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31 (0.81-2.12) for those with mildly decreased kidney function, 4.13 (1.73-9.89) for those with grades 3 CKD (P for trend 0.014). Baseline eGFR was significantly and linearly associated with incident PAD (OR [95% CI] for each 5 mL/min/1.73 m2 decrease of eGFR 1.23 [1.09-1.38]) in participants with baseline eGFR  less then  90 mL/min/1.73 m2 but not in those with baseline eGFR ≥ 90 mL/min/1.73 m2 after adjustment for covariates. CONCLUSION Kidney function was an independent risk factor for development of incident PAD in community-based population with baseline eGFR ≤ 90 mL/min/1.73 m2.PURPOSE Tolvaptan, a vasopressin V2 receptor antagonist, slows the decline in renal function in autosomal dominant polycystic kidney disease (ADPKD). However, it increases urine output such that patient adherence could be compromised. In a cohort of patients with ADPKD on tolvaptan, we aimed to identify the contribution of sodium and urea excretion rate to daily urine output, and to evaluate the effectiveness of dietary counseling on sodium and urea excretion rates. METHODS Retrospective analysis of 30 ADPKD patients who underwent a single session of personalized dietary counseling to reduce sodium and protein intake before initiation of tolvaptan. Creatinine and 24-h urine were obtained regularly on treatment. Generalized estimation equations were used. RESULTS Mean age and median eGFR were 44 ± 11 years and 52 (43-74) ml/min/1.73 m2. Tolvaptan increased diuresis from 2.5 to 5.2 l/day. After adjusting for the dose of tolvaptan, an increase in sodium and urea excretion rate by 50 mmol/day was associated with an estimated additional urine volume of 0.6 l/day (95% CI 0.4-0.8 l/day; P  less then  0.001) and 0.25 l/day (95% CI 0.11-0.39 l/day; P  less then  0.001), respectively. Dietary counseling resulted in a transient reduction of sodium excretion by 19 mmol/day during the first 4 months (P = 0.016) but resulted in a more sustained reduction in urea excretion by 69 mmol/day (P = 0.008). CONCLUSION Both sodium and urea excretion rates contribute significantly to daily urine volume in patients treated with tolvaptan, and a single session of dietary counseling was transiently effective in reducing sodium intake but achieved a more sustained reduction in protein intake. Dietary counseling should be considered in the management of ADPKD patients treated by tolvaptan.BACKGROUND AND OBJECTIVES Contrast-induced nephropathy (CIN) is a relatively common complication following primary coronary angiography (CAG) or percutaneous coronary intervention (PCI), especially in at-risk patients. The goal of this study is to evaluate the role of pre-procedural serum osmolarity as a risk factor for CIN in patients undergoing elective CAG for stable coronary artery disease (CAD). MATERIALS AND METHODS A total of 356 stable CAD patients scheduled to undergo CAG or PCI were included in this two-center study. Serum osmolarity was calculated on admission. CIN was defined according to the KDIGO criteria. RESULTS There were 45 (12.6%) patients who developed CIN 48-72 h after CAG or PCI. CIN patients had a higher prevalence of diabetes (51.1% in those with CIN vs 24.4% in those without CIN, p  less then  0.001), higher serum glucose (129 mg/dL in those with CIN vs 108 mg/dL in those without CIN, p  less then  0.001), blood urea nitrogen (22.4 mg/dL in those with CIN vs 19.0 mg/dL in those withoumal cutoff for serum osmolarity that would warrant preventive interventions. Furthermore, later research may investigate the role of serum osmolarity not only as a risk factor but also as a pathogenetic mechanism underlying CIN.PURPOSE In chronic kidney disease (CKD) patients, dysbiosis is associated with inflammation and cardiovascular risk, so many nutritional strategies are being studied to reduce these complications. Resistant starch (RS) can be considered a prebiotic that promotes many benefits, including modulation of gut microbiota which is linked to immune-modulatory effects. The aim of this study was to evaluate the effects of RS supplementation on proinflammatory cytokines in CKD patients on hemodialysis (HD). METHODS A double-blind, placebo-controlled, randomized trial was conducted with sixteen HD patients (55.3 ± 10.05 years, body mass index (BMI) 25.9 ± 5.42 kg/m2, 56% men, time on dialysis 38.9 ± 29.23 months). They were allocated to the RS group (16 g RS/day) or placebo group (manioc flour). The serum concentration of ten cytokines and growth factors was detected through a multiparametric immunoassay based on XMap-labeled magnetic microbeads (Luminex Corp, USA) before and after 4 weeks with RS supplementation. RESULTS After RS supplementation, there was a reduction of Regulated upon Activation, Normal T-Cell Expressed and Secreted (p  less then  0.001), platelet-derived growth factor (two B subunits) (p = 0.014) and interferon-inducible protein 10 (IP-10) (p = 0.027). The other parameters did not change significantly. CONCLUSION This preliminary result indicates that RS may contribute to a desirable profile of inflammatory markers in CKD patients.The commonly employed design of detention tanks cannot effectively control overflow pollution because of non-stormwater entry and sewer sediments in the urban drainage system. selleck inhibitor Herein, a multi-source overflow model considering both overflow water quality and quantity has been developed for simulating real overflow events. Subcatchment and drainage information is extracted through geographic information system (ArcGIS) and a multi-source overflow model is developed in Stormwater Management Model (SWMM) by coupling runoff mode, non-stormwater mode, and sediment mode. This model is successfully calibrated and validated with the reasonable root-mean-square error (RMSE) of 8.2 and 5.8% for water quality and quantity, respectively. The simulated results suggest that the misconnected non-stormwater entry can affect overflow contaminant concentrations over the period of overflow due to its continuous pollution, while sewer sediments mainly exert effects on the peak pollution period of overflow. Based on model prediction, an approach called overflow peak pollution interception (OPPI) is proposed for model application and design optimization.