Renal disease

肾脏疾病
  • 文章类型: Case Reports
    X-连锁无丙种球蛋白血症(XLA)是一种以反复感染为特征的体液免疫缺陷疾病,严重的低丙种球蛋白血症,循环B细胞缺乏.虽然XLA的标志性临床表现通常包括呼吸道,皮肤病学,和胃肠系统,肾脏受累是罕见的。在这篇文章中,我们报告了两例XLA并发肾脏疾病,补充了对记录在案的案例的审查。
    所描述的两个案例涉及孪生兄弟,均表现为呼吸道感染和肾脏表现。随后的基因检测证实了XLA的诊断。弟弟在静脉注射免疫球蛋白(IVIG)治疗和抗感染治疗后表现出改善。由于资金紧张,哥哥只接受了抗感染和对症治疗。出院后七个月,哥哥患上了肾炎。然而,他在IVIG治疗后表现出改善。
    对于复发性感染的男性儿童,应考虑进行免疫分析和基因检测,以促进XLA的有效诊断。定期监测对于检测和治疗XLA患者的免疫介导的肾脏疾病也是必要的。
    UNASSIGNED: X-linked agammaglobulinemia (XLA) is a humoral immunodeficiency disorder characterized by recurrent infections, severe hypogammaglobulinemia, and a deficiency of circulating B cells. While the hallmark clinical manifestations of XLA typically include the respiratory, dermatological, and gastrointestinal systems, renal involvement is infrequent. In this article, we report two cases of XLA with concurrent renal disease, supplemented with a review of documented cases.
    UNASSIGNED: The two cases described involve twin brothers, both presenting with respiratory tract infections and renal manifestations. Subsequent genetic testing confirmed the diagnosis of XLA. The younger brother exhibited improvement following intravenous immunoglobulin (IVIG) therapy and anti-infection treatment. Due to financial constraints, the older brother received only anti-infection and symptomatic treatments. Seven months after discharge, the older brother developed nephritis. However, he showed improvement following IVIG treatment.
    UNASSIGNED: Immune profiling and genetic testing should be considered in male children with recurrent infections to facilitate the effective diagnosis of XLA. Regular monitoring is also imperative to detect and treat immune-mediated renal diseases in patients with XLA.
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  • 文章类型: Journal Article
    髓源性生长因子(MYDGF)是一种新型分泌蛋白,具有有效的抗凋亡和组织修复特性,存在于近140个人类组织和细胞系中。在口腔上皮和皮肤中丰度最高。最初,在骨髓来源的单核细胞和巨噬细胞中发现MYDGF用于心肌梗死后的心脏保护和修复。随后的研究表明,MYDGF在其他心血管疾病中起着重要作用(例如,动脉粥样硬化和心力衰竭),代谢紊乱,肾脏疾病,自身免疫性/炎症性疾病,和癌症。尽管基本机制尚未得到充分探索,MYDGF在健康和疾病中的作用可能涉及细胞凋亡和增殖,组织修复和再生,抗炎,和糖脂代谢调节。在这次审查中,我们总结了目前在了解MYDGF在健康和疾病中的作用方面的进展,专注于它的结构,功能和机制。图形摘要显示了MYDGF在不同器官和疾病中的当前作用(图。1).
    Myeloid-derived growth factor (MYDGF) is a novel secreted protein with potent antiapoptotic and tissue-repairing properties that is present in nearly 140 human tissues and cell lines, with the highest abundance in the oral epithelium and skin. Initially, MYDGF was found in bone marrow-derived monocytes and macrophages for cardioprotection and repair after myocardial infarction. Subsequent studies have shown that MYDGF plays an important role in other cardiovascular diseases (e.g., atherosclerosis and heart failure), metabolic disorders, renal disease, autoimmune/inflammatory disorders, and cancers. Although the underlying mechanisms have not been fully explored, the role of MYDGF in health and disease may involve cell apoptosis and proliferation, tissue repair and regeneration, anti-inflammation, and glycolipid metabolism regulation. In this review, we summarize the current progress in understanding the role of MYDGF in health and disease, focusing on its structure, function and mechanisms. The graphical abstract shows the current role of MYDGF in different organs and diseases (Fig. 1).
