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Abstract Background Responsiveness to erythropoiesis-stimulating agents (ESAs) is thought to be related to prognosis in patients on hemodialysis. A multi-center, prospective cohort study was conducted to investigate the effects of hyporesponsiveness to long-acting ESAs on cardiovascular events and mortality in Japanese patients on chronic hemodialysis. Methods A total of 127 chronic hemodialysis patients treated with long-acting ESAs were followed-up prospectively. Responsiveness to ESA was evaluated using an erythropoietin resistance index (ERI) calculated by dividing the weekly body-weight-adjusted ESA dose by the hemoglobin concentration. The primary endpoint of this survey was defined as a combination of cardiovascular events and all-cause deaths. The association between hyporesponsiveness to ESAs evaluated by the highest quartile of the ERI and the primary endpoint was investigated. Results During the follow-up period (median 4.6 years), 32 patients reached the primary end point. Kaplan-Meier curve analysis showed that patients with ESA hyporesponsiveness belonging to the highest quartile of the ERI reached the primary end point more frequently than those without (P = 0.031). Cox regression analysis showed that an ERI in the highest quartile was an independent predictor of the primary end point, even after adjustment using a propensity score (hazard ratio 2.76, 95% confidence interval 1.19–6.40). Conclusions ESA hyporesponsiveness in hemodialysis patients treated with long-acting ESAs is related to cardiovascular events and death.

Abstract As previous studies have reported finding an association between hyperuricemia and the development of cardiovascular and chronic kidney disease, hyperuricemia is thought to be an independent risk factor for hypertension and diabetic mellitus. However, we have not been able to determine whether the use of xanthine oxidase inhibitors can reduce cardiovascular disease. The present study used the longitudinal data of the Fukushima Cohort Study to investigate the relationship between the use of xanthine oxidase inhibitors and cardiovascular events in patients with cardiovascular risks. During the 3-year period between 2012 and 2014, a total of 2724 subjects were enrolled in the study and followed. A total of 2501 subjects had hypertension, diabetic mellitus, dyslipidemia, or chronic kidney disease, and were identified as having cardiovascular risks. The effects of xanthine oxidase inhibitor use on the development of cardiovascular events was evaluated in these patients using a time to event analysis. During the observational periods (median 2.7 years), the incidence of cardiovascular events was 20.7 in subjects with xanthine oxidase inhibitor and 11.2 (/1000 person-years, respectively) in those without. Although a univariate Cox regression analysis showed that the risk of cardiovascular events was significantly higher in subjects administered xanthine oxidase inhibitors (HR = 1.87, 95% CI 1.19–2.94, p = 0.007), the risk was significantly lower in subjects administered a xanthine oxidase inhibitor after adjustment for covariates (HR = 0.48, 95% CI 0.26–0.91; p = 0.024) compared to those without. Xanthine oxidase inhibitor use was associated with reduced risk of cardiovascular disease in patients with cardiovascular risk factors.

Abstract Background Kidney function after acute myocardial infarction (AMI) correlates with patient prognosis. Several studies reported the role that indoxyl sulfate (IS), a uremic toxin, plays in the progression of chronic kidney disease and cardiovascular diseases. This study aims at investigating the serum IS level changes after AMI and their correlation with kidney injury. Methods In this observational study, twenty consecutive patients with AMI who received percutaneous coronary intervention within 2 h after admission were enrolled. We measured serum IS levels on admission (day 1) and day 2–3 and evaluated their clinical characteristics. Further, we measured serum neutrophil gelatinase-associated lipocalin (NGAL) levels at admission as a marker of kidney injury. Results Although estimated glomerular filtration rate (eGFR) decreased at day 2–3 compared to that at day 1, serum IS levels at day 1 were rather higher than those at day 2–3. Further analysis only among patients with preserved kidney function revealed that serum IS levels at day 1 were significantly higher than those at day 2–3, despite a higher eGFR. Additionally, serum NGAL levels at admission were higher in these patients than in healthy subjects. Further, serum NGAL levels were significantly higher in patients with higher serum IS levels compared to those with lower IS levels. Conclusion This study suggests that pathophysiological conditions in patients with AMI may elevate serum IS levels independent of kidney dysfunction and that IS may be one of the contributory factors related to kidney injury in AMI.

