Efficacy of levocarnitine combined with peritoneal dialysis in the treatment of uremia based on TGF-β1/Smad signaling pathway
Objective To explore the effects and the mechanism of levocarnitine and peritoneal dialysis on uremia.Methods Tally 110 patients with uremia in our hospital from March 2021 to February 2023 were selected,they were randomized 1∶1 to receive peritoneal dialysis(the control group)or levocarnitine combined with peritoneal dialysis(the observation group)for 3 months.Before treatment and after 3 months of treatment,the nutritional status(albumin[Alb],haemoglobin[Hb],triceps skinfold thickness[TSF]),renal function(blood creatinine[Scr],urea nitrogen[BUN]),renal fibrosis(angiotensin Ⅱ[Ang Ⅱ],transforming growth factor β1[TGF-β1],connective tissue growth factor[CTGF]),inflammation(high-sensitivity C-reactive protein[hs-CRP],tumor necrosis factor α[TNF-α],interleukin 6[IL-6]),oxidative stress(malondialdehyde[MDA],glutathione peroxidase[GSH-Px],superoxide dismutase[SOD]),TGF-β1/Smad signaling pathway(transforming growth factor β1[TGF-β1],SMA-and MAD-related protein 3[Smad3],SMA-and MAD-related protein 7[Smad7])were included as comparisons in both groups.Results After treatment,the observation group had significantly elevated Hb,Alb and TSF,reduced BUN and Scr,down-regulated AngⅡ,TGF-β1,CTGF,hs-CRP,IL-6,TNF-α and MDA,up-regulated GSH-Px and SOD,decreased TGF-β1,Smad3 and increased Smad7 compared with the control group(allP＜0.05).Conclusion Levocarnitine combined with peritoneal dialysis can improve the nutritional status of uremia patients,reduce microinflammation,reduce oxidative stress,and produce nephron protection by inhibiting the activation of TGF-β1/Smad signaling pathway,then delay the progression of renal fibrosis.
NETL
NSTL
万方数据
维普
