2015年 · 第31卷第06期

Anemia is very common in patients with end-stage renal disease treated with peritoneal dialysis (PD), and erythropoiesis-stimulating agents are needed to maintain Hb at 11.5-130.0 g/L^[1]。 Polycythemia vera is a myeloproliferative tumor with abnormal proliferation of clonal red blood cells. The incidence rate in European countries is 0.4/100,000~2.8/100,000 per year^[2]。 Patients with myeloproliferative tumors have a lower life expectancy than the general population, with a 10-year relative survival rate of 64%^[3]。 However, PD patients with true red are rarely reported. This article reports one case with literature review for colleagues' reference to reduce misdiagnosis.

The common feature of chronic kidney disease (CKD) progressing to end-stage kidney disease is renal fibrosis, and the sparsity and loss of kidney microvasculature is one of its important manifestations. In early research, our research group found that intermedin (IMD) has a protective effect on acute renal injury and can alleviate renal fibrosis in rats with unilateral ureteral obstruction (UUO). Vascular endothelial growth factor (VEGF) is the most important vascular-related factor, which can increase the vascular permeability, promote the proliferation of endothelial cells and the germination of blood vessels, etc. It is very important for the regeneration and repair of blood vessels after injury^[1,2]。 Vascular endothelial growth factor receptor 2 (VEGFR2), which is an important signaling pathway for angiogenesis, is mainly mediated by the physiological or pathological changes of endothelial cells induced by VEGF^[3]。 VEGF and VEGFR2 were expressed in renal tubular epithelial cells and endothelial cells. Vascular endothelial cadherin (VE-cadherin) belongs to type II cadherin, which is located at the adhesion junction of vascular endothelial cells, and plays an important role in maintaining the structural integrity and barrier of vascular endothelial layer^[4]。 At the beginning of angiogenesis, VEGF first induces the enhancement of VEGFR2 activity in apical cells, and the decrease of VEGFR2 activity in stem cells, which promotes vascular budding. When vascular lumen is further formed, VEGFR2 activity in stem cells is enhanced, VE-cadherin phosphorylation is increased, cell polarity disappears, and finally lumen is formed^[5]This indicates that the VEGF-VEGFR2 pathway is closely related to VE-cadherin. The purpose of this study was to investigate the effect of IMD on VEGF-VEGFR2 signaling pathway in UUO rat model, and to explore the possible mechanism of IMD delaying renal fibrosis in UUO rats.

Idiopathic focal segmental glomerulosclerosis (FSGS) has occult onset and complicated etiology. Its onset is related to genetics, metabolism, poisoning, infection and other factors, and the etiology of most patients is unknown. Some patients developed hormone resistance, progressive deterioration of renal function, and gradually progressed to chronic renal failure. Anemia, hypertension, hyperuricemia, electrolyte disorder, etc. are common complications in patients with FSGS. We explored the clinical factors affecting the progression of renal function in FSGS patients by understanding the occurrence of clinical comorbidities in FSGS eGFR1-3 patients.

eosinophilic cystitis (EC) in children is a rare inflammatory disease of the bladder in children, and only cases have been reported at present. The etiology of the disease is unknown, and the clinical manifestations are frequent urination, urgency, painful urination, dysuria, hematuria, suprapubic pain, etc., which can cause bladder perforation in serious cases. Imaging can show only bladder wall thickening or tumor-like changes, so it is often confused with bladder tumors or urinary tract infections. A case of EC confirmed in our department is now reported as follows.

Abdominal Burkitt lymphoma is characterized by high invasion of mesenteric, retroperitoneal lymph nodes, spleen, liver, kidney, pancreas, adrenal gland and testis^[1]Acute kidney injury is very prone to occurrence, which makes further treatment difficult. We treated a child with abdominal Burkitt's lymphoma complicated with acute kidney injury with combined blood purification therapy to secure treatment space for chemotherapy in the child, which is reported below.

polycystic kidney disease (PKD) refers to a genetic disease in which multiple cysts develop and grow progressively in bilateral kidneys, resulting in damage to kidney structure and function. It is characterized by multiple fluid-filled cysts in kidneys and other organs. It is the most common genetic kidney disorder. At present, approximately 125 million people worldwide suffer from the disease, and 5% of end-stage kidney disease develops from polycystic kidney disease^[1]。 According to different patterns of inheritance, polycystic kidney disease can be divided into autosomal dominant polycystic kidney disease (ADPKD) and autosomal recessive polycystic kidney disease (ARPKD). Different types of polycystic kidney disease occur in different age groups, with different incidence rates and different extrarenal manifestations^[2]。 The incidence of ADPKD ranged from 1/400 to 1/1000^[3]Cysts occur in the embryonic stage and progress slowly. They often have obvious clinical manifestations after the age of 40. Cysts in ARPKD also occur in the embryonic period, but they progress rapidly and are often accompanied by liver fibrosis.

Chronic kidney disease (CKD) has become a public health problem due to its high prevalence, high mortality, high medical expenses and serious socio-economic burden. The study shows that the prevalence of CKD in the general population in China is 10.8%^[1], close to the level of developed countries. Rational diagnosis and treatment of CKD and its complications is an important content to control the burden of CKD disease. Renal anemia is a common complication of CKD. With the decrease of estimated glomerular filtration rate (eGFR), the incidence of anemia gradually increases and the degree of anemia gradually increases. Renal anemia is an important risk factor for the progression of CKD and cardiovascular complications. erythropoiesis stimulating agents (ESAs) can effectively correct anemia and improve the quality of life of patients, and are widely used in the treatment of renal anemia.

Kidney is the most important organ in the body to regulate water and salt metabolism. It is not only the target organ of hypertension involvement, but also an important factor in the occurrence and development of hypertension. The prevalence of hypertension in patients with chronic kidney disease (CKD) increases with decreased glomerular filtration rate, and the proportion of hypertension in stage 4 CKD is as high as 80%^[1]Its blood pressure level is considered to be the main cause of cardiovascular and cerebrovascular events and the target of treatment. However, more and more studies have confirmed that blood pressure variability, the fluctuation of blood pressure, is a risk factor for target organ damage independent of blood pressure levels^[2,3]This article will review the role of blood pressure variation in the occurrence and development of CKD.