Association of Age With Short-term and Long-term Mortality Among Patients Discharged From Intensive Care Units in France DOI Creative Commons

Alice Atramont,

V. Lindecker-Cournil, Jérémie Rudant

et al.

JAMA Network Open, Journal Year: 2019, Volume and Issue: 2(5), P. e193215 - e193215

Published: May 10, 2019

Importance

An aging population is increasing the need for intensive care unit (ICU) beds. The benefit of ICU admission elderly patients remains a subject debate; however, long-term outcomes across all adult age strata are unknown.

Objective

To describe short-term and mortality (up to 3 years after discharge) in admitted French ICUs.

Design, Setting, Participants

Using data extracted from national health system database, this cohort study determined in-hospital at months discharge (older than 18 years) ICUs January 1 December 31, 2013, focusing on strata. dates analysis were November 2017 2018.

Exposure

Intensive admission.

Main Outcomes Measures

In-hospital hospital discharge.

Results

included 133 966 (median age, 65 [interquartile range, 53-76 years); 59.9% male). Total was 19.0%, 3-year 39.7%. For 108 539 discharged alive hospital, 6.8% died by months, 25.8% After adjustment sex, comorbidities, reason hospitalization, organ support (invasive ventilation, noninvasive vasopressors, inotropes, fluid resuscitation, blood products administration, cardiopulmonary renal replacement therapy, mechanical circulatory support), risk increased progressively but with sharp increase those 80 older. postdischarge rates, respectively, 30.5% 44.9% older compared 16.5% 22.5% younger years. 61.4% among vs 35.1% 80. sex standardization, excess highest young during their first year persisted into second third In contrast, close general (≥80 years). Age hospitalization strongly associated (9-, 13-, 20-fold death aged 80-84, 85-89, ≥90 years, <35 years), while use showed weaker association (all had 1.3-fold or lower death).

Conclusions Relevance

Results suggest that an admission, However, matched high surviving not patients.

Language: Английский

Upregulated PD-1 signaling antagonizes glomerular health in aged kidneys and disease DOI Creative Commons
Jeffrey W. Pippin, Natalya Kaverina, Yuliang Wang

et al.

Journal of Clinical Investigation, Journal Year: 2022, Volume and Issue: 132(16)

Published: Aug. 14, 2022

With an aging population, kidney health becomes important medical and socioeconomic factor. Kidney mechanisms are not well understood. We previously showed that podocytes isolated from aged mice exhibit increased expression of programmed cell death protein 1 (PD-1) surface receptor its 2 ligands (PD-L1 PD-L2). PDCD1 transcript with age in microdissected human glomeruli, which correlated lower estimated glomerular filtration rate higher segmental glomerulosclerosis vascular arterial intima-to-lumen ratio. In vitro studies demonstrated a critical role for PD-1 signaling survival the induction senescence-associated secretory phenotype. To prove was to podocyte aging, were injected anti–PD-1 antibody. Treatment significantly improved phenotype both liver. glomerulus, it life span podocytes, but parietal epithelial, mesangial, or endothelial cells. Transcriptomic immunohistochemistry antibody treatment podocytes. Administering same young experimental focal (FSGS) lowered proteinuria number. These results suggest contribution toward liver FSGS.

Language: Английский

Citations

54
Kidney Damage Caused by Obesity and Its Feasible Treatment Drugs DOI Open Access
Meihui Wang, Zixu Wang, Yaoxing Chen

et al.

International Journal of Molecular Sciences, Journal Year: 2022, Volume and Issue: 23(2), P. 747 - 747

Published: Jan. 11, 2022

The rapid growth of obesity worldwide has made it a major health problem, while the dramatic increase in prevalence had significant impact on magnitude chronic kidney disease (CKD), especially developing countries. A vast amount researchers have reported strong relationship between and disease, can serve as an independent risk factor for disease. histological changes kidneys obesity-induced renal injury include glomerular or tubular hypertrophy, focal segmental glomerulosclerosis bulbous sclerosis. Furthermore, inflammation, hemodynamic changes, insulin resistance lipid metabolism disorders are all involved development progression nephropathy. However, there is no targeted treatment obesity-related In this review, RAS inhibitors, SGLT2 inhibitors melatonin would be presented to treat injury. we concluded that protect damage caused by inhibiting inflammation oxidative stress, revealing its therapeutic potential.

Language: Английский

Citations

53
Reduction in podocyte SIRT1 accelerates kidney injury in aging mice DOI Open Access

Peter Y. Chuang,

Weijing Cai,

Xuezhu Li

et al.

