To analyze the prevalence and related factors of hyperuricemia in the inland rural areas of northern China, so as to provide a basis for understanding the risk factors of hyperuricemia.

The data were obtained from a population of the Handan Eye Study (HES), by means of stratified, clustered, and probability proportional sampling methods to extract the respondents. Questionnaires, physical examination, and laboratory tests of blood and urine were conducted. The population was divided into two groups according to serum uric acid level: the hyperuricemia group and the normouricemia group. The propensity score matching module in the SPSS22.0 software was applied for propensity score matching analysis.

The overall prevalence of hyperuricemia in this population was 2.51%(95/3 785), with 2.75%(47/1 711) in the male and 2.31%(48/2 074) in the female, respectively. The age, prevalence of hypertension, prevalence of diabetes mellitus, body mass index (BMI), waist-to-hip ratio (WHR), serum C reactive protein (CRP), serum total cholesterol (TCH), low density lipoprotein cholesterol (LDL-C), triglyceride (TG), and brachial-ankle pulse wave velocity (baPWV) were significantly higher in the hyperuricemia group than in the normouricemia group. The cigarette smoking rate and serum high density lipoprotein cholesterol (HDL-C) were significantly lower in the hyperuricemia group than in the normouricemia group. Logistic multiple regression analysis showed that male gender, increased BMI, increased CRP, non-smoking, and decreased eGFR were independently associated with hyperuricemia. The propensity score matching analysis showed that male gender, hypertension, diabetes mellitus, non-smoking, alcohol drinking, increased BMI, increased WHR, decreased eGFR, and increased urine albumin/creatinin ratio (ACR) were influence factors of hyperuricemia.

The results of the present study indicated that male gender, hypertension, diabetes mellitus, alcohol drinking, obesity, increased albuminuria, and decreased renal function were related factors to hyperuricemia.

Insulin resistance (IR) is a pathological state in which target tissues fail to respond normally to insulin. A compensatory rising in circulating insulin to maintain normal blood glucose levels results in hyperinsulinemia. Hyperinsulinemic euglycemic clamp is the gold standard for diagnosis of IR. Insulin sensitivity index estimated by fasting blood glucose or insulin and oral glucose tolerance test is commonly used in clinical practice. The combination of the two methods can better evaluate the IR of patients with chronic kidney disease (CKD). IR is a common alteration in CKD patients. The mechanism leading to CKD-IR mainly involves post-insulin receptor signal transduction disorder. The etiology of CKD-IR includes unhealthy diet, physical inactivity, metabolic acidosis, anemia, vitamin D deficiency, chronic inflammation, oxidative stress, and adipokine derangement, etc. Although there is still debate about the correlation between IR and renal and cardiovascular events, more and more clinical studies have confirmed that IR is an independent risk factor for occurrence or progression of CKD and cardiovascular complications. Interventions including lifestyle modifications, especially plant-based diets such as Mediterranean diet, dietary approaches to stop hypertension (DASH) diet, vegetarian diet, combined with aerobic exercise or resistance exercise, plus pharmacological strategies with metformin, pioglitazone, renin-angiotensin system (RAS) inhibitors, vitamin D, as well as adaptations of dialysis mode and optimization of membrane materials, may improve IR in patients with CKD.

Assessment and comparison of protein-energy wasting (PEW) in maintenance hemodialysis (MHD) patients of different age groups in order to provide basis for clinical work.

A cross-sectional and retrospective study was performed. Assessment and comparison of PEW were made by means of objective score of nutrition on dialysis (OSND) and modified quantitative subjective global assessment (MQSGA) combining questionnaires, anthropometrics, blood biochemistry, and other indicators in the 242 patients of the adult group (aged < 65 years) and the 106 patients of the elderly group (aged ≥65 years). The PEW diagnosis criteria were as follows: the OSND score ≤22 points, the MQSGA score 21 to 35 points, the triceps skinfold thickness (TSF) <12.5 mm for males and <16.5 mm for females, the mid-upper arm circumference (MAC) <25.3 cm for males and <23.2 cm for females, albumin (ALB) <38 g/L, and the body mass index (BMI) <18.5 kg/m². The PEW was divided into mild, medium and severe grades according to the different scores and percentages of OSND, MQSGA, TSF, and MAC.

