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steroids in diabetic nephropathy

Chieh Kai Chan, Tai Shuan Lai, Ping Min Chen, Yu Hsiang Chou, Ching Fang Wu, Yen Ling Chiu, Wen Chih Chiang, Yung Ming Chen, Tzong-Shinn Chu, Kwan Dun Wu
BACKGROUND: Suggestion for the management of idiopathic membranous nephropathy (IMN) includes 6 months of observation, followed with steroid plus alkylating agent. However, delayed immunosuppression exposes the kidneys to persistent damage. This study aimed to examine the benefit of early immunosuppression in IMN patients. METHOD: A retrospective study was performed. From 1993 to 2013, 161 IMN patients were enrolled. Patients receiving immunosuppression within 6 months after diagnosis were classified as initial-treatment group, whereas other patients as initial-no-treatment group...
February 12, 2017: Journal of the Formosan Medical Association, Taiwan Yi Zhi
Mercedes Martín-Martínez, Felipe L Pérez-Gordillo, Diego Álvarez de la Rosa, Yoel Rodríguez, Guillermo Gerona-Navarro, Rosario González-Muñiz, Ming-Ming Zhou
Steroidal mineralocorticoid receptor (MR) antagonists are used for treatment of a range of human diseases, but they present challenging issues of complex chemical synthesis, undesirable physical properties, and poor selectivity along with unwanted side effects. Therefore, there is a great interest in the discovery of non-steroidal ligands able to bind to the ligand-binding domain of the MR and recruit different co-regulators to produce tissue-specific therapeutic effects. Several academic groups and pharmaceutical companies have been developing a series of non-steroidal ligands that consist of different chemical scaffolds, yielding MR antagonists currently evaluated in clinical studies for the treatment of congestive heart failure, hypertension, or diabetic nephropathy...
January 24, 2017: Journal of Medicinal Chemistry
Shigehiro Katayama, Daishiro Yamada, Mikihiro Nakayama, Takashi Yamada, Masafumi Myoishi, Masaharu Kato, Christina Nowack, Peter Kolkhof, Yoshimitsu Yamasaki
AIMS: Finerenone (BAY 94-8862) is a novel non-steroidal mineralocorticoid receptor antagonist. The aim of this study was to compare the efficacy and safety of seven once-daily oral doses of finerenone (1.25-20mg) and placebo in 96 patients with type 2 diabetes mellitus (T2DM) and diabetic nephropathy (DN) receiving a RAS blocker. METHODS: ARTS-DN Japan was a multicenter, randomized, double-blind, placebo-controlled, phase 2b study. RESULTS: Analysis of the urinary albumin-to-creatinine ratio (UACR) at day 90 relative to baseline indicated a nominally significant effect of finerenone...
April 2017: Journal of Diabetes and its Complications
Yasuhiko Tomino
Chronic kidney disease (CKD) is a worldwide public health problem that affects millions of people from all racial and ethnic groups. Although CKD is not one specific disease, it is a comprehensive syndrome that includes IgA nephropathy. As reported by the Japanese Society of Nephrology, 13.0 million people have CKD. In Japan, major causes of end-stage kidney disease are type 2 diabetic nephropathy, chronic glomerulonephritis, especially IgA nephropathy, hypertensive nephrosclerosis, and polycystic kidney disease...
December 2016: Kidney Research and Clinical Practice
Thomas Vanhove, Roel Goldschmeding, Dirk Kuypers
All causes of renal allograft injury, when severe and/or sustained, can result in chronic histological damage of which interstitial fibrosis and tubular atrophy are dominant features. Unless a specific disease process can be identified, what drives interstitial fibrosis and tubular atrophy progression in individual patients is often unclear. In general, clinicopathological factors known to predict and drive allograft fibrosis include graft quality, inflammation (whether "nonspecific" or related to a specific diagnosis), infections, such as polyomavirus-associated nephropathy, calcineurin inhibitors (CNI), and genetic factors...
April 2017: Transplantation
Yasuyuki Nagasawa, Ryohei Yamamoto, Tatsuya Shoji, Maki Shinzawa, Yukiko Hasuike, Katsuyuki Nagatoya, Atsushi Yamauchi, Terumasa Hayashi, Takayuki Kuragano, Toshiki Moriyama, Yoshitaka Isaka, Takeshi Nakanishi
BACKGROUND: Immunoglobulin A nephropathy (IgAN) is one of most common forms of glomerulonephritis. At this point, the clinical impact of hyperuricemia on IgAN is not clear. The aim of the present study was to explore the clinical impact of hyperuricemia on the progression of IgAN. STUDY DESIGN: Multicenter retrospective cohort study. SETTING & PARTICIPANTS: 935 IgAN patients who were diagnosed by kidney biopsy at Osaka University Hospital, Osaka General Hospital, and Osaka Rosai Hospital...
