RESUMEN
Background: Microangiopathy (MA) lesions are not rare in immunoglobulin A nephropathy (IgAN) and have been suggested to have a potential role in increasing risk in renal function decline. However, this suggestion has not been universally accepted. We aimed to investigate its role in our cohort and in multiple studies through a systematic meta-analysis. Methods: This cohort study included 450 IgAN patients, confirmed by renal biopsy, at Tongji Hospital, China, from January 2012 to December 2016. Clinical data were collected and analysed. We systematically searched PubMed and Web of Science for studies investigating the association between MA lesions and IgAN. Results: In our cohort, IgAN patients with MA were significantly older and had higher blood pressure, more proteinuria, worse kidney function and increased uric acid levels compared with patients without MA. When comparing pathological features with the non-MA group, the MA group exhibited more global glomerulosclerosis and interstitial fibrosis/tubular atrophy. MA lesions were independently associated with a composite kidney outcome in IgAN patients {adjusted hazard ratio 2.115 [95% confidence interval (CI) 1.035-4.320], P = .040}. Furthermore, this relationship was validated in a meta-analysis involving 2098 individuals from five independent cohorts. The combined data showed a 187% adjusted risk of poor renal outcome in IgAN patients with MA compared with patients without MA [adjusted risk ratio 2.87 (95% CI 2.05-4.02; I2 = 53%). Conclusion: MA lesions could serve as a valuable predictor for disease progression in patients with IgAN, extending beyond the widely recognized Oxford MEST-C score.
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Background: Current evidence on the relationship between carotenoids and chronic kidney disease (CKD) patients are limited and controversial. Methods: Data were obtained from the Nutrition and Health Examination Survey (NHANES) database and the NHANES Linked Mortality File, both from a nationally representative sample. Dietary intake was assessed through 24-h dietary recall, and information was available both on dietary and serum α-carotene, ß-carotene, ß-cryptoxanthin, lycopene, and lutein/zeaxanthin (combined) through the NHANES cycles used. We used multivariable Cox proportional hazards regression models to estimate the risk for all-cause mortality associated with carotene intakes and serum levels, adjusting for potential confounding factors. Results: Of the 6,095 CKD participants, 1,924 subjects died (mean follow-up time, 8.1 years). After eliminating all the confounding factors, we found that high levels of total carotene (HR = 0.85, 95% CI, 0.75-0.97, P = 0.011) intakes at baseline were significantly associated with a lower risk of death. And the serum concentrations of carotenoid were also showing that a-carotene (HR = 0.77, 95%CI, 0.65-0.92, P = 0.002), beta-cryptoxanthin (HR = 0.83, 95%CI, 0.70-0.98, P = 0.019), lycopene (HR = 0.77, 95% CI, 0.65-0.91, P = 0.002), and lutein + zeaxanthin (HR = 0.82, 95% CI, 0.70-0.96, P = 0.002) was significantly associated with decreased all-cause mortality of CKD patients. The associations remained similar in the sensitivity analyses. Conclusion: Findings suggest that high-level carotene dietary intake and the serum concentration were associated with a lower risk of mortality in the CKD population.
RESUMEN
BACKGROUND: Nuts have been found to have beneficial effects on some diseases, including cardiovascular disease and cancer, in several studies. However, there are few studies to show the effects of nuts on chronic kidney disease (CKD). Thus, we conducted this study to examine the association between the consumption frequency of nuts and the prevalence and mortality of CKD among adults in the USA. METHODS: We analyzed data from 6,072 individuals (aged ≥20 years) who participated in the NHANES 2003-2006 following the scheduled procedure. Data on death were provided by the CDC. A logistic regression model was used to evaluate the association between nut consumption frequency and the prevalence of CKD. A Cox proportional hazards regression model was performed to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between nut consumption frequency and all-cause mortality and cardiovascular mortality in the CKD and non-CKD populations. RESULTS: Consuming nuts 1-6 times per week was associated with a lower prevalence of CKD (model 3: OR: 0.67; 95% CI: 0.49-0.91). In addition, higher nut consumption was significantly associated with lower all-cause and cardiovascular mortality in the non-CKD population. For the CKD population, a consistently significant inverse association could be seen between consuming nuts 1-6 per week and all-cause mortality (model 3: HR: 0.63; 95% CI: 0.47-0.86). No groups showed a significant difference in cardiovascular mortality compared with the reference in the full model. CONCLUSION: We recommend the CKD population to have an adequate intake of nuts 1-6 times per week, while the consumption frequency can be more flexible for the non-CKD. Further prospective studies should be conducted to confirm this conclusion.