Is hemodialysis itself a risk factor for dementia? An analysis of nationwide registry data of patients on maintenance hemodialysis in Japan

Abstract Background Chronic kidney disease is a major risk factor for dementia, but the influence of hemodialysis itself on the development of dementia remains unclear. We previously reported that non-diabetic patients on maintenance hemodialysis have preserved cognitive function; hemodialysis removes blood amyloid β (Aβ), which is a major cause of Alzheimer’s disease in the brain; and the number of Aβ deposits in the postmortem brains of hemodialysis patients was significantly less compared to that in age-matched controls not undergoing hemodialysis. We aimed to evaluate the influence of hemodialysis on the development of dementia. Methods We accessed the Japanese Society for Dialysis Therapy Renal Data Registry between December 31, 2009, and December 31, 2010. Dementia was identified in 120,101 patients undergoing maintenance hemodialysis. The association between hemodialysis duration and dementia risk was analyzed using logistic regression analysis. Results There was a significant decrease in the dementia risk with an increase in the hemodialysis duration, with odds ratios (95% confidence intervals) of 0.78 (0.74–0.82) and 0.88 (0.78–0.99) for every 10 years in non-diabetic and diabetic patients, respectively. However, in diabetic patients, the correlation between hemodialysis duration and dementia risk was not consistent. Conclusion A longer hemodialysis duration was correlated with a lower dementia risk, but the correlation between hemodialysis duration and dementia risk in diabetic patients was much weaker and vaguer than that in non-diabetic patients. This finding does not appear to contradict greatly the assumption that the reduction in dementia risk with a prolonged hemodialysis duration in non-diabetic patients was caused not only by the survivor effect but also by hemodialysis itself

Additional file 1: of Is hemodialysis itself a risk factor for dementia? An analysis of nationwide registry data of patients on maintenance hemodialysis in Japan

Table S1. Mortality risk analysis. Table S2. Mortality risk with hemodialysis duration. Table S3. Dementia incidence of the subjective patients of the present study whose age is more than 65 years old. Table S4. Dementia risk of diabetes calculated using a simple analytic model. Table S5. Dementia risk of hemoglobin level calculated using a simple analytic model. (DOC 13433 kb

Sclerosing thymoma-like thymic amyloidoma with nephrotic syndrome: a case report

Abstract Background Primary localized amyloidosis presenting as an isolated mediastinal mass is extremely rare, especially in the thymus. Sclerosing thymoma is also an extremely rare anterior mediastinal tumor, pathologically characterized by extensive sclerotic lesions with hyalinization and calcification. Only 14 cases of sclerosing thymoma and five cases of thymic amyloidosis have been reported to date. Case presentation A 78-year-old Japanese woman was diagnosed as having sclerosing thymoma (Masaoka stage IVa pericardial dissemination)-like thymic amyloidoma. She was diagnosed as having either lung cancer or mediastinal tumor with pericardial dissemination, and received palliative treatment. Three years later, she was readmitted with a complaint of general malaise. Since minimal change nephrotic syndrome was suspected based on the disease onset and selectivity index of urinary protein, steroid pulse therapy was started. Subsequently, because a marked reduction in tumor size was observed during maintenance treatment with prednisolone, a thoracoscopic needle biopsy was performed for a definitive diagnosis. According to the pathological findings and clinical investigations, a final diagnosis of sclerosing thymoma (Masaoka stage IVa pericardial dissemination)-like thymic amyloidoma was made. Conclusions This is a case report of sclerosing thymoma-like thymic amyloidoma. Both sclerosing thymoma and thymic amyloidoma are extremely rare diseases: only 14 cases of sclerosing thymoma and five cases of thymic amyloidosis have been reported to date. In either diagnosis, our case is the first case in which marked reduction in tumor size was observed with steroid therapy. All reported cases of sclerosing thymomas underwent surgical resection, but steroid therapy to sclerosing thymoma has not been reported. It is still unknown whether steroid therapy is effective or not. The hyalinized components of sclerosing thymoma possibly contain amyloid deposits. The marked reduction in tumor size with steroid therapy may result in amyloid deposits. The association between sclerosing thymoma and thymic amyloidoma remains uncertain. Sclerosing thymoma should be stained with Congo red

Difference of Irreversible Strain Limit in Technical RHQT Nb3Al Superconductors

Strain limit for critical current degradation in various technical rapid-heating, quenching, and transformation-processed Nb3 Al strands has been studied with respect to the matrix material and filament diameter. This property is one important factor as well as the strain sensitivity to Jc characteristics, especially when we consider to apply the so-called react and wind technique to large magnets such as DEMO reactors.We compared five strands, including a standard Nb matrix, standard Ta matrix, Nb/Ag/Nb three-layered barrier structure, and other two fine filament diameter strands prepared by the restackingmethod. In normal Nb and Ta matrix strands with a filament diameter of more than 30 μm, the irreversible strain limit is about 0.3%. Refinement of the filament diameter enables us to significantly improve the irreversible strain limit up to more than 0.7%. The Nb/Ag/Nb three-layered barrier structure appearsmore attractive from a practical point of view. The irreversible strain limit was improved up to nearly 0.6%, even if the filament diameter is more than 20 μm. The Ag layer between the Nb3 Al filaments seems to act as a cushion to mitigate the stress concentration in the wire. The Ag barrier also seems tobe effective for current bypass in existence of cracks, resulting in suppressing Ic degradation in a higher strain range