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https://www.readbyqxmd.com/read/28743130/sglt-2-inhibition-a-potential-new-treatment-for-diabetic-kidney-disease
#1
Robert D Toto
Diabetic nephropathy is the leading cause of kidney failure. Treatments with drugs that block the renin-angiotensin system have proven beneficial in slowing kidney disease progression among those with diabetes; their benefit is limited and they do not stop disease progression. Despite multiple clinical trials of various interventions including dual blockade of the renin-angiotensin system over the past 15 years, no new therapies have emerged to slow kidney disease progression in diabetes. SGLT-2 inhibitors are a new class of antiglycemic drugs that have been shown to lower blood glucose by inhibition of the sodium-glucose transporter 2 in the proximal tubule of the kidney...
July 26, 2017: Nephron
https://www.readbyqxmd.com/read/28743129/fibroblast-growth-factor-23-predicts-mortality-and-end-stage-renal-disease-in-a-canadian-asian-population-with-chronic-kidney-disease
#2
Ishwarlal Jialal, Fernando Camacho, Bharat Nathoo, Paul Tam, Roma Pahwa, George G Wu
BACKGROUND: Chronic kidney disease (CKD) is a leading cause of morbidity and mortality. Biomarkers that predict end-stage renal disease (ESRD) and/or mortality could usher in new therapeutics to halt this onslaught. While fibroblast growth factor (FGF)23 can predict both ESRD and mortality, it has not been studied in North American CKD patients of Asian ethnicity. METHOD: This is a prospective investigation about the role of FGF23 in 998 Canadian patients of Asian descent with CKD defined by an estimated glomerular filtration rate (eGFR) <60 mL/min/m2 and followed up for 3 years...
July 26, 2017: Nephron
https://www.readbyqxmd.com/read/28743127/a-rare-presentation-of-immunoglobulin-a-nephropathy-acute-kidney-injury
#3
Meric Oruc, Haydar Durak, Serkan Feyyaz Yalin, Nurhan Seyahi, Mehmet Rıza Altıparmak, Sinan Trabulus
BACKGROUND: Acute kidney injury (AKI) is known as an uncommon presentation in immunoglobulin A nephropathy (IgAN). The aim of our study was to analyze the clinical data and biopsy findings in IgAN patients presenting with AKI. METHODS: We performed a retrospective analysis of all subjects who had biopsy-proven IgAN and presented with AKI during June 2002 September 2015. The following data were obtained from medical records. RESULTS: A total of 15 patients of 123 patients (12...
July 26, 2017: Nephron
https://www.readbyqxmd.com/read/28743124/the-role-of-discoidin-domain-receptor-1-in-inflammation-fibrosis-and-renal-disease
#4
Aude Dorison, Jean-Claude Dussaule, Christos Chatziantoniou
Discoidin domain receptors (DDRs) are a family of 2 non-integrin collagen receptors, DDR1 and DDR2, which display a tyrosine kinase activity. They are mainly expressed during embryonic development and their role during adulthood is very limited. DDR1 has been widely studied in several types of cancers, in atherosclerosis and fibrosis, but also in chronic kidney disease (CKD). This review focuses on the role of DDR1 in chronic nephropathies and on the effect of its deletion in the pathological processes involved in renal disease progression...
July 26, 2017: Nephron
https://www.readbyqxmd.com/read/28697495/electrolyte-and-acid-base-abnormalities-in-infants-with-community-acquired-acute-pyelonephritis-prospective-cross-sectional-study
#5
Gregorio P Milani, Angela Grava, Mario G Bianchetti, Sebastiano A G Lava, Laura Dell'Era, Thomas Teatini, Emilio F Fossali
BACKGROUND: Retrospective case series suggest that abnormalities in fluid, electrolyte, and acid-base homeostasis may occur among infants with a febrile urinary tract infection. Potentially inaccurate laboratory methods of sodium testing have often been used. METHODS: Between January 2009 and June 2016, we managed 80 previously healthy infants (52 males and 28 females) ≥4 weeks to ≤24 months of age with their first episode of acute pyelonephritis. Ionized sodium, ionized potassium and ionized chloride were determined by direct potentiometry, as recommended by the International Federation of Clinical Chemistry...
