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risk factors of progression of renal diseases

Taner Basturk, Ozlem Sari, Yener Koc, Nezaket Eren, Mahmoud Isleem, Ekrem Kara, Mustafa Sevinc, Tamer Sakaci, Elbis Ahbap, Nuri B Hasbal, Feyza B Caglayan, Abdulkadir Unsal
BACKGROUND: Neutrophilgelatinase-associated lipocalin (NGAL) has been proven to be a useful biomarker for early detection of acute kidney injury, but it is not known whether adding NGAL measurements to conventional risk factors will improve the risk assessment in the setting of chronic kidney disease (CKD). The aim of the present study was to examine the correlation of NGAL with early stage renal impairment in CKD and to evaluate its prognostic value in these subjects. METHODS: This is a prospective observational cohort study of 54 patients with early stage (stage 1-2) CKD...
October 21, 2016: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
Claudio Bazzi, Tomoko Usui, Virginia Rizza, Daniela Casellato, Maurizio Gallieni, Masaomi Nangaku
BACKGROUND: The clinical course of idiopathic membranous nephropathy (IMN) varies from spontaneous remission of nephrotic syndrome (NS) to end-stage renal disease (ESRD). Selecting patients with high risk of progression for immunosuppressive therapy is mandatory. METHODS: 86 IMN subjects were followed for median of 69 months (range 6-253). Receiver operating characteristic curve and Cox proportional hazards model were used to evaluate prognostic factors for progression, defined as ESRD or eGFR reduction ≥50% of baseline...
October 20, 2016: Nephrology
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
Junichiro Hashimoto
Arterial structure and function change progressively with advancing age. Owing to long-lasting repetitive stretch with intermittent cardiac contraction, elastic fibers in the tunica media of large arteries gradually degenerate and are replaced by collagenous fibers. Such medial degeneration causes elastic arteries to stiffen and dilate. However, the speed of the vascular aging varies considerably among individuals; a discrepancy often exists between the chronological age of an individual and the biological age of his or her arteries...
September 2016: Journal of Hypertension
Josep Redon
The ESH-ESC Guidelines published in 2007 stated that "Further emphasis has been given to identification of target organ damage, since hypertension-related subclinical alterations in several organs indicate progression in the cardiovascular disease continuum which markedly increases the risk beyond that caused by the simple presence of risk factors" Several studies have shown that the regression of asymptomatic TOD occurring during treatment reflects the treatment-induced reduction of morbid and fatal CV events, thereby offering valuable information on whether patients are more or less effectively protected by the treatment strategies adopted...
September 2016: Journal of Hypertension
Masatsugu Horiuchi
Hypertensive patients have greater chances of such cardiovascular events as stroke, coronary heart disease, heart or renal failure, peripheral artery disease, and dementia. It is also well recognized that diabetes increases the cardiovascular risks in concert with hypertension. Therefore, main goals for an innovation of anti-hypertensive therapy would be to achieve further risk reduction by targeting the functional, metabolic, and structural alterations associated with hypertension. Professors Dzau and Braunwald et al proposed the concept of "the cardiovascular disease continuum" in 1991, and that hypertension may trigger the chain of events, leading to end-stage heart disease; however, this concept was quite new at that time, and there was some discussion whether "the cardiovascular disease continuum" is true or not...
September 2016: Journal of Hypertension
Solomon Kadiri
Hypertension prevalence rates in most urbanized areas of Africa range from 20-30%, with a recent systematic review reporting 16.2% for sub-Saharan Africa. These rates are lower than those in the West but the age standardized rates are higher than in other regions of the world. The attendant morbidity and mortality are disproportionately high. For example, failure of nocturnal dipping and microalbuminuria, predictive of vascular disease, occur relatively early in the course of hypertension and predispose to early vascular disease...
September 2016: Journal of Hypertension
Tazeen Jafar
Chronic kidney disease (CKD) defined as reduced estimated glomerular filtration rate (eGFR) or presence of albuminuria, progresses to end stage renal disease (ESRD), needing dialysis or kidney transplant to sustain life, and is associated with increased risks of premature cardiovascular disease (CVD) and mortality. CKD ranked 18 leading (and most rapidly rising cause of mortality by the Global Burden of Disease Study 2010. The social and economic consequences of CKD are far worse in low and middle income countries (LMICs) including India, Pakistan, Bangladesh, and Sri Lanka...
