Long-term peritoneal dialysis is accompanied by functional and histopathological alterations in the peritoneal membrane.

SummaryBackground and objectives Lower heart rate variability implies increased risk of cardiovascular disease. This study aimed to evaluate the relationship between mineral metabolism and heart rate variability and longitudinal changes of heart rate variability after parathyroidectomy in stage 5 CKD patients.Design, setting, participants, & measurements This cross-sectional study included 118 stage 5 CKD patients, 87 controls, and a prospective study in two subgroups classified as successful (n=17) and unsuccessful (n=4) parathyroidectomy follow-up enrolled from March of 2011 to December of 2012. Blood examination and 24-hour Holter for heart rate variability were measured.Results Most heart rate variability indices were lower in stage 5 CKD patients. In multivariate stepwise regression models, serum intact parathyroid hormone was correlated with mean normal-to-normal R-R intervals, mean heart rate, and very low frequency, serum calcium was correlated with SD of 5-minute average of normal R-R intervals, and serum phosphorus was correlated with very low frequency and low frequency/high frequency. Compared with baseline, the successful parathyroidectomy subgroup had significant improvements in mean normal-to-normal R-R intervals, mean heart rate, SD of normal-to-normal R-R intervals, SD of 5-minute average of normal R-R intervals, very low frequency, high frequency, and low frequency/high frequency. There was no significant change of heart rate variability in patients after unsuccessful parathyroidectomy.Conclusions Disorders of mineral metabolism are associated with decreased heart rate variability in stage 5 CKD. Successful parathyroidectomy may contribute to reverse this cardiovascular disease risk in severe secondary hyperparathyroidism patients.

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Purpose: Microwave ablation (MWA) is feasible for severe renal secondary hyperparathyroidism (SHPT) and primary hyperparathyroidism (PHPT) patients ineligible for parathyroidectomy (PTX).Here we compared the clinical manifestations and characteristics of parathyroid glands in these two groups, and summarized the techniques, safety and efficacy of MWA. Methods: Baseline clinical characteristics, ablation-related techniques, adverse events/complications, and efficacy were recorded. Results: In SHPT group, malnutrition, cardiovascular/pulmonary complications, and abnormal bone metabolism were severe. SHPT patients had more hyperplastic parathyroid glands. The volume of each gland was smaller, and the time of ablation for a single parathyroid was shorter in the SHPT group, although there were no significant differences compared with patients in the PHPT group. Three patients in both groups had recurrent laryngeal nerve injuries and all recovered, except for one SHPT patient. By the end of follow-up, serum iPTH levels had decreased from 2400.26 ± 844.26 pg/mL to 429.39 ± 407.93 pg/mL (p < .01) in SHPT and from 297.73 ± 295.32 pg/mL to 72.22 ± 36.51 pg/mL in PHPT group (p < .01). Hypocalcemia was more common (p < .001) and serum iPTH levels were prone to rebound in SHPT patients after MWA. Conclusion: MWA can be reserved for those who had high surgical risks because of less invasiveness. Injuries of recurrent laryngeal nerves should be noticed. The health status, perioperative, and intraoperative procedures were more complicated and all parathyroids found by ultrasound should be ablated completely in SHPT patients.

Raman spectroscopy is critically evaluated to establish the limits to which it may be used to detect changes in protein conformation upon extrusion. Rice bran protein (RBP) extruded with different temperatures (100, 120, 140, and 160°C, labeled as ERBP-) was considered. DSC showed that extrusion at 100°C increasedTDof RBP but decreased itsΔH, while, after extrusion treatment at 120°C, RBP completely denatured. A progressive increase in unordered structure and a general decrease inα-helix structure andβ-sheet structure of extruded RBP were observed from Raman study. Meanwhile the content of unordered structure increased up to 140°C and then decreased at 160°C, while the trend ofα-helix andβ-sheet content was opposite, which was contributed to the composite effect of formation of some more protein aggregation and protein denaturation. Extrusion generally induced a significant decrease in Trp band near 760 cm−1but an increase at 160°C. No significant difference was observed in Tyr doublet ratios between controlled RBP samples and extruded RBP below 160°C, whereas Tyr doublet ratios of extruded RBP decreased at 160°C. Intensity of the band assigned toCHnbending decreased progressively and then increased as extrusion temperature increased, indicating changes in microenvironment and polarity.