EFFECTS OF MO, CR, AND V ADDITIONS ON TENSILE AND CHARPY IMPACT PROPERTIES OF API X80 PIPELINE STEELS

In this study, four API X80 pipeline steels were fabricated by varying Mo, Cr, and V additions, and their microstructures and crystallographic orientations were analyzed to investigate the effects of their alloying compositions on tensile properties and Charpy impact properties. Because additions of Mo and V promoted the formation of fine acicular ferrite (AF) and granular bainite (GB) while prohibiting the formation of coarse GB, they increased the strength and upper-shelf energy (USE) and decreased the energy transition temperature (ETT). The addition of Cr promoted the formation of coarse GB and hard secondary phases, thereby leading to an increased effective grain size, ETT, and strength, and a decreased USE. The addition of V resulted in a higher strength, a higher USE, a smaller effective grain size, and a lower ETT, because it promoted the formation of fine and homogeneous of AF and GB. The steel that contains 0.3 wt pct Mo and 0.06 wt pct V without Cr had the highest USE and the lowest ETT, because its microstructure was composed of fine AF and GB while its maintained excellent tensile properties.X1126sciescopu

A multicenter, randomized, open-label, comparative, phase IV study to evaluate the efficacy and safety of combined treatment with mycophenolate mofetil and corticosteroids in advanced immunoglobulin A nephropathy

Background It remains unclear whether immunosuppressive agents are effective in patients with immunoglobulin A nephropathy (IgAN). We investigated the efficacy of a mycophenolate mofetil (MMF) and corticosteroid combination therapy in patients with advanced IgAN. Methods We conducted a multicenter, randomized, placebo-controlled, parallel-group study of 48 weeks administration of MMF and corticosteroids in biopsy-proven advanced IgAN patients with estimated glomerular filtration rate (eGFR) of 20–50 mL/min/1.73 m2 and urine protein-to-creatinine ratio (UPCR) of >0.75 g/day. The primary outcome was complete (UPCR 50% reduction of UPCR compared to baseline) remission at 48 weeks. Results Among the 48 randomized patients, the percentage that achieved complete or partial remission was greater in thecombination therapy group than in the control group (4.2% vs. 0% and 29.1% vs. 5.0%, respectively). Compared with the combination therapy group, eGFR in the control group decreased significantly from week 36 onward, resulting in a final adjusted mean change of –4.39 ± 1.22 mL/min/1.73 m2 (p = 0.002). The adjusted mean changes after 48 weeks were 0.62 ± 1.30 and –5.11 ± 1.30 mL/min/1.73 m2 (p = 0.005) in the treatment and control groups, respectively. The UPCR was significantly different between the two groups; the adjusted mean difference was –0.47 ± 0.17 mg/mgCr and 0.07 ± 0.17 mg/mgCr in the treatment and control group, respectively (p = 0.04). Overall adverse events did not differ between the groups. Conclusion In advanced IgAN patients with a high risk for disease progression, combined MMF and corticosteroid therapy appears to be beneficial in reducing proteinuria and preserving renal function

Kidney Health Plan 2033 in Korea: bridging the gap between the present and the future

In response to the increase in the prevalence of chronic kidney disease (CKD) in Korea, the growth of patients requiring renal replacement therapy and the subsequent increase in medical costs, the rapid expansion of patients with end-stage kidney disease (ESKD), and the decrease in patients receiving home therapy, including peritoneal dialysis, the Korean Society of Nephrology has proclaimed the new policy, Kidney Health Plan 2033 (KHP 2033). KHP 2033 would serve as a milestone to bridge the current issues to a future solution by directing the prevention and progression of CKD and ESKD, particularly diabetic kidney disease, and increasing the proportion of home therapy, thereby reducing the socioeconomic burden of kidney disease and improving the quality of life. Here, we provide the background for the necessity of KHP 2033, as well as the contents of KHP 2033, and enlighten the Korean Society of Nephrology’s future goals. Together with patients, healthcare providers, academic societies, and national policymakers, we need to move forward with goal-oriented drive and leadership to achieve these goals

Upregulation of VSIG4 in Type 2 Diabetic Kidney Disease

Fibrosis is the final common finding in patients with advanced diabetic kidney disease. V-set Ig domain containing 4 (VSIG4) is related to fibrosis in several diseases. It also contributes to fibrosis under high-glucose conditions in renal tubule cells. To determine the role of VSIG4 in type 2 diabetes, we examined VSIG4 expression in a type 2 diabetic animal model and podocyte. Urinary excretion of albumin and VSIG4 was significantly higher in db/db mice than in the control group. Urine VSIGs levels for 6 h were about three-fold higher in db/db mice than in db/m mice at 20 weeks of age: 55.2 ± 37.8 vs. 153.1 ± 74.3 ng, p = 0.04. Furthermore, urinary VSIG4 levels were significantly correlated with urinary albumin levels (r = 0.77, p < 0.01). Intrarenal VSIG4 mRNA expression was significantly higher in db/db mice than in control mice (1.00 ± 0.35 vs. 1.69 ± 0.77, p = 0.04). Further, VSIG4 expression was almost twice as high in db/db mice at 20 weeks of age. Intrarenal VSIG immunoreactivity in db/db mice was also significantly higher than that in control mice. In cultured podocytes, both high glucose and angiotensin II significantly upregulated the expression of VSIG4 mRNA and protein. In conclusion, VSIG4 was upregulated in an animal model of type 2 diabetes and was related to albuminuria and pro-fibrotic markers. Considering these relationships, VSIG4 may be an important mediator of diabetic nephropathy progression

