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resistance to diuretics

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https://www.readbyqxmd.com/read/29100270/albuminuria-confers-renal-resistance-to-loop-diuretics-via-the-stimulation-of-nlrp3-inflammasome-prostaglandin-signaling-in-thick-ascending-limb
#1
Yibo Zhuang, Zhanjun Jia, Caiyu Hu, Guixia Ding, Xintong Zhang, Yue Zhang, Guangrui Yang, Rajeev Rohatgi, Songming Huang, John Ci-Jiang He, Aihua Zhang
Renal resistance to loop diuretics is a frequent complication in a number of kidney disease patients with elusive mechanism. Employing human renal biopsy specimens, albumin overload mouse model, and primary cultures of mouse renal tubular cells, albuminuria effect on NKCC2 expression and function and the underlying mechanisms were investigated. In the renal biopsy specimens of albuminuric patients, we found that NKCC2 was significantly downregulated with a negative correlation with albuminuria severity as examined by immunohistochemistry...
September 29, 2017: Oncotarget
https://www.readbyqxmd.com/read/29075541/unusual-complication-of-multidrug-resistant-tuberculosis
#2
Prerna Sharma, Ravindra Nath Sahay
INTRODUCTION: Capreomycin is a second-line drug often used for multidrug-resistant tuberculosis which can result in nephrotoxic effects similar to other aminoglycosides. We describe a case of capreomycin induced Bartter-like syndrome with hypocalcemic tetany. CASE REPORT: 23-year-old female patient presented with carpopedal spasms and tingling sensations in hands. Patient was being treated with capreomycin for two months for tuberculosis. On further investigation, hypocalcemia, hyponatremia, hypomagnesemia, hypokalemia, and hypochloremic metabolic alkalosis were noted...
2017: Case Reports in Nephrology
https://www.readbyqxmd.com/read/29063302/effects-of-tolvaptan-on-urine-output-in-hospitalized-heart-failure-patients-with-hypoalbuminemia-or-proteinuria
#3
Koji Takagi, Naoki Sato, Shiro Ishihara, Michiko Sone, Hideo Tokuyama, Kenji Nakama, Toshiya Omote, Arifumi Kikuchi, Masahiro Ishikawa, Kenichi Amitani, Naoto Takahashi, Yuji Maruyama, Hajime Imura, Wataru Shimizu
Hypoalbuminemia is an independent prognostic factor in hospitalization for heart failure (HHF). Hypoalbuminemia or proteinuria is related to resistance to loop diuretics. Tolvaptan is an oral non-peptide, competitive antagonist of vasopressin receptor-2. It has been used for the treatment of volume overload in HHF patients in several Asian countries. Several studies have demonstrated marked improvement in congestion in HHF patients. However, whether tolvaptan is useful for HHF patients with hypoalbuminemia or proteinuria (both of which are related to resistance to loop diuretics) has not been clarified...
October 23, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/29043393/characterization-of-a-set-of-abdominal-neuroendocrine-cells-that-regulate-stress-physiology-using-colocalized-diuretic-peptides-in-drosophila
#4
Meet Zandawala, Richard Marley, Shireen A Davies, Dick R Nässel
Multiple neuropeptides are known to regulate water and ion balance in Drosophila melanogaster. Several of these peptides also have other functions in physiology and behavior. Examples are corticotropin-releasing factor-like diuretic hormone (diuretic hormone 44; DH44) and leucokinin (LK), both of which induce fluid secretion by Malpighian tubules (MTs), but also regulate stress responses, feeding, circadian activity and other behaviors. Here, we investigated the functional relations between the LK and DH44 signaling systems...
October 17, 2017: Cellular and Molecular Life Sciences: CMLS
https://www.readbyqxmd.com/read/29034321/refractory-versus-resistant-hypertension-novel-distinctive-phenotypes
#5
Tanja Dudenbostel, Mohammed Siddiqui, Nitin Gharpure, David A Calhoun
Resistant hypertension (RHTN) is relatively common with an estimated prevalence of 10-20% of treated hypertensive patients. It is defined as blood pressure (BP) >140/90 mmHg treated with ≥3 antihypertensive medications, including a diuretic, if tolerated. Refractory hypertension is a novel phenotype of severe antihypertensive treatment failure. The proposed definition for refractory hypertension, i.e. BP >140/90 mmHg with use of ≥5 different antihypertensive medications, including a diuretic and a mineralocorticoid receptor antagonist (MRA) has been applied inconsistently...
