Cross-section schematic of the mounted bioreactor with the endothelial cells culture on top of the home-modified membrane and the HSC culture on top of the lower plate.

<p>Cross-section schematic of the mounted bioreactor with the endothelial cells culture on top of the home-modified membrane and the HSC culture on top of the lower plate.</p

Representative images of endothelial cells cultured in the present system under continuous perfusion (shear stress) and static conditions (static).

<p><i>Top</i>, Cell membrane staining (red) and nuclei (blue). <i>Bottom</i>, Real-time production of nitric oxide (green) and fluorescence quantification (data come from n = 3 experiments; and fluorescence intensity was divided by the total number of cultured cells; *p<0.05 vs. static t-test).</p

mRNA expression of two activation markers (a-SMA and Collagen I) in hepatic stellate cells co-cultured in the bioreactor with endothelial cells under shear stress stimulus or under static conditions.

<p>The reduction in both markers indicates an improvement in the stellate cells phenotype, most probably derived from the nitric oxide produced by the endothelial cells stimulated with shear stress (data from n = 3 experiments; * p<0.01 vs. static t-test).</p

Additional file 1: of Implementation of a pragmatic randomized trial of screening for chronic kidney disease to improve care among non-diabetic hypertensive veterans

Sample doctor note. (DOCX 13 kb

Adiposity and risk of decline in glomerular filtration rate: meta-analysis of individual participant data in a global consortium

OBJECTIVE:To evaluate the associations between adiposity measures (body mass index, waist circumference, and waist-to-height ratio) with decline in glomerular filtration rate (GFR) and with all cause mortality. DESIGN:Individual participant data meta-analysis. SETTING:Cohorts from 40 countries with data collected between 1970 and 2017. PARTICIPANTS:Adults in 39 general population cohorts (n=5 459 014), of which 21 (n=594 496) had data on waist circumference; six cohorts with high cardiovascular risk (n=84 417); and 18 cohorts with chronic kidney disease (n=91 607). MAIN OUTCOME MEASURES:GFR decline (estimated GFR decline ≥40%, initiation of kidney replacement therapy or estimated GFR <10 mL/min/1.73 m2) and all cause mortality. RESULTS:Over a mean follow-up of eight years, 246 607 (5.6%) individuals in the general population cohorts had GFR decline (18 118 (0.4%) end stage kidney disease events) and 782 329 (14.7%) died. Adjusting for age, sex, race, and current smoking, the hazard ratios for GFR decline comparing body mass indices 30, 35, and 40 with body mass index 25 were 1.18 (95% confidence interval 1.09 to 1.27), 1.69 (1.51 to 1.89), and 2.02 (1.80 to 2.27), respectively. Results were similar in all subgroups of estimated GFR. Associations weakened after adjustment for additional comorbidities, with respective hazard ratios of 1.03 (0.95 to 1.11), 1.28 (1.14 to 1.44), and 1.46 (1.28 to 1.67). The association between body mass index and death was J shaped, with the lowest risk at body mass index of 25. In the cohorts with high cardiovascular risk and chronic kidney disease (mean follow-up of six and four years, respectively), risk associations between higher body mass index and GFR decline were weaker than in the general population, and the association between body mass index and death was also J shaped, with the lowest risk between body mass index 25 and 30. In all cohort types, associations between higher waist circumference and higher waist-to-height ratio with GFR decline were similar to that of body mass index; however, increased risk of death was not associated with lower waist circumference or waist-to-height ratio, as was seen with body mass index. CONCLUSIONS:Elevated body mass index, waist circumference, and waist-to-height ratio are independent risk factors for GFR decline and death in individuals who have normal or reduced levels of estimated GFR