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  • 文章类型: Journal Article
    尿液检测作为常规筛查程序,异常的测试结果可能对临床医生有提示,但有时可能会被忽视,建立诊断模型可以更好地帮助临床医生识别潜在问题。BLD(血),LEU(白细胞),PRO(蛋白质)和GLU(葡萄糖)是尿液检测中四个最重要的参数,结果的准确性是临床医生的一个关键问题,因此,验证其结果的准确性至关重要。在这项研究中,我们评估了Mindray的自动尿液干化学分析仪的分析和临床性能,UA-5600(以下简称(UA-5600),和配置有仪器的测试条,并根据UA-5600输出的11个参数的结果开发了用于肾脏疾病筛查的机器学习(ML)模型,目的是检测异常的尿液检测结果。
    于2022年8月至9月收集中山大学附属第一医院门诊患者和住院患者的尿样,以评估迈瑞UA-5600干化学分析仪和试纸的性能。对UA-5600及其测试条的评估集中在尿液BLD和LEU读数与通过MindrayEH-2090尿液形成元素分析仪获得的RBC(红细胞)和WBC(白细胞)计数的一致性。我们还将PRO和GLU读数与MindrayBS-2800M生物化学分析仪的结果进行了比较。对门诊和住院患者的尿液样本进行回顾性分析,并根据LIS诊断进行分组。此外,使用UA-5600测量的11个参数,建立了8个用于肾脏疾病筛查的ML模型.并通过验证集对模型进行了验证。
    与EH-2090分析仪相比,UA-5600对BLD的一致率为89.55%,对LEU的一致率为91.04%。以BS-2800M为基准时,PRO和GLU的一致率为94.14%和95.20%,分别。总共使用了1691个样本来构建ML模型,其中346名患者(男性135名,女性211名,年龄范围:18至98岁)诊断患有肾脏疾病,1345名患者(男性397名,女性948名,年龄范围:18至92岁)诊断为其他疾病的非肾脏疾病。值得注意的是,朴素贝叶斯(NB)模型,它是根据UA-5600参数构建的,对肾脏疾病表现出卓越的预测能力,受试者工作特征曲线下面积为0.9470,灵敏度为0.7767,特异性为0.9457。
    迈瑞UA-5600对BLD和LEU均具有强大的检测能力,PRO和GLU的结果与化学分析仪的结果非常吻合。NB模型具有良好的筛选能力,有望成为有效的筛选工具。
    UNASSIGNED: Urine testing as a routine screening programme, abnormal test results can be suggestive to clinicians but can sometimes be overlooked, and the establishment of a diagnostic model can better assist clinicians in identifying potential problems. BLD (blood), LEU (leukocyte), PRO (protein) and GLU (glucose) are the four most important parameters in urine testing, and the accuracy of their results is a key concern for clinicians, so it is essential to verify the accuracy of their results. In this study, we evaluated the analytical and clinical performance of Mindray\'s automatic urine dry chemistry analyzer, the UA-5600 (Hereinafter referred to as the (UA-5600), and the test strips configured with the instrument, and developed a machine-learning (ML) model for kidney disease screening from the results of 11 parameters output from the UA-5600 with the aim of detecting abnormal urine test results.
    UNASSIGNED: Urine samples from outpatients and inpatients at The First Affiliated Hospital of Sun Yat-sen University were collected from August to September 2022 to evaluate the performance of the Mindray UA-5600 dry chemistry analyzer and test strips. The evaluation of the UA-5600 and its test strips focused on the agreement of the urine BLD and LEU readings with the RBC (red blood cell) and WBC (white blood cell) counts obtained by the Mindray EH-2090 urine formed element analyzer. We also compared the PRO and GLU readings with the results of the Mindray BS-2800M biochemistry analyzer. Urine samples from outpatients and inpatients were retrospectively analysed and grouped according to LIS diagnosis. Additionally, eight ML models for kidney disease screening were developed using 11 parameters measured by the UA-5600. And the model was validated by the validation set.