We experimentally investigated the practical electromagnetic effects in surface-enhanced Raman scattering (SERS), using the precisely fabricated array of gold nanosquare dimers. The array of gold nanosquare dimers was fabricated by electron-beam exposure and the lift-off process. The Raman spectra of 1,4-benzenedithiol and 4-aminothiophenol were obtained at room temperature by exciting the longitudinal mode of the plasmon of gold nanodimers. The gap-size dependency of the enhancement factor of the complete symmetric mode clearly exhibited exponential decay with an increase in the gap size. The exponential decay behavior of each mode and molecule did not show a critical difference in the decay constant. The exponential decay of the enhancement factor was explained by the discrete dipole approximation. The pre-exponential factor obtained by the ν7a modes of ATP was much larger than that of BDT; however, the gap-size dependency of the enhancement factor of the ν8a mode did not exhibit a significant difference in the pre-exponential factors between BDT and ATP that reflects the difference in the chemical effects in SERS between vibration modes. By estimating the gap size dependency of the SERS intensity, we were able to compare the intrinsic chemical effects on the SERS enhancement between two molecules.

Background/Aims: Hypertension (HT) is a common complication in patients with chronic kidney disease (CKD). However, the relationship between circadian rhythm disorder of blood pressure (BP) and intra-renal damage remains unclear. Methods: Ninety patients with chronic glomerular disease (CGD) were included in the present study. On the basis of the clinic BP (CBP) and 24 h-ambulatory BP (ABP) measurements, the patients were divided into the following groups; normotension (NT), white coat HT (WHT), masked HT (MHT), and sustained HT (SHT). For renal histopathological assessment, we evaluated each biopsy specimen for sclerotic glomeruli (SG), interstitial fibrosis (IF), intimal thickening of intra-lobular arteries (ILA), and arteriolar hyalinosis (AH). Results: The prevalence of NT, WHT, MHT and SHT was 60.0%, 3.3%, 23.3%, and 13.4%, respectively. Compared with circadian BP pattern, all-day HT was most prevalent in the SHT group, whereas nighttime HT was most prevalent in the MHT group. The results of histological analysis showed that the SHT group had more severe SG and IF and the MHT group had more severe IF compared to the NT group. As for renal arteriolosclerosis, the MHT and SHT groups had more severe AH compared with the NT group, whereas ILA was comparable among all four groups. Furthermore, multivariate analysis revealed that ILA was significantly correlated only with age, whereas AH was significantly correlated with age and HT based on ABP, but not HT based on CBP. Conclusions: Our findings suggest that renal AH was severe not only in the SHT group, but also in the MHT group. Careful ABP monitoring should be recommended in patients with CGD.

Localized surface plasmon-induced photoreactions at metal nanostructures have become central research topics in biology, catalysis, and analytical chemistry. In particular, the decomposition of organic pollutants is a popular topic. Rhodamine B is useful in the dye industry and biology; however, it is harmful to humans and the environment. In this study, we investigated the decomposition of the Rhodamine B molecule with a structurally well-defined array of gold square dimers. The array of gold square dimers was fabricated by electron beam lithography, which provided a homogenous well-defined reaction field. Continuous Raman spectral measurements using a near-infrared laser clearly showed that while the Rhodamine B molecules were stable in the absence of the gold square dimers, they were decomposed under near-infrared-light irradiation.

Gasification of coal or biomass with in-situ CO2 capture is an emerging technology aiming to address the problem of climate change. Development of a CO2 sorbent with desirable properties and understanding the behavior of such a material in carbonation/calcination reactions is an important part of developing the technology. In this paper, we report experimental results describing the carbonation behavior of three synthetic CaO-based sorbents. We also present a physically-based model of the reactive transport processes in sorbent particles, which have complicated pore structures. This modeling is based on the conditional approach (i.e., conditional moment closure (CMC)), which has proven to be successful in modeling reactive transport phenomena in porous media. The model predictions are in good agreement with the experimental data.