AJP Renal Physiology, Journal Year: 2017, Volume and Issue: 313(3), P. F621 - F628

Published: June 15, 2017

Both the incidence and prevalence of chronic kidney disease are increasing in elderly population. Although aging is known to induce injury, underlying molecular mechanisms remain unclear. Sirtuin 1 (Sirt1), a longevity gene, protect cell injury from various cellular stresses. In previous studies, we showed that podocyte-specific loss Sirt1 aggravates diabetic injury. However, role aging-induced podocyte not known. Therefore, this study sought determine effects reduction age-induced We employed inducible knockdown mice express shRNA against (Pod-Sirt1RNAi) control for luciferase (Pod-LuciRNAi). found led aggravated glomerulosclerosis albuminuria. addition, urinary level 8-hydroxy-2'-deoxyguanosine (8-OHdG), marker oxidative stress, was markedly increased aged Pod-Sirt1RNAi compared with Pod-LuciRNAi mice. markers decreased young controls, decrease further exacerbated Interestingly, expression senescence significantly higher glomeruli than mice, suggesting may contribute kidneys. Finally, confirmed were associated reduced activation transcription factors peroxisome proliferator-activated receptor (PPAR)-α coactivador-1 (PGC1α)/PPARγ, forkhead box O (FOXO)3, FOXO4, p65 NF-κB, through SIRT1-mediated deacetylation. Together, our data suggest SIRT1 be potential therapeutic target treat patients aging-related disease.

Language: Английский

Citations

82
Relationships among injury, fibrosis, and time in human kidney transplants DOI Open Access
Jeffery M. Venner, Konrad S. Famulski, J. Reeve

et al.

JCI Insight, Journal Year: 2016, Volume and Issue: 1(1)

Published: Jan. 20, 2016

Kidney transplant biopsies offer an opportunity to understand the pathogenesis of organ fibrosis. We studied relationships between time biopsy after (TxBx), histologic fibrosis, diseases, and transcript expression.Expression microarrays from 681 kidney indication taken either early (n = 282, <1 year) or late 399, >1 were used analyze molecular landscape fibrosis in relationship diseases.Fibrosis was absent at transplantation but present some by 4 months transplant, apparently as a self-limited response donation implantation injury not associated with progression failure. The phenotype represented sequence wounding: immediate expression acute transcripts, followed fibrillar collagen transcripts several weeks, then appearance immunoglobulin mast cell appeared. Fibrosis correlated injury, collagen, immunoglobulin, these independent time. Pathway analysis revealed epithelial response-to-wounding pathways such Wnt/β-catenin.Fibrosis had different associations because many kidneys potentially progressive diseases subsequently failed. Molecular correlations time, probably ongoing obscured sequence. results indicate that transplants is driven nephron failure reflects continuing autonomous fibrogenesis.INTERCOM study (www.clinicalTrials.gov; NCT01299168).Canada Foundation for Innovation Genome Canada.

Language: Английский

Citations

76
Association of Age With Short-term and Long-term Mortality Among Patients Discharged From Intensive Care Units in France DOI Creative Commons

Alice Atramont,

V. Lindecker-Cournil, Jérémie Rudant

et al.

JAMA Network Open, Journal Year: 2019, Volume and Issue: 2(5), P. e193215 - e193215

Published: May 10, 2019

Importance

An aging population is increasing the need for intensive care unit (ICU) beds. The benefit of ICU admission elderly patients remains a subject debate; however, long-term outcomes across all adult age strata are unknown.

Objective

To describe short-term and mortality (up to 3 years after discharge) in admitted French ICUs.

Design, Setting, Participants

Using data extracted from national health system database, this cohort study determined in-hospital at months discharge (older than 18 years) ICUs January 1 December 31, 2013, focusing on strata. dates analysis were November 2017 2018.

Exposure

Intensive admission.

Main Outcomes Measures

In-hospital hospital discharge.

Results

included 133 966 (median age, 65 [interquartile range, 53-76 years); 59.9% male). Total was 19.0%, 3-year 39.7%. For 108 539 discharged alive hospital, 6.8% died by months, 25.8% After adjustment sex, comorbidities, reason hospitalization, organ support (invasive ventilation, noninvasive vasopressors, inotropes, fluid resuscitation, blood products administration, cardiopulmonary renal replacement therapy, mechanical circulatory support), risk increased progressively but with sharp increase those 80 older. postdischarge rates, respectively, 30.5% 44.9% older compared 16.5% 22.5% younger years. 61.4% among vs 35.1% 80. sex standardization, excess highest young during their first year persisted into second third In contrast, close general (≥80 years). Age hospitalization strongly associated (9-, 13-, 20-fold death aged 80-84, 85-89, ≥90 years, <35 years), while use showed weaker association (all had 1.3-fold or lower death).

Conclusions Relevance

Results suggest that an admission, However, matched high surviving not patients.

Language: Английский

Citations

73