Qhov cuam tshuam ntawm Preoperative High-oral Protein Loading ntawm luv-thiab-ntev ntev lub raum cov txiaj ntsig tom qab Kev phais plawv: Kev Kawm Cohort

Keeb kwm ntawm Abstract:Post-cardiac phais mob raum raug mob (AKI) yog txuam nrog kev tuag ntau ntxiv. Cov zaub mov muaj protein ntau ua rau lub raum ntshav khiav thiabglomerular pom tus nqi(GFR) thiab tuaj yeem tiv thaiv lub raum los ntawm kev ua phem rau ischemic. Yog li, peb tau soj ntsuam cov txiaj ntsig ntawm preoperative high-qhov ncauj protein load rau tom qab lub plawv phais lub raum muaj nuj nqi thiab siv cov qauv kev sim los elucidate mechanisms los ntawm cov protein yuav txhawb lub raum-productive teebmeem.

Txoj kev:Cov yav tom ntej "Preoperative Renal Functional Reserve PredictsKev pheej hmoo ntawm AKI tom qab Kev Ua Haujlwm Mob Siab" txoj kev tshawb nrhiav tau txuas ntxiv mus rau kev ua haujlwm tom qab 12 lub hlis rau 109 tus neeg mob. A 1: 2 ratio propensity score matching method tau siv los txheeb xyuas pawg tswj hwm (n=214) los ntsuas qhov cuam tshuam. Cov ntsiab lus tseem ceeb ntawm kev ua haujlwm preoperative protein load thiab kev saib xyuas tus qauv. Cov ntsiab lus tseem ceeb yog AKI txoj kev loj hlob thiab postoperative kwv yees GFR (eGFR) poob ntawm 3 thiab 12 lub hlis. }) thiab insulin-zoo li kev loj hlob zoo-binding protein 7 (IGFBP7), biomarkers cuam tshuam hauv kev sib kholub raum-tiv thaiv mechanismshauvtib neeg lub raumtubular hlwb uas peb raug rau qhov sib txawv ntawm cov protein ntau.

Cov txiaj ntsig:Tus nqi AKI tsis txawv ntawm cov protein loading thiab tswj pawg (13.6 vs. 12.3%; p=0.5). Txawm li cas los xij, qhov nruab nrab eGFR poob qis dua qub tom qab 3 lub hlis (0.1 [95% CI−1.4,−1.7] vs.−3.3 [95% CI−4.4,−2.2] ml/min/ 1.73 m2 ) thiab 12 lub hlis (−2.7 [95% CI−4.2,−1.2] vs−10.2 [95% CI−11.3,−9.1] ml/min/1.73 m2; p<0.001 for both). On stratification based on AKI development, the eGFR loss after 12 months was also found to be lower in the former (−8.0 [95% CI−14.1,−1.9] vs.−18.6 [95% CI−23.3,−14.0] ml/min/1.73 m2; p=0.008). A dose–response analysis of the protein treatment of the primary human proximal and distal tubule epithelial cells in culture showed significantly increased IGFBP7 and TIMP-2 expression. 

Cov lus xaus:Ib qho preoperative high-oral protein load tsis txo AKI txoj kev loj hlob tab sis tau cuam tshuam nrog kev ua haujlwm ntawm lub raum ntau dua rau cov neeg mob thiab tsis muaj AKI ntawm 12 lub hlis tom qab kev phais mob plawv. Cov txheej txheem muaj peev xwm ntawm kev ua los ntawm kev thauj khoom protein tuaj yeem ua rau lub raum tiv thaiv cov lus teb tuaj yeem suav nrog kev cuam tshuam ntawm lub voj voog ntawm tes.lub raum tubular epithelial hlwb. ClinicalTrials.gov: NCT03102541 (retrospectively sau npe rau lub Plaub Hlis 5, 2017) thiab kev sim tshuaj. gov: NCT03092947 (retrospectively sau npe nyob rau lub Peb Hlis 28, 2017).