July 12, 2017: Nephron
https://www.readbyqxmd.com/read/28683450/acute-kidney-injury-and-hemolytic-anemia-secondary-to-mycoplasma-pneumoniae-infection
#6
Camillo Carrara, Mauro Abbate, Ettore Sabadini, Giuseppe Remuzzi
Glomerulonephritis as well as kidney injury secondary to fulminant intravascular hemolysis are rare extrapulmonary manifestations of Mycoplasma pneumoniae infection. We describe a 50-year-old female diagnosed with M. pneumoniae infection-associated hemolytic anemia, characterized by negative cold agglutinin tests but with laboratory evidence of complement alternative pathway activation. The patient presented both with anemia and severe kidney failure and she was treated with steroids and red blood cell transfusions along with plasmapheresis...
July 7, 2017: Nephron
https://www.readbyqxmd.com/read/28662513/lymphocyte-function-in-human-acute-kidney-injury
#7
Sophie Weller, Matt Varrier, Marlies Ostermann
Acute kidney injury (AKI) has been recognised as an inflammatory condition with serious short- and long-term complications. Animal studies primarily using models of ischaemia reperfusion injury or caecal ligation and perforation have clearly demonstrated that inflammatory cells contribute to the initiation, propagation and recovery phase of AKI and that lymphocytes have a key role in these processes. Less is known about their involvement in common types of human AKI. This paper summarises the key findings of experimental AKI studies and limited human data with particular focus on the role of T-lymphocytes...
June 30, 2017: Nephron
https://www.readbyqxmd.com/read/28662505/empirically-reduced-dosages-of-tinzaparin-in-patients-with-moderate-to-severe-renal-insufficiency-lead-to-inadequate-anti-xa-levels
#8
Renske H Olie, Nathalie E L Meertens, Yvonne M C Henskens, Hugo Ten Cate
BACKGROUND: Due to the higher molecular weight of tinzaparin, the low molecular weight heparin (LMWH) is less dependent on renal excretion than other LMWH preparations. However, several international guidelines recommend the same preemptive dosage reduction for all therapeutic dose LMWHs prescribed in renal insufficient patients, to ensure that there is no accumulation of anticoagulant activity and increased risk of bleeding. This study is aimed at assessing whether a preemptive dosage reduction of tinzaparin in all renal insufficient patients (comprising 25% reduction in patients with Modification of Diet in Renal Disease - estimated glomerular filtration rate (MDRD-eGFR) 30-60 mL/min/1...
June 30, 2017: Nephron
https://www.readbyqxmd.com/read/28641285/role-of-glycyrrhizin-in-the-reduction-of-inflammation-in-diabetic-kidney-disease
#9
Vikram Thakur, Syeda Nargis, Mayra Gonzalez, Swetak Pradhan, Daniel Terreros, Munmun Chattopadhyay
BACKGROUND: Diabetic kidney disease (DKD) is one of the most debilitating complications of type 2 diabetes. Recent evidence suggests chronic inflammation to be one of the causal factors of DKD. The mechanisms entailed are not completely elucidated except that a variety of cytokines play a major role in this process. High mobility group box 1 (HMGB1) is a pro-inflammatory toll-like receptor-4 (TLR4)-binding cytokine that is involved in inflammation-associated gene expression. This investigation was designed to assess the involvement of HMGB1, TLR-4, and nuclear factor (NF)-κB in the development of DKD and to evaluate that whether blocking HMGB1 by its natural inhibitor Glycyrrhizin (GLC) can reduce the progression of the disease...