The incidence of PEW diagnosed by the OSND score, MQSGA score, TSF, MAC, ALB, and BMI was 79.3%, 67.8%, 43.9%, 23.0%, 43.1%, and 19.5%, respectively in all, but was 74.0%, 62.2%, 39.7%, 19.0%, 25.6%, and 17.8%, respectively in the adult group, and was 91.5%, 81.4%, 53.8%, 32.1%, 40.6%, and 23.5%, respectively in the elderly group. The incidence of severe PEW diagnosed by OSND, MQSGA, TSF, and MAC was 13.5%, 6.9%, 15.5%, and 3.7%, respectively. There were statistically significant differences in the incidence of PEW, and multiple baseline nutrition-related indicators between the two groups (P<0.05). The high-sensitivity C-reactive protein (hs-CRP) in the elderly group was significantly higher than in the adult group (P<0.05).

Compared with the ones of the adult group, the MHD patients of the elderly group had higher incidence of PEW, lower levels of nutritional indicators, and severer inflammatory status, indicating that PEW status of elderly dialysis patients should be more concerned in clinical work.

Malnutrition is a risk factor for the decline of quality of life and increased hospitalization and mortality in patients undergoing maintenance hemodialysis (MHD), and is also a problem often faced by blood purification workers. The assessment of malnutrition has important practical significance for its prevention, monitoring, diagnosis, and treatment. This article reviewed the research progress of malnutrition assessment in recent years.

IgA nephropathy (IgAN) is the most common primary glomerulonephritis in the world. Although it is a chronic progressive disease, the prognosis of individuals varies greatly. Therefore, the prognosis assessment and the end-point event prediction have been hot issues of study. At present, the prognosis-assessing methods of IgAN mainly include pathological classification (Lee′s classification, Oxford classification, etc), clinical indicators (baseline proteinuria, eGFR, etc), mathematical models (ARR score, GOTO model), and biomarkers (urinary TGF-β1, IL-6, etc). A variety of methods provides means for the early prediction and intervention of IgAN prognosis, but each method has its advantages and disadvantages, of which recent research progress was reviewed in this article.

To investigate the value of urinary neutrophil gelatinase-associated lipocalin (NGAL) in evaluation of renal tubulointerstitial injury of type 2 diabetic nephropathy (DN).

167 patients with type 2 diabetes and 50 patients without diabetes were recruited in this study from the Department of Nephrology of Daping Hospital from January of 2012 to December of 2015. The diabetic patients were categorized into normoalbuminuria group (n=56), microalbuminuria group (n=58), and macroalbuminuria group (n=53), among whom 51 patients received renal biopsies. Urinary NGAL levels were measured by ELISA, and urinary NAG levels were measured by the spectrophotometric method. Analysis was made for correlation of urinary NGAL with renal function parameters, and with renal histopathological sores. The value of urinary NGAL in evaluation of renal tubulointerstitial injury of DN was also analyzed.

Urinary NGAL levels were elevated in diabetic patients compared with the non-diabetes control. Urinary NGAL levels were positively associated with both urinary NAG (r=0.528, P<0.001) and ACR (r=0.578, P<0.001), and negatively associated with eGFR (r=-0.637, P<0.001). Urinary NGAL levels were significantly correlated with scores of renal tubular atrophy and interstitial fibrosis (r=0.652, P<0.001) in DN. Urinary NGAL had the largest area under the curve (AUC=0.868), with a specificity of 94.7% and a sensitivity of 71.9%.

Urinary NGAL could serve as one of the most ideal biomarkers for evaluating the tubulointerstitial injury in DN.

The acceleration of population ageing develops serious medical challenges to society. With organ dysfunction progresses, various age-related diseases have become increasingly prominent, the most prominent of which is the kidney. After the age of 40, the kidney function begins to wane, and can still maintain normal physiological activities in general conditions; but in case of diseases or under some kind of stress condition, the kidney load is increased, which can lead to occurrence of various kidney diseases. Structural and functional changes in kidney take place with age, as a process of physiological aging, which should be distinguished from the kidney diseases. Due to the age-related changes in kidney, the existing renal assessment methods have certain limitations for the elderly, and there has not been any perfect assessment method suitable for the elderly. In the process of diagnosis for the elderly patients with kidney diseases, it should be made clear first whether the renal function change is a physiological or pathological one, so that the treatment can be individualized based on etiology and physiological characteristics of the elderly.