Original
Urinary liver-type fatty acid-binding protein predicts recovery from acute kidney injury
Liang Wang, Jing Xue, Caimei Chen, Zhijian Zhang, Zhaohong Deng, Zhuxing Sun, and Changying Xing
Volume 84 (2015) p. 255 - 261
Abstract
Clinical Nephrology, Vol. 84 – No. 5/2015 (255-261)
Urinary liver-type fatty acid-binding protein predicts recovery from acute kidney injury
Liang Wang1, Jing Xue1, Caimei Chen1, Zhijian Zhang1, Zhaohong Deng2, Zhuxing Sun1, and Changying Xing3
1Department of Nephrology, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, 2School of Digital Media, Jiangnan University, Wuxi, 3Department of Nephrology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China
Objectives: Despite significant advances in the epidemiology of acute kidney injury (AKI), there is no reliable method to predict renal recovery. Using acute kidney injury network (AKIN) criteria, we tested whether higher urinary L-FABP (uL-FABP) concentrations in the patients with AKIN stage 3 (AKIN3) after nephrology consultation would predict failure to recover. Methods: This is a prospective cohort study of 114 patients with AKIN3 at WuXi People’s Hospital from August 2011 to July 2014. The levels of serum creatinine, urine creatinine, and uL-FABP were obtained at the time of nephrology consultation. Results: Patients who recovered had lower uL-FABP than those who failed to recover at time of nephrology consultation (71.42 (11.1 – 118.3) vs. 335.18 (103.9 – 422.3) ng/mg×creatinine, p < 0.001). Urinary L-FABP predicted failure to recover with an area under the receiver operating characteristic curve of 0.906 (95% CI 0.837 – 0.953). A clinical model using age, APACHE II score and acute tubular necrosis severity scoring index (ATN-ISS) predicted failure to recover with an area under the curve of 0.825 (95% CI 0.743 – 0.890). When uL-FABP was compared to the clinical model, the reclassification of risk of renal recovery had significantly improved by 35.1%. Conclusion: Urinary L-FABP appears to be a useful biomarker to predict failure to recover during hospitalization in the cohort of patients with AKIN3.Correspondence to:
Changying Xing, PhD, MD
Department of Nephrology
The First Affiliated Hospital of Nanjing Medical University
Jiangsu Province Hospital
No.300 Guangzhou Road
Nanjing, 210029, Jiangsu, China
Email: [email protected]
Original
Impact of 14 types of genetic polymorphisms on antihypertensive efficacy of felodipine in healthy Chinese subjects
Zi-Qing-Yun Yuan, Hong-Wen Zhang, Zi-Dan Yu, Yuan Tian, Lu-Ning Sun, Li-Jun Xie, Juan Chen, Ling Meng, Zun-Jian Zhang, Xue-Hui Zhang, and Yong-Qing Wang
Price
42.00 $
Volume 58 (2020) p. 375 - 386
Abstract
Impact of 14 types of genetic polymorphisms on antihypertensive efficacy of felodipine in healthy Chinese subjects
Zi-Qing-Yun Yuan1*, Hong-Wen Zhang1*, Zi-Dan Yu1, Yuan Tian3, Lu-Ning Sun1, Li-Jun Xie1, Juan Chen1, Ling Meng1, Zun-Jian Zhang3, Xue-Hui Zhang2, and Yong-Qing Wang1,2
1Research Division of Clinical Pharmacology, First Affiliated Hospital of Nanjing Medical University, Nanjing, 2Department of Pharmacy, Jiangsu Shengze Hospital, Nanjing Medical University, Suzhou, and 3Analysis and Testing Center, China Pharmaceutical University, Nanjing, China
Objective: This study evaluated different influences of 14 single nucleotide polymorphisms (SNPs) and demographic factors leading to individual differences in the antihypertensive efficacy of felodipine in healthy Chinese subjects.
Materials and methods: 24 subjects were sequenced for candidate SNPs. Plasma samples were obtained as clinical trial protocol, and were determined by a HPLC-MS/MS method. Pharmacokinetic parameters were calculated by WinNonlin 6.0. Statistical analysis was mainly performed by SPSS 22.0. A multiple linear regression model provided different weight coefficients of different demographic and genetic factors.
