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Milton Packer
Three classes of anti-hyperglycaemic medications are distinguished by their urinary sodium excretion-enhancing and blood pressure-lowering actions: long-acting glucagon-like peptide-1 receptor agonists, dipeptidyl peptidase-4 inhibitors and sodium-glucose co-transporter-2 inhibitors. Yet, these drugs exert different effects on macrovascular risk. Glucagon-like peptide-1 receptor agonists reduce atherosclerotic thromboembolic events, but have little effect on heart failure; sodium-glucose co-transporter-2 inhibitors decrease the occurrence of heart failure, but have minimal effect on myocardial infarction and stroke; and dipeptidyl peptidase-4 inhibitors do not ameliorate either atherosclerotic thromboembolic events or heart failure...
March 12, 2018: Diabetic Medicine: a Journal of the British Diabetic Association
Jie Zhang, Shan Jiang, Jin Wei, Kay-Pong Yip, Lei Wang, En Yin Lai, Ruisheng Liu
Glomerular hyperfiltration often occurs during the early stage of diabetes. An acute glucose infusion increases glomerular filtration rate (GFR). The involvement of tubuloglomerular feedback response and direct effect of glucose on the afferent arterioles (Af-Arts) have been suggested. However, the signaling pathways to trigger Af-Art dilatation have not been fully identified. Therefore, in the present study we tested our hypothesis that an increase of glucose concentration enhances endothelial nitric oxide synthesis (NOS3) activity and dilates the Af-Arts via glucose transporter 1 (GLUT1) using isolated mouse Af-Arts with perfusion...
March 7, 2018: American Journal of Physiology. Renal Physiology
Yogavijayan Kandasamy, Donna Rudd, Roger Smith, Eugenie R Lumbers, Ian Mr Wright
OBJECTIVE: We carried out a study to determine the impact of prematurity on renal development. The primary outcomes measured were nephrinuria and albuminuria; renal volume and glomerular filtration rate were the secondary outcomes. METHODS: Preterm neonates born at less than 28 weeks of gestation, with birth weight between 10th and 90th centile (appropriate for gestational age), were recruited and underwent assessments at 28, 32 and 37 weeks postmenstrual age (PMA)...
March 2, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Richard Van Krieken, Mandeep Marway, Pavithra Parthasarathy, Neel Mehta, Alistar J Ingram, Bo Gao, Joan C Krepinsky
Sterol regulatory element binding protein (SREBP) is an important potential mediator of kidney fibrosis, and is known to be upregulated in diabetic nephropathy. Here we evaluate the effectiveness of SREBP inhibition as treatment for diabetic nephropathy.Type 1 diabetes was induced in uninephrectomized male CD1 mice with streptozotocin. Mice were treated with the SREBP inhibitor fatostatin for 12 weeks. At endpoint, kidney function and pathology were assessed. Fatostatin inhibited the increase of both isoforms of SREBP (1 and 2) in diabetic kidneys...
February 5, 2018: Endocrinology
J Brett Heimlich, Godwin Chipoka, Laila Elsherif, Emeraghi David, Graham Ellis, Portia Kamthunzi, Robert Krysiak, Pilirani Mafunga, Qingning Zhou, Jianwen Cai, Satish Gopal, Nigel S Key, Kenneth I Ataga
BACKGROUND: Glomerulopathy is an increasingly identified complication in young patients with sickle cell disease (SCD). Hyperfiltration and albuminuria followed by declining glomerular filtration rates and eventual end-stage renal disease (ESRD) is assumed to be the typical progression of glomerular disease. There are only a few reported biomarkers to identify early-stage renal disease in SCD. PROCEDURES: We detail the renal profile of 101 children with SCD in Malawi and propose a novel urinary biomarker for the identification of early renal disease...
February 7, 2018: Pediatric Blood & Cancer
Clara Hoffmann, Stéphanie Zbinden, Vincent Bourquin
Renal function is usually estimated through the blood measurement of creatinine, which allows estimating the glomerular filtration rate (GFR). However, this value only decreases when half the nephrons are damaged, limiting the detection of early renal disease. The ingestion of an important amount of protein can increase the GFR. The renal functional reserve concept is the difference between the maximal GFR, stimulated by an important protein intake, and the baseline GFR. A diminished renal functional reserve could mean glomerular hyperfiltration and early renal disease...
January 31, 2018: Revue Médicale Suisse
Roxana Cleper
Solitary functioning kidney (SFK) occurs with unilateral renal agenesis (URA) in 1/2000 live births - or after uninephrectomy for tumor, trauma, uncontrolled infections or hypertension and post-kidney donation. URA-associated states include urological, cardiac, gastrointestinal and skeletal anomalies or it might be a component of a genetic syndrome. In 10% of cases of URA another family member is affected. In any case of SFK a compensatory process is triggered consisting of glomerular hypertension with hyperfiltration which achieves 75% of two kidneys' function...