    UNASSIGNED: The UA-5600 had an 89.55% concordance rate for BLD and a 91.04% concordance rate for LEU compared to the EH-2090 analyzer. When benchmarked against the BS-2800M, the concordance rates for PRO and GLU were 94.14% and 95.20%, respectively. A total of 1,691 samples were used for the construction of the ML models, of which 346 patients (135 males and 211 females, age range: 18 to 98 years) diagnosed with renal disease, and 1,345 patients (397 males and 948 females, age range: 18 to 92 years) with non-renal disease diagnosed with other conditions. Notably, the Naïve Bayes (NB) model, which was built from the UA-5600 parameters, demonstrated superior predictive capabilities for renal disease, with an area under the receiver operating characteristic curve of 0.9470, a sensitivity of 0.7767, and a specificity of 0.9457.
    UNASSIGNED: The Mindray UA-5600 demonstrates robust detection abilities for both BLD and LEU, and its results for PRO and GLU align closely with those obtained from the chemistry analyzer. The NB model has a good screening ability and shows promise as an effective screening tool.
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  • 文章类型: Journal Article
    目的:本研究旨在探讨饮食习惯与胃食管反流病(GERD)之间的潜在因果关系。
    方法:使用逆方差加权方法,我们进行了双样本孟德尔随机化(MR)分析,以调查22种饮食习惯与GERD之间的因果关系.采用留一法分析评估结果的稳定性和可靠性,异质性测试,并基于效应测度比值比(OR)和95%置信区间(CI)进行水平多效性检验。
    结果:MR分析结果表明饮酒(OR=1.472;95%CI,1.331至1.629;p<1.0×10-3)与食物中添加的盐(OR=1.270;95%CI,1.117至1.443;p<1.0×10-3)与GERD的风险呈正相关。相反,面包摄入量(OR=0.613;95%CI,0.477至0.790;p<1.0×10-3),谷物摄入量(OR=0.613;95%CI,0.391至0.677;p<1.0×10-3),奶酪摄入量(OR=0.709;95%CI,0.593至0.846;p<1.0×10-3),干果摄入量(OR=0.535;95%CI,0.404至0.709;p<1.0×10-3),新鲜水果摄入量(OR=0.415;95%CI,0.278至0.619;p<1.0×10-3),和油性鱼的摄入量(OR=0.746;95%CI,0.633至0.879;p<1.0×10-3)与GERD的风险呈负相关。敏感性分析显示没有反向因果关系的证据,多功能性,或异质性。
    结论:食物中添加酒精和盐会增加GERD风险,当面包摄入时,谷物摄入量,奶酪摄入量,摄入某些干果和某些新鲜水果,油性鱼降低了它。我们的研究证实了这些饮食与GERD之间的潜在因果关系,提供有针对性的预防策略的见解。
    OBJECTIVE: This study aimed to explore the potential causal relationship between dietary habits and Gastroesophageal Reflux Disease (GERD).
    METHODS: Using the inverse-variance weighted method, a two-sample Mendelian randomization (MR) analysis was performed to investigate the causal relationship between 22 dietary habits and GERD. The stability and reliability of the results were assessed using leave-one-out analysis, heterogeneity tests, and tests for horizontal pleiotropy based on the effect measure odds ratio (OR) and 95% confidence interval (CI).
    RESULTS: The results of the MR analysis indicated a positive association between alcohol drinking (OR=1.472; 95% CI, 1.331 to 1.629; p<1.0×10-3) and salt added to food (OR=1.270; 95% CI, 1.117 to 1.443; p<1.0×10-3) with the risk of GERD. Conversely, bread intake (OR=0.613; 95% CI, 0.477 to 0.790; p<1.0×10-3), cereal intake (OR=0.613; 95% CI, 0.391 to 0.677; p<1.0×10-3), cheese intake (OR=0.709; 95% CI, 0.593 to 0.846; p<1.0×10-3), dried fruit intake (OR=0.535; 95% CI, 0.404 to 0.709; p<1.0×10-3), fresh fruit intake (OR=0.415; 95% CI, 0.278 to 0.619; p<1.0×10-3), and oily fish intake (OR=0.746; 95% CI, 0.633 to 0.879; p<1.0×10-3) were negatively associated with the risk of GERD. Sensitivity analysis showed no evidence of reverse causation, pleiotropy, or heterogeneity.