September 2016: Journal of Hypertension
Chen-Huan Chen
Aging causes progressive changes in the structure and function of the large arteries that adversely impact the heart and vital organs. Vascular aging is a major independent risk factor for the development of cardiovascular diseases and events. Arterial stiffening is the dominant hemodynamic manifestation of vascular aging and a major independent predictor for incident hypertension. Arterial stiffening is therefore responsible for the very high residual lifetime risk for hypertension for middle-aged and elderly individuals...
September 2016: Journal of Hypertension
Ajay Gupta, Siddhartha Baxi, Christopher Hoyne
INTRODUCTION: Comprehensive oncology services have recently been introduced in the Northern Territory (NT) enabling delivery of concurrent chemo-radiotherapy (CCRT) in locally advanced head and neck squamous cell carcinoma (LAHNSC). The purpose of this study is to assess feasibility, compliance and toxicity of CCRT in remote Australia. METHODS: Chart review was conducted for all patients >18 years, with biopsy-proven LAHNSC, receiving curative intent CCRT between January 2010 and September 2012...
July 1, 2016: Journal of Medical Radiation Sciences
Yuta Matsukuma, Kosuke Masutani, Shigeru Tanaka, Akihiro Tsuchimoto, Kiichiro Fujisaki, Kumiko Torisu, Ritsuko Katafuchi, Hideki Hirakata, Kazuhiko Tsuruya, Takanari Kitazono
Recently, low serum uric acid (SUA) levels and high SUA levels, have emerged as risk factors for cardiovascular disease, as well as for the incidence of acute kidney injury and chronic kidney disease (CKD). However, the effect of low SUA on the progression of CKD remains unclear. To evaluate the association between SUA and renal prognosis in patients with immunoglobulin A nephropathy (IgAN), one of the most common causes of CKD, we retrospectively followed 1218 patients who were diagnosed with primary IgAN by kidney biopsy between October 1979 and December 2010...
October 13, 2016: Hypertension Research: Official Journal of the Japanese Society of Hypertension
Sumanta K Pal, Harry A Drabkin, James A Reeves, John D Hainsworth, Susan E Hazel, Dario A Paggiarino, Jon Wojciak, Gary Woodnutt, Rupal S Bhatt
BACKGROUND: Upregulation of sphingosine-1-phosphate (S1P) may mediate resistance to vascular endothelial growth factor (VEGF)-directed therapies and inhibit antitumor immunity. Antagonism of S1P in preclinical models appears to overcome this resistance. In this phase 2 study, the authors assessed the activity of sonepcizumab, a first-in-class inhibitor of S1P, in patients with metastatic renal cell carcinoma (mRCC) with a history of prior VEGF-directed therapy. METHODS: Patients were required to have clear cell mRCC and to have received treatment with at least 1 prior VEGF-directed agent...
October 11, 2016: Cancer
Brian I Rini, Arnulf Stenzl, Romauld Zdrojowy, Mikhail Kogan, Mikhail Shkolnik, Stephane Oudard, Steffen Weikert, Sergio Bracarda, Simon J Crabb, Jens Bedke, Joerg Ludwig, Dominik Maurer, Regina Mendrzyk, Claudia Wagner, Andrea Mahr, Jens Fritsche, Toni Weinschenk, Steffen Walter, Alexandra Kirner, Harpreet Singh-Jasuja, Carsten Reinhardt, Tim Eisen
BACKGROUND: In a phase 2 study in patients with metastatic renal cell carcinoma, overall survival was associated with T-cell responses against IMA901, a vaccine consisting of ten tumour-associated peptides. In this phase 3 trial, we aimed to determine the clinical effect of adding IMA901 to sunitinib, the standard first-line treatment in metastatic renal cell carcinoma with postulated favourable immunomodulatory effects. METHODS: The IMPRINT study is an open-label, randomised, controlled, phase 3 trial done at 124 clinical sites in 11 countries...
October 3, 2016: Lancet Oncology
Belinda Spoto, Anna Pisano, Carmine Zoccali
Insulin resistance (IR) is an early metabolic alteration in CKD patients, being apparent when the glomerular filtration rate is still within the normal range and becoming almost universal in those who reach the ESKF. The skeletal muscle represents the primary site of IR in CKD and post-receptor alterations are recognized as the main defect underlying IR in this condition. Estimates of IR based on fasting insulin concentration are easier but may not be adequate in CKD patients because renal insufficiency reduces insulin catabolism...
