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Uremic toxins

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https://www.readbyqxmd.com/read/27904864/nephrotic-range-proteinuria-and-peripheral-edema-in-a-child-not-only-idiopathic-nephrotic-syndrome
#1
Valentina Dolcemascolo, Marina Vivarelli, Manuela Colucci, Francesca Diomedi-Camassei, Rossella Piras, Marta Alberti, Francesco Emma
Hemolytic uremic syndrome (HUS) is defined by the simultaneous occurrence of hemolytic anemia, thrombocytopenia, and acute kidney injury due to thrombotic microangiopathy (TMA) mainly occurring in renal and cerebral microvessels. Although the most common cause of HUS in children is Shiga toxin-producing Escherichia coli, atypical forms in which Shiga toxin is not the trigger may occur. Research over the last few years has shown that complement dysregulation secondary to mutations of genes coding for proteins involved in the regulation of the alternative pathway of complement account for most forms of atypical HUS (aHUS)...
September 2016: Case Reports in Nephrology and Dialysis
https://www.readbyqxmd.com/read/27893870/associations-between-hydration-status-intravenous-fluid-administration-and-outcomes-of-patients-infected-with-shiga-toxin-producing-escherichia-coli-a-systematic-review-and-meta-analysis
#2
Silviu Grisaru, Jianling Xie, Susan Samuel, Lisa Hartling, Phillip I Tarr, David Schnadower, Stephen B Freedman
Importance: The associations between hydration status, intravenous fluid administration, and outcomes of patients infected with Shiga toxin-producing Escherichia coli (STEC) remain unclear. Objective: To determine the relationship between hydration status, the development and severity of hemolytic uremic syndrome (HUS), and adverse outcomes in STEC-infected individuals. Data Sources: MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials via the OvidSP platform, PubMed via the National Library of Medicine, CINAHL Plus with full text, Scopus, Web of Science, ClinicalTrials...
November 28, 2016: JAMA Pediatrics
https://www.readbyqxmd.com/read/27886001/strategy-for-the-hemocompatibility-testing-of-microparticles
#3
S Braune, S Basu, K Kratz, J Bäckemo Johansson, M Reinthaler, A Lendlein, F Jung
Polymer-based microparticles are applied as non-thrombogenic or thrombogenic materials in a wide variety of intra- or extra-corporeal medical devices. As demanded by the regulatory agencies, the hemocompatibility of these blood contacting biomaterials has to be evaluated in vitro to ensure that the particle systems appropriately fulfill the envisioned function without causing undesired events such as thrombosis or inflammation. Currently described in vitro assays for hemocompatibility testing of particles comprise tests with different single cell types (e...
November 23, 2016: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/27884120/removal-of-free-light-chains-in-hemodialysis-patients-without-multiple-myeloma-a-crossover-comparison-of-three-different-dialyzers
#4
Gabriele Donati, Maria Ilaria Moretti, Olga Baraldi, Alessandra Spazzoli, Irene Capelli, Giorgia Comai, Antonio Marchetti, Maria Sarma, Rita Mancini, Gaetano La Manna
BACKGROUND: Immunoglobulin light chains are classified as middle molecule uremic toxins able to interact with B lymphocyte membranes leading to the activation of transmembrane signaling. The ensuing impairment of neutrophil function can contribute to the chronic inflammation state of uremic patients, and the increased risk of bacterial infections or vascular calcifications. The aim of this crossover observational study was to assess the difference in free light chain removal by three different hemodialysis filters in patients not affected by multiple myeloma...
November 25, 2016: BMC Nephrology
https://www.readbyqxmd.com/read/27880834/overexpressed-proteins-in-hypervirulent-clade-8-and-clade-6-strains-of-escherichia-coli-o157-h7-compared-to-e-coli-o157-h7-edl933-clade-3-strain
#5
Natalia Amigo, Qi Zhang, Ariel Amadio, Qunjie Zhang, Wanderson M Silva, Baiyuan Cui, Zhongjian Chen, Mariano Larzabal, Jinlong Bei, Angel Cataldi
Escherichia coli O157:H7 is responsible for severe diarrhea and hemolytic uremic syndrome (HUS), and predominantly affects children under 5 years. The major virulence traits are Shiga toxins, necessary to develop HUS and the Type III Secretion System (T3SS) through which bacteria translocate effector proteins directly into the host cell. By SNPs typing, E. coli O157:H7 was separated into nine different clades. Clade 8 and clade 6 strains were more frequently associated with severe disease and HUS. In this study, we aimed to identify differentially expressed proteins in two strains of E...
