2016年 · 第32卷第11期

cardiac surgery-associated acute kidney injury (CSA-AKI) is an acute kidney injury (AKI) that occurs within 2 weeks of cardiac surgery^[1]The incidence rate is about 8.9% ~39.0%, and the mortality rate is as high as 3.8% ~54.4%^[2,3,4]。 2.1% of the patients undergoing cardiac surgery required continuous renal replacement therapy (continuous renal replacement therapy, CRRT)^[5]Its mortality rate is as high as 36% ~78%^[6]。 Death in patients with CSA-AKI is associated with multiple risk factors such as fluid overload^[7]And CRRT ultrafiltration treatment is an important means to solve the fluid overload of such patients. The purpose of this study was to analyze the relationship between the prognosis of CSA-AKI patients and CRRT ultrafiltration, input and output balance.

Hemodialysis patients have low immune function and more opportunities to be exposed to invasive procedures, so they are at high risk for blood-borne diseases. In order to comprehensively understand the current situation of blood-borne diseases in hemodialysis patients in Tianjin, we conducted a survey on the current situation of blood-borne diseases in hemodialysis patients in Tianjin, so as to provide clinical basis for the prevention and control measures of this kind of diseases.

Renal interstitial fibrosis is a common pathological process experienced by chronic kidney disease to the terminal stage. transforming growth factor-β 1 (TGF-β 1) is a well-recognized fibrogenic factor^[1]It can mediate the transcription factor serum-response factor (SRF). The expression of α-smooth muscle actin (α-SMA), a major contraction protein in the interstitium, is regulated by SRF and its coactivator MRTF-A (myocardin-related transcription factor-A)^[2]。 Recent studies have found that homeostatic imbalance of renin-angiotensin system (RAS) may be related to the development of renal interstitial fibrosis. Angiotensin Ⅱ (Ang Ⅱ) is the main effector molecule in RAS, and aliskiren is a new generation of non-peptide oral direct renin inhibitor^[3]It can inhibit the conversion of angiotensinogen into AngⅠ, inhibit the compensatory increase of plasma renin activity, and reduce AngⅡ^[4]。 In this study, we intended to make a model of renal interstitial fibrosis in vivo by unilateral ureteral ligation, and pretreated with aliskiren to observe whether aliskiren exerts an anti-fibrotic effect by regulating the expression of AngⅡ, angiotensin type 1 receptor (AT1) and transcription factor SRF in RAS system, and inhibiting the expression of type Ⅰ collagen (ColⅠ), so as to elucidate the role and mechanism of aliskiren.

Infectious pericarditis caused by Nocardia is rarely reported in China, and only cases are reported abroad. A case of ANCA-associated vasculitis with renal damage combined with Nocardia pericarditis was admitted to our department, which is reported as follows.

Peritoneal dialysis (peritoneal dialysis) is an important renal replacement therapy for patients with end-stage renal disease (ESRD). China's large-scale peritoneal dialysis centers have ranked at the highest level in the world in the key indicators of evaluating the quality of peritoneal dialysis technology, such as peritoneal dialysis technique survival rate, patient survival rate and peritonitis incidence rate^[1,2,3,4]。 Peritoneal dialysis catheter is the lifeline of peritoneal dialysis patients. Choosing the appropriate catheter placement, using the correct catheter placement method and establishing a successful dialysis path are the key links to ensure the smooth progress of peritoneal dialysis for a long time. The purpose of this guide is to draw lessons from the experience and guidelines of international peers, summarize the experience and clinical research results of nephrologists in China, and formulate a guideline for peritoneal dialysis catheter placement in line with the actual situation in China, which can be used to guide the clinical practice of nephrologists in China.

diabetic nephropathy (DN) is an important cause of end-stage kidney disease and one of the main complications of diabetes involving microvasculature. About 30% of diabetic patients worldwide will develop diabetic nephropathy^[1]。 Diabetic nephropathy has the characteristics of rapid progression, irreversibility, high morbidity and mortality, which not only brings physical and psychological pain to patients, but also causes a heavy burden to society and economy. Therefore, how to prevent and treat diabetic nephropathy has become a public health problem that has attracted much attention of researchers.

The proportion of older people in the global population is growing rapidly, and the risk of aging-related diseases, especially kidney disease, is also increasing. During the occurrence and development of kidney diseases, the kidney has different degrees of cellular senescence, and secretes a large number of factors similar to the senescence-related secretory phenotype. The latter play different roles according to different physiological or pathological environments, and feedback accelerates the process of kidney senescence. But so far, a comprehensive analysis of cellular senescence and its secretory phenotype in kidney disease is lacking. This review mainly expounds the involvement of senescence-related secretory phenotypes in the process of cellular senescence in the pathological process of different kidney diseases, and summarizes the types, generation, characteristics, functions and application value of senescence-related secretory phenotypes in kidney diseases, so as to provide reference significance for the prevention and treatment of kidney diseases.