Ntsiab lus: Mob raum raug mob, Mob raum mob,Kev kuaj mob raum, Lub raum rov qab

Nyem qhov no kom tau txais Natural organic CISTANCHE EXTRACT nrog 25% ECHINACOSIDE thiab 9% ACTEOSIDE rau lub raum ua haujlwm

Keeb kwm

Mob raum raug mob(AKI) yog qhov teeb meem loj tshaj plaws ntawm kev phais mob plawv thiab nws tus kheej cuam tshuam nrog kev nce luv luv thiab ntev morbidity thiab kev tuag [1, 2]. Txawm hais tias ntau tus neeg mob qhia AKI thim rov qab nyob rau hauv ib hnub rau lub lis piam ntawm kev loj hlob, cov ntaub ntawv qhia txog kev sib raug zoo ntawm AKI thiab kab mob raum tom qab (CKD) [3, 4]. Yog li, txoj hauv kev zoo los tiv thaiv kev txhim kho ntawm AKI yog qhov tseem ceeb rau kev txo lub nra ntawm CKD. Lub pathophysiology ntawm AKI tom qab kev phais mob plawv zoo li yuav tshwm sim los ntawm kev koom tes ntawm ntau txoj kev raug mob mus rau qhov sib txawv ntawm cov neeg mob ua ntej, intraoperatively, thiab postoperatively [5]. Ntawm cov txheej txheem tau hais tseg, kev hloov pauv hauv lub raum perfusion thaum lub sijhawm cardiopulmonary bypass thiab postoperative lub raum ischemic raug mob yog xav tias tseem ceeb.contributors rau AKI [6].

Hauv cov tib neeg noj qab haus huv thiab cov neeg laus uas tau teem sijhawm mus rau kev phais mob plawv, cov khoom noj muaj protein ntau tau tshaj tawm txhim kho glomerular filtration rate (GFR) los ntawm lub ntiaj teb nce hauv lub raum cov ntshav ntws vim yog afferent arteriolar dilation thiab txo qis hauv lub raum vascular tsis kam ua rau glomerular hyperfiltration [7] ]. Qhov no tshwm sim los ntawm kev hloov pauv ntawm tubuloglomerular tawm tswv yim mechanism thiab kev hloov pauv hauv cov theem ntawm vasoactive compounds [8, 9]. Hauv qhov sib piv, kev txwv cov protein yog cuam tshuam nrog kev txo qis hauv lub raum cov ntshav khiav thiabGFR[10]. Cov qauv tsiaj tau pom tias cov amino acids tuaj yeem tiv thaiv ob lub raum los ntawm kev ua phem rau ischemic, zoo li los ntawm kev tswj lub raum cov ntshav khiav thiab yog li ameliorating ischemic thiab inflammatory kev raug mob uas tuaj yeem ua rau AKI [11].

Txawm li cas los xij, cov kev cuam tshuam uas ua rau kom cov ntshav ntws mus rau hauv lub raum (xws li, daim ntawv thov dopamine) tsis muaj txiaj ntsig zoo hauv kev tiv thaiv lossis kho AKI. Ib qho laj thawj yog vim li cas cov protein ntau tuaj yeem ua rau lub raum ua rau tib txoj kev uas ncaj qha lossis tej thaj chaw deb ischemic preconditioning (RIPC) yuav [12, 13]. Qhov kev puas tsuaj rau "kev ntxhov siab" no tuaj yeem ua rau muaj kev tiv thaiv hauv lub raum. Kev tso tawm ntawm cov ntaub so ntswg inhibitors ntawm metalloproteases -2 (TIMP-2) thiab insulin-zoo li kev loj hlob zoo-binding protein 7 (IGFBP7), uas induce cell voj voog ntes, zoo li yog ib tug cim ntawm qhov kev tiv thaiv teb [ 12, 13] ib.

Peb yav dhau los tau tshaj tawm txog tus nqi ntawm lub raum kev ua haujlwm cia (RFR), ntsuas raws li kev ua haujlwm ntawm lub qhov ncauj qhov ncauj ua ntej, rau kev kwv yees ntawm AKI hauv cov neeg mob uas tau xaiv txoj kev phais mob plawv [14]. Hauv txoj kev tshawb fawb tam sim no, peb tau tshawb xyuas seb puas muaj cov protein thauj khoom nws tus kheej tuaj yeem cuam tshuam rau txoj kev loj hlob ntawm AKI thiab lub raum ua haujlwm ntev tom qab kev phais mob plawv hauv kev sib piv nrog cov kev tswj hwm zoo sib xws nrog cov pej xeem zoo sib xws, kev pheej hmoo, thiab kev phais mob uas tau txais kev kho mob ua ntej. Tsis tas li ntawd, peb tau siv hauv vitro cell kab lis kev cai qauv uas muaj cov tib neeg lub raum proximal thiab distal tubule hlwb los elucidate lub peev xwm mechanism uas cov protein yuav ua rau lub raum-tiv thaiv cov teebmeem ncaj qha ntawm cov tubular theem.

