To investigate whether urokinase-type plasminogen activator receptor (uPAR) affected renal interstitial fibrosis and angiogenesis induced by renal unilateral ischemia-reperfusion injury (uIRI) in mice.

Female wild-type (WT) mice and uPAR-knockout (uPAR-ko) mice aged 8-10 weeks with C57BL/6J background were selected to construct the renal uIRI model. The experimental mice were divided into four groups: wild-type sham operation group (WT sham group), WT uIRI group, uPAR-ko sham group, and uPAR-ko uIRI group, with five mice in each group. The mice were sampled on days 1, 3, and 14 after modeling to detect serum creatinine, blood urea nitrogen, and renal histopathological changes. Sirius red staining was used to detect collagen deposition area in renal tissues. Western blotting, RT-qPCR, and immunohistochemistry were used to detect the expression of type Ⅰ collagen, vimentin, E-cadherin, α-smooth muscle actin, and endomucin in renal tissues. Immunofluorescence was used to detect the expression of CD31, a marker of angiogenesis, in renal tissues. Statistical comparisons between groups were performed using the two-way analysis of variance.

Compared with the WT sham group and the uPAR-ko sham group, respectively, the WT uIRI group and the uPAR-ko uIRI group showed higher levels of serum creatinine, blood urea nitrogen, and renal tubular injury scores at both 1 day and 3 days after modeling (all P< 0.05). Compared with the WT uIRI group, the uPAR-ko uIRI group exhibited higher levels of serum creatinine, blood urea nitrogen, and renal tubular injury scores at both 1 day and 3 days after modeling, but lower level of blood urea nitrogen at 14 days after modeling (all P<0.05). Compared with the WT sham group and the uPAR-ko sham group, respectively, after 14 days of modeling, the WT uIRI group and the uPAR-ko uIRI group exhibited higher levels of renal tissue collagen area, and higher levels of mRNA and protein expressions of type I collagen, vimentin, and α-smooth muscle actin, but lower levels of protein expressions of E-cadherin, endomucin, and CD31 (all P< 0.05). Compared with the WT uIRI group, the uPAR-ko uIRI group displayed higher level of renal tissue collagen area, and higher levels of protein and mRNA expressions of type I collagen, vimentin, and α-smooth muscle actin, while the protein expressions of E-cadherin, endothelial cadherin, and CD31 were lower (all P< 0.05).

The deficiency of uPAR could exacerbate the kidney dysfunction and renal interstitial fibrosis induced by uIRI, as well as reduced renal angiogenesis in mice.

To evaluate the efficacy and safety of coated aldehyde oxystarch in the treatment of chronic renal failure.

Retrievals were made in the databases of CNKI, Wanfang, VIP, PubMed, EMbase, and Cochrane Library, etc. Randomized controlled trials on the treatment of chronic renal failure with aldehyde oxidized starch were screened out. And meta-analysis was performed with the RevMan 5.4 software.

Seven randomized controlled trials involving 838 patients with chronic renal failure were included. The meta-analysis results showed that the experimental group was significantly superior to the control group in terms of clinical efficacy in treating chronic renal failure (OR=9.19, 95%CI: 4.54-18.62, P<0.01), reducing blood urea nitrogen (MD=-5.21, 95%CI: -6.05- -4.35, P<0.01), decreasing serum creatinine (MD=-69.60, 95%CI: -98.18 - -41.03, P<0.01), and improving creatinine clearance rate (MD=5.26, 95%CI: 2.34-8.18, P<0.01). No serious adverse events were reported.

Coated aldehyde oxystarch had a positive role in reducing blood urea nitrogen and serum creatinine, as well as improving creatinine clearance rate in the patients with chronic renal failure.

To explore the relationship between levels of 25-hydroxyvitamin D and parathyroid hormone (PTH) in maintenance hemodialysis (MHD) patients.

A single-center cross-sectional study was conducted, including patients who underwent regular maintenance hemodialysis (MHD) treatment in the Department of Blood Purification of the First Affiliated Hospital of Xi′an Jiaotong University from March 2022 to May 2022. General patient information, as well as laboratory indicators such as serum 25-hydroxyvitamin D, parathyroid hormone (PTH), and alkaline phosphatase, were collected. The patients were categorized into the following groups based on their 25-hydroxyvitamin D levels, PTH levels, and whether they received ordinary vitamin D supplementation: vitamin D normal group, vitamin D insufficient group, and vitamin D deficient group; PTH normal group, PTH mild elevation group, PTH moderate elevation group, and PTH severe elevation group; vitamin D supplement group and vitamin D non-supplement group. The differences in clinical indicators among the groups were compared, and the correlation between 25-hydroxyvitamin D, PTH, and ordinary vitamin D supplement were analyzed with the Spearman′s rank correlation method and multiple linear regression method.

