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Bartter syndrome (BS, OMIM #601678) is a rare inherited salt-losing tubulopathy characterized by hypokalemia metabolic alkalosis with secondary renin-angiotensin-aldosterone system activation. As reported, BS type 1 is generally presented prenatal and neonatal period, and symptoms usually appear before and after birth or in infancy, accompanied by severe salt loss, whilst kidney function remains mostly normal. In this study, we report a case of BS type 1 with childhood onset and proteinuria and renal impairment. The child was born preterm due to hyperamniotic fluid, but there were no apparent symptoms after birth until the age of 3 when the child began to present with polydipsia, polyuria and increased nocturnal uria. At the age of 5, she had elevated serum creatinine level and proteinuria. After admission, she was diagnosed with chronic tubulointerstitial disease and stage 2 chronic kidney disease(CKD). According to the chloride clearance test, the abnormal function of medullary thick ascending limb Henle′s loop, was confirmed and BS type 1 was diagnosed by gene sequencing. After active management of complications, kidney function of the child improved. In the long-term follow-up, the urinary protein amount of the child still increased, eGFR slowly decreased, and the child was currently in the CKD2 stage. Children with prenatal BS may not present typical clinical manifestations immediately after birth until the onset of relevant clinical symptoms in childhood. BS type 1 patients may have renal impairment, which needs to be identified in time. Clinical differentiation diagnosis between BS and Gitelman syndrome can be made by chloride clearance tests. Early diagnosis and treatment are critical to improve prognosis.

BackgroundPerfluoroalkyl substances (PFASs) are classified as persistent organic pollutants and have been widely detected in human. Studies investigating the associations between PFASs exposure and estimated glomerular filtration rate (eGFR) yielded inconsistent results, and little is known about the effects of PFASs on eGFR in population without kidney disease. ObjectiveTo explore the associations of exposure to PFASs with eGFR and renal dysfunction in population without kidney disease. MethodsA total of 609 participants with an eGFR > 60 mL·min−1·1.73 m−2 and without renal impairment matched for sex and age (1∶1) were recruited from endocrinology department and medical examination center of two hospitals in Tianjin, China, from April 2021 to March 2022. Each subject was interviewed using a structured questionnaire to collect information about sex, age, height, weight, disease history, smoking, alcohol intake, etc. Clinical parameters were obtained from medical record, such as fasting blood glucose (FBG), creatinine (Cre), total cholesterol (TC), and triglyceride (TG). Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured by professionals using standard methods. The serum concentrations of PFASs were determined by liquid chromatography/mass spectrometry. Multivariable linear and logistic regression models were performed to evaluate the associations of PFASs exposure with eGFR and renal dysfunction, respectively. Subgroup analyses stratified by age and sex were also performed to assess the modified effects of covariates on the associations of PFASs exposure with eGFR. ResultsThere were 283 males, accounting for 46.5% of the total population. The mean age of the participants was (56.86±12.47) years, and the average body mass index (BMI) was (25.59±3.84) kg·m−2. Perfluoro-n-octanoic acid (PFOA), perfluorohexane sulfonic acid (PFHxS), perfluorooctane sulfonic acid (PFOS), perfluoro-n-nonanoic acid (PFNA), perfluoro-n-decanoic acid (PFDA), perfluoro-n-undecanoic acid (PFUnDA), sodium 1H, 1H, 2H, 2H-perfluoro-1-octanesulfonate (6:2 FTS), and perfluoropentane sulfonic acid (PFPeS) were positive in more than 75% of serum samples, and the corresponding median concentrations were 9.50, 1.67, 17.22, 1.86, 1.41, 0.78, 0.42, and 0.43 μg·L−1, respectively. After full adjustments of sex, age, BMI, hypertension, diabetes, TC, TG, smoking, and drinking, the linear regression models showed that log2-transformed PFHxS concentration was negatively associated with eGFR (b=−1.160, 95%CI: −2.280, −0.410). Compared with the lowest exposure tertile, the estimated change of eGFR in the highest tertile for PFHxS was significantly decreased (b=−2.471, 95%CI: −4.574, −0.368). Furthermore, compared with males, the negative association of PFHxS with eGFR was strengthened among females (female: b=−1.281, 95%CI: −2.388, −0.174; male: b=−0.781, 95%CI: −2.823, 1.261, Pinteraction=0.043). ConclusionA significant negative association between serum PFHxS and eGFR is observed in the sampled population without kidney disease, and females are more susceptible to PFASs exposure than the males.