September 2017: Journal of Nature and Science
https://www.readbyqxmd.com/read/29034087/spironolactone-in-cardiovascular-disease-an-expanding-universe
#6
REVIEW
John W Funder
Spironolactone has been marketed for over half a century as a 'potassium-sparing diuretic', used primarily in patients with ascites. With the realization that primary aldosteronism is the most common (5-13%) form of secondary hypertension, it has become widely used as a mineralocorticoid receptor antagonist. More recently, in the wake of the RALES trial, spironolactone in addition to standard therapy has been shown to be very beneficial in heart failure with a reduced ejection fraction. Despite the failure of the TOPCAT trial, spironolactone is being increasingly used in diastolic heart failure (i...
2017: F1000Research
https://www.readbyqxmd.com/read/29033430/the-prevalence-of-japanese-outpatients-with-hypertension-who-meet-the-definition-of-treatment-resistant-hypertension-and-are-eligible-for-enrolment-in-clinical-trials-of-endovascular-ultrasound-renal-denervation
#7
Keisuke Okamura, Kazuyuki Shirai, Tetsu Okuda, Hidenori Urata
Objective A clinical trial (REQUIRE) was started to investigate the use of an ultrasound renal denervation system in the treatment of resistant hypertension (RHT). We analyzed the prevalence of patients who were eligible for inclusion in this cross-sectional study at the time of screening. Methods Nine-hundred ninety-nine consecutive hypertension (HT) patients who were treated in our hospital as outpatients were classified into the following categories: patients treated with at least 3 types of antihypertensive drugs including diuretic agents who were eligible for enrolment in SYMPLICITY HTN-Japan (SH-J) with an office systolic blood pressure (SBP) of ≥160 mmHg, who were ≤80 years of age, and an eGFR of ≥45 mL/min/1...
October 16, 2017: Internal Medicine
https://www.readbyqxmd.com/read/29018014/elizabethkingia-meningoseptica-emerging-multidrug-resistance-in-a-nosocomial-pathogen
#8
Sairam Raghavan, Biji Thomas, B A Shastry
A 46-year-old male patient presented with complaints of burning micturition for 2 days. Initial history, physical examination and laboratory investigations were consistent with the diagnosis of congestive cardiac failure (CCF) and concomitant urinary tract infection. CCF was treated with diuretics and a urine culture/sensitivity (C/S) was sent which returned growing Elizabethkingia meningoseptica resistant to all tested drugs. Intravenous cefotaxime which had been started empirically 3 days earlier was withheld at this point, and a repeat urine C/S was sent revealing resistance to all tested drugs (including reserved drugs) barring minocycline...
October 10, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28980452/rationale-and-study-design-of-intravenous-loop-diuretic-administration-in-acute-heart-failure-diur-ahf
#9
Alberto Palazzuoli, Gaetano Ruocco, Giorgio Vescovo, Roberto Valle, Salvatore Di Somma, Ranuccio Nuti
AIMS: Although loop diuretics are the most commonly used drugs in acute heart failure (AHF) treatment, their short-term and long-term effects are relatively unknown. The significance of worsening renal function occurrence during intravenous treatment is not clear enough. This trial aims to clarify all these features and contemplate whether continuous infusion is better than an intermittent strategy in terms of decongestion efficacy, diuretic efficiency, renal function, and long-term prognosis...
October 4, 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/28977099/fluid-overload-in-children-undergoing-mechanical-ventilation
#10
Clarice Laroque Sinott Lopes, Jefferson Pedro Piva
Patients admitted to an intensive care unit are prone to cumulated fluid overload and receive intravenous volumes through the aggressive resuscitation recommended for septic shock treatment, as well as other fluid sources related to medications and nutritional support. The liberal liquid supply strategy has been associated with higher morbidity and mortality. Although there are few prospective pediatric studies, new strategies are being proposed. This non-systematic review discusses the pathophysiology of fluid overload, its consequences, and the available therapeutic strategies...
