Low erythropoietin levels predict faster renal function decline in diabetic patients with anemia: a prospective cohort study

Elevated erythropoietin (EPO) levels have been reported to predict poor survival in various populations including diabetic patients. However, data regarding its impact on renal outcomes are scarce. We conducted a single-center, prospective cohort study of 339 type 2 diabetic patients with anemia. The primary outcome was the estimated glomerular filtration rate (eGFR) slope for two years. We performed multiple linear regression and restricted cubic spline analyses to assess the association of serum EPO levels with the renal outcome. Chronic kidney disease (CKD) was defined as eGFR 30 mg/g creatinine. Median baseline EPO and eGFR level were 14.4 IU/L and 53 mL/min/1.73 m2, respectively. Inappropriately low EPO levels were observed in 73% of anemic patients and 59% of anemic patients even without CKD, suggesting that EPO deficiency precedes the onset of CKD in diabetes mellitus. Multivariable analysis revealed that iron status and hemoglobin levels were major determinants of EPO levels. Median eGFR slope was −1.3 mL/min/1.73 m2/year. We found that low EPO levels, but not low hemoglobin levels, were associated with a faster decline in eGFR, independent of clinically relevant factors. The eGFR decline was steeper, particularly when the EPO level was below the upper limit of normal. Lower EPO concentrations were associated with rapid eGFR decline, especially in patients with iron deficiency (P for interaction = 0.01). Relative EPO deficiency should be considered as a culprit in anemia of unknown etiology in diabetic patients, even those without CKD. Low EPO levels, especially when accompanied by poor iron status, are predictive of rapid loss of renal function.Fujita Y., Doi Y., Hamano T., et al. Low erythropoietin levels predict faster renal function decline in diabetic patients with anemia: a prospective cohort study. Scientific Reports 9, 14871 (2019); https://doi.org/10.1038/s41598-019-51207-8

Recurrence of Proliferative Glomerulonephritis with Monoclonal Immunoglobulin G Deposits with a Striated Ultrastructure

This is the peer-reviewed but unedited manuscript version of the following article: Nephron 2020;144(suppl 1):43–48 (DOI: 10.1159/000512330)]. The final, published version is available at http://www.karger.com/?doi=10.1159/000512330

Comparison of Bacterial Flora in a Methane Fermentation Plant in Field Science Center at Tohoku University and Bovine Rumen Used as the Plant Microbial Resource by 16S rRNA Gene Sequencing

Poster Sessio

An ancillary study of participants in a randomized, placebo-controlled trial suggests that ingestion of bovine lactoferrin promotes expression of interferon alpha in the human colon

AbstractStudies using animal models have demonstrated that ingestion of bovine lactoferrin (bLF) is able to induce cytokine expression in the intestine and inhibit carcinogenesis in the colon and other organs of experimental animals. Consequently, a clinical trial was conducted in the National Cancer Center Hospital, Tokyo, Japan to determine whether ingestion of bLF affected the growth of colorectal polyps in humans. The Tokyo-trial found that ingestion of 3.0 g bLF suppressed the growth of colorectal polyps and increased the level of serum human lactoferrin in participants 63 years old or younger. The present study is a complementary study to the Tokyo-trial to determine if a change in the expression of one or more cytokines could be detected in the colon of the Tokyo-trial participants after ingesting bLF. We found that daily ingestion of 3.0 g bLF promoted the expression of interferon alpha in the colon of the Tokyo-trial participants

Daptomycin-related Musculoskeletal Adverse Events and Statin Use

Background. There is a growing concern about the association between the combined use of daptomycin (DAP) and statins and the occurrence of musculoskeletal adverse events (MAEs), but this remains controversial. This study aimed to clarify the association between statin use and DAP-related MAEs. Methods. We used a mixed approach that combines 2 methodologies. First, we conducted a meta-analysis to examine the effects of statin use on DAP-related MAEs. Second, we conducted a disproportionality analysis using the US Food and Drug Administration Adverse Events Reporting System (FAERS) to further confirm the results of the meta-analysis and to examine the effect of each type of statin on DAP-related MAEs in a large population. Results. In the meta-analysis, statin use significantly increased the incidence of DAP-related rhabdomyolysis (odds ratio [OR]: 3.83; 95% confidence interval [CI]: 1.43–10.26) but not DAP-related myopathy (OR: 1.72; 95% CI: .95–3.12). In the disproportionality analysis using the FAERS, the use of statin significantly increased the reporting OR (ROR) for DAP-related myopathy (ROR: 5.69; 95% CI: 4.31–7.51) and rhabdomyolysis (ROR: 5.77; 95% CI: 4.33–7.68). Atorvastatin, rosuvastatin, and simvastatin all increased the incidence of DAP-related myopathy and rhabdomyolysis. Conclusion. The mixed approach combining a meta-analysis and disproportionality analysis showed that statin use was associated with the occurrence of DAP-related rhabdomyolysis. The appropriate use of statins and DAP should be performed with careful consideration of its safety

Hypertension treatment status and ultrasonic cardiography findings in temporary housing residents after the Kumamoto earthquake: a cross-sectional study

Background: We aimed to investigate and report the relationship between hypertension treatment status and cardiac functions among temporary housing residents after the Kumamoto earthquake. Material and methods: Ultrasonic cardiography examinations were conducted for 56 residents at temporary housing complexes in Minami Aso village in Kumamoto Prefecture in December 2016. The subjects were divided into the following three groups according to the incidence of hypertension and the antihypertensive treatment status: normal (without hypertension), treated, and untreated. Subsequently, their cardiac functions were compared. Results: Age and BMI were found to be positive predictors for hypertension. Moreover, age, LAVI, and LVMI tended to be higher in the untreated group than in the treated group. Moderate or severe mitral regurgitation was significantly more common in the untreated group than in the treated group. Conclusions: Controlling blood pressure may help to prevent new cardiac diseases (e.g., valve regurgitation) among survivors after a major disaster. In addition, for survivors who are  severely affected by psychological stress, improving the mental stress support system may be an effective measure to reduce health problems