  
Ulrike Nowak-Göttl ◽  
Roswith Eisert ◽  
Christian Dieterich ◽  
Monika Barthels ◽  
...  
Keyword(s):  
Risk Factor ◽  
Venous Thromboembolism ◽  
Protein C ◽  
Independent Risk Factor ◽  
Elevated Serum ◽  
Prothrombin G20210a ◽  
Control Group ◽  
Healthy Controls ◽  
Lipoprotein A

Elevation of serum lipoprotein (a) (Lp[a]) is a known risk factor predisposing to cardiovascular and cerebrovascular disease. However, little is known about the role of increased Lp(a) in venous thromboembolism (VTE). This study evaluated the role of Lp(a) among a panel of established hereditary thrombogenic defects in patients with VTE. A total of 685 consecutive patients with at least one episode of VTE and 266 sex- and age-matched healthy controls were screened with regard to activated protein C resistance, protein C, protein S, and antithrombin deficiency, elevated serum levels of Lp(a), and the factor V G1691A, MTHFR C677T, and prothrombin G20210A mutations. Elevated Lp(a) levels above 30 mg/dL were found in 20% of all patients, as compared to 7% among healthy controls (P < .001, odds ratio [OR] 3.2, 95% confidence interval [CI], 1.9-5.3). The coexistence of FV G1691A and elevated Lp(a) was significantly more prevalent among patients with VTE than in the control group (7% versus 0.8%; P < .001, OR 9.8, 95% CI, 2.4-40.7). No other established prothrombotic risk factor was found to be significantly combined with increased Lp(a). These data suggest that Lp(a) concentrations greater than 30 mg/dL are a frequent and independent risk factor for VTE. Furthermore, elevated Lp(a) levels might contribute to the penetrance of thromboembolic disease in subjects being affected by other prothrombotic defects, such as FV G1691A mutation.

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