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Hepatitis in CKD

Norihiko Morisawa, Yohei Koshima, Jun-Ichi Satoh, Yukio Maruyama, Satoru Kuriyama, Takashi Yokoo, Morimasa Amemiya
AIM: Combination therapy with Daclatasvir (DCV) plus Asunaprevir (ASV) has been proven effective in patients with chronic hepatitis C virus (HCV) infection. However, little is known as to the effect of this therapy in patients with reduced renal function. Focusing on CKD patients whose renal function has declined, the present trial addresses the efficacy and safety of this combination therapy in CKD patients with reduced estimated glomerular filtration rate (eGFR). MATERIALS AND METHODS: The study design is a single-center, retrospective longitudinal observational study enrolling 106 patients with (n = 29) or without (n = 77) CKD...
October 22, 2016: Clinical and Experimental Nephrology
G Fenna van Breda, Lennart G Bongartz, Wenqing Zhuang, Rachel P L van Swelm, Jeanne Pertijs, Branko Braam, Maarten-Jan Cramer, Dorine W Swinkels, Pieter A Doevendans, Marianne C Verhaar, Roos Masereeuw, Jaap A Joles, Carlo A J M Gaillard
BACKGROUND: Hepcidin regulates systemic iron homeostasis by downregulating the iron exporter ferroportin. Circulating hepcidin is mainly derived from the liver but hepcidin is also produced in the heart. We studied the differential and local regulation of hepcidin gene expression in response to myocardial infarction (MI) and/or chronic kidney disease (CKD). We hypothesized that cardiac hepcidin gene expression is induced by and regulated to severity of cardiac injury, either through direct (MI) or remote (CKD) stimuli, as well as through increased local iron content...
October 22, 2016: American Journal of Nephrology
Esmeralda Castillo-Rodriguez, Raul Fernandez-Prado, Catalina Martin-Cleary, Maria Soledad Pizarro-Sánchez, Maria Dolores Sanchez-Niño, Ana Belen Sanz, Beatriz Fernandez-Fernandez, Alberto Ortiz
The current categorization of chronic kidney disease (CKD) is based on biomarkers of the glomerular function (estimated glomerular filtration rate, eGFR) and injury (urinary albumin creatinine ratio, UACR) and provides information on the risk of death and of progression of kidney disease. However, there are gaps in knowledge regarding the risk stratification of elderly patients with eGFR 45-60 ml/min/1.73 m2 and of younger patients with higher eGFR but physiological albuminuria. In this regard, most of the kidney cell mass is composed of tubules...
October 22, 2016: Nephron
Qing-Chun Cai, Shu-Qi Zhao, Tong-Dong Shi, Hong Ren
PURPOSE: To evaluate the association of Chronic hepatitis B virus (HBV) infection and chronic kidney disease (CKD). METHODS: We searched Embase, Grateful Med, Ovid, PubMed, and the China Biological Medicine Database. A meta-analysis was performed to assess whether HBV infection plays an independent impact on the development of CKD in the general population. Relative risks of CKD (defined as reduced glomerular filtration rate or proteinuria) according to HBsAg serologic status were studied...
October 18, 2016: Renal Failure
Patrice Cacoub, Anne Claire Desbois, Corinne Isnard-Bagnis, Dario Rocatello, Clodoveo Ferri
Hepatitis C virus (HCV) infection is associated with tremendous morbidity and mortality due to liver complications. HCV infection is also associated with many extrahepatic manifestations including cardiovascular diseases, glucose metabolism impairment, cryoglobulinemia vasculitis, B cell non-Hodgkin lymphoma and chronic kidney disease (CKD). Many studies have shown a strong association between HCV and CKD, by reporting (i) an increased prevalence of HCV infection in patients on haemodialysis, (ii) an increased incidence of CKD and proteinuria in HCV-infected patients, and (iii) the development of membranoproliferative glomerulonephritis secondary to HCV-induced cryoglobulinemia vasculitis...
October 2016: Journal of Hepatology
Shyam Patel, Jennifer Andres, Kamran Qureshi
Hepatitis C virus (HCV) infection affects roughly 170 million people worldwide. Sofosbuvir/Ledipasvir (Sof/Led) is a new once daily direct acting antiviral combination pill that was approved in October 2014 for use in patients with HCV genotype 1 infection. Coadministration of Sof/Led is studied only with rosuvastatin which shows significantly increased level of drug and is associated with increased risk of myopathy, including rhabdomyolysis. There is no mention of such HMG-CoA reductase inhibitor interaction as a class, as pravastatin did not have any clinically significant interaction with Sof/Led...
2016: Case Reports in Medicine
S Avinash, V P Singh, A K Agarwal, S Chatterjee, V Arya
BACKGROUND: Cystatin C is a low molecular weight protein produced by all nucleated human cells, with a stable production rate. Its levels are not influenced by inflammation, infections, hepatic or renal diseases, or by dietary or constitutional factors. We compared serum cystatin C and serum creatinine based predicting equations to estimate glomerular filteration rate (GFR) in type 2 diabetes mellitus, using the staging of chronic kidney disease (CKD) defined by the National Kidney Foundation...