The eGFR Decline as a Risk Factor for Metabolic Syndrome in the Korean General Population: A Longitudinal Study of Individuals with Normal or Mildly Reduced Kidney Function

Metabolic syndrome (MS) is a risk factor for the development and progression of chronic kidney disease (CKD). However, it is unclear whether decreased renal function affects MS. Through a longitudinal study, we investigated the effect of estimated glomerular filtration rate (eGFR) changes on MS in participants with an eGFR above 60 mL/min/1.73 m2. A cross-sectional (n = 7107) and a 14-year longitudinal study (n = 3869) were conducted to evaluate the association between MS and eGFR changes from the Korean Genome and Epidemiology Study data. The participants were categorized by their eGFR levels (60–75, 75–90, and 90–105 versus ≥ 105 mL/min/1.73 m2). In a cross-sectional analysis, the MS prevalence was significantly increased with a decline in the eGFR in a fully adjusted model. The odds ratio of individuals with an eGFR of 60–75 mL/min/1.73 m2 was observed to be the highest (2.894; 95% confidence interval (CI), 1.984–4.223). In the longitudinal analysis, incident MS significantly increased with an eGFR decline in all the models, with the highest hazard ratio in the lowest eGFR group (1.803; 95% CI, 1.286–2.526). In joint interaction analysis, all covariates showed a significant joint effect with an eGFR decline on the incident MS. MS incidents are associated with eGFR changes in the general population without CKD

Associations between Renal Hyperfiltration and Serum Alkaline Phosphatase

<div><p>Renal hyperfiltration, which is associated with renal injury, occurs in diabetic or obese individuals. Serum alkaline phosphatase (ALP) level is also elevated in patients with diabetes (DM) or metabolic syndrome (MS), and increased urinary excretion of ALP has been demonstrated in patients who have hyperfiltration and tubular damage. However, little was investigated about the association between hyperfiltration and serum ALP level. A retrospective observational study of the 21,308 adults in the Korea National Health and Nutrition Examination Survey IV-V databases (2008–2011) was performed. Renal hyperfiltration was defined as exceeding the age- and sex-specific 97.5^th percentile. We divided participants into 4 groups according to their estimated glomerular filtration rate (eGFR): >120, 90–119, 60–89, and <60 mL/min/1.73 m². The participants with eGFR >120 mL/min/1.73 m² showed the highest risk for MS, in the highest ALP quartiles (3.848, 95% CI, 1.876–7.892), compared to the lowest quartile. Similarly, the highest risk for DM, in the highest ALP quartiles, was observed in participants with eGFR >120 ml/min/1.73 m² (2.166, 95% CI, 1.084–4.329). ALP quartiles were significantly associated with albuminuria in participants with eGFR ≥ 60 ml/min/1.73m². The highest ALP quartile had a 1.631-fold risk elevation for albuminuria with adjustment of age and sex. (95% CI, 1.158-2.297, P = 0.005). After adjustment, the highest ALP quartile had a 1.624-fold risk elevation, for renal hyperfiltration (95% CI, 1.204–2.192, <i>P</i> = 0.002). In addition, hyperfiltration was significantly associated with hemoglobin, triglyceride, white blood cell count, DM, smoking, and alcohol consumption (<i>P</i><0.05). The relationship between serum ALP and metabolic disorders is stronger in participants with an upper-normal range of eGFR. Higher ALP levels are significantly associated with renal hyperfiltration in Korean general population.</p></div

Distribution of estimated glomerular filtration rate by sex and age.

<p>The 97.5th percentiles are shown in 10-year age groups. Hyperfiltration was defined as an estimated glomerular filtration rate (eGFR) over the age- and sex-specific 97.5th percentile.</p

Associations of albuminuria among serum alkaline phosphatase quartiles in participants with eGFR ≥ 60 ml/min/1.73m².

<p>Associations of albuminuria among serum alkaline phosphatase quartiles in participants with eGFR ≥ 60 ml/min/1.73m².</p

Associations between serum alkaline phosphatase quartiles and diabetes according to the estimated glomerular filtration rate (eGFR).

<p>*The odds ratios of serum alkaline phosphatase quartiles were adjusted by age, sex, systolic blood pressure, body mass index, hemoglobin, cholesterol, current smoking, alcohol, hypertension, myocardial infarction, stroke, and malignancy.</p><p>Associations between serum alkaline phosphatase quartiles and diabetes according to the estimated glomerular filtration rate (eGFR).</p

Associations of glomerular hyperfiltration among serum alkaline phosphatase quartiles in participants with an estimated glomerular filtration rate ≥ 60 ml/min/1.73 m².

<p>*The odds ratios of serum alkaline phosphatase quartiles were adjusted by age, sex, diastolic blood pressure, glucose, body mass index, alanine aminotransferase, aspartate aminotransferase, hemoglobin, white blood cell count (WBC), ferritin, triglyceride, diabetes (DM), metabolic syndrome, angina, current smoking, and alcohol consumption.</p><p>Associations of glomerular hyperfiltration among serum alkaline phosphatase quartiles in participants with an estimated glomerular filtration rate ≥ 60 ml/min/1.73 m².</p