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Methods: A total of 2426 study subjects from rural China aged 35 years and above (934 men and 1492 women) were enrolled in a cross-sectional survey. The eGFR calculation was based on the Modification of Diet in Renal Disease (MDRD) equation. The strength of the association between cardiovascular metabolic risk factors and eGFR was analyzed using a linear regression model. Results: Cardiovascular metabolic risk factors, including age, body weight, waist circumference, fasting plasma glucose (FPG), creatinine (Cr), high-density lipoprotein-cholesterol (HDL-C), total cholesterol (TC), triglyceride (TG), systolic pressure, and diastolic pressure, were associated with eGFR. Additionally, the eGFR level gradually decreased and showed a linear trend with the increase in metabolic syndrome risk factors. Conclusion: Metabolic risk factors are correlated with a reduction in renal function and CKD. [ABSTRACT FROM AUTHOR]

Background: Peritoneal dialysis is an important type of renal replacement therapy for uremic patients. In peritoneal dialysis, fluids fill in and flow out of the abdominal cavity three to five times per day. Usually, the fluid is packed in a polyvinyl chloride (PVC) bag. Safety concerns have arisen over di-(2-ethylhexyl) phthalate, which is essential in the formation of PVC materials. In 2011, the National Development and Reform Commission of China released a catalog of industrial structural adjustments, mandating the elimination of PVC bags for intravenous infusion and food containers. Although bags for peritoneal dialysis fluid were not included in the elimination list, several manufacturers began to develop new materials for fluid bags. HUAREN peritoneal dialysis fluid consists of the same electrolytes and buffer agent as in Baxter fluid, but is packed in bags that do not contain PVC. This multicenter randomized controlled trial was designed to compare peritoneal dialysis fluid packed in non-PVC-containing and PVC-containing bags. Further, the study sought to determine the proper dose of peritoneal dialysis fluid and the actual survival rates of Chinese patients undergoing peritoneal dialysis.Methods/design: The study participants are adults undergoing continuous ambulatory peritoneal dialysis for 30 days to 6 months. All eligible patients are randomized (1:1) to peritoneal dialysis with Baxter and HUAREN dialysis fluids (initial dose, 6 l/day), with dosages adjusted according to a unified protocol. The primary outcomes are the 1-, 2-, 3-, 4-, and 5-year overall survival rates. Secondary outcome measures include technique survival rates, reductions in estimated glomerular filtration rate, nutritional status, quality of life, cardiovascular events, medical costs and drop-out rates. Safety outcome measures include adverse events, changes in vital signs and laboratory parameters, peritonitis, allergies, and quality of products.Discussion: This study is the first to evaluate the long-term safety and effectiveness of a non-PVC packed peritoneal dialysis fluid. The effects of plasticizer on patient long-term survival will be determined. The characteristics of Chinese patients undergoing peritoneal dialysis will be determined, including proper dose, technique survival rates, patient survival rates, and medical costs.Trial Registration: Clinicaltrials.gov NCT01779557 . [ABSTRACT FROM AUTHOR]

Background: A previous meta-analysis indicated that L-carnitine significantly increased hemoglobin and decreased the required erythropoietin dose in maintenance hemodialysis patients. Objective: An updated systematic review and meta-analysis of randomized controlled trials (RCTs) was performed to reevaluate effects of L-carnitine. Design: The Cochrane Library, PubMed, and EMBASE databases (31 December 2012) were searched to identify RCTs that investigated effects of L-carnitine in adults with end-stage kidney disease that required maintenance hemodialysis. Results: Forty-nine RCTs (1734 participants) were included. L-Carnitine significantly decreased serum low-density lipoprotein (LDL) (mean difference: -5.82 mg/dL; 95% CI: -11.61, -0.04 mg/dL) and C-reactive protein (CRP) (-3.65 mg/L; -6.19, -1.12 mg/L). There were no significant differences in triglycerides (-0.89 mg/dL; -29.32, 27.53 mg/dL), cholesterol (0.14 mg/dL; -6.15, 6.42 mg/dL), high-density lipoprotein (1.13 mg/dL; -2.44, 4.70 mg/dL), hemoglobin (0.68 g/dL; 0.14, 1.50 g/dL), hematocrit (2.04%; -1.39, 5.48%), albumin (1.65 g/L; -0.22, 3.51 g/L), or the required erythropoietin dose (- 0.76 KU/wk; - 1.75, 0.23 KU/wk). No adverse effects were reported. Conclusions: This meta-analysis failed to confirm the previous findings regarding the effects of L-carnitine on hemoglobin and the erythropoietin dose but showed that L-carnitine significantly decreased serum LDL and CRP. The extent of the decrease in LDL was not clinically relevant, whereas the significant decrease in CRP was both statistically and clinically relevant. However, the relevance of decrease in CRP with hard endpoints such as all-cause mortality and cardiovascular complications still remains to be clarified. [ABSTRACT FROM AUTHOR]