    CONCLUSIONS: Alcohol and salt added to food raised GERD risk, while bread intake, cereal intake, cheese intake, intake of certain dried fruits and certain fresh fruits, and oily fish lowered it. Our study affirms the potential causal link between these diets and GERD, offering insights into targeted prevention strategies.
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  • 文章类型: Journal Article
    髓过氧化物酶(MPO)是一种含血红素的过氧化物酶,主要在中性粒细胞中表达,在较小程度上,在单核细胞中。已知MPO通过催化Cl-与H2O2的反应产生强氧化剂而具有广泛的杀菌能力,次氯酸(HOCl)。然而,MPO衍生氧化剂的过量生产引起了人们对其有害作用的关注,尤其是以急性或慢性炎症为特征的疾病。广义地说,MPO及其衍生的氧化剂主要通过生物分子的氧化参与疾病的病理过程,促进炎症和氧化应激。同时,一些研究人员发现,MPO缺乏或使用MPO抑制剂可以减轻炎症和组织损伤。一起来看,MPO可能是预后和治疗干预的有希望的目标。因此,了解MPO在各种疾病进展中的作用具有重要价值。这篇综述全面分析了MPO在几种疾病进展中的不同作用。包括心血管疾病(CVD),神经退行性疾病,癌症,肾脏疾病,和肺部疾病(包括COVID-19)。这些信息为后续的机理研究和药物开发提供了有价值的参考。
    Myeloperoxidase (MPO) is a heme-containing peroxidase, mainly expressed in neutrophils and, to a lesser extent, in monocytes. MPO is known to have a broad bactericidal ability via catalyzing the reaction of Cl- with H2O2 to produce a strong oxidant, hypochlorous acid (HOCl). However, the overproduction of MPO-derived oxidants has drawn attention to its detrimental role, especially in diseases characterized by acute or chronic inflammation. Broadly speaking, MPO and its derived oxidants are involved in the pathological processes of diseases mainly through the oxidation of biomolecules, which promotes inflammation and oxidative stress. Meanwhile, some researchers found that MPO deficiency or using MPO inhibitors could attenuate inflammation and tissue injuries. Taken together, MPO might be a promising target for both prognostic and therapeutic interventions. Therefore, understanding the role of MPO in the progress of various diseases is of great value. This review provides a comprehensive analysis of the diverse roles of MPO in the progression of several diseases, including cardiovascular diseases (CVDs), neurodegenerative diseases, cancers, renal diseases, and lung diseases (including COVID-19). This information serves as a valuable reference for subsequent mechanistic research and drug development.
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  • 文章类型: Review
    生酮饮食限制了葡萄糖的能量供应并刺激脂解,脂质氧化,和生酮,导致血液中酮体水平升高。酮体在肝细胞的线粒体基质中合成,β-羟基丁酸(BHB)是最丰富的酮体类型。在这里,我们回顾了已发表的关于酮体代谢和BHB在肾脏疾病中的作用的发现。通过血液循环,酮体到达代谢活性组织并提供替代的能量来源。BHB,作为一个信号分子,介导各种类型的细胞信号转导,参与多种疾病的发生发展。BHB还对多种肾脏疾病具有保护和治疗作用。BHB改善肾脏疾病的预后,比如糖尿病肾病,慢性肾病,急性肾损伤,多囊肾病,通过它的抗氧化剂,抗炎,和应激反应机制。先前的研究集中在酮体在调节免疫细胞中的炎症和氧化应激中的作用。关于酮体水平升高对肾足细胞和肾小管细胞代谢的影响的研究仍然没有定论。需要进一步的研究来研究BHB对肾脏疾病中足细胞损伤和足细胞衰老的影响。
    A ketogenic diet limits energy supply from glucose and stimulates lipolysis, lipid oxidation, and ketogenesis, resulting in elevated levels of ketone bodies in the bloodstream. Ketone bodies are synthesized in the mitochondrial matrix of liver cells and β-hydroxybutyric acid (BHB) is the most abundant type of ketone body. Herein, we reviewed published findings on the metabolism of ketone bodies and the role of BHB in renal diseases. Through blood circulation, ketone bodies reach metabolically active tissues and provides an alternative source of energy. BHB, being a signaling molecule, mediates various types of cellular signal transduction and participates in the development and progression of many diseases. BHB also has protective and therapeutic effects on a variety of renal diseases. BHB improves the prognosis of renal diseases, such as diabetic kidney disease, chronic kidney disease, acute kidney injury, and polycystic kidney disease, through its antioxidant, anti-inflammatory, and stress response mechanisms. Previous studies have focused on the role of ketone bodies in regulating inflammation and oxidative stress in immune cells. Investigations into the effect of elevated levels of ketone bodies on the metabolism of renal podocytes and tubular cells remain inconclusive. Further research is needed to investigate the effect of BHB on podocyte damage and podocyte senescence in renal diseases.
