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Pathogenesis treatment chronic kidney disease

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https://www.readbyqxmd.com/read/27884222/a-reassessment-of-the-pathophysiology-of-progressive-cardiorenal-disorders
#1
REVIEW
Richard N Re
Heart failure and chronic renal diseases are usually progressive and only partially amenable to therapy. These disorders can be the sequelae of hypertension or worsened by hypertension. They are associated with the tissue up-regulation of multiple peptides, many of which are capable of acting within the cell interior. This article proposes that these peptides, intracrines, can form self-sustaining regulatory loops that can spread through heart or kidney, producing progressive disease. Moreover, mineralocorticoid activation seems capable of amplifying some of these peptide networks...
January 2017: Medical Clinics of North America
https://www.readbyqxmd.com/read/27865823/gut-hormones-and-gut-microbiota-implications-for-kidney-function-and-hypertension
#2
REVIEW
Baris Afsar, Nosratola D Vaziri, Gamze Aslan, Kayhan Tarim, Mehmet Kanbay
Increased blood pressure (BP) and chronic kidney disease are two leading risk factors for cardiovascular disease. Increased sodium intake is one of the most important risk factors for development of hypertension. Recent data have shown that gut influences kidney function and BP by variety of mechanisms. Various hormones and peptides secreted from gut such as gastrin, glucocorticoids, Glucagon-like peptide-1 impact on kidney function and BP especially influencing sodium absorption from gut. These findings stimulate scientist to find new therapeutic options such as tenapanor for treatment of hypertension by blocking sodium absorption from gut...
November 1, 2016: Journal of the American Society of Hypertension: JASH
https://www.readbyqxmd.com/read/27863350/arterial-calcification-a-new-perspective
#3
REVIEW
R Nicoll, M Henein
Arterial calcification is commonly seen in atherosclerosis, chronic kidney disease (CKD) and diabetes and has long been considered a natural progression of atherosclerosis. Yet it is a systemic condition, occurring in a wide and diverse range of disease states and no medical treatment for cardiovascular disease has yet found a way to regress it; on the contrary, lipid-lowering therapy may worsen its progression. Although numerous studies have found associations between calcification and biomarkers, none has yet found a unifying mechanism that explains the calcification found in atherosclerosis, CKD or diabetes and many of the biomarkers are equally associated with atheroma development and cardiovascular events...
November 9, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27858997/a-novel-assay-to-assess-the-effect-of-pharmaceutical-compounds-on-the-differentiation-of-podocytes
#4
Frances Kindt, Elke Hammer, Stefan Kemnitz, Antje Blumenthal, Paul Klemm, Rabea Schlüter, Susan E Quaggin, Jens van den Brandt, Georg Fuellen, Uwe Völker, Karlhans Endlich, Nicole Endlich
BACKGROUND AND PURPOSE: Therapeutic options to treat glomerulopathies, the main cause of chronic kidney disease, are limited. Podocyte dedifferentiation is a major event in the pathogenesis of glomerulopathies. The goal of the present study was therefore to develop an assay to monitor podocyte differentiation suited for compound screening. EXPERIMENTAL APPROACH: We isolated and cultured glomeruli from transgenic mice, expressing cyan fluorescent protein (CFP) under control of the promoter of nephrin, a marker of podocyte differentiation...
November 14, 2016: British Journal of Pharmacology
https://www.readbyqxmd.com/read/27821390/update-on-lupus-nephritis
#5
Salem Almaani, Alexa Meara, Brad H Rovin
SLE is a chronic inflammatory disease that affects the kidneys in about 50% of patients. Lupus nephritis is a major risk factor for overall morbidity and mortality in SLE, and despite potent anti-inflammatory and immunosuppressive therapies still ends in CKD or ESRD for too many patients. This review highlights recent updates in our understanding of disease epidemiology, genetics, pathogenesis, and treatment in an effort to establish a framework for lupus nephritis management that is patient-specific and oriented toward maintaining long-term kidney function in patients with lupus...