Background: Family members of patients with end stage renal disease were reported to have an increased prevalence of chronic kidney disease (CKD). However, studies differentiated genetic and non-genetic family members are limited. We sought to investigate the prevalence of CKD among fist-degree relatives and spouses of dialysis patients in China. Methods: Seventeen dialysis facilities from 4 cities of China including 1062 first-degree relatives and 450 spouses of dialysis patients were enrolled. Sex- and age- matched controls were randomly selected from a representative sample of general population in Beijing. CKD was defined as decreased estimated glomerular (eGFR < 60 mL/min/1.73 m2) or albuminuria. Results: The prevalence of eGFR less than 60 mL/min/1.73 m2, albuminuria and the overall prevalence of CKD in dialysis spouses were compared with their counterpart controls, which was 3.8% vs. 7.8% (P < 0.01), 16.8% vs. 14.6% (P = 0.29) and 18.4% vs. 19.8% (P = 0.61), respectively. The prevalence of eGFR less than 60 mL/min/1.73 m2, albuminuria and the overall prevalence of CKD in dialysis relatives were also compared with their counterpart controls, which was 1.5% vs. 2.4% (P = 0.12), 14.4% vs. 8.4% (P < 0.01) and 14.6% vs. 10.5% (P < 0.01), respectively. Multivariable Logistic regression analysis indicated that being spouses of dialysis patients is negatively associated with presence of low eGFR, and being relatives of dialysis patients is positively associated with presence of albuminuria. Conclusions: The association between being family members of dialysis patients and presence of CKD is different between first-degree relatives and spouses. The underlying mechanisms deserve further investigation. [ABSTRACT FROM AUTHOR]

Aim: In order to determine the relationship between glomerular filtration rate (GFR) and age, the associated factors, and the accurate method of GFR in healthy adults, we conducted a cross-sectional study in community-dwelling adults in Beijing. Methods: Renal function of 201 clinically healthy subjects was determined using technetium-99 m-labelled diethylene triamine pentacetic acid (99mTc-DTPA). Estimated GFR was calculated with the Cockcroft–Gault (CG) equation, abbreviated Modification of Diet in Renal Disease (MDRD) equation, and plasma clearance of creatinine (Ccr). Serum cystatin C, biomarkers of inflammatory and endothelial cells were analyzed as well. Protein intake, carotid artery intima-media thickness and plaque formation were assayed as well. Results: Glomerular filtration rate was negatively associated with age and the correlation coefficient for 99mTc-GFR, CG-GFR, MDRD-GFR, Ccr were −0.643, −0.736, −0.55 and −0.619, respectively ( P < 0.001), while the correlation coefficient between cystatin C and age was 0.681 ( P < 0.001). Estimated GFR were associated with measured GFR, and the correlation coefficient for Ccr, CG-GFR and MDRD-GFR were 0.813, 0.582 and 0.418, respectively ( P < 0.001). The area under the receiver–operator curve of Ccr was larger, CG was smaller while MDRD was the smallest, and the difference was significant ( P < 0.001). So a predicted equation was presented by cystatin C and C-reactive protein for the elderly. Conclusion: In the clinically healthy adults, GFR declined with age. MDRD and CG equation are not suitable to estimate GFR in healthy adults. The predicted equation established by cystatin C and C-reactive protein may be more accurate. [ABSTRACT FROM AUTHOR]

An interview is presented with the Chinese medical doctor Chen Xiangmei and physicist Zeng Xuan, discussing the ways in which women's participation in science is changing in 21st-century China. Questions address topics such as gender stereotypes in China regarding educational tracks for women, challenges facing women scholars' work-life balance, and description of how employment opportunities have begun to equalize in the country.

In experimental research, progesterone has been found to be beneficial to the central nervous and cardiovascular systems; however, its potential role in preventing atherosclerosis in elderly men remains unclear. In this prospective study, we analyzed data in 385 older men and women from 6 communities in Beijing, China, in order to discover whether progesterone is associated with carotid intima--media thickness and plaque occurrence. Intima--media thickness and atherosclerotic plaques were determined by use of ultrasonography. Sex-hormone levels were measured by immunoassay. The data were analyzed via analysis of covariance and logistic regression analysis; P <0.05 was considered statistically significant. We found a negative association between mean intima--media thickness and progesterone concentration in men, before and after adjustments for such traditional risk factors of atherosclerosis as age, triglyceride levels, total and low-density lipoprotein cholesterol levels, high-sensitivity C-reactive protein, systolic blood pressure, waist-to-hip ratio, and body mass index (analysis of covariance, P=0.007 and P=0.015, respectively). However, no such association was found in women (P=0.304 and P=0.247, respectively). In the logistic regression model that was adjusted for the confounding factors of atherosclerosis, men with progesterone levels in the lowest quartile ( <1.87 nmol/L) had more risk of higher intima--media thickness (odds ratio, 2.15; P=0.042). Although further experimental and prospective studies are warranted in order to determine the mechanism of progesterone's function in atherosclerosis prevention, we conclude that progesterone concentrations are negatively associated with carotid artery atherosclerosis in northern Chinese men 60 years of age or older. [ABSTRACT FROM AUTHOR]