d-serine, a long-term undetected enantiomer of serine, is a biomarker that reflects kidney function and disease activity. The physiologic functions of d-serine are unclear.
The dynamics of d-serine ...were assessed by measuring d-serine in human samples of living kidney donors using two-dimensional high-performance liquid chromatography, and by autoradiographic studies in mice. The effects of d-serine on the kidney were examined by gene expression profiling and metabolic studies using unilateral nephrectomy mice, and genetically modified cells.
Unilateral nephrectomy in human living kidney donors decreases urinary excretion and thus increases the blood level of d-serine. d-serine is quickly and dominantly distributed to the kidney on injection in mice, suggesting the kidney is a main target organ. Treatment of d-serine at a low dose promotes the enlargement of remnant kidney in mouse model. Mechanistically, d-serine activates the cell cycle for tissue remodeling through an mTOR-related pathway.
d-serine is a physiologic molecule that promotes kidney remodeling. Besides its function as a biomarker, d-serine has a physiologic activity that influences kidney function.
ABSTRACT
We perform a series of three-dimensional smoothed particle hydrodynamics (SPH) simulations to study the evolution of the angle between the protostellar spin and the protoplanetary disc ...rotation axes (the star–disc angle ψsd) in turbulent molecular cloud cores. While ψsd at the protostar formation epoch exhibits broad distribution up to ∼130°, ψsd decreases (≲ 20°) in a time-scale of ∼104 yr. This time-scale of the star–disc alignment, talignment, corresponds basically to the mass doubling time of the central protostar, in which the protostar forgets its initial spin direction due to the mass accretion from the disc. Values of ψsd both at t = 102 yr and t = 105 yr after the protostar formation are independent of the ratios of thermal and turbulent energies to gravitational energy of the initial cloud cores: α = Ethermal/|Egravity| and γturb = Eturbulence/|Egravity|. We also find that a warped disc is possibly formed by the turbulent accretion flow from the circumstellar envelope.
Background
Cause-and-effect associations between sevelamer hydrochloride (HCl) and mortality have yet to be clarified. The effects of sevelamer HCl on mortality, lipid abnormality and arterial ...stiffness were examined in patients with chronic kidney disease stage 5D.
Methods
The effects of sevelamer HCl were studied by a single-center cohort study that was conducted from January 1, 2005 to December 31, 2008 (
n
= 483). By the end of the study, 172 patients (Sevelamer group) had succeeded in continuing sevelamer HCl for >6 months (median 37 months), and 300 patients (Control group) had received calcium carbonate (
n
= 264) or no phosphate binder (
n
= 36). The mortality and other outcomes were compared between these two groups after matching by a propensity score calculated using age, gender, diabetes prevalence, and dialysis vintage.
Results
All-cause hazard ratio (HR) 0.4,
P
= 0.02 and cardiovascular (CV)-cause HR 0.29,
P
= 0.03 cumulative mortality were significantly lower in the matched Sevelamer group than in the matched Control group. The matched Sevelamer group showed increased high-density lipoprotein cholesterol (
P
= 0.003) and no change in pulse wave velocity (PWV) and ankle-brachial index (ABI), whereas the matched Control group showed increased serum low-density lipoprotein (LDL) cholesterol (
P
= 0.003), increased PWV (
P
= 0.03), and decreased ABI (
P
= 0.0009). Change in serum LDL cholesterol level correlated inversely with sevelamer HCl dosage (
P
= 0.02).
Conclusions
Reduced mortality in patients with sevelamer HCl may, at least in part, be explained by an improvement in dyslipidemia and arterial stiffness by sevelamer HCl.
The Kidney Disease: Improving Global Outcomes (KDIGO) Clinical Practice Guideline on Chronic Kidney Disease–Mineral and Bone Disorder (CKD–MBD) 2009 provided recommendations on the detection, ...evaluation, and treatment of CKD-MBD in patients CKD who are and are not undergoing dialysis. Because of the accumulation of evidence since this initial publication, the CKD-MBD Guideline underwent a selective update in 2017. In April 2018, KDIGO convened a CKD-MBD Guideline Implementation Summit in Japan with the key objective to discuss various barriers to the uptake and implementation of the CKD-MBD Guideline in 8 Asian countries/regions. These countries/regions were comparable according to their high-to-middle economic ranking assigned by the World Bank. The discussion took into account the availability of CKD-MBD medication therapies and government health policies that may influence reimbursement and practice patterns in the region. Most importantly, Summit participants developed a framework of multifaceted strategies aimed at overcoming barriers to guideline implementation. The Summit attendees suggested a shared decision-making approach between clinicians and patients in CKD-MBD management, as well as individualized care based on the treatment risk-benefit ratio. The Summit participants also discussed how KDIGO, as a guideline development organization, may work in partnership with local and national nephrology societies to provide education and facilitate implementation of the guideline by clinicians. The conclusions drawn from this Summit in Asia may serve as an important guide for other regions to follow.