November 2015: Journal of the Association of Physicians of India
Hassan Askari, Behjat Seifi, Mehri Kadkhodaee
BACKGROUND: Chronic kidney disease (CKD) is defined as either kidney damage or a decline in renal function as determined by a decreased glomerular filtration rate (GFR) for three months or longer. CKD is an important risk factor for mortality. OBJECTIVES: The aim of this study was to evaluate the effects of CKD on renal-hepatic functional indices and blood pressure in 5/6 nephrectomized (5/6 Nx) rats over the course of nine months. MATERIALS AND METHODS: Male Wistar rats were subjected to either 5/6 Nx or sham operations (n = 8)...
May 2016: Nephro-urology Monthly
Fabrizio Fabrizi, Piergiorgio Messa
Recent evidence has been accumulated showing a negative impact of chronic hepatitis C virus infection on survival in patients with chronic kidney disease. Moreover, it appears that anti-HCV positive status has been associated with an increased risk of developing chronic kidney disease in the adult general population. These reports have emphasized the need for safe and effective therapies for hepatitis C virus infection in the chronic kidney disease population. Treatment of HCV has made considerable progress with the approval of interferon-free, direct-acting antiviral drug-based combination therapies among patients with intact kidneys; but a paucity of information exists regarding chronic kidney disease patients...
July 2016: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
Kazeem Olalekan, Andy Fox, Rodney Gilbert
BACKGROUND: Unlicensed medications are used all the time in the management of diseases in childhood. Tolvaptan (Jinarc®) is a vasopressin V2-receptor antagonist licensed for use to slow the progression of cyst development and renal insufficiency of ADPKD in adults with CKD stage 1 to 3 with evidence of rapidly progressing disease. Studies of animal models implicate the antidiuretic hormone arginine vasopressin and its messenger cyclic adenosine monophosphate (cAMP) as promoters of kidney-cyst cell proliferation and luminal fluid secretion...
September 2016: Archives of Disease in Childhood
Cassianne Robinson-Cohen, Richard Newitt, Danny D Shen, Allan E Rettie, Bryan R Kestenbaum, Jonathan Himmelfarb, Catherine K Yeung
Elevated levels of circulating pro-atherogenic uremic solutes, particularly trimethylamine N-oxide (TMAO), have been implicated in cardiovascular disease development in patients with chronic kidney disease (CKD). TMAO is generated from trimethylamine (TMA) via metabolism by hepatic flavin-containing monooxygenase isoform 3 (FMO3). We determined the functional effects of three common FMO3 variants at amino acids 158, 308, and 257 on TMAO concentrations in a prospective cohort study and evaluated associations of polymorphisms with CKD progression and mortality...
2016: PloS One
Johanna Kurko, Maaria Tringham, Laura Tanner, Kirsti Näntö-Salonen, Mari Vähä-Mäkilä, Heli Nygren, Päivi Pöhö, Niina Lietzen, Ismo Mattila, Anu Olkku, Tuulia Hyötyläinen, Matej Orešič, Olli Simell, Harri Niinikoski, Juha Mykkänen
BACKGROUND: Lysinuric protein intolerance (LPI [MIM 222700]) is an aminoaciduria with defective transport of cationic amino acids in epithelial cells in the small intestine and proximal kidney tubules due to mutations in the SLC7A7 gene. LPI is characterized by protein malnutrition, failure to thrive and hyperammonemia. Many patients also suffer from combined hyperlipidemia and chronic kidney disease (CKD) with an unknown etiology. METHODS: Here, we studied the plasma metabolomes of the Finnish LPI patients (n=26) and healthy control individuals (n=19) using a targeted platform for analysis of amino acids as well as two analytical platforms with comprehensive coverage of molecular lipids and polar metabolites...
September 2016: Metabolism: Clinical and Experimental
Makoto Harada, Yuji Kamijo, Takero Nakajima, Koji Hashimoto, Yosuke Yamada, Hisashi Shimojo, Frank J Gonzalez, Toshifumi Aoyama
Activation of renal peroxisome proliferator-activated receptor α (PPARα) is renoprotective, but there is no safe PPARα activator for patients with chronic kidney disease (CKD). Studies have reported that irbesartan (Irbe), an angiotensin II receptor blocker (ARB) widely prescribed for CKD, activates hepatic PPARα. However, Irbe's renal PPARα-activating effects and the role of PPARα signalling in the renoprotective effects of Irbe are unknown. Herein, these aspects were investigated in healthy kidneys of wild-type (WT) and Ppara-null (KO) mice and in the murine protein-overload nephropathy (PON) model respectively...
