Additionally, multivariate Cox analysis for mortality was used to evaluate independent prognostic value of MPV. Results: The mean age was 61.3 years and 218 patients (62.5%) were male. The median MPV was 0.12 fL. At the initiation of CRRT, MPV level was inversely correlated with platelet count, whereas it was positively associated with C-reactive protein levels and APACHE II scores (r = 0.110, P = 0.045 and r = 0.134, P = 0.012, respectively). During
the study period, 231 deaths (66.2%) occurred. K-M curve showed that 28-day all-cause mortality was significantly higher in patients with MPV ≥ 0.12 fL compared to those with MPV < 0.12 fL (P < 0.001). Moreover, Cox regression analysis revealed that MPV was an independent predictor for 28-day all-cause mortality after adjustment of age, age-adjusted Charlson Comorbidity Index, selleck cause of AKI, platelet count, and APACHE II score (hazard ratio, 1.093; 95% confidence interval, 1.023–1.167; P = 0.008). Conclusion: MPV at the time of CRRT initiation may be an inexpensive and useful predictor for find more 28-day all-cause mortality in patients with AKI requiring CRRT. IWAKURA TAKAMASA1, FUJIGAKI YOSHIHIDE1,2, FUJIKURA TOMOYUKI1, OHASHI NARO1,
KATO AKIHIKO3, YASUDA HIDEO1 1Internal Medicine I, Division of Nephrology, Hamamatsu University School of Medicine; 2Department of Internal Medcine, Teikyo University School of Medicine; 3Blood Purification Unit, Hamamatsu University School of Medicine Introduction: It is known that proximal tubule (PT) cells can proliferate explosively in response to acute tubular injury. To elucidate the relationship between the cell cycle and proliferative ability, we examined the cell cycle status and
transition in PT cells just after proliferative or injurious stimuli. Methods: Rats treated with or without lead acetate (a proliferative stimulus) or uranyl acetate (UA, which injures mainly S3 segment of PT) were used. Isolated tubular cells were separated into PT and distal tubule (DT) cells by Percoll density-gradient centrifugation. The cell cycle status was analyzed by flow cytometry. The separation of G0 and G1 phase cells was done by Hoechst33342/Pyronin Y method or immunohistochemistry Ixazomib for Cdt1. Western blotting and immunohistochemistry for the cell cycle inhibitor p27 were also examined. Results: Most of normal PT and DT cells were in G0/G1 phase with 36.8% and 13.6% of G1 phase in PT and DT, respectively. Lead acetate and UA administration promoted the G0-G1 transition before S phase progression in PT. p27 protein level initially increased in lead acetate and tended to increase in sub-nephrotoxic dose of UA, then decreased with S phase progression in both groups, suggesting that increased p27 may reflect G1 arrest. In contrast, p27 protein level vanished in nephrotoxic dose of UA, might reflecting the dying cells in the large part of PT.