Results: The trend of Cmax is almost consistent with AUCss increase, but tmax of individuals is different; the antihypertensive effect of felodipine is individually different. A significant association was observed between systolic blood pressure decrease (ΔSBP) and SNPs of CACNA1C, CACNA1D, GNB3 respectively, while CACNA1C and CACNA1 were associated with diastolic blood pressure decrease (ΔDBP). CYP3A5 rs766746 and CYP3A4 rs2242480 were linked with Cmax and AUCss, and ABCB1 rs1045642 was associated with T1/2. Significant relationships were shown between AUCss and ΔSBP (p = 0.022) as well as Cmax and ΔSBP (p = 0.015).
Conclusion: The efficacy of felodipine is individually different, influenced especially by CACNA1C rs1051375 and ABCB1 rs1045642. ΔDBP is associated with ΔSBP in multiple-dosing of felodipine in healthy Chinese subjects.
Zi-Qing-Yun Yuan and Hong-Wen Zhang contributed equally to this work as co-first authors.Correspondence to:
Yong-Qing Wang, PhD
Research Division of Clinical Pharmacology
First Affiliated Hospital of Nanjing Medical University
Nanjing, China
Email: [email protected]
Neph
rology Education
Two cases of atypical anti-GBM nephritis following SARS-CoV-2 virus vaccination
Liqin Zhang, Wenjuan Wang, Rong Xue, Jian Zhang, Yunfei Hao, and Xiaoli Li
Volume 105 (2026) p. 291 - 296
Abstract
Clinical Nephrology, Vol. 105 – No. 4/2026 (291-296)
Two cases of atypical anti-GBM nephritis following SARS-CoV-2 virus vaccination
Liqin Zhang1, Wenjuan Wang1, Rong Xue2, Jian Zhang2, Yunfei Hao3, and Xiaoli Li2
1Department of Critical Care Medicine, 2Department of Nephrology, and 3Cerebrovascular Center, Gansu Provincial Hospital, Lanzhou, China
Atypical anti-glomerular basement membrane (GBM) nephritis is a rare autoimmune disease characterized by the linear deposition of immunoglobulin G (IgG) detected in the GBM without circulating anti-GBM antibodies or lung involvement. Atypical anti-GBM disease is distinguished from typical anti-GBM disease in both clinical and pathological features. Herein, we report 2 patients who developed mild proteinuria, hematuria, and elevated serum creatinine levels following coronavirus disease 2019 (COVID-19) vaccination. Renal biopsy found bright linear IgG deposition along the GBM, but anti-GBM antibodies were seronegative. Atypical anti-GBM nephritis was determined. The female patient improved with the treatment of valsartan. For the male patient, serum creatinine levels significantly decreased through two plasma exchange sessions, cyclophosphamide, and glucocorticoid. Atypical and typical anti-GBM nephritis are different clinical entities. They target different antigen epitopes and, therefore, atypical anti-GBM disease is not the early stage of typical anti-GBM disease. In atypical anti-GBM nephritis, monoclonal IgG deposition in the glomeruli is not equal to plasma cell dyscrasias but still needs close monitoring for hematologic diseases. The relationship between the disease and COVID-19 vaccination is uncertain and needs further exploration.Correspondence to:
Xiaoli Li, Deputy Chief Physician
Department of Nephrology
Gansu Provincial Hospital, Lanzhou, China
Email: [email protected]
Neph
Education
A rare case of renal cancer with PLA2R-positive membranous nephropathy and AL amyloidosis: Insights into mechanisms and treatment
Jian Zhang, Junyue Huang, Bin Zhou, Limin Tian, Zhigang Ma, Wenhui Huang, and Hui Zhao
p. 0 - 7
Abstract
Jian Zhang1,2, Junyue Huang1, Bin Zhou3, Limin Tian4,5, Zhigang Ma6, Wenhui Huang1, and Hui Zhao1,4
1Department of Nephrology, Gansu Provincial Hospital, 2The Second Hospital & Clinical Medical School, Lanzhou University, 3The Blood Purification Center of Gansu Provincial Hospital, 4College of Integrated Traditional Chinese and Western Medicine, Gansu University of Traditional Chinese Medicine, Lanzhou, 5Department of Endocrinology, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, and 6Department of Nephrology, The Second Affiliated Hospital of The Chinese University of Hong Kong, Shenzhen (Longgang District People’s Hospital), Shenzhen, China