2016: PloS One
https://www.readbyqxmd.com/read/27872172/urea-a-true-uremic-toxin-the-empire-strikes-back
#6
REVIEW
Wei Ling Lau, Nosratola D Vaziri
Blood levels of urea rise with progressive decline in kidney function. Older studies examining acute urea infusion suggested that urea was well-tolerated at levels 8-10× above normal values. More recent in vitro and in vivo work argue the opposite and demonstrate both direct and indirect toxicities of urea, which probably promote the premature aging phenotype that is pervasive in chronic kidney disease (CKD). Elevated urea at concentrations typically encountered in uremic patients induces disintegration of the gut epithelial barrier, leading to translocation of bacterial toxins into the bloodstream and systemic inflammation...
January 1, 2017: Clinical Science (1979-)
https://www.readbyqxmd.com/read/27869414/prevalence-and-clinical-course-of-typical-hemolytic-uremic-syndrome-among-sibling
#7
Alfredo Eymann, Paula Coccia, Claudia Raddavero, Gabriela Lafi, Verónica Ferraris, José Ramírez, Jorge Ferraris
Introduction: Hemolytic uremic syndrome (HUS) isaninfectious disease caused by Shiga toxin-producing Escherichia coli. The objective of this study was to assess the risk of transmission and clinical course between siblings with typical HUS. Population and methods: Medical records of children with typical HUS between 1997 and 2012 were reviewed. Sibling pairs were established as inclusion criteria. A severity score was defined. Results: A total of 133 patients with HUS were recorded; 40 had siblings and 4 progressed to HUS (10%)...
December 1, 2016: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/27854278/n-methyl-2-pyridone-5-carboxamide-2py-major-metabolite-of-nicotinamide-an-update-on-an-old-uremic-toxin
#8
REVIEW
Aurélie Lenglet, Sophie Liabeuf, Sandra Bodeau, Loïc Louvet, Aurélien Mary, Agnès Boullier, Anne Sophie Lemaire-Hurtel, Alexia Jonet, Pascal Sonnet, Said Kamel, Ziad A Massy
N-methyl-2-pyridone-5-carboxamide (2PY, a major metabolite of nicotinamide, NAM) was recently identified as a uremic toxin. Recent interventional trials using NAM to treat high levels of phosphorus in end-stage renal disease have highlighted new potential uremic toxicities of 2PY. In the context of uremia, the accumulation of 2PY could be harmful-perhaps by inhibiting poly (ADP-ribose) polymerase-1 activity. Here, we review recently published data on 2PY's metabolism and toxicological profile.
November 15, 2016: Toxins
https://www.readbyqxmd.com/read/27853704/molecular-and-phylogenetic-characterization-of-non-o157-shiga-toxin-producing-escherichia-coli-strains-in-china
#9
Xiangning Bai, Bin Hu, Yanmei Xu, Hui Sun, Ailan Zhao, Pengbin Ba, Shanshan Fu, Ruyue Fan, Yujuan Jin, Hong Wang, Qiusheng Guo, Xuebin Xu, Shan Lu, Yanwen Xiong
Shiga toxin-producing Escherichia coli (STEC) causes diarrhea and hemorrhagic colitis with life-threatening complications, such as hemolytic uremic syndrome. The aim of this study was to assess the molecular epidemiologic features of non-O157 STEC strains from different resources in China and illustrate the role of animal reservoirs or animal-derived foodstuffs in human STEC infections. A collection of 301 non-O157 STEC isolates from domestic and wild animals (i.e., cattle, goat, pig, yak, pika, and antelope), raw meats (i...
2016: Frontiers in Cellular and Infection Microbiology
https://www.readbyqxmd.com/read/27848096/the-gut-kidney-axis
#10
REVIEW
Pieter Evenepoel, Ruben Poesen, Björn Meijers
The host-gut microbiota interaction has been the focus of increasing interest in recent years. It has been determined that this complex interaction is not only essential to many aspects of normal "mammalian" physiology but that it may also contribute to a multitude of ailments, from the obvious case of inflammatory bowel disease to (complex) diseases residing in organs outside the gut. An increasing body of evidence indicates that crosstalk between host and microbiota is pathophysiologically relevant in patients with chronic kidney disease (CKD)...