ABSTRACT
We study the formation and early evolution of young stellar objects (YSOs) using three-dimensional non-ideal magnetohydrodynamic (MHD) simulations to investigate the effect of cosmic ray ...ionization rate and dust fraction (or amount of dust grains) on circumstellar disc formation. Our simulations show that a higher cosmic ray ionization rate and a lower dust fraction lead to (i) a smaller magnetic resistivity of ambipolar diffusion, (ii) a smaller disc size and mass, and (iii) an earlier timing of outflow formation and a greater angular momentum of the outflow. In particular, at a high cosmic ray ionization rate, the discs formed early in the simulation are dispersed by magnetic braking on a time-scale of about 104 yr. Our results suggest that the cosmic ray ionization rate has particularly a large impact on the formation and evolution of discs, while the impact of the dust fraction is not significant.
Most insect species exhibit characteristic behavioral changes after mating. Typical post-mating behaviors in female insects include noticeable increases in food intake, elevated oviposition rates, ...lowered receptivity to courting males, and enhanced immune response. Although it has been reported that mated females of several insect species including the fruit fly, Drosophila melanogaster increase the amount of food intake and change their dietary preferences, the limited number of comparative studies prevent the formulation of generalities regarding post-mating behaviors in other insects in particular amongst orthopteran species. Here, we investigated whether females of the two-spotted cricket, Gryllus bimaculatus, alter their feeding behavior after mating. Although significant differences in the amount of food intake after mating were not observed, all experimental data indicated a clear trend among crickets toward the ingestion of larger quantities of food. Geometric framework analyses revealed that the mated female crickets preferred food with higher protein content compared to virgin female crickets. This implies that this species required different nutritional demands after mating. These findings further expand our understanding of the behavioral and biological changes that are triggered in female insects post-mating, and highlight the potential for this species in investigating the molecular-based nutritional dependent activities that are linked to post-mating behaviors.
Prader–Willi Syndrome (PWS) is characterized by hyperphagia, severe obesity, and mental retardation from early childhood and occurs 1/10,000 to 1/15,000 live births in Japan. There is high prevalence ...of diabetes mellitus because of hyperphagia. The patient may sometimes face the necessity of renal replacement therapy (RRT) because of end-stage kidney disease (ESKD) caused by diabetes-associated kidney disease (DKD). Since mental retardation and extreme obesity usually prevent to introduce peritoneal dialysis (PD), hemodialysis (HD) has been the first choice of RRT. In this report, we experienced one case of patient with PWS suffering from ESKD due to DKD who started PD as an initial RRT and succeeded to continue for total of 40 months. The patient was 37-year-old man at the time of initiation of dialysis. PD was chosen for RRT because we suspected that he might have more technical difficulties for continuing HD. After several episodes of peritonitis, he successfully continues PD without peritonitis for next 27 months until the present time with good support by his family member. To our best knowledge, this is the first reported case of ESKD associated with PWS who was successfully treated with PD for long period.
Background
Hyporesponsiveness to a large dose of erythropoietin-stimulating agents (ESA) could increase mortality risk among chronic kidney disease patients. This study aimed to assess a safe dose of ...ESA and the impact of hyporesponsiveness to ESA on mortality risk among hemodialyzed patients.
Methods
Patients on hemodialysis were enrolled in this cohort study. The first year was used to assess the longitudinal dialysis status of patients; the subsequent 2 years were used to assess the time-dependent risk of mortality.
Results
Of the 349 subjects enrolled, 40 died within 2 years. When subjects were stratified by epoetin dose and hemoglobin level into four groups, those who had low hemoglobin despite a high dose of epoetin were associated with the highest risk of mortality among the four groups (adjusted hazard ratio 2.73; 95 % confidence interval 1.20–6.24). These highest-risk subjects had lower serum albumin and higher serum ferritin than any of the other subjects. The impact of serum albumin and serum ferritin on mortality risk in an unadjusted Cox proportional hazards model was attenuated in an adjusted model which included factors of low hemoglobin and higher ESA. A dose of epoetin up to 9000 U/week had no impact on mortality risk as long as hemoglobin levels stayed above 10 g/dL.
Conclusions
Hyporesponsiveness to ESA was associated with an increased risk of mortality. There was no sign of increased mortality risk associated with epoetin itself up to a total dose of 9000 U/week.
Purpose The objectives of the present study were to assess the changes in upper airway morphology and function in response to advancement of the maxilla and mandible. Patients and Methods ...Orthognathic surgery was performed. During the surgery, the maxilla and mandible were each advanced as a maxillomandibular advancement simulation. A total of 18 patients with a chief complaint of malocclusion were studied. The distance in jaw advancement and the anteroposterior and left–right diameters of the velopharyngeal space before and after jaw advancement were measured. After the anteroposterior and left–right dilation rates and area enlargement rates were calculated, we compared advancement of the maxilla with that of the mandible. Results Each of the jaw advancements resulted in statistically significant increases in the anteroposterior and left–right diameters of the velopharyngeal space, and the area was significantly enlarged. The anteroposterior dilation rate was significantly greater after advancement of the maxilla, and the left–right dilation rate was significantly greater after advancement of the mandible. The velopharyngeal space area enlargement rate was significantly greater with advancement of the maxilla. Conclusions These data suggest that the mode of dilation of the velopharyngeal space differs between maxillary advancement and mandibular advancement. Jaw advancement affects the soft palate muscles, and the velopharyngeal space is expanded 3-dimensionally by each of those muscles. The difference in the pattern of expansion of the velopharyngeal space was related to differences in the functions of the soft palate muscles.
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