January 2018: Harefuah
Julie A Lovshin, Marko Škrtić, Petter Bjornstad, Rahim Moineddin, Denis Daneman, David Dunger, Heather N Reich, Farid H Mahmud, James W Scholey, David Z I Cherney, Etienne B Sochett
AIM: Adolescents with T1DM (type 1 diabetes mellitus) are at risk for hyperfiltration and elevated urinary albumin-to-creatinine ratio (ACR), which are early indicators of diabetic nephropathy. Adolescents with T1DM also develop early changes in blood pressure, cardiovascular structure and function. Our aims were to define the relationships between hyperfiltration, ACR, and 24-Hr ambulatory blood pressure over time in adolescents with T1DM. METHODS: Normotensive, normoalbuminuric adolescents (n=98) with T1DM underwent baseline and 2-year 24-Hr ambulatory blood pressure monitoring, glomerular filtration rate (eGFR) estimated by cystatin C (Larsson equation) and ACR measurements...
December 13, 2017: American Journal of Physiology. Renal Physiology
Daisuke Yamazaki, Hirofumi Hitomi, Akira Nishiyama
Chronic diabetic complications are classified as microvascular or macrovascular and contribute to mortality and loss of quality of life. Hyperglycemia plays a critical role in the pathogenesis of microvascular complications, such as diabetic retinopathy, incipient nephropathy, and neuropathy, while atherosclerosis contributes to the pathogenesis of macrovascular complications. Diabetes mellitus and hypertension are frequently present together. Among many microvascular diabetic complications, hypertension plays a predominant role in the progression of diabetic nephropathy by glomerular hyperfiltration...
January 22, 2018: Hypertension Research: Official Journal of the Japanese Society of Hypertension
Grith Møller, Jens Rikardt Andersen, Christian Ritz, Marta P Silvestre, Santiago Navas-Carretero, Elli Jalo, Pia Christensen, Elizabeth Simpson, Moira Taylor, J Alfredo Martinez, Ian Macdonald, Nils Swindell, Kelly A Mackintosh, Gareth Stratton, Mikael Fogelholm, Thomas M Larsen, Sally D Poppitt, Lars O Dragsted, Anne Raben
Concerns about detrimental renal effects of a high-protein intake have been raised due to an induced glomerular hyperfiltration, since this may accelerate the progression of kidney disease. The aim of this sub-study was to assess the effect of a higher intake of protein on kidney function in pre-diabetic men and women, aged 55 years and older. Analyses were based on baseline and one-year data in a sub-group of 310 participants included in the PREVIEW project (PREVention of diabetes through lifestyle Intervention and population studies in Europe and around the World)...
January 9, 2018: Nutrients
Fedaey Abbas, Mohsen El Kossi, Jon Kim Jin, Ajay Sharma, Ahmed Halawa
The glomerular diseases after renal transplantation can occur de novo, i.e ., with no relation to the native kidney disease, or more frequently occur as a recurrence of the original disease in the native kidney. There may not be any difference in clinical features and histological pattern between de novo glomerular disease and recurrence of original glomerular disease. However, structural alterations in transplanted kidney add to dilemma in diagnosis. These changes in architecture of histopathology can happen due to: (1) exposure to the immunosuppression specifically the calcineurin inhibitors (CNI); (2) in vascular and tubulointerstitial alterations as a result of antibody mediated or cell-mediated immunological onslaught; (3) post-transplant viral infections; (4) ischemia-reperfusion injury; and (5) hyperfiltration injury...
December 24, 2017: World Journal of Transplantation
Moumouni Garba, Zeinabou Maiga Moussa Tondi, Hassan Diongoule, Samaila Aboubacar, Abdou Ide, Nadège Ruddy Biyao-Nelson, Illiassou Soumaila, Soumana Alido
BACKGROUND: Sickle cell anemia is the most common hereditary hemopathy in the world. It is a disease that attacks all the systems of the organism. The kidneys are among the most sensitive organs of this disease. The main objective of this study is to detect sickle cell nephropathy in patients followed at the National Reference Center for Sickle Cell Disease in Niamey. METHODS: It is a prospective study carried out over a period of one year (January to December 2016)...
January 5, 2018: Néphrologie & Thérapeutique
Milton Packer
Drugs that inhibit dipeptidyl peptidase-4 (DPP-4) are conventionally regarded as incretin-based agents that signal through the glucagon-like peptide-1 (GLP-1) receptor. However, inhibition of DPP-4 also potentiates the stem cell chemokine, stromal cell-derived factor-1 (SDF-1), which can promote inflammation, proliferative responses and neovascularization. In large-scale cardiovascular outcome trials, enhanced GLP-1 signaling has reduced the risk of atherosclerotic ischemic events, potentially because GLP-1 retards the growth and increases the stability of atherosclerotic plaques...