Methods Kawm tsim thiab koom

Qhov no ib leeg-chaw, tsis yog qhov muag tsis pom, kev tshawb fawb koom nrog suav nrog cov neeg mob nkag rau hauv "Preoperative RFR Predicts Risk of AKI after Cardiac Operation" txoj kev tshawb fawb [14]. Txoj kev tshawb no suav nrog 110 tus neeg laus nrog eGFR [15] val ues Ntau dua lossis sib npaug li 60 ml / min / 1.73 m2 teem rau kev phais mob plawv (kab mob hlab ntsha tawg, hloov lub valve, ua ke ntawm ob, lossis lwm yam kev phais mob, nrog rau kev phais plawv. bypass) thaum lub Kaum Ib Hlis 2014 thiab Lub Kaum Hli 2015 ntawm Lub Tsev Haujlwm Saib Xyuas Kev Kho Mob, San Bortolo Tsev Kho Mob, Vicenza, Ltalis. Cov txheej txheem nthuav dav suav nrog kev kho mob phais tau piav qhia hauv Cov Ntaub Ntawv Ntxiv 1. Qhov tseem ceeb, cov neeg mob uas tsis tau txiav kev kho mob nrog renin-angiotensin-system blockers (ib feem ntawm cov txheej txheem txheej txheem ntawm Lub Tsev Haujlwm Saib Xyuas Kev Kho Mob hauv Vicenza), tsawg kawg ntawm 48 teev ua ntej kev nkag tau raug cais tawm.

Txoj kev kawm raws tu qauv tau piav qhia hauv lwm qhov [14]. Luv luv, cov neeg mob tau txais cov protein ntau hauv qhov ncauj (1.2 g / kg lub cev qhov hnyav ntawm cov nqaij tsis qab ntsev liab tsis muaj cov khoom noj ntxiv) los ntsuas lawv RFR ib hnub ua ntej kev phais ntxiv rau kev kho mob ua ntej [14] thiab ntawm 3 lub hlis tom qab kev phais. hauv tsev kho mob [16] Kwv yees li ib lub lis piam ua ntej qhov kev ntsuam xyuas RFR, cov neeg koom tau muab cov lus qhia meej txog kev siv tshuaj (tsis muaj cov tshuaj tsis muaj tshuaj tiv thaiv kab mob, tsis muaj renin-angiotensin-system blockers) uas tau tso cai thaum sawv ntxov ntawm kev kuaj mob. Kev kwv yees ntawm qhov muaj peev xwm tshwm sim thiab qhov sib txawv ntawm kev noj cov protein ntau ntawm GFR tau txais los ntawm kev tshaj tawm yav dhau los [17, 18]. Tsis tas li ntawd, qhov siab ntawm qhov ncauj cov khoom noj tau raug txhais raws li kev tshuaj ntsuam xyuas tsis ntev los no, uas tau pom tias muaj cov nyhuv qab nthab nrog qhov txwv siab tshaj plaws ntawm GFR qhov siab tshaj plaws tom qab noj cov protein ntau hauv qhov ncauj ntau dua lossis sib npaug li 1 g / kg lub cev hnyav [19 ]. Cov txiaj ntsig ntawm bioimpedance vector tsom xam nyob rau hauv pab pawg neeg thauj khoom protein tau muab rau hauv Cov Ntaub Ntawv Ntxiv 1: Table S1. Pab pawg tswj hwm tau txheeb xyuas los ntawm kev txheeb xyuas cov qhab nia zoo uas tau ua los ntawm cov sib txawv ntawm hnub nyoog, poj niam los txiv neej, haiv neeg, kab mob plawv, thiab cov hauv paus ntsiab lus eGFR tau ua cov txheej txheem zoo sib xws nyob ib puag ncig lub sijhawm uas RFR pawg tau txais kev phais (ntau: 0-3 lub hlis) siv 1: 2 piv txoj kev sib piv (rau lwm yam kev tsim nyog tau txais saib Ntxiv cov ntaub ntawv 1). Cov neeg mob tswj tau txais kev kho mob preopera tiv thaiv tus qauv, uas tau txhais pragmatically. Txoj kev tshawb no tau pom zoo los ntawm Pawg Neeg Saib Xyuas Kev Ncaj Ncees hauv cheeb tsam (79/16F) thiab ua raws li cov cai ntawm Kev Tshaj Tawm ntawm Helsinki. Cov neeg mob tau mus txog rau kev tso npe nkag thaum muaj kev sib tham txog kev lees paub thiab tau sau ntawv tso cai.