November 7, 2016: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/27798196/klotho-suppresses-the-renin-angiotensin-system-in-adriamycin-nephropathy
#6
Tsuneo Takenaka, Tsutomu Inoue, Takashi Miyazaki, Hiroyuki Kobori, Akira Nishiyama, Naohito Ishii, Matsuhiko Hayashi, Hiromichi Suzuki
BACKGROUNDS: Klotho protein interacts with the transforming growth factor β (TGF-β) receptor and Wnt, which contribute to the progression of renal disease, inhibiting their signals. Renal and circulating klotho levels are diminished in chronic kidney disease. METHODS: Experiments were performed to assess whether supplementation of klotho protein could have protective effects on the kidney. Rats were injected with adriamycin (5 mg/kg) and divided into three groups: those treated with vehicle, those treated with klotho protein and those treated with klotho plus 4-benzyl-2-methyl-1,2,4-thiadiazolidine-3,5-dione (TDZD)...
October 17, 2016: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/27774877/genitourinary-complications-of-diabetes-mellitus-an-overview-of-pathogenesis-evaluation-and-management
#7
Jason Gandhi, Gautam Dagur, Kelly Warren, Noel Smith, Sardar Ali Khan
BACKGROUND: Diabetes mellitus is a vastly prevalent metabolic disorder with escalating global health concerns. Particularly when mismanaged, chronic micro- and macrovascular complications may highly impair physiological systems while immunodeficiency disposes us to infection. OBJECTIVE: We investigate infections, localized complications, and neoplasms of the genitourinary system secondary to the chronic complications of diabetes mellitus in males and females. METHOD: A comprehensive MEDLINE® search was guided using key words relevant to diabetes mellitus and the genitourinary system...
October 19, 2016: Current Diabetes Reviews
https://www.readbyqxmd.com/read/27757935/impact-of-salt-intake-on-the-pathogenesis-and-treatment-of-hypertension
#8
Petra Rust, Cem Ekmekcioglu
Excessive dietary salt (sodium chloride) intake is associated with an increased risk for hypertension, which in turn is especially a major risk factor for stroke and other cardiovascular pathologies, but also kidney diseases. Besides, high salt intake or preference for salty food is discussed to be positive associated with stomach cancer, and according to recent studies probably also obesity risk. On the other hand a reduction of dietary salt intake leads to a considerable reduction in blood pressure, especially in hypertensive patients but to a lesser extent also in normotensives as several meta-analyses of interventional studies have shown...
October 19, 2016: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/27754167/sy-12-3-are-ras-inhibitors-necessary-for-all-patients-with-diabetes-and-chronic-kidney-disease
#9
Shokei Kim-Mitsuyama
There is accumulating evidence that RAS inhibitors not only reduce blood pressure, but also exert pleiotropic effects, including a renoprotective effect, amelioration of insulin resistance, reduction in onset of diabetes, and suppression of cardiovascular remodelling,. However, the definite benefit of RAS inhibition in treatment of hypertension with CKD or DM is not conclusive. We previously performed the OlmeSartan and Calcium Antagonists Randomized (OSCAR) study comparing the preventive effect of high-dose ARB therapy versus ARB plus CCB combination therapy on cardiovascular morbidity and mortality in 1164 Japanese elderly hypertensive patients with baseline type 2 diabetes and/or CVD (Am J Med (2012))...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27752007/chemerin-a-biomarker-for-cardiovascular-disease-in-diabetic-chronic-kidney-disease-patients
#10
Farag E Salama, Qasem A Anass, Abdelnaem A Abdelrahman, Elsayed B Saeed
Cardiovascular disease is the leading cause of morbidity and mortality in patients with chronic kidney disease (CKD). The carotid intima-media thickness (CIMT) and arterial stiffness are useful markers of subclinical atherosclerosis and significantly correlate with various metabolic risk factors. Chemerin is one of the adipokines that may represent a link between obesity and inflammation and may be a potential candidate playing a role in the pathogenesis of atherosclerosis and cardiovascular complications. Therefore, we studied the relationship of chemerin levels with atherosclerosis as measured by CIMT in diabetic CKD patients, either predialysis or on hemodialysis (HD)...