October 5, 2016: American Journal of Physiology. Renal Physiology
Po-Ya Chang, Li-Nien Chien, Yuh-Feng Lin, Wen-Ta Chiu, Hung-Yi Chiou
BACKGROUND AND AIM: Hyperglycemic, hypertension, and lipid abnormalities are risk factors for diabetic kidney disease However, no study has discussed the association of the simultaneous control of glycemic, blood pressure, and lipids with renal function among diabetes patients. Thus, this study examined the interactive effects of the intensive control of all 3 conditions on the progression of renal function. MATERIALS AND METHODS: The study population was derived from eight hospitals in Taiwan from October 2008 to April 2015...
October 2, 2016: European Journal of Internal Medicine
Kun Li, Jianan Zou, Zhibin Ye, Jianzhong Di, Xiaodong Han, Hongwei Zhang, Weijie Liu, Qinggui Ren, Pin Zhang
BACKGROUND: Obesity is an independent risk factor of development and progression of chronic kidney disease (CKD). Data on the benefits of bariatric surgery in obese patients with impaired kidney function have been conflicting. OBJECTIVE: To explore whether there is improvement in glomerular filtration rate (GFR), proteinuria or albuminuria after bariatric surgery. METHODS: We comprehensively searched the databases of MEDLINE, Embase, web of science and Cochrane for randomized, controlled trials and observational studies that examined bariatric surgery in obese subjects with impaired kidney function...
2016: PloS One
Valentina Corradi, Fiorella Gastaldon, Carlotta Caprara, Anna Giuliani, Francesca Martino, Fiorenza Ferrari, Claudio Ronco
INTRODUCTION: Autosomal dominant polycystic kidney disease (ADPKD) is one of the most common genetic diseases with a reported prevalence of 1:400 to 1:1000. Since the intact kidneys can compensate for the loss of glomerular filtration in ADPKD patients, renal insufficiency usually remains undetected until almost the fourth decade of life. Hereafter, reliable diagnostic and prognostic biomarkers to identify ADPKD progression are urgently needed. Several studies and systematic reviews tried to identify markers or predictors of rapid disease progression of ADPKD...
October 4, 2016: Minerva Medica
Jesús García-Donas, Benoit Beuselinck, Lucía Inglada-Pérez, Osvaldo Graña, Patrick Schöffski, Agnieszka Wozniak, Oliver Bechter, Maria Apellániz-Ruiz, Luis Javier Leandro-García, Emilio Esteban, Daniel E Castellano, Aranzazu González Del Alba, Miguel Angel Climent, Susana Hernando, José Angel Arranz, Manuel Morente, David G Pisano, Mercedes Robledo, Cristina Rodriguez-Antona
The majority of metastatic renal cell carcinoma (RCC) patients are treated with tyrosine kinase inhibitors (TKI) in first-line treatment; however, a fraction are refractory to these antiangiogenic drugs. MicroRNAs (miRNAs) are regulatory molecules proven to be accurate biomarkers in cancer. Here, we identified miRNAs predictive of progressive disease under TKI treatment through deep sequencing of 74 metastatic clear cell RCC cases uniformly treated with these drugs. Twenty-nine miRNAs were differentially expressed in the tumors of patients who progressed under TKI therapy (P values from 6 × 10(-9) to 3 × 10(-3))...
July 7, 2016: JCI Insight
Federico Franchi, Xiang Yang Zhu, Tyra A Witt, Lilach O Lerman, Martin Rodriguez-Porcel
The renal microvascular compartment plays an important role in the progression of kidney disease and hypertension, leading to the development of End Stage Renal Disease with high risk of death for cardiovascular events. Moreover, recent clinical studies have shown that renovascular structure and function may have a great impact on functional renal recovery after surgery. Here, we describe a protocol for the delivery of drugs into the renal artery of rats. This procedure offers significant advantages over the frequently used systemic administration as it may allow a more localized therapeutic effect...
2016: Journal of Visualized Experiments: JoVE
Shun-Yang Cheng, Yu-Hsiang Chou, Fang-Ling Liao, Chi-Chun Lin, Fan-Chi Chang, Chia-Hao Liu, Tao-Min Huang, Chun-Fu Lai, Yu-Feng Lin, Vin-Cent Wu, Tzong-Shinn Chu, Ming-Shiou Wu, Shuei-Liong Lin
Acute kidney injury (AKI) is an important risk factor for incident chronic kidney disease (CKD). Clinical studies disclose that ensuing CKD progresses after functional recovery from AKI, but the underlying mechanisms remain illusive. Using a murine model representing AKI-CKD continuum, we show angiotensin II type 1a (AT1a) receptor signaling as one of the underlying mechanisms. Male adult CD-1 mice presented severe AKI with 20% mortality within 2 weeks after right nephrectomy and left renal ischemia-reperfusion injury...
September 28, 2016: Scientific Reports
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