Correlation between renal function and common risk factors for chronic kidney disease in a healthy middle-aged population: a prospective observational 2-year study.

Age, proteinuria, metabolic syndrome, and hyperuricemia are the reported risk factors for chronic kidney disease (CKD) and cardiovascular disease (CVD). However, the best predictor of changes in renal function in the early stages of renal disease in a healthy middle-aged population is still unknown. Our study evaluated the correlation between changes in renal function and common risk factors to determine such a predictor.In total, 2,853 healthy persons aged ≤50 years participated in the study. They had no proteinuria and were not on medications for hypertension, diabetes mellitus, hyperlipidemia, or hyperuricemia. Over 2 years, participants underwent annual health screening. The relationship between changes in estimated glomerular filtration rate (eGFR) and changes in risk factors for CKD was evaluated using univariate and multivariate linear regression analyses.Over 2 years, eGFR showed a significant decrease. Univariate regression analysis revealed that changes in fasting plasma glucose (FPG), total cholesterol, LDL-cholesterol, serum uric acid levels, and hemoglobin showed a significant negative correlation with changes in eGFR. Multiple regression analysis confirmed that changes in FPG, serum uric acid levels, in particular, and hemoglobin had a significant negative correlation with changes in eGFR.The changes in eGFR and other variables over 2 years were small and could be within expected biologic variation. A longer observational study is needed to elucidate whether FPG, serum uric acid and hemoglobin represent the earliest markers of eGFR decline

Sarcomatoid malignant pleural mesothelioma associated with anti-Ma2-related paraneoplastic neurological syndrome: A case report

Paraneoplastic neurological syndrome (PNS) is rarely associated with malignant pleural mesothelioma (MPM). We report the first case of sarcomatoid mesothelioma in a 63-year-old female diagnosed with cerebellar degeneration in January 2018. Systemic examination showed right pleura thickening. The pleural biopsy of the mass revealed a sarcomatoid MPM cT3N0M0. In February 2018, anti-Ma2 antibody positivity indicated PNS complicated with MPM. First, cisplatin (75 mg/m2) + pemetrexed (500 mg/m2) chemotherapy was given. For PNS, steroid pulse therapy and high-dose immunoglobulin therapy were administered. MPM may cause anti-Ma2 antibody-related PNS. Early diagnosis and starting anticancer treatment and immunotherapy are critical

Simple linear regression analysis of factors related to ΔeGFR.

<p>All values are expressed as mean ± SD.</p><p>Abbreviations and symbols: eGFR, estimated glomerular filtration rate; Δ, change in the variable over 2 years; β, standardized regression coefficient; MetS, metabolic syndrome; BMI, body mass index; BP, blood pressure; FPG, fasting plasma glucose; HbA_1c, hemoglobin A_1c; HDL, high density lipoprotein; LDL, low density lipoprotein; Hb, hemoglobin.</p><p>Simple linear regression analysis of factors related to ΔeGFR.</p

Characteristics of subjects at baseline and 2 years.

<p>All values are expressed as mean ± SD. <i>P</i> values: a, paired <i>t</i>-test; b, McNemar's test comparing baseline with 2 years.</p><p>Abbreviations and symbols: Δ, change in the variable over 2 years; 95% CI, 95% confidence interval; BMI, body mass index; BP, blood pressure; FPG, fasting plasma glucose; HbA_1c, hemoglobin A_1c; eGFR, estimated glomerular filtration rate; HDL, high density lipoprotein; LDL, low density lipoprotein; Hb, hemoglobin.</p><p>Characteristics of subjects at baseline and 2 years.</p

Multiple regression models for factors related to ΔeGFR.

<p>Model 1: all variables, Model 2: all variables except total cholesterol, Model 3: significant variables in univariate analysis, Model 4: significant variables in univariate analysis except total cholesterol.</p><p>Abbreviations and symbols: eGFR, estimated glomerular filtration rate; Δ, change in the variable over 2 years; β, standardized regression coefficient; BMI, body mass index; BP, blood pressure; FPG, fasting plasma glucose; HbA_1c, hemoglobin A_1c; HDL, high density lipoprotein; LDL, low density lipoprotein; Hb, hemoglobin.</p><p>Multiple regression models for factors related to ΔeGFR.</p

Prevalence of hyperuricemia (male, n = 1,515; female, n = 1,257).

<p>Hyperuricemia: serum uric acid ≥7 mg/dL in males and ≥6 mg/dL in females.</p><p>Prevalence of hyperuricemia (male, n = 1,515; female, n = 1,257).</p

Change in eGFR over 2 years.

<p>eGFR was classified from stage 1 to stage 3a according to the CKD stage. Note that eGFR changed over 2 years.</p

Disposition of the study population.

<p>Disposition of the study population.</p