A total of 395 MHD patients were enrolled, with an average age of 51.38±15.10 years, including 260 males and 135 females. The median duration of dialysis was 45.00 (20-75) months. There were 153 patients (38.73%) with vitamin D insufficiency, 59 patients (14.94%) with vitamin D deficiency, and 372 patients (94.18%) with PTH elevation. The levels of alkaline phosphatase and PTH, as well as the proportions of females, aortic calcification, and abdominal aorta calcification, were significantly higher in the vitamin D deficiency group than in the vitamin D normal group (all P<0.05). The dialysis duration, serum creatinine, serum phosphorus, alkaline phosphatase, albumin, and the proportions of aortic calcification and abdominal aortic calcification were significantly higher, while the 25-hydroxyvitamin D level was significantly lower, in the PTH severe elevation group than in the normal PTH group (all P<0.05). The correlation analysis revealed a negative correlation between PTH and 25-hydroxyvitamin D (r=-0.191, P<0.01). In addition, there was no correlation between supplementation of ordinary vitamin D and PTH (β=-42.725, P=0.280).

The MHD patients generally suffered from vitamin D insufficiency or deficiency, accompanied with PTH elevation. Their 25-hydroxyvitamin D was negatively correlated with PTH, while no significant correlation was found between ordinary vitamin D supplement and PTH.

The autologous arteriovenous fistula (AVF) is the preferred permanent vascular access for hemodialysis. However, approximately 30% to 50% of AVFs may develop dysfunction due to pathological mechanisms such as thrombosis, vascular intimal hyperplasia, and abnormal vascular remodeling. Studies have confirmed that hemodynamic abnormalities are the core driving factors behind AVF dysfunction. Following AVF surgery, local hemodynamic changes can lead to AVF maturation failure by promoting neointimal hyperplasia, inducing phenotypic transformation of endothelial cells, and driving extracellular matrix remodeling in the vascular wall. Improving surgical techniques and adopting multi-stage comprehensive intervention strategies can enhance the AVF maturation rate. And individualized design based on hemodynamic simulation technology represents an important future direction. This article provided an overview of the hemodynamic mechanisms underlying AVF dysfunction and methods to enhance the maturation rate of AVF, aiming to provide a theoretical basis for developing targeted intervention strategies to extend the service life of AVF.

Screening and intervention for the influencing factors of lower urinary tract symptoms (LUTS) in their early stages play a crucial role in the prevention and treatment of LUTS. This article provided a comprehensive review of the epidemiology, influencing factors, and their mechanisms in LUTS of the elderly. Additionally, the limitations and contradictions of previous LUTS studies as well as future research directions were discussed.

Uremic pruritus is a common complication in patients with end-stage renal disease, severely affecting their quality of life. The pathogenesis of uremic pruritus remains unclear and may be associated with various inflammatory mediators, neurotransmitters, opioid receptors, and other factors. Recent studies found that treatments such as opioid receptor antagonists, gabapentinoids, antihistamines, and traditional Chinese medicine could effectively alleviate uremic pruritus in the patients. This article reviewed the research progress on the pathogenesis and treatment methods of uremic pruritus, aiming to provide references for clinical practice.

Mechanical ventilation is closely related to the occurrence and development of acute kidney injury (AKI). Its mechanism involves a comprehensive interaction of multiple factors, such as hemodynamic changes, release of inflammatory mediators, activation of neurohumoral systems, and blood gas disorders. New biomarkers, such as neutrophil gelatinase-associated lipocalin, tissue inhibitor of metalloproteinase-2, and insulin-like growth factor binding protein-7, along with machine learning models, aid in the early warning of AKI. This article reviewed the research progress on the epidemiology, pathophysiological mechanisms, early warning, and prevention and treatment strategies of mechanical ventilation-associated acute kidney injury (AKI), aiming to provide references for early identification, precise diagnosis, and standardized treatment of such patients.