Publications by authors named "Yih-Ting Chen"

Objective: Intradialytic hypotension (IDH), a common complication of hemodialysis (HD), is associated with increased cardiovascular risk, morbidity, and mortality. Fatigue is one of the most frequent symptoms of IDH, and deteriorates the quality of life of patients. This study aimed to evaluate the efficacy and safety of electronic moxibustion for improving IDH and its associated symptoms.

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Background: Endocrine-disrupting chemicals (EDCs) are pervasive in everyday environments. The impacts of these chemicals, along with EDC-related lifestyle and dietary habits on neurocognitive function, are not well understood.

Methods: The Chang Gung Community Medicine Research Center conducted a cross-sectional study involving 887 participants.

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This study explores the extended renal effects of endocrine-disrupting chemicals (EDCs) exposure, a linkage already established with adverse health outcomes, notably chronic kidney disease. To delve deeper, the Chang Gung Community Research Center conducted a longitudinal study with 887 participants. Among them, 120 individuals were scrutinized based on EDC scores, analyzing 17 urinary EDCs and renal function.

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Background: Urinary C-C motif chemokine ligand 14 (CCL14) has been described as an effective marker for delayed recovery of acute kidney injury (AKI), yet its efficacy has been found to vary between different trials. The goal of this research was to assess the predictive performance of urinary CCL14 as a marker for persistent AKI.

Methods: In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched the PubMed, Embase, and Cochrane databases up to April 2023 for studies of adults (> 18 years) that reported the diagnostic performance of urinary CCL14.

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Diabetic kidney disease is the most common primary disease of end-stage kidney disease globally; however, a sensitive and accurate biomarker to predict this disease remains awaited. microRNAs are endogenous single-stranded noncoding RNAs that have intervened in different post-transcriptional regulations of various cellular biological functions. Previous literatures have reported its potential role in the pathophysiology of diabetic kidney disease, including regulation of Transforming Growth Factor-β1-mediated fibrosis, extracellular matrix and cell adhesion proteins, cellular hypertrophy, growth factor, cytokine production, and redox system activation.

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Background: Acute kidney disease (AKD) defines the period after kidney damage and it is a critical period of both repair and fibrotic pathways. However, the outcomes of patients with AKD have not been well-defined.

Methods: In this meta-analysis, PubMed, Embase, Cochrane and China National Knowledge Infrastructure were searched on July 31,2022.

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Article Synopsis
  • The study aimed to evaluate and compare the effectiveness of various biomarkers in predicting acute kidney injury (AKI) based on existing research.
  • A systematic review analyzed data from 110 studies, involving 38,725 adult patients, focusing on biomarkers like NGAL, KIM-1, IL-18, and others.
  • Findings indicated that urinary NGAL and serum NGAL had the highest accuracy for predicting AKI, particularly in non-critically ill patients, while the diagnostic performance was similar across all biomarkers in critically ill patients.
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Article Synopsis
  • A study was conducted to determine the impact of the oral absorbent AST-120 on gut microbiota and metabolism in patients with advanced chronic kidney disease (CKD) compared to non-CKD controls.
  • Eight CKD patients taking AST-120 showed a significantly different microbial community and increased levels of certain bacteria associated with fatty acid production, compared to 24 other CKD patients and 24 non-CKD participants.
  • Results indicated that AST-120 might help improve gut health in advanced CKD by changing the composition of gut bacteria and influencing the metabolism of lipids, amino acids, and carbohydrates.
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Background: Micronutrients are essential in maintaining normal human physiology. Data regarding the association between micronutrients and renal outcomes in chronic kidney disease (CKD) are lacking. Methods: This prospective observational cohort study enrolled 261 patients with CKD stages 1−5 and 30 subjects with normal renal function.

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Background: Immune response assessed by the quantification of neutralizing antibodies (nAbs) and predictors associated with immunogenicity after the prime-boost ChAdOx1 (Oxford−AstraZeneca) COVID-19 vaccine in hemodialysis (HD) patients remains unclear. Methods: This prospective study enrolled 174 HD patients and 67 healthy subjects to evaluate antibodies against the spike protein 1 and receptor-binding domain of severe acute respiratory syndrome coronavirus type 2 after prime-booster vaccination, by using enzyme-linked immunosorbent assay and applied spline-based generalized additive model regression analysis to predict 50% neutralization titer (NT50). The correlation between HD parameters and NT50 was analyzed.

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Background: Data are lacking regarding predictors of quantification of neutralizing antibodies (nAbs) based on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) 50% neutralization titer (NT) after a single dose of COVID-19 vaccine in hemodialysis (HD) patients.

Methods: This prospective single-center study enrolled 200 HD patients and 82 healthy subjects to estimate antibodies against the SARS-CoV-2 viral spike protein 1 and receptor-binding domain after a first dose of a COVID-19 vaccine (ChAdOx1 or mRNA-1273), measured by enzyme-linked immunosorbent assay and applied spline-based generalized additive model regression analysis to predict NT converted to international units.

