Increasing evidence indicates that mitochondrial dysfunction plays an important role in modulating the development of septic shock. In the present study, we investigated whether continuous veno-venous haemofiltration (CVVH) with high-volume might improve myocardial mitochondrial dysfunction in a porcine model of peritonitis-induced septic shock. Sixteen male Landrace pigs weighing 31±5 kg were randomly assigned to normal control group (n=4), peritonitis group (n=6) and peritonitis plus CVVH group (n=6). All animals were anaesthetised and mechanically ventilated. After baseline examinations, the peritonitis group and the peritonitis plus CVVH group underwent induction of peritonitis. One hour later, the animals in the peritonitis plus CVVH group received treatment with high-volume CVVH. Twelve hours after treatment, the animals were sacrificed. Animals in the peritonitis group were killed 13 hours after induction of peritonitis. Peritonitis challenge induced septic shock associated with increased blood lactate and high-volume CVVH improved lactate acidosis. Compared with the peritonitis group, cardiac output, stroke volume and mean arterial pressure were better maintained in peritonitis plus CVVH group. More importantly, high-volume CVVH improved myocardial mitochondrial complex I activity (0.22±0.03 vs. 0.15±0.04, P=0.04). These results suggest that high-volume CVVH improves haemodynamics and heart dysfunction in septic shock and the improvement may be attributed to amelioration of myocardial mitochondrial dysfunction.
Being overweight or obese promotes microalbuminuria and increases the risk of chronic kidney disease. This study aimed to develop a mathematical model to estimate the risk of microalbuminuria in overweight Chinese men. Urine albumin/creatinine ratio and metabolic variables were assessed in 1179 subjects, randomly divided into estimation and validation groups that were comparable with respect to all variables. Regression analysis identified body mass index, systolic blood pressure, fasting plasma glucose and blood uric acid as significant variables; these were used to develop a mathematical model for estimating the risk of microalbuminuria. The model generated a receiver-operating characteristic curve indicative of strong predictive accuracy for microalbuminuria (area under the curve, 0.81). A probability cut-off point of 0.50 resulted in global predictive values for microalbuminuria of 86.4% and 84.1% in the validation group (n = 354) and in all subjects, respectively. This model provides a beneficial tool for identifying overweight Chinese men at risk of microalbuminuria; additional studies are required to examine the predictive ability of the model further.
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