November 15, 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/27843201/indoxyl-sulfate-induces-mesangial-cell-proliferation-via-the-induction-of-cox-2
#11
Shuzhen Li, Sijie Cheng, Zhenzhen Sun, Harr-Keshauve Mungun, Wei Gong, Jing Yu, Weiwei Xia, Yue Zhang, Songming Huang, Aihua Zhang, Zhanjun Jia
Indoxyl sulfate (IS) is one of important uremic toxins and is markedly accumulated in the circulation of end stage renal disease (ESRD) patients, which might contribute to the damage of residual nephrons and progressive loss of residual renal function (RRF). Thus this study was undertaken to investigate the role of IS in modulating mesangial cell (MC) proliferation and the underlying mechanism. The proliferation of MCs induced by IS was determined by cell number counting, DNA synthase rate, and cell cycle phase analysis...
2016: Mediators of Inflammation
https://www.readbyqxmd.com/read/27830716/metabolic-alterations-by-indoxyl-sulfate-in-skeletal-muscle-induce-uremic-sarcopenia-in-chronic-kidney-disease
#12
Emiko Sato, Takefumi Mori, Eikan Mishima, Arisa Suzuki, Sanae Sugawara, Naho Kurasawa, Daisuke Saigusa, Daisuke Miura, Tomomi Morikawa-Ichinose, Ritsumi Saito, Ikuko Oba-Yabana, Yuji Oe, Kiyomi Kisu, Eri Naganuma, Kenji Koizumi, Takayuki Mokudai, Yoshimi Niwano, Tai Kudo, Chitose Suzuki, Nobuyuki Takahashi, Hiroshi Sato, Takaaki Abe, Toshimitsu Niwa, Sadayoshi Ito
Sarcopenia is associated with increased morbidity and mortality in chronic kidney disease (CKD). Pathogenic mechanism of skeletal muscle loss in CKD, which is defined as uremic sarcopenia, remains unclear. We found that causative pathological mechanism of uremic sarcopenia is metabolic alterations by uremic toxin indoxyl sulfate. Imaging mass spectrometry revealed indoxyl sulfate accumulated in muscle tissue of a mouse model of CKD. Comprehensive metabolomics revealed that indoxyl sulfate induces metabolic alterations such as upregulation of glycolysis, including pentose phosphate pathway acceleration as antioxidative stress response, via nuclear factor (erythroid-2-related factor)-2...
November 10, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27814290/influence-of-nanoporous-poly-ether-imide-particle-extracts-on-human-aortic-endothelial-cells-haecs
#13
Reddi K Kumar, Sayantani Basu, Horst-Dieter Lemke, Joachim Jankowski, Karl Kratz, Andreas Lendlein, Sarada D Tetali
Accumulated uremic toxins like indoxyl sulphate, hippuric acid and p-cresyl sulphates in renal failure patients stimulate proinflammatory effects, and consequently kidney and cardiovascular diseases. Low clearance rate of these uremic toxins from the blood of uremic patients by convention techniques like hemodialysis is due to their strong covalent albumin binding (greater than 95%) and hydrophobic nature, which led to alternatives like usage of hydrophobic adsorber's in removing these toxins from the plasma of kidney patients...
November 4, 2016: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/27768015/hemolytic-uremic-syndrome-in-children
#14
Valentina Talarico, Monica Aloe, Alice Monzani, Roberto Miniero, Gianni Bona
Hemolytic uremic syndrome (HUS) is a thrombotic microangiopathy defined by thrombocytopenia, non-immune microangiopathic hemolytic anemia and acute renal failure. HUS is typically classified into two primary types: 1) HUS due to infections, often associated with diarrhea (D+HUS, Shiga toxin-producing Escherichia Coli-HUS), with the rare exception of HUS due to a severe disseminated infection caused by Streptococcus; 2) HUS related to complement, such HUS is also known as "atypical HUS" and is not diarrhea associated (D-HUS, aHUS); but recent studies have shown other forms of HUS, that can occur in the course of systemic diseases or physiopathological conditions such as pregnancy, after transplantation or after drug assumption...
December 2016: Minerva Pediatrica
https://www.readbyqxmd.com/read/27766679/hemodialysis-time-and-kt-v-less-may-be-better
#15
James Tattersall
Current guidelines focus on conventional dialysis defined as 3-5 hours, three times per week, and suggest that longer or more frequent dialysis be considered. This paper presents the case for considering that shorter or less frequent dialysis should also be considered. More frequent and/or longer dialysis facilitates control of fluid overload, blood pressure, and phosphate levels. These benefits will require time to translate into probable hard outcome improvement. Patients are unlikely to participate in productive or pleasurable activities while undergoing dialysis in center or traveling to treatment...