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  • 文章类型: Case Reports
    背景:伴有畸形因子和远端骨骼异常的神经发育障碍(NEDDFSA)是一种罕见且表型可变的疾病。含1基因的锌指MIZ型(ZMIZ1)是NEDDFSA的致病基因,编码激活的STAT样家族转录调节因子的蛋白质抑制剂。鉴于报告的NEDDFSA病例很少,这种疾病的新表型和基因型仍在被发现。
    目的:本研究描述了由新型ZMIZ1变体引起的中国NEDDFSA家族的表型特征。
    方法:我们回顾了一名中国NEDDFSA患者的临床表型,并对患者家属进行了全外显子组测序(WES)。我们模拟了突变蛋白的潜在生物学危害性。构建质粒并用于蛋白质印迹和免疫荧光测定以分析蛋白质表达水平。
    结果:患者是一名6个月大的男性婴儿,表现出畸形面部特征,神经发育异常,先天性心脏病,和以前未报告的泌尿生殖系统异常。WES在ZMIZ1中显示出非移码缺失变体(NM_020338.4:c.858_875del,p.Val288_Ala293del),导致蛋白质富含丙氨酸结构域的结构改变。蛋白质印迹和免疫荧光测定表明,与野生型蛋白相比,突变型ZMIZ1蛋白的表达水平显着降低。
    结论:该患者的临床表现可能与ZMIZ1变异有关,ZMIZ1蛋白富含丙氨酸结构域的结构改变可能导致更复杂的疾病表型。这些结果扩大了ZMIZ1的基因型-表型相关性。
    Neurodevelopmental disorder with dysmorphic factors and distal skeletal anomalies (NEDDFSA) is a rare and phenotypically variable disorder. The zinc finger MIZ-type containing 1 gene (ZMIZ1) is a causative gene of NEDDFSA that encodes a protein inhibitor of the activated STAT-like family transcriptional regulator. Given the rarity of reported NEDDFSA cases, new phenotypes and genotypes of this disorder are still being discovered.
    This study describes the phenotype characteristics of a Chinese NEDDFSA family caused by a novel ZMIZ1 variant.
    We reviewed the clinical phenotype of a Chinese patient with NEDDFSA and performed whole-exome sequencing (WES) of the patient\'s family. We simulated the potential biological harmfulness of the mutant protein. Plasmids were constructed and used for western blot and immunofluorescence assays to analyze protein expression levels.
    The patient was a 6-month-old male infant who exhibited dysmorphic facial features, neurodevelopmental abnormalities, congenital heart disease, and previously unreported genitourinary system anomalies. WES revealed a non-frameshift deletion variant in ZMIZ1 (NM_020338.4: c.858_875del, p.Val288_Ala293del), resulting in a structural alteration in the protein\'s alanine-rich domain. Western blot and immunofluorescence assays indicated a significant decrease in the expression level of the mutant ZMIZ1 protein compared to the wild-type protein.
    The clinical manifestations of this patient may be associated with the ZMIZ1 variant, and the structural alteration in the alanine-rich domain of the ZMIZ1 protein may contribute to a more complex disease phenotype. These results expand the genotype-phenotype correlation of ZMIZ1.