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目的 观察急性缺血性卒中（acute ischemic stroke，AIS）患者的临床特点及入院时的尿白蛋白肌酐 比（albumin-to-creatinine ratio，ACR）和估算的肾小球滤过率（evaluated glomerular filtration rate，eGFR） 对患者3个月预后的影响。 方法 本研究为前瞻性研究，连续性纳入北京医院2017年3月27日-11月16日住院治疗的AIS患者作为 研究对象。收集患者一般资料、血管危险因素、ACR、eGFR和其他相关实验室检查结果，评估患者入 院时NIHSS评分，随访3个月时的mRS评分。按照患者是否有肾功能障碍分为肾功能障碍组和肾功能正 常组，比较两组的临床特点；按照患者3个月的mRS评分，分为预后良好组（mRS评分0～2分）和预后 不良组（mRS评分3～6分），比较两组的上述临床特点，并分析3个月预后不良的独立危险因素。 结果 共纳入115例患者，AIS患者的肾功能障碍患病率为44.3%（51/115）。与肾功能正常组相比，肾 功能障碍组平均年龄较高（P =0.009）；糖尿病（P =0.001）、冠状动脉粥样硬化性心脏病（P =0.026）、 心房颤动（P =0.003）的发病率较高；入院时NIHSS评分（P =0.013）、入院后的血糖（P =0.001）、血 浆纤维蛋白原（P =0.008）及D -二聚体（P =0.001）水平较高。与预后良好组相比，预后不良组的 平均年龄较高（P =0.007）；既往卒中史（P =0.002）、心房颤动患病率（P =0.040）、血浆纤维蛋白 原（P =0.004）及D-二聚体水平（P

Objective : To investigate methods and modes of standard pharmaceutical care for the patients with type 2 diabetes complicated with hepatic and renal dysfunctions. Methods : Through active involvement in the treatment process of 1 case of type 2 diabetes complicated with hepatic and renal dysfunctions,clinical pharmacists offered good advice on the administration of anti-diabetic drugs,anti-bacterial and anti-hepatitis B virus drugs,and above all provided individualized pharmaceutical care. Results : Through integrated pharmaceutical care,clinical pharmacists duly found out and solved related problems con - cerning drug treatment,thus promoting rational medication clinically. Conclusion : Integration of clinical pharmacists into the medical care team and active pharmaceutical care could contribute to the promotion of rational medication clinically. [ABSTRACT FROM AUTHOR]

Copyright of Chinese Journal of Contemporary Pediatrics is the property of Xiangya Medical Periodical Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

PURPOSE: To explore whether the renal function parameters were associated with urinary nickel (Ni) and chromium (Cr) in patients undergoing dental restoration of nickel-chromium (Ni-Cr). METHODS: Seven hundred and ninety-five Ni-Cr alloy consumers were investigated by the questionnaire and the biological examination of renal function. The correlations between renal function parameters and urinary Ni (or Cr) were determined by Student's t test, one-way ANOVA, and Logistic regression analysis using SPSS12.0 software package. RESULTS: After dividing all subjects into three groups with equal sample size by urinary Ni (<38,38-90, ≥90µg/mol crea.), the middle group (38-90µg/mol crea.) had a significantly higher serum creatinine and estimated glomerular filtration rate (eGFR) compared to the other two groups, and there was no significant difference in other serum or urinary parameters of renal function. After dividing all subjects into three groups by urinary Cr (<38,38-88, and ≥901µg/mol crea.), no change was found in serum parameters, but urinary N-acetyl-β-D-glucosaminidase (UNAG) and retinol-binding protein (URBP) showed negative association with urinary Cr. The prevalence of either abnormal eGFR and abnormal urine parameters of renal function did not show significant change between different dose of urinary Ni or Cr. CONCLUSIONS: No association of renal changes with urinary excretion of Ni and Cr was found in patients undergoing dental restoration of Ni-Cr alloy. [ABSTRACT FROM AUTHOR]