Cov txheej txheem thiab kev ntsuas Kev ntsuas ntawm lub raum kev ua haujlwm

AKI tau txhais raws li KDIGO cov txheej txheem ua haujlwm raws li kev nce hauv SCr los ntawm Ntau dua lossis sib npaug rau {{{0}}.3 mg/dl hauv 48 h lossis Ntau dua lossis sib npaug rau 1.5 npaug ntawm tus nqi pib hauv 7 hnub lossis zis tso zis < 0.5 ml/kg/h rau 6 h [20]. Baseline SCr tau txiav txim siab raws li tag nrho cov txiaj ntsig SCr muaj los ntawm tsev kho mob thiab cov ntaub ntawv kho mob sab nraud hauv 90 hnub dhau los. Rau cov neeg uas nws cov ntaub ntawv theem pib SCr tsis muaj, peb tau nthuav dav cov qauv tshuaj ntsuam kom nce lossis txo qis hauv SCr los ntawm 0.3 mg / dL thaum nyob hauv tsev kho mob. Qhov zoo ntawm cov kua dej sib npaug thiab hemodilution raug txiav txim siab hauv kev kuaj mob thiab theem ntawm AKI siv cov qauv hauv qab no [21]:

Kho SCr qib=SCr × kho qhov zoo

nyob qhov twg qhov kho qhov tseem ceeb {{0}}(qhov hnyav (kg) thaum mus pw hauv tsev kho mob ×0.6+Σ (cov dej sib npaug txhua hnub (liter))) / tsev kho mob qhov hnyav × 0.6

AKI thim rov qab tau txhais tias yog qhov tsis muaj ib theem ntawm AKI ntawm tsev kho mob tawm [22]. Tag nrho cov xwm txheej tau raug tshuaj xyuas los ntawm rooj plaub kom paub meej tias txhua qhov kev kuaj mob ntawm AKI thiab AKI thim rov qab los ntawm pawg neeg saib xyuas qhov muag tsis pom kev suav nrog peb tus kws tshaj lij nephrologists dig muag rau cov ntaub ntawv kho mob. Yog tias ob tus neeg soj ntsuam tsis pom zoo, tus neeg soj ntsuam thib peb tau muab cov tswv yim thiab kev pom zoo tau tsim. Cov zis tso zis rau albuminuria tau sau ua ntej kev phais thiab tom qab 3 thiab 12 lub hlis tom qab. Albuminuria tau normalized rau cov zis creatinine concentration kom suav rau cov zis dilution. Cov ntaub ntawv hais txog kev sau cov qauv thiab cov txheej txheem kuaj tau muab rau hauv Cov Ntaub Ntawv Ntxiv 1.

Tom qab thiab qhov kawg

Clinical outcomes were evaluated for 1  year after discharge. Changes in medication for clinical reasons were permitted. At 3 and 12  months of follow-up, analyses were conducted at the Outpatient Nephrology Department, and patients were contacted via the telephone 1  week before the follow-up analyses and advised to maintain their usual dietary habits and avoid high dietary protein intake (>0.8 g / kg lub cev hnyav ib hnub). Kev noj zaub mov ntawm qhov ncauj siab thaum lub sijhawm ua raws li tsis tau npaj raws li txoj cai kawm. Cov neeg mob tau rov hais dua kom ncua renin-angiotensin-system blockers thiab cov tshuaj uas tsis yog-steroidal inflammatory yam tsawg kawg nkaus ntawm 48 teev ua ntej tus neeg mob nthuav tawm. Thawj qhov kawg yog AKI hauv 7 hnub tom qab kev phais mob plawv. Cov kev ntsuas ntxiv suav nrog qhov sib txawv hauv eGFR ntawm 3 thiab 12 lub hlis tom qab kev phais mob piv rau cov txiaj ntsig ua ntej (Ntxiv cov fle 1: Fig. S2). Kev siv cov tshuaj muaj peev xwm nephrotoxic tau sau tseg thaum nyob hauv tsev kho mob.