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  • 文章类型: Journal Article
    翻译后修饰(PTM)是调节各种细胞生物学过程的重要表观遗传机制。质谱(MS)-蛋白质组学的使用导致了许多新型蛋白质PTM的发现,如乙酰化,巴豆酰化,2-羟基异丁酰,β-羟基丁酰化,蛋白质丙酰化和丁酰化,琥珀酰化,丙二基化,乳酸化,和组蛋白甲基化。在这次审查中,我们特别强调了各种组蛋白和一些非组蛋白PTM在肾脏疾病中的分子机制和作用,包括糖尿病肾病.PTM对肾脏疾病表现出不同的影响,既可以是保护性的,也可以是有害的,取决于蛋白质PTM的特定类型及其各自的靶标。不同的PTM在不同的肾脏病理条件下激活不同的信号通路,这可以为研究表观遗传机制和开发肾脏疾病的潜在治疗策略提供新的见解。
    Post-translational modifications (PTMs) are crucial epigenetic mechanisms that regulate various cellular biological processes. The use of mass spectrometry (MS)-proteomics has led to the discovery of numerous novel types of protein PTMs, such as acetylation, crotonylation, 2-hydroxyisobutyrylation, β-hydroxybutyrylation, protein propionylation and butyrylation, succinylation, malonylation, lactylation, and histone methylation. In this review, we specifically highlight the molecular mechanisms and roles of various histone and some non-histone PTMs in renal diseases, including diabetic kidney disease. PTMs exhibit diverse effects on renal diseases, which can be either protective or detrimental, depending on the specific type of protein PTMs and their respective targets. Different PTMs activate various signaling pathways in diverse renal pathological conditions, which could provide novel insights for studying epigenetic mechanisms and developing potential therapeutic strategies for renal diseases.
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  • 文章类型: Journal Article
    线粒体抗病毒信号蛋白(MAVS)是线粒体外膜上的关键先天免疫适配器,在病毒感染的免疫信号转导应答中起开关作用。一些研究报道,MAVS在病毒感染期间介导NF-κB和I型干扰素信号传导,并且也是最佳NLRP3炎性体活性所必需的。最近的研究报道,MAVS与各种癌症有关,系统性红斑狼疮,肾脏疾病,和心血管疾病。在这里,我们总结了结构,激活,病理生理作用,和基于MAVS的肾脏疾病疗法。这篇综述提供了对MAVS在肾脏疾病发病机制中的作用和治疗潜力的新见解。
    Mitochondrial antiviral signaling protein (MAVS) is a key innate immune adaptor on the outer mitochondrial membrane that acts as a switch in the immune signal transduction response to viral infections. Some studies have reported that MAVS mediates NF-κB and type I interferon signaling during viral infection and is also required for optimal NLRP3 inflammasome activity. Recent studies have reported that MAVS is involved in various cancers, systemic lupus erythematosus, kidney diseases, and cardiovascular diseases. Herein, we summarize the structure, activation, pathophysiological roles, and MAVS-based therapies for renal diseases. This review provides novel insights into MAVS\'s role and therapeutic potential in the pathogenesis of renal diseases.
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  • 文章类型: Journal Article
    肾脏疾病是全球主要的健康问题,影响数百万人。由于肾脏疾病引起的凝血障碍,肾学家对血小板表现出了兴趣。随着对血小板的深入了解,已经发现这些无核和丰富的血细胞不仅在止血中起作用,而且在炎症和免疫中也有重要功能。血小板不仅受到肾脏疾病的影响,但也可能通过介导炎症和免疫效应导致肾脏疾病进展。这篇综述总结了目前关于肾脏疾病中血小板异常的证据。以及血小板对肾脏疾病进展的多重影响。血小板与肾脏疾病之间的关系仍在探索中,进一步的研究可以为血栓形成之间的关系提供机制上的见解,出血,和肾脏疾病相关的炎症,并阐明肾脏疾病患者的靶向治疗。
    Kidney disease is a major global health concern, affecting millions of people. Nephrologists have shown interest in platelets because of coagulation disorders caused by renal diseases. With a better understanding of platelets, it has been found that these anucleate and abundant blood cells not only play a role in hemostasis, but also have important functions in inflammation and immunity. Platelets are not only affected by kidney disease, but may also contribute to kidney disease progression by mediating inflammation and immune effects. This review summarizes the current evidence regarding platelet abnormalities in renal disease, and the multiple effects of platelets on kidney disease progression. The relationship between platelets and kidney disease is still being explored, and further research can provide mechanistic insights into the relationship between thrombosis, bleeding, and inflammation related to kidney disease, and elucidate targeted therapies for patients with kidney disease.
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