June 23, 2017: Nephron
https://www.readbyqxmd.com/read/28637038/synergic-impact-of-vascular-calcification-and-low-autonomic-tone-in-mortality-of-hemodialysis-patients
#10
Hwee-Yeong Ng, Shu-Kai Hsueh, Yueh-Ting Lee, Terry Ting-Yu Chiou, Pei-Chen Huang, Chien-Te Lee
BACKGROUND: Both cardiovascular calcification and autonomic dysfunction are frequently encountered in hemodialysis patients. We aimed to investigate the relationship between cardiovascular calcification and heart rate variability (HRV) and their influence on long-term outcome. METHODS: Seventy-eight hemodialysis patients underwent echocardiogram and radiography of the pelvis and hands to identify valvular and vascular calcification. HRV was evaluated using a commercial machine...
June 22, 2017: Nephron
https://www.readbyqxmd.com/read/28633144/standardized-renal-endpoints-for-perioperative-clinical-trials-the-standardized-endpoints-in-perioperative-medicine-initiative
#11
David R McIlroy, Andrew D Shaw, Paul S Myles
Perioperative acute kidney injury is a common problem. While clinical trials seek to evaluate the impact of interventions on a variety of primary and secondary endpoints with the aim of implementing this knowledge to improve perioperative outcomes, the use of valid and relevant endpoints within clinical trials is of critical importance to achieving this goal. Suitable endpoints must be validated for the study population and in light of the clinical context under investigation while also considering regulatory requirements that govern the licensing of new therapeutic agents as well as the values of patients whose outcomes we seek to improve...
June 21, 2017: Nephron
https://www.readbyqxmd.com/read/28614837/renal-oxygenation-and-hemodynamics-in-kidney-injury
#12
Alexander Bullen, Zhi Zhao Liu, Mark Hepokoski, Ying Li, Prabhleen Singh
Acute kidney injury (AKI) continues to be a major therapeutic challenge. Despite significant advances made in cellular and molecular pathophysiology of AKI, major gaps in knowledge exist regarding the changes in renal hemodynamics and oxygenation in the early stages and through the continuum of AKI. Particular features of renal hemodynamics and oxygenation increase the susceptibility of the kidney to sustain injury due to oxygen demand-supply mismatch and also play an important role in the recovery and repair from AKI as well as the transition of AKI to chronic kidney disease...
June 15, 2017: Nephron
https://www.readbyqxmd.com/read/28614830/expression-of-tlr2-nod1-and-nod2-and-the-nlrp3-inflammasome-in-renal-tubular-epithelial-cells-of-male-versus-female-mice
#13
Sean E DeWolf, Alana A Shigeoka, Andrew Scheinok, Sashi G Kasimsetty, Alexander K Welch, Dianne B McKay
BACKGROUND: Gender-biased outcomes are associated with acute kidney injury (AKI) and human and animal studies have shown that females are preferentially protected from renal ischemia. However, the reason for this is not known. One clue might lie with pattern recognition receptors (PRRs), which are triggers of ischemic injury when ligated by molecules in the ischemic milieu. Several PRR families are expressed by renal tubular epithelial cells (RTEs) and incite cell death signaling and production of pro-inflammatory molecules...
June 15, 2017: Nephron
https://www.readbyqxmd.com/read/28614829/aki-adjudication-do-we-need-it
#14
Yuenting D Kwong, Kathleen D Liu
Adjudication, which comes from the Latin term "adjudicare" (to act as a judge), uses expert opinion to define and classify disease entities. The use of clinical adjudication may help to define more homogeneous disease subsets but comes at the expense of effort needed and generalizability. Here, we will describe the pros and cons of acute kidney injury (AKI) adjudication under varied circumstances. We will use heart failure as a paradigm and provide comparable examples from the current AKI literature.
June 15, 2017: Nephron
https://www.readbyqxmd.com/read/28614822/drug-discovery-to-halt-the-progression-of-acute-kidney-injury-to-chronic-kidney-disease-a-case-for-phenotypic-drug-discovery-in-acute-kidney-injury
#15
Neil Hukriede, Andreas Vogt, Mark de Caestecker
The cellular responses that occur following acute kidney injury (AKI) are complex and dynamic, involving multiple cells types and molecular pathways. For this reason, early selection of defined molecular targets for therapeutic intervention is unlikely to be effective in complex in vivo models of AKI, let alone Phase 3 clinical trials in patients with even more complex AKI pathobiology. Phenotypic screening using zebrafish provides an attractive alternative that does not require prior knowledge of molecular targets and may identify compounds that modify multiple targets that might be missed in more traditional target-based screens...