Objective: To analyze the relationship of renal dysfunction and linezolid-induced thrombocytopenia. Methods: A retrospective analysis was performed on the clinical data of 92 cases of linezolid-treated patients with Gram-positive bacterial infections. 33 patients with renal dysfunction were designed into the renal dysfunction group, and 59 other patients were assigned as normal group. Detected the platelet before and after treatment, and observe the time for platelet count recovering to normal after treatment and the occurrence of adverse reactions. Results: After treatment, platelet count of renal dysfunction group was significantly lower than before treatment and normal group (P<0.01). There was no statistical difference in platelet count between before and after treatment in the normal group (P>0.05). In renal dysfunction group, the incidence of thrombocytopenia was higher than in the normal group(P<0.05). After treatment, the normal group took shorter time to have the platelet recovered than the renal dysfunction group(P<0.01). Hemoglobin decreased greater in renal dysfunction group than in the normal group (P<0.05). The other incidences of adverse reactions showed no significant differences (P>0.05). Conclusion: The kidney function of infected patients can affect their linezolid-induced thrombocytopenia. Patients with renal dysfunction should have regular monitor on platelet counts when taking linezolid. [ABSTRACT FROM AUTHOR]

Objective: To explore the relationship between lipoprotein(a) [Lp(a)] and chronic cardio-renal syndrome (CRS) in elderly patients. Methods: Chronic heart failure (CHF) patients age ≥ 65 years old, who hospitalized in the department of Cardiology of Hebei General Hospital from December 2017 to October 2019, were included in this study. According to the estimate glomerular filtration rate (eGFR) level, patients were divided into CRS group (eGFR<60 ml·min -1 ·1.73 m -2 ) and CHF group (eGFR ≥60 ml·min -1 ·1.73 m -2 ). The blood index and basic disease information were collected and compared. Left ventricular ejection fraction (LVEF) were measured by echocardiography. The correlation between clinical indicators and cardio-renal function (LVEF and eGFR) was assessed. The multivariate logistic regression analysis was used to evaluate the related risk factors of CRS in elderly patients; subgroup logistic regression analysis was performed according to the basic disease of patients to assess the relationship between Lp(a) and CRS. Results: A total of 172 elderly patients (85 males (49.4%), aged 79 (71, 84) years) were finally enrolled. Among them, 88 cases (51.2%) were in CRS group and 84 cases (48.8%) were in CHF group. Age (80 (74, 84) years old vs. 74 (70, 82) years old) and LP (a) levels (222.0 (112.0, 445.3) mg/L vs. 155.0 (97.0, 348.7) mg/L) were significantly higher in the CRS group than in the CHF group ( P <0.05). Lp(a) levels were negatively correlated with LVEF ( r =-0.155, P =0.043) and eGFR ( r =-0.220, P =0.004) in total cohort. In the subgroup analysis of patients with 2 high-incidence basic diseases (coronary heart disease and hypertension), Lp(a) was negatively correlated with LVEF ( r =-0.250, P =0.007) in the coronary heart disease group, and negatively correlated with eGFR ( r =-0.233, P =0.013) in the hypertension group. Multivariate logistic regression analysis showed that age ( OR = 1.069, 95%CI : 1.017-1.124, P = 0.009) and Lp(a) ( OR = 3.719, 95%CI : 1.339-10.326, P = 0.012) were independent correlates of CRS. The results of logistic regression analysis showed that Lp(a) was an independent correlative factor of CRS in the subgroups of coronary heart disease ( OR =3.207, 95%CI : 1.129-9.108, P =0.029) and hypertension ( OR =3.054, 95%CI : 1.086-8.587, P =0.034). Conclusion: Serum Lp(a) level is independently related with CRS in elderly patients.