Protein load thiab biomarker secretion hauv tib neeg lub raum tubule hlwb

Kev zais ntawm AKI biomarkers IGFBP7 thiab TIMP-2 tom qab kev thauj khoom protein tau soj ntsuam siv peb cov qauv tsim hauv vitro qauv ntawm thawj tib neeg cov kab mob sib luag thiab cov kab mob distal [23]. Immunoafnity isolated proximal thiab distal tubule hlwb raug coj los ntawm qhov sib txuam ntawm Transwell permeable kev txhawb nqa hauv hormonally txhais, tsis muaj cov tshuaj yeeb dej caw los tsim cov epithelial monolayers. Tom qab ntawd cov hlwb raug kho ntawm sab apical nrog kev nce ntxiv (0, 2.5, 5, 10, 20, thiab 50 µM) ntawm cov protein (Lub Neej Extension, Kev Noj Qab Haus Huv Code® Whey Protein Concentrate; amino acid profile muab ntxiv cov ntaub ntawv 1) rau 6 h ntawm 37 degree hauv 5% CO2. Apical conditioned media tau raug rau SDS-PAGE thiab immunoblot tsom xam kom pom cov zais IGFBP7 thiab TIMP-2 los ntawm kev siv tshis polyclonal antibodies muab los ntawm Astute Medical Inc. Raw immunoblot signals tau normalized rau lysate concentration, thiab cov teeb liab los ntawm whey- kho cov hlwb tau muab piv rau cov uas tsis kho cov hlwb thiab cov duab tau tsim tawm. Plaub tus neeg pub dawb cais tawm los ntsuas IGFBP7 thiab peb qhov cais cais los ntsuas TIMP-2 tau siv. Qhov nruab nrab µM concentration ntawm whey protein yog nyob ntawm qhov hnyav molecular ntawm -lactoglobulin.

Kev txheeb cais

Cov kev piav qhia txawv txawv tau qhia tias yog qhov nruab nrab (interquartile range) lossis txhais tau tias [95% kev ntseeg siab ib ntus] rau qhov sib txawv tsis tu ncua, thiab n (%) rau qhov sib txawv categorical. Qhov sib txawv ntawm kev faib tawm ntawm cov pab pawg tau sim siv Mann-Whitney U cov kev xeem rau cov lej sib txawv thiab cov kev xeem chi-squared rau categorical variables. Kev hloov pauv hauv eGFR thiab SCr tau suav rau hauv cov neeg mob raws li qhov sib txawv ntawm qhov tseem ceeb ntawm kev soj ntsuam thiab 1 hnub ua ntej kev phais (ua ntej cov khoom noj protein). Kev tshuaj xyuas tau hloov kho rau hnub nyoog, poj niam txiv neej, lub cev qhov hnyav, qhov kub siab, thiab ntshav qab zib. Kev faib tawm ntawm cov lus teb hloov pauv tau pom tias muaj kev kwv yees zoo txaus rau qhov kev faib tawm ib txwm, raws li kev soj ntsuam siv cov phiaj xwm quantile-quantile. Cov ntaub ntawv raug txheeb xyuas siv R 3.6.0 (R Center for Statistical Computing, Vienna, Aus tria) [24]. Ob-tailed p qhov tseem ceeb < 0.05 tau txiav txim siab los qhia txog qhov tseem ceeb. Kev kwv yees qhov loj me yog ua raws li kev soj ntsuam tsis ntev los no hauv cov neeg mob zoo sib xws [25] thiab ntawm qhov kawg ntawm qhov tseem ceeb (piv txwv li, AKI kev loj hlob hauv 7 hnub tom qab kev phais plawv). Siv Fisher qhov kev ntsuas tseeb, peb suav tias 339 tus neeg mob (226 tus neeg mob hauv pawg tswj hwm thiab 113 tus neeg mob hauv pawg neeg nqa khoom noj protein) yuav tsum muab 80% lub zog ntawm hom 1 yuam kev ntawm 5% txhawm rau txheeb xyuas ib qho AKI feem ntawm 0.2 thiab 0.05 thiab ib pawg hnyav ntawm 2: 1, raws li. Cov neeg nyob ze tshaj plaws uas sib piv nrog cov qhab nia zoo li caliper nrug ntawm 0.1 tau ua haujlwm los xaiv cov neeg mob kho nrog tus qauv saib xyuas kom suav nrog hauv pawg tswj hwm. A 1: 2 ratio matching method tau siv. Qhov kev sib tw zoo tshaj plaws tau txhais tias yog qhov sib txawv ntawm tus qauv (SMD) Tsawg dua lossis sib npaug ntawm 0.1 rau qhov sib txawv ntawm cov neeg mob hauv kev tshawb fawb thiab tswj pawg. Lub sijhawm kawm ntawm eGFR qhov tseem ceeb txheeb ze rau qhov tseem ceeb ua ntej tau txheeb xyuas nrog cov qauv sib xyaw ua ke los ntawm kev siv lub logarithm ntawm tus txheeb ze tus nqi eGFR. Qhov sib txawv ntawm categorical variables ntawm cov pab pawg tau soj ntsuam siv Fisher qhov tseeb xeem. Rau cov kev tshawb fawb hauv vitro, cov yeeb yaj kiab immunoblot tau teeb tsa thiab suav nrog siv ImageJ thiab ua ke t-test muaj nuj nqi ntawm GraphPad Prism 8.0 (GraphPad Software, La Jolla, CA).

