Additional file 1: Figure S1. of Endothelial bioreactor system ameliorates multiple organ dysfunction in septic rats

The endothelial bioreactor (EBR) had no effect on the levels of T lymphocytes in septic rats. Circulating and splenic levels of CD4+ helper T cells, CD8+ cytotoxic T cells, and CD4+ CD25+ Foxp3+ T regulatory cells were analyzed by flow cytometer at 72 h after CLP (n = 7–9 per group). EBR = endothelial bioreactor; CLP = cecal ligation and puncture. (TIF 307 kb

Effects and Safety of Calcimimetics in End Stage Renal Disease Patients with Secondary Hyperparathyroidism: A Meta-Analysis

<div><h3>Purpose</h3><p>Secondary hyperparathyroidism (SHPT) is one of the most common abnormalities of mineral metabolism in patients with chronic kidney disease. We performed a meta-analysis to determine the effect and safety of cinacalcet in SHPT patients receiving dialysis.</p> <h3>Methods</h3><p>The meta-analysis was performed to determine the effect and safety of cinacalcet in SHPT patients receiving dialysis by using the search terms ‘cinacalcet’ or ‘mimpara’ or ‘sensipar’ or ‘calcimimetic’ or ‘R586’ on MEDLINE and EMBASE (January 1990 to February 2012).</p> <h3>Results</h3><p>Fifteen trials were included, all of which were performed between 2000 and 2011 enrolling a total of 3387 dialysis patients. Our study showed that calcimimetic agents effectively ameliorated iPTH levels(WMD, −294.36 pg/mL; 95% CI, −322.76 to −265.95, <em>P</em><0.001) in SHPT patients and reduced serum calcium (WMD, −0.81 mg/dL; 95% CI, −0.89 to −0.72, <em>P</em><0.001) and phosphorus disturbances(WMD, −0.29 mg/dL; 95% CI, −0.41 to −0.17, <em>P</em><0.001). The percentage of patients in whom there was a 30% decrease in serum iPTH levels by the end of the dosing was higher in cinacalcet group than that in control group(OR = 10.75, 95% CI: 6.65–17.37, <em>P</em><0.001). However, no significant difference was found in all-cause mortality and all adverse events between calcimimetics and control groups(OR = 0.86, 95% CI: 0.46–1.60, <em>P</em> = 0.630; OR = 1.30, 95% CI: 0.78–2.18, <em>P</em> = 0.320, respectively). Compared with the control therapy, there was a significant increase in the episodes of hypocalcemia (OR = 2.46, 95% CI: 1.58–3.82, <em>P</em><0.001), nausea (OR = 2.45, 95% CI: 1.29–4.66, <em>P</em> = 0.006), vomiting(OR = 2.78, 95% CI: 2.14–3.62, <em>P</em><0.001), diarrhea(OR = 1.51, 95% CI: 1.04–2.20, <em>P</em> = 0.030) and upper respiratory tract infection (OR = 1.79, 95% CI: 1.20–2.66, <em>P</em> = 0.004)in calcimimetics group.</p> <h3>Conclusions</h3><p>Calcimimetic treatment effectively improved biochemical parameters of SHPT patients receiving dialysis without increasing all-cause mortality and all adverse events.</p> </div

Effect of calcimimetics and control therapy on patient-level outcomes (All-cause mortality, all adverse events, hypocalcemia, nausea, vomiting, diarrhea, dyspnea, upper respiratory tract infection and headache).

<p>Abbreviations:OR, Odds ratio; 95%CI, 95% confidence interval;</p

Procedure used for the trial selection.

<p>Abbreviation: RCT, randomized controlled trial.</p

Forest plot of iPTH of patients treated with calcimimetics and control therapy.

<p>Studies are identified by name of the first author and year of publication. Mean differences (MDs) are pooled using the fixed-effect model and shown on a scale of −500 to 500.</p

Forest plot of serum calcium of patients treated with calcimimetics and control therapy.

<p>Studies are identified by name of the first author and year of publication. Mean differences (MDs) are pooled using the fixed-effect model and shown on a scale of −2 to 2.</p

Forest plot of serum phosphate of patients treated with calcimimetics and control therapy.

<p>Studies are identified by name of the first author and year of publication. Mean differences (MDs) are pooled using the fixed-effect model and shown on a scale of −2 to 2.</p

Characteristics of Trials of Calcimimetic Agents for SHPT in Dialysis Patients.

<p>Abbreviations: SHPT, secondary hyperparathyroidism; iPTH, intact PTH; HD, hemodialysis; Cin, Cinacalcet; Vit, Vitamin; d, day; w, week; mo, month;</p

Multiple logistic regression analysis of factors associated with CAC score tertile in MHD patients.

<p>SD and CV were calculated from the past 6 follow-up values.</p><p>MHD, maintenance hemodialysis; CAC, coronary artery calcification; OR, Odds ratio; CI, confidence interval; Alb, albumin; CRP, C-reactive protein; PTH, parathyroid hormone; FGF23, fibroblast growth factor 23; HDL, high-density lipoprotein; SD, standard deviation; CV, coefficient of variation.</p><p><i>P₁</i> from multiple regression that adjusted for female sex, age, FGF23, and SD-phosphate.</p><p><i>P₂</i> from multiple regression that adjusted for female sex, age, FGF23, and CV-phosphate.</p

Distribution of coronary artery calcification scores (CACs) in MHD patients.

<p>Seventeen patients had no evidence of coronary calcification (CACs = 0) and 60 patients had CACs from 0.5 to 6493.2. Seventy five percent of the CACs were between 0 and 811.6, the mean CACs was 609.6±1062.9, the median CACs was 168.5, and the interquartile range was 2.5 to 788.2.</p