Results: After the first dose of ChAdOx1, multiple linear regression showed that age ( 0.

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The Taiwan Acute Kidney Injury (AKI) Task Force conducted a review of data and developed a consensus regarding nephrotoxins and AKI. This consensus covers: (1) contrast-associated AKI; (2) drug-induced nephrotoxicity; (3) prevention of drug-associated AKI; (4) follow up after AKI; (5) re-initiation of medication after AKI. Strategies for the avoidance of contrast media related AKI, including peri-procedural hydration, sodium bicarbonate solutions, oral N-acetylcysteine, and iso-osmolar/low-osmolar non-ionic iodinated contrast media have been recommended, given the respective evidence levels.

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Vaccination plays an important role during the COVID-19 pandemic. Vaccine-induced thrombotic thrombocytopenia (VITT) is a major adverse effect that could be lethal. For cancer patients, cancer-related thromboembolism is another lethal complication.

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Article Synopsis
  • A systematic review and meta-analysis were conducted to examine the impact of low protein diets (LPD) on gut microbiota in chronic kidney disease (CKD) patients, with limited studies available on this topic.
  • * The analysis included five articles, finding an increase in certain bacteria (like Lactobacillaceae and Bacteroidaceae) and a decrease in others (like Bacteroides eggerthii) when comparing LPD patients to those on a normal protein diet.
  • * No significant differences in overall renal function or various clinical and anthropometric measures were observed between the two groups, indicating that LPD primarily alters gut microbiota without major impacts on other health markers.
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Background: Dialyzed patients are vulnerable to coronavirus infection disease 2019 (COVID-19). The incidence and outcome of COVID-19 in hemodialysis (HD) patients in Taiwan remain unclear. A series of preventive measures were executed to combat COVID-19 transmission among HD patients.

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Associations between hepatitis C virus (HCV) and chronic kidney disease (CKD) have been reported; however, differences of renal progression between general and CKD population remain to be elucidated in prospective studies. A total of 1179 participants, who have tested for anti-HCV antibody, were enrolled and prospectively followed for 3 years. The risks associated with HCV infection, in terms of incidence of CKD, annual estimated glomerular filtration rate (eGFR) changes and 50% decline of eGFR at 3-year from baseline, were compared between normal renal function subjects and CKD patients.

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Hemodialysis (HD) patients are highly susceptible to COVID-19 infection. However, comprehensive assessments of current evidence regarding COVID-19 in HD patients remain incomplete. We systematically searched PUBMED and EMBASE for articles published on incidence or mortality of COVID-19 infection in HD patients until September 2020.

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Background: Cardiac troponins are important markers for diagnosis of acute myocardial infarction (AMI) in general population; however, chronically-elevated troponins levels are often seen in patients with renal insufficiency, which reduce their diagnostic accuracy. The aim of our study was to access the diagnostic values of initial high-sensitive cardiac troponin T (hs-cTnT) and relative change of hs-cTnT for AMI in patients with and without renal insufficiency.

Methods: Cardiac care unit patients with elevated hs-cTnT levels in 2017-2018 were enrolled.

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Article Synopsis
  • Acute kidney disease (AKD) can develop following acute kidney injury (AKI) within 7 to 90 days, and this study focused on how well AKI biomarkers can predict AKD in patients in a coronary care unit (CCU).
  • The study involved 269 patients, mostly men, measuring various factors and specific biomarkers—NGAL, CysC, and IL-18—on their first day in the CCU to assess their risk for AKD.
  • Results showed that nearly half of the patients developed AKD, with age, hemoglobin, ejection fraction, and IL-18 being significant predictors, while urine NGAL and other factors were linked to 5-year survival rates.
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Article Synopsis
  • The study investigates the impact of acute kidney disease (AKD) on the survival of patients on extracorporeal membrane oxygenation (ECMO), revealing a high mortality rate, particularly among those with AKI.
  • A total of 168 patients who received ECMO support and survived longer than 7 days were followed for 10 years, with findings showing varying median survival times based on AKD stages, with stage 0 having the best outcome (≥ 10 years) and stage 3 the worst (0.5 months).
  • AKD stage was identified as a significant independent predictor of survival, with higher stages correlating with increased mortality risk (e.g., stage 3 having a hazard ratio of 5.252).
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Daily urine protein (UP) loss is a cumbersome but important measurement to guide diagnosis and treatment of renal disease. Spot urine protein-creatinine ratio (UPCR) can been applied to estimate daily proteinuria. However, the correlations between spot and 24h proteinuria remain controversial.

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Background: Technique failure secondary to peritonitis is a grave impediment to remain in peritoneal dialysis (PD) therapy leading to high mortality. Multidisciplinary predialysis education (MPE) has shown improvement in outcomes of chronic kidney disease (CKD) patients. However, the legacy effects of MPE in PD patients remain unclear.

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