2016: PloS One
E Feigerlová, P-J Saulnier, P Gourdy, R Roussel, J-M Halimi, E Gand, D Dardari, B Guerci, P Sosner, M Marre, P Zaoui, S Ragot, S Hadjadj
BACKGROUND: Greater renal function decline (RFD) in type 2 diabetes (T2DM) has been suggested in men compared with women, and imbalances in estrogen/androgen levels have been associated with cardiovascular disease mortality in elderly men, but it remains unclear whether sex hormone disequilibrium is related to diabetic nephropathy (DN) in men with T2DM. OBJECTIVE: This study examined the relationship between sex steroid concentrations and renal outcomes in male T2DM patients...
April 2017: Diabetes & Metabolism
Weiqing Xia, Huaying Pei, Shaomei Li, Shuxia Fu, Li Tian
OBJECTIVE: To explore the clinical efficacy and safety of modified Ponticelli regimen in treating patients with idiopathic membranous nephropathy(IMN). METHODS: A retrospective analysis was performed in 90 patients with IMN (type Ⅰ/Ⅱ, 79/11 respectively) diagnosed by clinical data and renal biopsy. The patients were divided into modified Ponticelli group (n=23), steroid plus cyclophosphamide(CTX) (CTX group, n=39) and steroid plus cyclosporine A(CsA) (CsA group, n=28) according to the treatment...
March 2016: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
Maurice Laville, Nicolas Rognant
The 9th World Kidney Day, on 13 March 2014, was devoted to the topic of renal aging. The proportion of older people in the general population is increasing steadily worldwide, with the most rapid growth in developing countries. This demographic upheaval is a consequence of socioeconomic development and increasing life expectancy. Chronic kidney disease is an important public health problem characterized by poor health outcomes and very high healthcare costs. Chronic kidney disease is a major risk multiplier in patients with diabetes, hypertension, heart disease and stroke, all of which are key causes of death and disability among older people...
April 2014: Bulletin de L'Académie Nationale de Médecine
Yong-Liang Yuan, Chang-Run Guo, Ling-Ling Cui, Shi-Xia Ruan, Chun-Feng Zhang, De Ji, Zhong-Lin Yang, Fei Li
BACKGROUND: Many synthesized drugs with clinical severe side effects have been used for diabetic nephropathy (DN) treatment. Therefore, it is urgent and necessary to identify natural and safe agents to remedy DN. Timosaponin B-II (TB-II), a major steroidal saponin constituent in Anemarrhena asphodeloides Bunge, exhibits various activities, including anti-inflammatory and hypoglycemic functions. However, the anti-DN effects and potential mechanism(s) of TB-II have not been previously reported...
2015: Drug Design, Development and Therapy
Peter Bramlage, Stephanie L Swift, Martin Thoenes, Joan Minguet, Carmen Ferrero, Roland E Schmieder
Pharmaceutical antagonism of the mineralocorticoid receptor (MR) can protect against organ damage caused by elevated aldosterone levels in patients experiencing heart failure (HF), chronic kidney disease (CKD), primary aldosteronism, and hypertension. While traditional steroid-based MR antagonists effectively reduce mortality rates and extend patient survival, their broad application has been limited by significant side effects, most notably hyperkalaemia. Recently, finerenone (BAY 94-8862) has emerged as a next-generation non-steroidal dihydropyridine-based MR antagonist designed to minimize off-target effects while maintaining potent efficacy...
January 2016: European Journal of Heart Failure
M Cordaro, D Impellizzeri, G Bruschetta, R Siracusa, R Crupi, R Di Paola, E Esposito, S Cuzzocrea
Contrast-induced nephropathy (CIN) is a complication in patients after administration of iodinated contrast media. Several risk factors contribute to the development and progression of CIN, including hypertension, diabetes, and dyslipidemia. Animal models of CIN by surgical intervention to reproduce its clinical and pathology has been developed, and thus, therapeutic methods tested. Palmitoylethanolamide (PEA) is a member of the fatty acid ethanolamine family with analgesic and anti-inflammatory effects. In this study, we analyzed streptozotocin-induced diabetes model and in an another set of experiment a surgical remotion of the kidney with the aim of evaluating effect of ultramicronized Palmitoylethanolamide (PEA-um(®)) on contrast induced renal disfunction and glomerular morphology alteration...
January 5, 2016: Toxicology Letters
S M Firdous
Diabetes Mellitus (DM) is one of the most prevalent metabolic disorders characterized by increased blood glucose levels and improper primary metabolism resulting from the defects in insulin secretion, insulin action, or both. It is one of the most common health problems worldwide, and the prevalence of this disease is rapidly increasing, leading to microvascular (retinopathy, neuropathy and nephropathy) and macrovascular (heart attack, stroke and peripheral vascular disease) complications (Umar et al., 2010[18])...