Cov txiaj ntsig Baseline yam ntxwv

Ntawm 540 cov neeg mob tau soj ntsuam rau txoj kev tshawb no, 324 tau cuv npe thiab suav nrog hauv kev tshuaj xyuas. 110 tus neeg mob tau txais preoperative high-oral protein loading raws li ib feem ntawm txoj kev tshawb no RFR, whereas 214 cov neeg mob tau sib phim rau cov protein-loading pawg (Ntxiv cov ntaub ntawv 1: Fig. S1). Te sib txuam zoo tau suav hais tias zoo heev, raws li kev xav los ntawm SMD Tsawg dua lossis sib npaug rau 0.1 rau txhua qhov sib txawv. Cov yam ntxwv ntawm lub hauv paus thiab cov ntaub ntawv phais tau zoo sib xws ntawm ob pawg (Table 1). eGFR qhov tseem ceeb ntawm kev nkag mus rau hauv tsev kho mob tau zoo sib xws hauv ob qho tib si cov protein thauj khoom thiab tswj pawg (90 [95% kev ntseeg siab lub sijhawm (CI) 87–92] vs. 90 ml / min / 1.73 m2 [95% CI 88–92], feem; p=0.914).

AKI tus nqi Te tus nqi ntawm AKI tsis txawv ntawm cov protein loading thiab tswj pawg (15/110 [13.6%] vs 26/214 [12.1%], p=0.5; siv tag nrho AKI staging: p=0.945; Table 2). Txhua tus neeg mob uas tsim AKI tau ntsib tsuas yog ib ntu ntawm AKI thoob plaws hauv tsev kho mob. Kev kho ntawm SCr rau cov kua dej tshuav tsis cuam tshuam rau kev kuaj mob thiab theem ntawm AKI. Tag nrho 15 tus neeg mob hauv pawg neeg nqa khoom noj protein tau tsim AKI raws li cov qauv SCr, thiab tsis muaj leej twg ua tau raws li cov zis tso zis. Nyob rau hauv sib piv, nyob rau hauv lub tswj pab pawg neeg, staging tau ua raws li cov SCr thiab zis tso zis qauv nyob rau hauv 19 (9.0%) thiab 4 (1.9%) cov neeg mob, feem; 3 (1.4%) cov neeg mob ua tiav ob qho kev cai (p=0.110). Nco ntsoov, ob tus neeg mob hauv pawg tswj hwm xav tau kev kho mob tom qab lub raum hloov pauv, qhov tsis muaj leej twg hauv pawg neeg nqa khoom noj protein yuav tsum tau kho zoo li no. Tag nrho 15 tus neeg mob hauv pawg neeg nqa khoom noj protein uas tsim AKI nthuav tawm AKI thim rov qab ua ntej tawm hauv tsev kho mob, tab sis tsuas yog 21 ntawm 26 tus neeg mob hauv pawg tswj hwm uas tau ntsib AKI nthuav tawm AKI thim rov qab ua ntej tawm hauv tsev kho mob (100% vs. 80.8%; p{{34} }}.139 ib.). Cov ntaub ntawv sau tseg ntawm txhua tus neeg mob categorized los ntawm AKI tau tshaj tawm hauv Cov Ntaub Ntawv Ntxiv 1: Table S2. Cov uas muaj AKI muaj feem ntau dua cov uas tsis muaj AKI yuav laus dua; muaj lub cev hnyav dua; muaj ntshav siab, ntshav qab zib mellitus, peripheral vasculopathy, thiab dyslipidemia; thiab muaj eGFR qis dua ntawm kev nkag.

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Nyem qhov no kom tau txais Natural organic CISTANCHE EXTRACT nrog 25% ECHINACOSIDE thiab 9% ACTEOSIDE rau lub raum ua haujlwm