Contrast-induced acute kidney injury (CIAKI) is a common complication after percutaneous coronary artery intervention (PCI). It is urgent to find a novel, easily measurable and accurate predictor for the early detection of CIAKI. Hyperosmolarity and large amounts of contrast media are risk factors for CIAKI. However, there is no study on plasma osmolar gap as a predictor of CIAKI. We enrolled 89 patients undergoing elective PCI and tested changes of serum sodium, osmolar gap, and renal function at 0, 6, 12 and 24 hours. Plasma osmolar gap was calculated using the following formula: measured plasma osmolarity - [2(Na) + serum urea nitrogen/2.8 + glucose/18]. CIAKI was defined as follows: increase in serum creatinine of >= 50%, increase in serum creatinine of >= 0.3 mg/dL, or decrease in estimated glomerular filtration rate of >= 25% within 24 hours after PCI. The incidence of CIAKI was 13.5% (12/89 patients). The CIAKI group had higher plasma osmolar gaps 6 hours after PCI. The adjusted hazard ratio of the plasma osmolar gap from hour 6 (1-mOsm/L increments) to the development of CIAKI was 1.12 (95% confidence interval [CI], 1.01-1.26; P = 0.041). Sensitivity and specificity of 7 mOsm/L or higher plasma osmolar gap at hour 6 were 70.0% and 76.6%, respectively (area under the ROC curve = 0.77 [95% Cl, 0.65-0.89]). Increased plasma osmolar gap may precede the development of CIAKI in patients undergoing PCI. In conclusion, plasma osnnolar gap may be a useful predictor for the development of CIAKI.

Background/Aims: The long-term effects of biocompatible peritoneal dialysis (PD) solution on residual renal function (RRF), inflammation, adipokines and metabolic acidosis are controversial. We evaluated the effects of biocompatible PD solution in continuous ambulatory PD (CAPD) patients for an additional 12-month period. Method: Among 91 incident patients who started CAPD with either biocompatible PD solution (Balance (R), Fresenius; LS, n = 48) or conventional PD solution (CAPD/DPCA (R), Fresenius; CS, n = 43), 63 patients, who were followed for 12 months, were enrolled and followed for an additional 12 months. Results: After 24 months of treatment, the glomerular filtration rate (GFR) of the LS group was twofold higher compared to the CS group (33.5 +/- 30.7 vs. 16.3 +/- 8 17.9 l/week/1.73 m(2), respectively, p = 0.021). In a subgroup of patients with an initial GFR >2 ml/min/1.73 m(2), the GFR of the LS group was significantly higher than the rate of the CS group after 24 months (43.7 +/- 30.5 vs. 18.6 +/- 19.0 l/week/1.73 m(2), respectively, p = 0.042). Over a 24-month period, effluent cancer antigen-125 levels were significantly increased in the LS group compared to the CS group, while effluent interleukin-6 levels did not differ between the two groups. The serum tCO(2) levels were consistently higher in the LS group compared to the CS group. Conclusions: We found that the effect of LS on preserving RRF may be maintained over a 24-month treatment period in CAPD patients, and LS use may have other benefits, such as the correction of metabolic acidosis. Copyright (C) 2012 S. Karger AG, Basel

Abstract Traditional approaches to pathophysiology are advancing but still have many limitations that arise from real biologic systems and their associated physiological phenomena being too complicated. Microfluidics is a novel technology in the field of engineering, which provides new options that may overcome these hurdles. Microfluidics handles small volumes of fluids and may apply to various applications such as DNA analysis chips, other lab-on-a-chip analyses, micropropulsion, and microthermal technologies. Among them, organ-on-a-chip applications allow the fabrication of minimal functional units of a single organ or multiple organs. Relevant to the field of nephrology, renal tubular cells have been integrated with microfluidic devices for making kidneys-on-a-chip. Although still early in development, kidneys-on-a-chip are showing potential to provide a better understanding of the kidney to replace some traditional animal and human studies, particularly as more cell types are incorporated toward the development of a complete glomeruli-on-a-chip.