2014: EXCLI journal
George L Bakris, Rajiv Agarwal, Juliana C Chan, Mark E Cooper, Ron T Gansevoort, Hermann Haller, Giuseppe Remuzzi, Peter Rossing, Roland E Schmieder, Christina Nowack, Peter Kolkhof, Amer Joseph, Alexander Pieper, Nina Kimmeskamp-Kirschbaum, Luis M Ruilope
IMPORTANCE: Steroidal mineralocorticoid receptor antagonists, when added to a renin-angiotensin system blocker, further reduce proteinuria in patients with chronic kidney disease but may be underused because of a high risk of adverse events. OBJECTIVE: To evaluate the safety and efficacy of different oral doses of the nonsteroidal mineralocorticoid receptor antagonist finerenone, given for 90 days to patients with diabetes and high or very high albuminuria who are receiving an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker...
September 1, 2015: JAMA: the Journal of the American Medical Association
Ashim Malhotra, Sundeep Bath, Fawzy Elbarbry
Resveratrol is a phenolic phytochemical, with a stilbene backbone, derived from edible plants such as grape and peanut. It is a bioactive molecule with physiological effects on multiple organ systems. Its effects range from the neuroprotective to the nephroprotective, including cardiovascular, neuronal, and antineoplastic responses as a part of its broad spectrum of action. In this review, we examine the effects of resveratrol on the following organ systems: the central nervous system, including neurological pathology such as Parkinson's and Alzheimer's disease; the cardiovascular system, including disorders such as atherosclerosis, ischemia-reperfusion injury, and cardiomyocyte hypertrophy; the kidneys, including primary and secondary nephropathies and nephrolithiasis; multiple forms of cancer; and metabolic syndromes including diabetes...
2015: Oxidative Medicine and Cellular Longevity
E Uysal, M F Yuzbasioglu, H Bakir, O A Gurer, A M Ikidag, M Dokur
The aim of this study was to determine the changes in body mass index (BMI) of patients after renal transplantation regarding causes like steroid use, lower necessity for dietary restrictions, and changes in eating habits. Ninety-seven patients were enrolled in this retrospective study; they had undergone cadaver or living donor renal transplantation between 2011 and 2013. Demographic features of patients, height, weight, and BMI were evaluated before and 6 and 12 months after surgery. The patients were grouped as malnutritioned, normal, overweight, and obese...
June 2015: Transplantation Proceedings
Peter Kolkhof, Christina Nowack, Frank Eitner
PURPOSE OF REVIEW: The broad clinical use of steroidal mineralocorticoid receptor antagonists (MRAs) is limited by the potential risk of inducing hyperkalemia when given on top of renin-angiotensin system blockade. Drug discovery campaigns have been launched aiming for the identification of nonsteroidal MRAs with an improved safety profile. This review analyses the evidence for the potential of improved safety profiles of nonsteroidal MRAs and the current landscape of clinical trials with nonsteroidal MRAs...
September 2015: Current Opinion in Nephrology and Hypertension
Li Wang, Nan Mao, Rui-Zhi Tan, Hong-Lian Wang, Ji Wen, Yu-Hang Liu, Md Furhad, Jun-Ming Fan
Aldosterone is a steroid hormone secreted from the adrenal cortex, which regulates blood pressure. Higher concentrations of aldosterone can cause several diseases, including hypertension, diabetic nephropathy and chronic kidney disease. Previous reports have demonstrated that aldosterone has a pathogenic role in renal injury via reactive oxygen species (ROS), which involves the regulation of autophagy. However, whether aldosterone can induce autophagy in renal tubular cells remains to be elucidated. In the present study, elevated autophagy was observed in rat renal tubular NRK-52E cells exposed to aldosterone, which was demonstrated by the increased number of autophagosomes, conversion of LC3-I to LC3-II and the expression of Beclin-1...
August 2015: International Journal of Molecular Medicine
Tarek Fayad, Emad William, Nasr Tawfik, Boulos Habashy, Hazem S Abou-Youssef, Sameh Shokry, Soha Khalil, Ahmed Morsy, Rashad Barsoum
OBJECTIVES: To describe the long-term results of a previously developed a sirolimus-based sequential immunosuppression protocol for kidney transplant comprising 2 phases: sirolimus + cyclosporine + prednisolone for 3 months followed by sirolimus + prednisolone + mycophenolate mofetil with steroid minimization the first year. Two-year outcomes of patients on this protocol (group A) showed equivalent patient and graft survival, yet with significantly better function, compared with those on cyclosporine + mycophenolate mofetil + prednisolone (group B)...
April 2015: Experimental and Clinical Transplantation
Fan Yang, Bing Li, Wenpeng Cui, Chunyan He, Shujun Liu, Qiaoyan Guo, Man Wu, Lining Miao, Ping Luo
PURPOSE: To investigate the clinical characteristics and histopathological features of kidney disease in elderly patients. METHODS: We retrospectively analyzed the results of 4,185 consecutive renal biopsies, and 288 patients aged >60 years at the Second Hospital of Jilin University from January 1998 to December 2013 were finally included. All patients had been clinically and histologically diagnosed with kidney disease. RESULTS: Nephrotic syndrome was the main clinical indication for biopsy...
February 2015: International Urology and Nephrology
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