June 15, 2017: Nephron
https://www.readbyqxmd.com/read/28609764/hemodialysis-and-kidney-transplantation-as-predisposing-conditions-to-onychomycosis
#16
Antonio M S Filho, Carlucci G Ventura, Paulo R Criado, Gilda B Del Negro, Roseli S Freitas, Olinda C Luiz, Mauro C Giudice, Elias D Neto, Gil Benard
BACKGROUND/AIM: Onychomycosis (OM) is one of the commonest superficial fungal infections. Patients undergoing hemodialysis (HD) treatment and kidney transplant recipients (KTR) are considered at risk of contracting fungal infections, but the few published data do not reach the conclusion of whether they are predisposed to OM. This study aimed to determine the prevalence and etiology of OM in these patients and to determine the antifungal susceptibility profile of the isolated fungal species...
June 14, 2017: Nephron
https://www.readbyqxmd.com/read/28601878/role-of-immune-cells-in-acute-kidney-injury-and-repair
#17
Sul A Lee, Sanjeev Noel, Mohanraj Sadasivam, Abdel R A Hamad, Hamid Rabb
Acute kidney injury (AKI) is a significant problem in both native and transplant kidneys. There have been significant advances in understanding the role of immune cells in the early injury and repair from AKI. In this brief review, we aim to update information on the pathophysiologic impact of various immune cells in AKI, with special emphasis on repair. An improved understanding of the AKI immunopathology will lead to new therapies that prevent AKI, accelerate repair, and prevent the progression of AKI to chronic kidney disease...
June 10, 2017: Nephron
https://www.readbyqxmd.com/read/28595193/the-economic-consequences-of-acute-kidney-injury
#18
Samuel A Silver, Glenn M Chertow
Acute kidney injury (AKI) is an increasingly common condition associated with poor health outcomes. Combined with its rising incidence, AKI has emerged as a major public health concern with high human and financial costs. In England, the estimated inpatient costs related to AKI consume 1% of the National Health Service budget. In the United States, AKI is associated with an increase in hospitalization costs that range from $5.4 to $24.0 billion. The most expensive patients are those with AKI of sufficient severity to require dialysis, where cost increases relative to patients without AKI range from $11,016 to $42,077 per hospitalization...
June 9, 2017: Nephron
https://www.readbyqxmd.com/read/28595190/nonpharmacological-biomechanical-approaches-to-control-inflammation-in-acute-kidney-injury
#19
Shinji Tanaka, Tsuyoshi Inoue, John A Hossack, Mark D Okusa
Inflammation is broadly recognized as an important factor in the pathogenesis of acute kidney injury (AKI), but pharmacological approaches to alleviate inflammation in AKI have been without success in clinical trials. Neuromodulation by nonpharmacological methods is emerging as a novel therapeutic strategy to treat inflammatory diseases. Recently, our group and others have demonstrated that vagus nerve stimulation and pulsed ultrasound ameliorated inflammation via the cholinergic anti-inflammatory pathway (CAP) in various animal models, including renal ischemia-reperfusion injury...
June 9, 2017: Nephron
https://www.readbyqxmd.com/read/28595180/fibrotic-changes-mediating-acute-kidney-injury-to-chronic-kidney-disease-transition
#20
Eoghainín Ó hAinmhire, Benjamin D Humphreys
End-stage renal disease (ESRD) is common, costly, and it results from progressive chronic kidney disease (CKD). ESRD claims many lives every year. It is increasingly recognized that episodes of acute kidney injury (AKI) predispose to the future development of CKD and ESRD. While our understanding of the pathophysiology of the AKI to CKD transition is improving, there are no validated therapeutic strategies to prevent this transition. In this review, we summarize the recent progress made in defining the cellular and molecular events underlying the AKI to CKD transition and highlight potential therapeutic targets and strategies to reduce the incidence of CKD following AKI...
June 9, 2017: Nephron
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