September 28, 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28959123/ultrasound-assessment-of-kidney-volume-in-patients-with-acute-decompensated-heart-failure-a-predictor-of-diuretic-resistance
#11
Shinobu Sugihara, Yoshiharu Kinugasa, Tomoaki Takata, Takaaki Sugihara, Keiko Hosho, Chitose Imai, Hiromi Ito, Kensaku Yamada, Masahiko Kato, Kazuhiro Yamamoto
BACKGROUND: Diuretics are essential for treating acute decompensated heart failure (ADHF), but the response is inconsistent. This study aimed to clarify whether kidney volume as assessed by ultrasound (US) predicts diuretic resistance in patients with ADHF. METHODS: We enrolled 29 patients with ADHF and 32 controls. Height-adjusted kidney volume was assessed by US. We divided patients into two groups based on the median value of total daily use of furosemide (intravenous dose plus 0...
September 2017: Yonago Acta Medica
https://www.readbyqxmd.com/read/28948051/persistent-unexplained-dyspnea-a-case-of-hepatopulmonary-syndrome
#12
Alfonso Campanile, Alessandro Colombo, Maurizio Del Pinto, Claudio Cavallini
Regarding a patient with dyspnea, the history and physical examination often lead to the correct diagnosis. In some circumstances, when more than one underlying disease is present, the diagnostic process can be more challenging. We describe an unusual case of dyspnea and persistent hypoxemia related to a hepatopulmonary syndrome in a 53-year-old patient with known heart failure and chronic liver disease. Initially managed with intravenous diuretic therapy, due to signs of lung and peripheral congestion, our patient did not improve as expected; therefore we performed more advanced studies with a chest-abdomen CT scan and a right heart catheterization...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28945024/-pathogenesis-and-treatment-of-insulin-resistance-in-chronic-kidney-disease-and-interventional-effects-of-chinese-herbal-medicine
#13
REVIEW
Wei Wu, Jing-Jing Yang, Yi-Gang Wan, Yue Tu, Ge Shi, Wen-Bei Han, Bu-Hui Liu, Jian Yao
The kidney is the target organ of insulin with abundant insulin receptors. Thereinto,the renal intrinsic cells including glomerular podocytes,endothelial cells,mesangial cells,renal tubular epitheliums and collecting duct epithelial cells are all highly sensitive to insulin as the effector cells. Furthermore,the structural and functional abnormalities of these cells are closely related to insulin and its receptors activity. It is reported that the chronic kidney disease(CKD)patients have systemic or renal insulin resistance(IR)...
January 2017: Zhongguo Zhong Yao za Zhi, Zhongguo Zhongyao Zazhi, China Journal of Chinese Materia Medica
https://www.readbyqxmd.com/read/28939590/trends-for-prevalence-and-incidence-of-resistant-hypertension-population-based-cohort-study-in-the-uk-1995-2015
#14
Sarah-Jo Sinnott, Liam Smeeth, Elizabeth Williamson, Ian J Douglas
Objective To estimate the incidence and prevalence of resistant hypertension among a UK population treated for hypertension from 1995 to 2015.Design Cohort study.Setting Electronic health records from the UK Clinical Practice Research Datalink in primary care.Participants 1 317 290 users of antihypertensive drugs with a diagnosis of hypertension.Main outcome measures Resistant hypertension was defined as concurrent use of three antihypertensive drugs inclusive of a diuretic, uncontrolled hypertension (≥140/90 mm Hg), and adherence to the prescribed drug regimen, or concurrent use of four antihypertensive drugs inclusive of a diuretic and adherence to the prescribed drug regimen...
September 22, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28939201/combination-drug-treatment-in-hypertension
#15
REVIEW
Costas Tsioufis, Costas Thomopoulos
Combination treatment of hypertension has been introduced almost 50 years ago, because of the marked blood pressure (BP) elevation of recruited patients in the early randomized controlled trials of BP lowering. However, in all subsequent trials combination treatment was per protocol anticipated irrespectively of the initial randomized treatment to ensure either a desirable BP lowering or a comparable level of BP reduction among arms. Beyond clinical trials, combination treatment is mainly used in the clinical practice to reinforce ongoing single-agent treatment to achieve hypertension control...