September 2016: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/27683634/tregs-and-kidney-from-diabetic-nephropathy-to-renal-transplantation
#11
REVIEW
Periklis Dousdampanis, Kostantina Trigka, Athanasia Mouzaki
Kidney transplantation is recognised as the most effective treatment for patients with end-stage renal disease (ESRD). Kidney transplantation continues to face several challenges including long-term graft and patient survival, and the side effects of immunosuppressive therapy. The tendency in kidney transplantation is to avoid the side effects of immunosuppresants and induce immune tolerance. Regulatory T-cells (Tregs) contribute to self-tolerance, tolerance to alloantigen and transplant tolerance, mainly by suppressing the activation and function of reactive effector T-cells...
September 24, 2016: World Journal of Transplantation
https://www.readbyqxmd.com/read/27660122/fatty-liver-and-chronic-kidney-disease-novel-mechanistic-insights-and-therapeutic-opportunities
#12
REVIEW
Giovanni Musso, Maurizio Cassader, Solomon Cohney, Franco De Michieli, Silvia Pinach, Francesca Saba, Roberto Gambino
Chronic kidney disease (CKD) is a risk factor for end-stage renal disease (ESRD) and cardiovascular disease (CVD). ESRD or CVD develop in a substantial proportion of patients with CKD receiving standard-of-care therapy, and mortality in CKD remains unchanged. These data suggest that key pathogenetic mechanisms underlying CKD progression go unaffected by current treatments. Growing evidence suggests that nonalcoholic fatty liver disease (NAFLD) and CKD share common pathogenetic mechanisms and potential therapeutic targets...
October 2016: Diabetes Care
https://www.readbyqxmd.com/read/27651468/albuminuria-and-masked-uncontrolled-hypertension-in-chronic-kidney-disease
#13
Rajiv Agarwal
BACKGROUND: Masked uncontrolled hypertension (MUCH) is associated with greater target organ damage such as left ventricular hypertrophy, increased arterial stiffness and albuminuria. Whether MUCH independently associates with greater cardiovascular end-organ damage or kidney damage is unclear. The objective of this study was to assess the strength of the relationship of MUCH (awake ambulatory blood pressure ≥135/85 mmHg and clinic blood pressure <140/90 mmHg) with target organ damage...
September 20, 2016: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/27649164/advanced-glycation-end-products-induce-apoptosis-of-vascular-smooth-muscle-cells-a-mechanism-for-vascular-calcification
#14
Sayo Koike, Shozo Yano, Sayuri Tanaka, Abdullah M Sheikh, Atsushi Nagai, Toshitsugu Sugimoto
Vascular calcification, especially medial artery calcification, is associated with cardiovascular death in patients with diabetes mellitus and chronic kidney disease (CKD). To determine the underlying mechanism of vascular calcification, we have demonstrated in our previous report that advanced glycation end-products (AGEs) stimulated calcium deposition in vascular smooth muscle cells (VSMCs) through excessive oxidative stress and phenotypic transition into osteoblastic cells. Since AGEs can induce apoptosis, in this study we investigated its role on VSMC apoptosis, focusing mainly on the underlying mechanisms...
2016: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/27643122/sy-12-3-are-ras-inhibitors-necessary-for-all-patients-with-diabetes-and-chronic-kidney-disease
#15
Shokei Kim-Mitsuyama
There is accumulating evidence that RAS inhibitors not only reduce blood pressure, but also exert pleiotropic effects, including a renoprotective effect, amelioration of insulin resistance, reduction in onset of diabetes, and suppression of cardiovascular remodelling,. However, the definite benefit of RAS inhibition in treatment of hypertension with CKD or DM is not conclusive. We previously performed the OlmeSartan and Calcium Antagonists Randomized (OSCAR) study comparing the preventive effect of high-dose ARB therapy versus ARB plus CCB combination therapy on cardiovascular morbidity and mortality in 1164 Japanese elderly hypertensive patients with baseline type 2 diabetes and/or CVD (Am J Med (2012))...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27634440/cell-cycle-arrest-as-a-therapeutic-target-of-acute-kidney-injury
#16
Wei-Gang Wang, Wei-Xia Sun, Bao-Shan Gao, Xin Lian, Hong-Lan Zhou
The current lack of complete understanding of the pathogenesis of acute kidney injury (AKI) is a significant barrier to its early diagnosis and treatment. Cell cycle arrest plays an important role in the protection of renal tubular epithelial cells and maladaptive repair following AKI. G1 phase cell arrest serves as a protective mechanism following AKI, avoiding replication of damaged DNA. Insulin-like growth factor-binding protein 7 (IGFBP7) and tissue inhibitor of metalloproteinase-2 (TIMP-2) are closely associated with G1 cell cycle arrest during the very early phase of cellular damage and can serve as an ideal biomarker to predict AKI...
