Our investigation suggests that Na-Cl is an independent predictor of CKD progression, especially among patients with CKD stage G4 and those with anemia.
Multiple studies have shown that Staphylococcus aureus bacteremia (SAB) has been a major cause of death in hemodialysis patients. We examined whether SAB is a risk for mortality among chronic hemodialysis patients in Japan where the standard vascular access is arteriovenous fistula (AVF). This was a multicenter, retrospective study of maintenance hemodialysis patients with bloodstream infection (BSI) from 2011 to 2013 at tertiary care centers in Japan. The endpoint was hospital mortality. Our cohort contained 32 SAB cases (14 MRSA and 18 MSSA) and 42 non-SAB cases. Hospital mortality was higher among SAB cases than non-SAB cases (46.9% vs. 23.8%, P = 0.038). In patients with BSI, SAB was significantly associated with hospital mortality after adjustment for potential confounders, including type of vascular access (OR 3.26). S. aureus was the leading cause of BSI and hospital mortality among this cohort. Therefore, initial empiric treatment should cover for S. aureus.
Introduction and Aims: Deposition of C1q occurs in 0 to 45% of patients with IgAN. In order to identify whether mesangial C1q deposition in IgAN is a novel marker for the response to tonsillectomy plus steroid pulse therapy (TSP), we studied the association between mesangial C1q deposition in IgAN and the remission rate after TSP therapy for IgAN. Methods: We conducted a retrospective cohort study at a single Japanese center. We analyzed data on 110 patients diagnosed with IgA nephropathy who received TSP between January 2003 and December 2012. Positive C1q findings were defined as diffuse mesangial C1q deposition. The study outcome was the resolution of abnormal urinary findings and was defined as negative proteinuria and negative occult blood 1 year after steroid pulse therapy. Results: In all enrolled cases, 69 patients (62.7%) went into remission. Ten out of 24 (41.7%) C1q-positive patients experienced remission, and 59 out of 86 (68.6%) C1q-negative patients experienced remission. Multiple logistic regression model analysis showed that the absence of C1q deposition increased the odds ratio for remission (odds ratio 4.41; 95% confidence interval 1.33-15.75, p = 0.017). Conclusions: These results suggest that the absence of diffuse C1q deposition in the mesangial area of the glomerulus in patients with IgA nephropathy is a positive predictive sign for a response to TSP and is associated with the resolution of urinary abnormalities 1 year after TSP.
Our study indicated that high levels of AGEs were independently associated with hearing impairment. Modifying levels of AGEs may prevent hearing impairment.
As few epidemiological studies have investigated the effect of lifestyle factors on hypertension in the very elderly population, we conducted a cross‐sectional study to examine the association of estimated salt intake and body weight with blood pressure in the very elderly population. We enrolled 288 participants aged 75 years or older who were residents of Sukagawa City, Fukushima Prefecture, Japan, who attended the health checkup conducted in 2015. Salt intake was estimated from spot urine samples using the Tanaka method. The mean values for age, estimated salt intake, and body weight of all participants were 79.7 years, 9.1 g/d (standard deviation 2.4 g), and 54.3 kg (standard deviation 10.2 kg), respectively. General linear models showed that salt intake and body weight were associated with higher systolic blood pressure (SBP) levels (per standard deviation higher level, adjusted difference 4.13 mm Hg [95% confidence interval 1.69‐6.57] and 5.34 mm Hg [95% confidence interval 2.12‐8.56], respectively). Body weight was associated with higher diastolic blood pressure (DBP) levels (per standard deviation higher level, 2.74 mm Hg [95% confidence interval 0.58‐4.90]). However, salt intake was not associated with higher diastolic blood pressure levels (per standard deviation higher level, 1.15 mm Hg [95% confidence interval −0.49 to 2.79]). Our findings suggest that higher SBP is associated with both salt intake and body weight and that higher DBP is associated with body weight in the very elderly population. This study provides a rationale for lifestyle modifications to prevent hypertension as a population approach.
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