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Human urotensin II (hUII) is a newly discovered substance that can dilate small blood vessels to decrease the blood pressure (BP). Our previous studies showed that some volume-overloaded patients on peritoneal dialysis can maintain normal BP (congestive heart failure excluded), suggesting that these patients have volume resistance capacity. This study is to investigate whether hUII plays an important role in this subgroup of patients on peritoneal dialysis. In this study, 105 patients on continuous ambulatory peritoneal dialysis were enrolled. Volume load was evaluated by the overhydration (OH) value obtained by bioimpedance analysis. OH2.0 kg was defined as normal volume (NV), and OH ≥ 2.0 kg as high volume (HV). Systolic blood pressure (SBP)130 mmHg was defined as normotension (NT) and ≥130 mmHg as hypertension (HT). The patients were thus divided into four subgroups: (1) normotension with normal volume (NT-NV), (2) normotension with high volume (NT-HV), (3) normal volume with hypertension (HT-NV), and (4) high volume with hypertension (HT-HV). hUII was measured using radioimmunoassay method. hUII was significantly higher in normal SBP group than that in high SBP group (p0.05). hUII was higher in the NT-HV group compared with that in the HT-HV group (p0.05). Our study suggests that hUII may be involved in the pathogenesis of the volume resistance HT in peritoneal dialysis patients.

This study aims to quantify and compare the risks of death and end stage renal disease (ESRD) in a prospective cohort of patients with chronic kidney disease (CKD) stages 1-5 under renal management clinic at Peking University Third Hospital and to evaluate the risk factors associated with these two outcomes.This was a prospective cohort study. Finally, 1076 patients at CKD stage 1-5 short of dialysis were recruited from renal management clinic. Patients were monitored for up to Dec, 2011 or until ESRD and death. Glomerular filtration rate was estimated (eGFR) according to the using the CKD Epidemiology Collaboration (CKD-EPI) formula.At the end of follow-up, 111 patients (10.1%) developed ESRD (initiated dialysis or kidney transplantation (ESRD)) and 24 patients (2.2%) had died. There were more ESRD occurrence rate in patients with baseline diabetic nephropathy, lower eGFR, hemoglobin100 g/L and 24 h urinary protein excretion ≥ 3.0 g. By multivariate Cox regression model, having heavy proteinuria and CKD stage were the risk factors of ESRD. For all-cause mortality, the most common cause was cardiovascular disease, followed by infectious disease and cancer. But we failed to conclude any significant variable as risk factors for mortality in multivariate analysis.Our study indicated that baseline diabetic nephropathy, lower hemoglobin level, lower baseline GFR and heavy proteinuria were the risk factors of ESRD. In this CKD cohort, patients were more likely to develop ESRD than mortality, and cardiovascular mortality was the leading cause of death, and then followed by infectious diseases and cancer in this population.

To investigate the difference between hospital-acquired acute renal failure (HA-ARF) and community-acquired acute renal failure (CA-ARF) in hospitalized Chinese.The diagnosis of ARF in Peking University Third Hospital from January 1994 to December 2003 was reconfirmed and subdivided into AC-ARF and HA-ARF. Data of epidemiology, etiology, prognosis, and associated factors were analyzed. Single-variable analysis and multivariate logistic regression analyses were performed to investigate the correlation between clinical features and prognosis respectively. Results among 205 reconfirmed CA-ARF had a predominance of 59.5%, but HA-ARF demonstrated an increase by 1.06 during the last five years (p = 0.003). In all, 70.5% CA-ARF was diagnosed in internal medicine with 45.9% in department of nephrology, whereas 59.1% HA-ARF was diagnosed in surgical department with 51.8% in ICU. Distribution difference among departments was significant (p0.01). Further, 90.2% CA-ARF was associated with a single factor, while 36.1% of HA-ARF had two or more causes (p0.01). Also, 26.5% HA-ARF and 18.9% CA-ARF was drug-associated (p0.05) while 24.1% HA-ARF and 12.3% CA-ARF was infection-associated (p0.01). HA-ARF vs. CA-ARF was 62.7% vs. 23.0% in mortality (p0.01), 0.54 +/- 0.24 vs. 0.27 +/- 0.18 in ATI-ISS index (p0.01) and 19.6 +/- 4.9 vs. 15.7 +/- 5.6 in APACHE II scores (p0.01). MODS and SIRS were common independent predictors with oliguria for HA-ARF and advanced age for CA-ARF, respectively.In hospitalized Chinese during the last ten years, CA-ARF was still predominant with simpler cause and lower mortality, whereas HA-ARF was increasing with more complicated cause and higher mortality.