Renal clear cell carcinoma (RCC), the predominant subtype of kidney cancer, is characterized by paraneoplastic syndromes, of which membranous nephropathy (MN) represents the most common paraneoplastic glomerulonephritis. While phospholipase A2 receptor (PLA2R) antibodies indicate primary MN, the concurrent presence of light-chain amyloidosis may further complicate the clinical manifestations in malignancy-associated cases. A rare case of RCC concurrent with phospholipase A2 receptor PLA2R-positive MN and light chain amyloidosis is reported in this paper. An elderly male patient presented with nephrotic syndrome and a right renal mass. The patient underwent a nephrectomy after admission. Pathological examination confirmed the diagnosis of right kidney renal clear cell carcinoma. Renal biopsy revealed PLA2R-positive MN and AL amyloidosis. Interestingly, in this case, glomerular light chain staining showed no monoclonal restriction, but λ light chain deposition was found in the vessels. However, the nephrotic syndrome showed no improvement after tumor resection. The patient achieved remission following sequential treatment with bortezomib, dexamethasone, daratumumab, and rituximab. This case illustrates the complex interplay among RCC, PLA2R-positive MN, and AL amyloidosis, complicating patient management. Future research should focus on the immunological mechanisms of PLA2R antibody production in malignancy and the pathophysiological links among these conditions. Clinicians should remain vigilant for secondary causes of nephrotic syndrome in renal malignancy patients and adopt comprehensive, multidisciplinary approaches to improve outcomes.
Correspondence to:
Hui Zhao, MD, 204 Donggang West Road, Chengguan District, Lanzhou 730000, Gansu, China
Email: [email protected]
Original
Composite dietary antioxidant index in predicting chronic kidney disease risk: Findings from NHANES 1999 – 2018
Weiwei Li, Linsen Jiang, Sixia Chen, Weiwei Shan, and Zhijian Zhang
p. 0 - 11
Abstract
Weiwei Li1, Linsen Jiang1, Sixia Chen1, Weiwei Shan2, and Zhijian Zhang2
1Department of Nephrology, The Second Affiliated Hospital of Soochow University, Suzhou, and 2Department of Nephrology, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi People’s Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, Jiangsu, China
Background: Chronic kidney disease (CKD) poses a significant global health burden, with oxidative stress implicated in its pathogenesis. The composite dietary antioxidant index (CDAI), integrating multiple dietary antioxidants, may offer a novel approach to CKD risk assessment, yet evidence remains limited. Objective: This study aimed to evaluate the association between CDAI and CKD risk in a nationally representative U.S. cohort. Materials and methods: Cross-sectional data from 24,202 adults in NHANES (1999 – 2018) were analyzed. CDAI was calculated from six dietary antioxidants (vitamins A/C/E, zinc, selenium, β-carotene). CKD was defined by estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73m2 or UACR ≥ 30 mg/g. Multivariable logistic regression, restricted cubic splines (RCS), and subgroup analyses were employed to assess associations, adjusted for demographics, lifestyle, comorbidities, and laboratory parameters. Results: Participants in the highest CDAI quartile (Q4) had a 27% lower CKD risk (adjusted OR = 0.73, 95% CI: 0.62 – 0.87, p < 0.001) vs. Q1, with a dose-dependent relationship (p-trend < 0.001). RCS revealed nonlinear effects, with steep risk reduction at CDAI < 10 and plateauing at CDAI > 20. Subgroup analyses showed stronger inverse associations in women, older adults (≥ 65 years), and individuals with diabetes or cardiovascular disease (p-interaction < 0.05). Mediation analysis indicated direct effects of CDAI, independent of traditional risk factors. Conclusion: Higher CDAI levels were independently associated with reduced CKD risk, particularly in high-risk subgroups. These findings support the potential role of dietary antioxidants in CKD prevention, warranting further prospective validation.
Correspondence to:
Zhijian Zhang, Department of Nephrology, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi People’s Hospital, Wuxi Medical Center, Nanjing Medical University, 299 Qingyang Rd, Wuxi, Jiangsu 214000, China, Or Weiwei Shan, Department of Nephrology, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi People’s Hospital, Wuxi Medical Center, Nanjing Medical University, 299 Qingyang Rd, Wuxi, Jiangsu 214000, China
Email: [email protected]