September 15, 2016: Current Protein & Peptide Science
https://www.readbyqxmd.com/read/27610006/tgf-%C3%AE-1-smads-and-mir-21-in-renal-fibrosis-and-inflammation
#17
REVIEW
Agnieszka Loboda, Mateusz Sobczak, Alicja Jozkowicz, Jozef Dulak
Renal fibrosis, irrespective of its etiology, is a final common stage of almost all chronic kidney diseases. Increased apoptosis, epithelial-to-mesenchymal transition, and inflammatory cell infiltration characterize the injured kidney. On the molecular level, transforming growth factor-β1 (TGF-β1)-Smad3 signaling pathway plays a central role in fibrotic kidney disease. Recent findings indicate the prominent role of microRNAs, small noncoding RNA molecules that inhibit gene expression through the posttranscriptional repression of their target mRNAs, in different pathologic conditions, including renal pathophysiology...
2016: Mediators of Inflammation
https://www.readbyqxmd.com/read/27602552/physiological-aspects-of-toll-like-receptor-4-activation-in-sepsis-induced-acute-kidney-injury
#18
S B Anderberg, T Luther, R Frithiof
Sepsis-induced acute kidney injury (SI-AKI) is common and associated with high mortality. Survivors are at increased risk of chronic kidney disease. The precise mechanism underlying SI-AKI is unknown, and no curative treatment exists. Toll-like receptor 4 (TLR4) activates the innate immune system in response to exogenous microbial products. The result is an inflammatory reaction aimed at clearing a potential infection. However, the consequence may also be organ dysfunction as the immune response can cause collateral damage to host tissue...
September 7, 2016: Acta Physiologica
https://www.readbyqxmd.com/read/27601015/mechanisms-in-endocrinology-kidney-involvement-in-patients-with-primary-hyperparathyroidism-an-update-on-clinical-and-molecular-aspects
#19
Chiara Verdelli, Sabrina Corbetta
Primary hyperparathyroidism (PHPT) is the third most common endocrine disease. Kidney is a target of both chronic elevated PTH and calcium in PHPT. The classic PHPT complications of symptomatic kidney stones and nephrocalcinosis have become rare and the PHPT current presentation is asymptomatic with uncertain and long lasting progression. Nonetheless, the routinely use of imaging and of biochemical determinations have revealed the frequent occurrence of asymptomatic kidney stones, hypercalciuria and reduced kidney function in asymptomatic PHPT patients...
September 6, 2016: European Journal of Endocrinology
https://www.readbyqxmd.com/read/27565581/the-role-of-the-gut-microbiome-on-chronic-kidney-disease
#20
B Sampaio-Maia, L Simões-Silva, M Pestana, R Araujo, I J Soares-Silva
Chronic kidney disease (CKD) is estimated to affect nearly 500 million people worldwide and cardiovascular (CV) disease is a major cause of death in this population. However, therapeutic interventions targeting traditional CV risks are not effective at lowering the incidence of CV events or at delaying the progression of the disease in CKD patients. In recent years, disturbances of normal gut microbiome were recognized in the pathogenesis of diverse chronic diseases. Gut dysbiosis is being unraveled in CKD and pointed as a nontraditional risk factor for CV risk and CKD progression...
2016: Advances in Applied Microbiology
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