January 8, 2018: Cardiovascular Diabetology
Biyu Hou, Guifen Qiang, Yuerong Zhao, Xiuying Yang, Xi Chen, Yu Yan, Xiaobo Wang, Chenge Liu, Li Zhang, Guanhua Du
BACKGROUND/AIMS: Glomerular endothelium dysfunction leads to the progression of renal architectonic and functional abnormalities in early-stage diabetic nephropathy (DN). Advanced glycation end products (AGEs) and receptor for AGEs (RAGE) are proved to play important roles in diabetic nephropathy. This study investigated the role of Salvianolic acid A (SalA) on early-stage DN and its possible underlying mechanism. METHODS: In vitro AGEs formation and breaking rate were measured to illustrate the effect of SalA on AGEs...
December 18, 2017: Cellular Physiology and Biochemistry
Ulla B Berg, Antal Németh
OBJECTIVES: Based on studies with hepatorenal syndrome, it is widely regarded that renal function is impacted in chronic liver disease. Therefore we investigated renal function in our children with chronic liver disease. METHODS: In a retrospective study of 277 children with chronic liver disease, renal function was investigated as glomerular filtration rate (GFR) and effective renal plasma flow (ERPF), measured as clearance of inulin and para-amino hippuric acid or clearance of iohexol...
December 12, 2017: Journal of Pediatric Gastroenterology and Nutrition
Ivano Riva, Andreas Katsanos, Francesco Oddone, Luciano Quaranta
INTRODUCTION: The aim of this study was to evaluate the effect of visually non-significant cataract extraction in patients with hypotony maculopathy and reduced visual acuity due to over-filtering blebs after trabeculectomy. METHODS: Patients with intraocular pressure (IOP) < 6 mmHg and documented hypotony maculopathy due to over-filtering blebs after trabeculectomy were prospectively recruited. Eligible patients underwent visually non-significant cataract phacoemulsification, no earlier than 12 weeks from the diagnosis of hypotony maculopathy...
January 2018: Advances in Therapy
Masahiro Eriguchi, Mercury Lin, Michifumi Yamashita, Tuantuan V Zhao, Zakir Khan, Ellen A Bernstein, Susan B Gurley, Romer A Gonzalez-Villalobos, Kenneth E Bernstein, Jorge Fernando Giani
Diabetic nephropathy is a major cause of end-stage renal disease in developed countries. While angiotensin-converting enzyme (ACE) inhibitors are used to treat diabetic nephropathy, how intrarenal ACE contributes to diabetic renal injury is uncertain. Here, two mouse models with different patterns of renal ACE expression were studied to determine the specific contribution of tubular versus glomerular ACE to early diabetic nephropathy: it-ACE mice, which make endothelial ACE but lack ACE expression by renal tubular epithelium, and ACE 3/9 mice, which lack endothelial ACE and only express renal ACE in tubular epithelial cells...
November 29, 2017: American Journal of Physiology. Renal Physiology
Petter Bjornstad, Edward Nehus, Laure El Ghormli, Fida Bacha, Ingrid M Libman, Siripoom McKay, Steven M Willi, Lori Laffel, Silva Arslanian, Kristen J Nadeau
BACKGROUND: Diabetic kidney disease is a major cause of premature mortality in type 2 diabetes mellitus (T2DM). Worsening insulin sensitivity independent of glycemic control may contribute to the development of diabetic kidney disease. We investigated the longitudinal association of insulin sensitivity with hyperfiltration and increased albumin excretion in adolescents with T2DM. STUDY DESIGN: Observational prospective cohort study. SETTING & PARTICIPANTS: 532 TODAY (Treatment Options for Type 2 Diabetes in Adolescents and Youth) participants aged 12 to 17 years with T2DM duration less than 2 years at baseline...
January 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
H J Kwon, D H Kim, H R Jang, S-H Jung, D H Han, H H Sung, J B Park, J E Lee, W Huh, S J Kim, Y-G Kim, D J Kim, H Y Oh
BACKGROUND: Despite compensatory hyperfiltration in remaining nephrons following donor nephrectomy, some donors show impaired renal adaptation and low estimated glomerular filtration rate (eGFR). We investigated the factors predicting early renal adaptation after nephrectomy and identified kidney donors at risk of inadequate renal adaptation. METHODS: A total of 265 living kidney donors from 2010 to 2013 were retrospectively analyzed. Renal function was serially followed for 6 months after the operation...
November 2017: Transplantation Proceedings
Luca Visconti, Valeria Cernaro, Sebastiano Calimeri, Antonio Lacquaniti, Francesca De Gregorio, Carlo Alberto Ricciardi, Viviana Lacava, Domenico Santoro, Michele Buemi
The impact of water intake has been studied in several renal diseases. For example, increasing water intake is useful to prevent primary and secondary nephrolithiasis. In autosomal dominant polycystic kidney disease, arginine vasopressin (AVP) is involved in the progression of the disease, and water intake could play a therapeutic role by inhibiting the synthesis of AVP, but its efficacy is still controversial. Conversely, the use of aquaretics, which are antagonists of AVP V2 receptors, results in the reduction of the increase rate of total kidney volume with a slower decline of glomerular filtration rate...
November 14, 2017: Journal of Renal Nutrition
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