November 1, 2016: Clinical Science (1979-)
Rashad S Barsoum
Geographical, ecological, and genetic factors result in many similarities among the six main countries of the African Sahara, including the epidemiology of kidney disease. With an average incidence of 182 and prevalence of 522 patients with end-stage kidney disease (ESKD) per million population, North Africa (NA) spends $650 million on dialysis and transplantation despite an estimated annual loss of 600,000 life years. The health burden of ESKD is not limited to its directly-related morbidity and mortality but affects even more significantly other body systems, particularly the cardiovascular system...
July 29, 2016: Clinical Nephrology
Saurav Singh, Alexander Grabner, Christopher Yanucil, Karla Schramm, Brian Czaya, Stefanie Krick, Mark J Czaja, Rene Bartz, Reimar Abraham, Giovana S Di Marco, Marcus Brand, Myles Wolf, Christian Faul
Patients with chronic kidney disease (CKD) develop increased levels of the phosphate-regulating hormone, fibroblast growth factor (FGF) 23, that are associated with a higher risk of mortality. Increases in inflammatory markers are another common feature that predicts poor clinical outcomes. Elevated FGF23 is associated with higher circulating levels of inflammatory cytokines in CKD, which can stimulate osteocyte production of FGF23. Here, we studied whether FGF23 can directly stimulate hepatic production of inflammatory cytokines in the absence of α-klotho, an FGF23 coreceptor in the kidney that is not expressed by hepatocytes...
November 2016: Kidney International
Rangaraj Narayanan, Lisa Liu, Matthew Hoffmann, Sekhar Surapaneni
: Chronic kidney disease (CKD) generally impacts clearance of renally eliminated drugs but growing evidence shows that it can influence clearance of hepatically eliminated drugs and a complete mechanistic understanding of this phenomenon is still lacking. CKD leads to accumulation of uremic toxins, including indoxyl-3-sulfate (3-INDS) and indole-3-acetic acid (3-IAA). OBJECTIVE: In this study, we evaluated the potential of 3-INDS and 3-IAA (10, 30 and 100 μM) to induce liver cytochrome P450 (CYP) enzymes CYP1A2, 2B6 and 3A4/5 using cultured primary human hepatocytes following once daily treatment for 3 days...
July 19, 2016: Drug Metabolism Letters
Rangaraj Narayanan, Lisa Liu, Matthew Hoffmann, Sekhar Surapaneni
: Chronic kidney disease (CKD) generally impacts clearance of renally eliminated drugs but growing evidence shows that it can influence clearance of hepatically eliminated drugs and a complete mechanistic understanding of this phenomenon is still lacking. CKD leads to accumulation of uremic toxins, including indoxyl-3-sulfate (3-INDS) and indole-3-acetic acid (3-IAA). OBJECTIVE: In this study, we evaluated the potential of 3-INDS and 3-IAA (10, 30 and 100 μM) to induce liver cytochrome P450 (CYP) enzymes CYP1A2, 2B6 and 3A4/5 using cultured primary human hepatocytes following once daily treatment for 3 days...
July 19, 2016: Drug Metabolism Letters
Joseph N Stember, Dustin Lynch, Gerald Behr, Shumyle Alam
OBJECTIVES: To predict the chronic kidney disease (CKD) state for pediatric patients based on scaled renal cortical echogenicity. METHODS: Sonograms from a cohort of 26 patients, half of whom had stage 4 or 5 CKD, whereas the other half had normal renal function, were analyzed. For each patient image, a region of interest (ROI) was drawn around the renal cortex for comparison with an ROI drawn around the hepatic parenchyma. The latter ROI was shifted spatially to normalize the signal attenuations and time-gain compensations of the two organs' ROIs...
August 2016: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
J Jing, N Isoherranen, C Robinson-Cohen, I Petrie, B R Kestenbaum, C K Yeung
Vitamin A, via retinoic acid (RA), is a critical micronutrient. Normally, plasma concentrations are tightly regulated. Concentrations of vitamin A metabolites (13cis-RA, atRA) and relationships between RBP4 and retinoids have never been fully evaluated in adult patients with CKD. We measured retinoid and RBP4 concentrations in plasma and urine from 55 adult patients with CKD and 21 matched healthy subjects. RBP4 and retinol levels were increased approximately twofold in patients with CKD, with a negative correlation between plasma retinol and eGFR (p = 0...
August 2016: Clinical and Translational Science
Hargovind Trivedi, Aruna Vanikar, Himanshu Patel, Kamal Kanodia, Vivek Kute, Lovelesh Nigam, Kamlesh Suthar, Umang Thakkar, Harsh Sutariya, Shruti Gandhi
BACKGROUND: Globally there is an increase in incidence of chronic kidney diseases (CKDs). Diabetes mellitus (DM), hypertension and stone diseases are the major risk factors for CKD. We organized kidney disease screening camps in a semi-urban population of Gujarat, India on the occasion of World Kidney Day (WKD). METHODS: Voluntary participants from six towns were screened. Estimated glomerular filtration rate (eGFR) was calculated by the Modification of Diet in Renal Disease formula and CKD was defined as an eGFR <60 mL/min/1...
June 2016: Clinical Kidney Journal
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