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https://www.readbyqxmd.com/read/28641285/role-of-glycyrrhizin-in-the-reduction-of-inflammation-in-diabetic-kidney-disease
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
https://www.readbyqxmd.com/read/28595179/epigenetic-changes-in-the-acute-kidney-injury-to-chronic-kidney-disease-transition
#13
Masaomi Nangaku, Yosuke Hirakawa, Imari Mimura, Reiko Inagi, Tetsuhiro Tanaka
Previously acute kidney injury (AKI) had been believed to be a transient event, and recovery from AKI had been thought to lead to no consequences. However, recent epidemiological studies have shown that even if there is complete recovery of the kidney function, AKI can eventually result in chronic kidney disease (CKD) and eventually in end-stage kidney disease in the long term. Transition of AKI to CKD is mediated by multiple mechanisms, including aberrant cell cycle arrest and hypoxia. Hypoxia of the kidney is induced by rarefaction of the peritubular capillaries after AKI episodes, and induces inflammation and fibrosis...
June 9, 2017: Nephron
https://www.readbyqxmd.com/read/28591760/cultural-challenges-in-the-care-of-refugees-with-end-stage-renal-disease-what-western-nephrologists-should-know
#14
Mohamed A Sekkarie, Emaad M Abdel-Rahman
Forced migration is on the rise, mainly from the Middle East to western countries, resulting in unprecedented moral, political, and economic challenges for both refugees and host communities. Recent research showed that refugees represent around 1.5% of the dialysis population in several European and Middle Eastern countries surveyed. Despite the fact that refugees represent a small percentage of all dialysis patients in these countries, adequate care for this population is challenging. There are cultural differences between refugee patients with end-stage renal disease hailing from the Middle East, who are predominantly Muslims, and people from the western host countries...
June 8, 2017: Nephron
https://www.readbyqxmd.com/read/28591759/ppar%C3%AE-coactivator-1%C3%AE-nicotinamide-adenine-dinucleotide-and-renal-stress-resistance
#15
Ali Poyan Mehr, Samir M Parikh
With one of the highest mitochondrial densities in the body, the kidneys consume approximately 10% of total oxygen while constituting 0.5% of body mass. Renal respiration is linear to solute extraction, linking oxidative metabolism directly to tubular function. This fundamental role of mitochondria in renal health may become an "Achilles heel" under duress. Acute kidney injury (AKI) related to each major class of stressor - inflammation, ischemia, and toxins - exhibits early and prominent mitochondrial injury...
June 8, 2017: Nephron
https://www.readbyqxmd.com/read/28591752/physical-activity-in-end-stage-renal-disease-patients-the-effects-of-starting-dialysis-in-the-first-6-months-after-the-transition-period
#16
Natascha J H Broers, Remy J H Martens, Tom Cornelis, Frank M van der Sande, Nanda M P Diederen, Marc M H Hermans, Joris J J M Wirtz, Frank Stifft, Constantijn J A M Konings, Tom Dejagere, Bernard Canaud, Peter Wabel, Karel M L Leunissen, Jeroen P Kooman
OBJECTIVES: Physical inactivity in end-stage renal disease (ESRD) patients is associated with increased mortality, and might be related to abnormalities in body composition (BC) and physical performance. It is uncertain to what extent starting dialysis influences the effects of ESRD on physical activity (PA). This study aimed to compare PA and physical performance between stage 5 chronic kidney disease (CKD-5) non-dialysis and dialysis patients, and healthy controls, to assess alterations in PA during the transition from CKD-5 non-dialysis to dialysis, and to relate PA to BC...
June 8, 2017: Nephron
https://www.readbyqxmd.com/read/28586768/a-role-of-remote-organs-effect-in-acute-kidney-injury-outcome
#17
François Dépret, Mathilde Prud'homme, Matthieu Legrand
Acute kidney injury (AKI) has been associated with both short- and long-term outcomes. To date, there is still a debate whether the increase risk of morbidity and mortality is directly due to AKI occurrence. There is, however, a potential causal impact of AKI on outcome, but evidence of this association is yet lacking. The hypothesis of remote organ damage and dysfunction (heart, lung, liver, brain, etc.) has emerged over the last decade and may explain the reason for the potential negative impact of AKI on outcome...
June 7, 2017: Nephron
https://www.readbyqxmd.com/read/28538218/dialysis-therapy-and-conservative-management-of-advanced-chronic-kidney-disease-in-the-elderly-a-systematic-review
#18
Supakanya Wongrakpanich, Paweena Susantitaphong, Suramath Isaranuwatchai, Jirat Chenbhanich, Somchai Eiam-Ong, Bertrand L Jaber
BACKGROUND: Dialysis in older adults with chronic kidney disease (CKD) and comorbidities may not be associated with improved life expectancy compared to conservative management. To inform clinical practice, we performed a systematic review of all available studies examining this hypothesis. METHODS: We performed a systematic review of retrospective and prospective cohort studies of older adults with stage-5 CKD who chose dialysis (hemodialysis or peritoneal dialysis) or opted for conservative management (including management of complications of CKD and palliative care)...
May 25, 2017: Nephron
https://www.readbyqxmd.com/read/28514785/effect-of-age-on-the-association-of-vascular-access-type-with-mortality-in-a-cohort-of-incident-end-stage-renal-disease-patients
#19
Tarek Saleh, Keiichi Sumida, Miklos Z Molnar, Praveen K Potukuchi, Fridtjof Thomas, Jun Ling Lu, Geeta G Gyamlani, Elani Streja, Kamyar Kalantar-Zadeh, Csaba P Kovesdy
BACKGROUND/AIMS: All hemodialysis (HD) patients are generally recommended to create a fistula first; but to create a mature arteriovenous fistula (AVF) can be challenging in elderly individuals. It is unclear if elderly incident HD patients derive a survival benefit from an AVF over an arteriovenous graft (AVG) or a tunneled central venous catheter (TDC). METHODS: We examined the association of vascular access type (AVF, AVG, and TDC with and without a maturing AVF/AVG at dialysis transition) at HD initiation with all-cause, cardiovascular (CV), and infection-related mortality in 46,786 US veterans using Cox models with adjustment for confounders...
May 18, 2017: Nephron
https://www.readbyqxmd.com/read/28511177/familial-hyperkalemia-and-hypertension-fhht-and-klhl3-description-of-a-family-with-a-new-recessive-mutation-s553l-compared-to-a-family-with-a-dominant-mutation-q309r-with-analysis-of-urinary-sodium-chloride-cotransporter
#20
Orit Kliuk-Ben Bassat, Vered Carmon, Aaron Hanukoglu, Liat Ganon, Eias Massalha, Eliezer J Holtzman, Zvi Farfel, Haim Mayan
BACKGROUND: Familial hyperkalemia and hypertension (FHHt) is an inherited disorder manifested by hyperkalemia and hypertension. The following four causative genes were identified: WNK1, WNK4, CUL3, and KLHL3. For the first 3 genes, inheritance is autosomal dominant. For KLHL3, inheritance is mostly dominant. A few cases with autosomal recessive disease were described. The mechanism of these 2 modes of inheritance is not clear. In the recessive form, the phenotype of heterozygotes is not well described...
May 17, 2017: Nephron
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