The American journal of the medical sciences
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Cardiovascular disease is the leading cause of death in chronic kidney disease. Extracellular matrix remodeling is implicated in atherosclerosis development. This study investigated the effects and possible mechanism of type I collagen expression on radial artery elasticity in patients with end-stage renal disease (ESRD). ⋯ Type I collagen expression is an essential factor for radial artery elasticity dysfunction in patients with ESRD. Uremic toxins apparently induced a phenotypic transition of the rat aortic VSMCs, leading to increased type I collagen secretion and subsequent extracellular matrix remodeling.
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Observational studies have linked vitamin D status and infectious disease. This association is supported by the presence of the vitamin D receptor and CYP27B1 in immune cells. This review aims to consolidate data from clinical trials that used vitamin D for the treatment or prevention of infectious disease. ⋯ Although some prospective studies show positive results regarding vitamin D on infectious disease, several robust studies are negative. Factors such as high variability between studies, the difference in individual responsiveness to vitamin D and study designs that do not primarily investigate infectious outcomes may mask the effects of vitamin D on infections.
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Randomized Controlled Trial Comparative Study
Early initiation of continuous renal replacement therapy improves clinical outcomes in patients with acute respiratory distress syndrome.
The acute respiratory distress syndrome (ARDS) is a common devastating syndrome in intensive care unit in critically ill patients. Continuous renal replacement therapy (CRRT) has been shown beneficial effects on oxygenation and survival in patients with ARDS. However, it is still controversial about the timing of initiation of CRRT. ⋯ Our findings showed that early initiation of CRRT is associated with favorable clinical outcomes in ARDS patients, which might be due to the reduced serum and BALF TGF-β1 levels through CRRT. However, large multi-center studies are needed to make further recommendations as to the optimal use of CRRT in ARDS patient populations.
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One previous study has shown that patients with end-stage renal disease (ESRD) with higher blood lead levels (BLLs) have shorter survival, in a cohort without occupational exposure where follow-up began an average of 5 years after dialysis (a survivor population). ⋯ The authors found no association between BLL and survival after ESRD diagnosis. The authors' finding differs from earlier findings, possibly because the cohort had higher blood leads (25 versus 10 μg/dL), follow-up began at the time of ESRD diagnosis, and BLLs were measured before ESRD incidence.