Objective: To compared the differences in pharmacokinetics of phosphate retagliptin tablets in patients with varying degrees of renal dysfunction., Methods: A total of 32 patients were categorized into five groups according to their renal function: normal,mild dysfunction, moderate dysfunction,severe dysfunction,and end stage renal dysfunction (ESRD). All of the patients took a single dose of 50 mg phosphate retagliptin tablet. Their plasma and urinary concentrations of phosphate retagliptin (SP2086) and phosphate retagliptin acid (SP2086 acid) were determined using LC-MS/MS methods. The plasma pharmacokinetic parameters were calculated using WinNolin 6.1 software., Results: Peak concentrations ( C ) of SP2086 reached at (1.07±0.35) h in the patients with mild renal dysfunction,(1.50±0.89) h in the patients with moderate renal dysfunction,(1.67±2.16) h in the patients with severe renal dysfunction,(2.42±2.15) h in the patients with ESRD,and (1.75±1.21) h in the normal participants,with a clearance ( max ) of SP2086 reached at (1.07±0.35) h in the patients with mild renal dysfunction,(1.50±0.89) h in the patients with moderate renal dysfunction,(1.67±2.16) h in the patients with severe renal dysfunction,(2.42±2.15) h in the patients with ESRD,and (1.75±1.21) h in the normal participants,with a clearance ( CL/F ) of (23.50±6.01) ,(12.90±4.34) ,(6.70±1.55) ,(3.10±0.48) ,and (30.50±10.70) L/h,respectively. With the increasing damages in renal function presented an incease in C max ,time to reach C max , of SP2086 and SP2086 acid. The 0-96 hurine cumulative excretion percentage (Ae%) of SP2086 ranged from 0.441% to 4.530%. The Ae% of SP2086 acid reached (71.7±14.3) % in the patients with mild renal dysfunction, (59.5±22.7) % in the patients with moderate renal dysfunction, (63.3±13.9) % in the patients with severe renal dysfunction, (34.1±20.0) % in the patient with ESRD,and (74.2±14.6) % in the normal participants, with a renal clearance (CL/R) of (220.0±51.2),(105.0±64.5),(54.5±7.6),(13.5±7.8),and (289.0±73.7) mL/min,respectively. Compared with the participants with normal renal function,the T s of SP2086 and SP2086 acid were 1.44 times and 2.32 times higher in the patients with moderate renal dysfunction,2.20 times and 4.39 times higher in the patients with severe renal dysfunction, and 2.83 times and 9.28 times higher in the patients with ESRD.max ),and area under curve ( AUC ), a decrease in CL/F , of SP2086 and SP2086 acid. The 0-96 hurine cumulative excretion percentage (Ae%) of SP2086 ranged from 0.441% to 4.530%. The Ae% of SP2086 acid reached (71.7±14.3) % in the patients with mild renal dysfunction, (59.5±22.7) % in the patients with moderate renal dysfunction, (63.3±13.9) % in the patients with severe renal dysfunction, (34.1±20.0) % in the patient with ESRD,and (74.2±14.6) % in the normal participants, with a renal clearance (CL/R) of (220.0±51.2),(105.0±64.5),(54.5±7.6),(13.5±7.8),and (289.0±73.7) mL/min,respectively. Compared with the participants with normal renal function,the AUC s of SP2086 and SP2086 acid were 1.44 times and 2.32 times higher in the patients with moderate renal dysfunction,2.20 times and 4.39 times higher in the patients with severe renal dysfunction, and 2.83 times and 9.28 times higher in the patients with ESRD., Conclusion: The dosage of phosphate retagliptin tablet is recommended at 100 mg/d for patients with normal renal function and those with mild renal dysfunction,at 50 mg/d for patients with moderate renal dysfunction,and at 25 mg/d for patients with severe renal dysfunction. No phosphate retagliptin tablet is recommended for patients with ESRD., (CopyrightCopyright© by Editorial Board of Journal of Sichuan University (Medical Science Edition).)