Ischemic acute kidney injury (AKI) is a prevalent disorder among hospitalized patients worldwide. Astragaloside IV (AS-IV) has been shown to protect against ischemic AKI. However, the specific effects and mechanisms of AS-IV on alleviating kidney ischemia-reperfusion (I/R) injury remain unclear. The objective of this research was to elucidate the regulatory targets and mechanisms through which AS-IV protects kidney I/R injury. A combination of network pharmacology, molecular docking, molecular dynamics (MD) simulation, pharmacodynamic study and Western blot were employed to explore the underlying mechanisms. Network pharmacology revealed that ferroptosis was a potential mechanism of AS-IV against kidney I/R injury. Molecular docking and MD simulations demonstrated strong binding affinity between the GPX4/SLC7A11 and AS-IV. The experimental verification demonstrated that AS-IV improved cell proliferation, decreased the level of ROS and Fe²⁺, and increased the expressions of GPX4 and SLC7A11 as same as Ferrostatin-1 in OGD/R-injured HUVECs. In conclusion, AS-IV had a significant inhibition on ferroptosis in kidney I/R injury, providing a new perspective for drug development on kidney I/R injury. Definitely, further exploration in vivo is necessary to fully understand whether AS-IV alleviates kidney I/R injury through inhibiting endothelial ferroptosis.

Maintenance hemodialysis patients are at increased risk of cardiovascular complications and mortality following COVID-19 infection due to compromised immune function. This study aims to evaluate the effect of COVID-19 vaccination (CoronaVac) on cardiac function and survival in this population. Background/Objectives: This study aimed to evaluate the effects of CoronaVac on echocardiographic parameters, BNP levels, and survival rates in maintenance hemodialysis patients. By comparing vaccinated and unvaccinated patients, we sought to assess whether vaccination provides a protective effect on cardiac function and contributes to improved clinical outcomes in this population. Methods: We conducted a retrospective analysis of 531 maintenance hemodialysis patients, comprising 452 unvaccinated and 79 vaccinated with CoronaVac. We compared changes in echocardiographic parameters and BNP levels before and after COVID-19 infection between the vaccinated and unvaccinated groups and assessed their association with survival rates. Results: Vaccinated patients were younger (60.54 ± 13.51 vs. 65.21 ± 13.76 years, p=0.006), had shorter dialysis durations (56.04 ± 51.88 vs. 73.73 ± 64.79 months, p=0.022). The mortality rate was also significantly lower in the vaccinated group (6.33% vs. 14.38%, p=0.049). In the unvaccinated group, BNP levels and multiple echocardiographic parameters (IVSD, LVPWD, AO, LA, EF, FS) significantly deteriorated post-infection, whereas no significant changes were observed in the vaccinated group. Multivariate analysis identified age, CAD, Hs-CRP, and LVIDs abnormalities as independent predictors of mortality, indicating that the independent protective effect of vaccination requires further validation. Conclusions: CoronaVac is associated with lower mortality and stable cardiac function in maintenance hemodialysis patients. The vaccine may reduce infection severity, lower cardiac load, and improve prognosis.

Maintenance hemodialysis patients are at increased risk of cardiovascular complications and mortality following COVID-19 infection due to compromised immune function. This study aims to evaluate the impact of the COVID-19 vaccine (CoronaVac) on cardiac function and survival in this population. Background/Objectives: We aimed to examine whether CoronaVac vaccination affects heart function and survival rates in maintenance hemodialysis patients. Specifically, we assessed changes in heart ultrasound (echocardiographic) measurements, B-type natriuretic peptide (BNP) levels, and survival outcomes by comparing vaccinated and unvaccinated patients. Methods: A retrospective analysis was conducted on 531 maintenance hemodialysis patients, including 79 who received CoronaVac and 452 who did not. We compared the pre- and post-infection changes in heart function (echocardiographic parameters) and BNP levels between the two groups and assessed their association with the survival rates. Results: The vaccinated patients were younger (60.54 ± 13.51 vs. 65.21 ± 13.76 years, p = 0.006) and had shorter dialysis durations (56.04 ± 51.88 vs. 73.73 ± 64.79 months, p = 0.022). The mortality rate was also significantly lower in the vaccinated group (6.33% vs. 14.38%, p = 0.049). After infection, the unvaccinated patients showed significant declines in heart function and increased B-type natriuretic peptide levels, while the vaccinated patients demonstrated no significant deterioration. Older age, coronary artery disease, inflammation levels, and heart abnormalities were identified as the key risk factors for mortality. Conclusions: CoronaVac was linked to lower mortality and better heart function in maintenance hemodialysis patients. The vaccine may help to reduce infection severity, lower strain on the heart, and improve the overall prognosis.