October 20, 2016: Seminars in Dialysis
https://www.readbyqxmd.com/read/27760772/downregulation-of-kidney-expression-of-protective-factors-by-renal-and-systemic-inflammation-role-of-transcription-factors-and-epigenetic-mechanisms
#16
Olga Ruiz-Andres, Maria Dolores Sanchez-Niño, Juan Antonio Moreno, Marta Ruiz-Ortega, Adrian Mario Ramos, Ana Belén Sanz, Alberto Ortiz
Chronic kidney disease (CKD) is associated to an increased risk of death, CKD progression and acute kidney injury (AKI) even from early stages, when glomerular filtration rate (GFR) is preserved. The link between early CKD and these risks is unclear, since there is no accumulation of uremic toxins. However, pathological albuminuria and kidney inflammation are frequent features of early CKD and the production of kidney protective factors may be decreased. Indeed, Klotho expression is already decreased in CKD category G1 (normal GFR)...
October 19, 2016: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/27758122/uremic-toxins-some-thoughts-on-acrolein-and-spermine
#17
Kunal K Sindhu
Chronic kidney disease (CKD) is characterized by the progressive reduction of glomerular filtration rate and subsequent retention of organic waste compounds called uremic toxins. While patients with CKD are at a higher risk of premature death due to cardiovascular complications, this increased risk cannot be completely explained by classical cardiovascular risk factors such as hypertension, diabetes mellitus, and obesity. Instead, recent research suggests that uremic toxins may play a key role in explaining this marked increase in cardiovascular mortality in patients with CKD...
October 19, 2016: Renal Failure
https://www.readbyqxmd.com/read/27751361/protein-bound-uremic-toxins-from-gut-microbiota-and-inflammatory-markers-in-chronic-kidney-disease
#18
Natália A Borges, Amanda F Barros, Lia S Nakao, Carla J Dolenga, Denis Fouque, Denise Mafra
OBJECTIVE: Protein-bound uremic toxins from gut microbiota tend to accumulate in chronic kidney disease (CKD) patients and are poorly removed by current dialysis techniques. These toxins induce inflammation and are associated with cardiovascular disease (CVD). The aim of this study was to report the relationship between uremic toxins and inflammatory and cardiovascular markers in CKD patients. DESIGN: This was a cross sectional study. SUBJECTS: Twenty-one nondialysis patients were included (43% men, 63...
November 2016: Journal of Renal Nutrition
https://www.readbyqxmd.com/read/27747196/shiga-toxin-mediated-neurologic-changes-in-murine-model-of-disease
#19
Suman Pradhan, Christine Pellino, Kayleigh MacMaster, Dennis Coyle, Alison A Weiss
Seizures and neurologic involvement have been reported in patients infected with Shiga toxin (Stx) producing E. coli, and hemolytic uremic syndrome (HUS) with neurologic involvement is associated with more severe outcome. We investigated the extent of renal and neurologic damage in mice following injection of the highly potent form of Stx, Stx2a, and less potent Stx1. As observed in previous studies, Stx2a brought about moderate to acute tubular necrosis of proximal and distal tubules in the kidneys. Brain sections stained with hematoxylin and eosin (H&E) appeared normal, although some red blood cell congestion was observed...
2016: Frontiers in Cellular and Infection Microbiology
https://www.readbyqxmd.com/read/27745751/province-wide-review-of-pediatric-shiga-toxin-producing-escherichia-coli-case-management
#20
Stephen B Freedman, Mohamed Eltorki, Linda Chui, Jianling Xie, Sharon Feng, Judy MacDonald, Andrew Dixon, Samina Ali, Marie Louie, Bonita E Lee, Lara Osterreicher, Jennifer Thull-Freedman
OBJECTIVE: To identify the gaps in the care of children infected with Shiga toxin-producing Escherichia coli (STEC), we sought to quantitate care received and management timelines. Such knowledge is crucial to the design of interventions to prevent the development of hemolytic uremic syndrome (HUS). STUDY DESIGN: We conducted a retrospective case-series study of 78 children infected with STEC in Alberta, Canada, through the linkage of microbiology and laboratory results, telephone health advice records, hospital charts, physician billing submissions, and outpatient antimicrobial dispensing databases...
October 10, 2016: Journal of Pediatrics
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