Preliminary study of Bim on the early diagnosis and prognosis of the elderly uremia with gastrointestinal nutrition combined with dialysis

OBJECTIVE: Elderly uremia frequently refers to the end stage of various chronic kidney diseases that threats the patients' health seriously. Enteral nutrition can reduce complications, while the molecular mechanism is still unclear. Mitochondrial protein Bim plays an essential role in regulating inflammation, restraining oxidative stress, and maintaining the balance of the mitochondrial membrane potential and energy production. This study aims to investigate the effect of Bim on the early diagnosis and prognosis of the elderly uremia with gastrointestinal nutrition combined with dialysis.

PATIENTS AND METHODS: Elderly patients with uremia in our hospital were selected and divided into parenteral nutrition group, enteral nutrition group, and regular treatment group. Healthy volunteers were chosen as the control group. Blood oxygen free radicals were tested by flow cytometry. Blood immune function parameter C-reactive protein and IL-6 levels were determined by Western blot. Bim expression in blood was evaluated by RT-PCR and Western blot. Correlation analysis was performed between Bim level and the prognosis of elderly patients with uremia who received gastrointestinal nutrition therapy.

RESULTS: Blood oxygen free radical level was significantly higher in parenteral nutrition group and regular treatment group compared with enteral nutrition group (p< 0.05). C-reactive protein and IL-6 contents were significantly reduced in parenteral nutrition group and regular treatment group compared to those in enteral nutrition group (p< 0.05). The expression of Bim at both mRNA and protein levels was declined in elderly patients with uremia after enteral nutrition combined with dialysis therapy to the normal level. The level of Bim was positively correlated with the severity of elderly uremia.

CONCLUSIONS: Bim is positively correlated with the severity of elderly uremia, which can be set as a potential specific biomarker, along with reactive oxygen radicals, CRP, IL-6, for the prognosis of elderly uremia.

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