September 20, 2017: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/28923179/drugs-and-hyperglycemia-a-practical-guide
#16
REVIEW
Vandana Jain, Ronak Kumar Patel, Zaureen Kapadia, Sneha Galiveeti, Maryann Banerji, Lisel Hope
Drug-induced diabetes is one of the factors contributing to the increasing incidence of diabetes worldwide. This review considers the frequency, pathogenesis and treatment of drug-induced diabetes. Drugs that induce diabetes include hormonal therapy, especially glucocorticoids and androgen blockers, cardiovascular drugs, especially statins, beta-blockers and diuretics, antipsychotics, especially clozapine, olanzapine and quetiapine, antiretrovirals (protease inhibitors and non-reverse transcriptase inhibitors - NRTIs) and other drugs (mechanistic target of rapamycin inhibitors -mTORs, post organ transplantation drugs, tyrosine kinase inhibitors and interferon-alpha)...
October 2017: Maturitas
https://www.readbyqxmd.com/read/28905546/-hypertension-in-people-of-african-descent
#17
Fabien Cane, Sofia Zisimopoulou, Antoinette Pechère-Bertschi
Hypertension in people of African descent presents an increased prevalence, an earlier and more severe target organ damage and is harder to control compared to other ethnicities. Preeclampsia and gestational hypertension are more frequent in black women. The physiological phenomenon of night time blood pressure dipping is often blunted. The low renin hypertension phenotype seems to be caused by an increase in sodium retention at renal level. The treatment of choice is calcium channel blockers and thiazide diuretics along with a renin-angiotensin-aldosterone blocker for kidney protection...
September 13, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28899928/treatment-of-hypertension-by-increasing-impaired-endothelial-trpv4-kca2-3-interaction
#18
Dongxu He, Qiongxi Pan, Zhen Chen, Chunyuan Sun, Peng Zhang, Aiqin Mao, Yaodan Zhu, Hongjuan Li, Chunxiao Lu, Mingxu Xie, Yin Zhou, Daoming Shen, Chunlei Tang, Zhenyu Yang, Jian Jin, Xiaoqiang Yao, Bernd Nilius, Xin Ma
The currently available antihypertensive agents have undesirable adverse effects due to systemically altering target activity including receptors, channels, and enzymes. These effects, such as loss of potassium ions induced by diuretics, bronchospasm by beta-blockers, constipation by Ca(2+) channel blockers, and dry cough by ACEI, lead to non-compliance with therapies (Moser, 1990). Here, based on new hypertension mechanisms, we explored a new antihypertensive approach. We report that transient receptor potential vanilloid 4 (TRPV4) interacts with Ca(2+)-activated potassium channel 3 (KCa2...
November 2017: EMBO Molecular Medicine
https://www.readbyqxmd.com/read/28886854/impact-of-cardiorespiratory-fitness-on-mortality-in-black-male-veterans-with-resistant-systemic-hypertension
#19
Puneet Narayan, Michael Doumas, Anubhav Kumar, Charles J Faselis, Jonathan N Myers, Andreas Pittaras, Peter F Kokkinos
Patients with resistant systemic hypertension have poorer outcomes than nonresistant hypertensives. The purpose of this study was to evaluate the association between cardiorespiratory fitness and all-cause mortality in black male Veterans with resistant systemic hypertension. Patients were identified from a cohort undergoing exercise tolerance test at the department of Veterans Affairs Medical Center in Washington, DC. Patients were divided into 4 cardiorespiratory fitness categories based on age-specific peak metabolic equivalents achieved on a standard Bruce protocol...
November 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28882918/prevalence-and-clinical-characteristics-of-apparent-therapy-resistant-hypertension-in-patients-with-cardiovascular-disease-a-cross-sectional-cohort-study-in-secondary-care
#20
Esther de Beus, Nicolette G C van der Sande, Michiel L Bots, Wilko Spiering, Michiel Voskuil, Frank L J Visseren, Peter J Blankestijn
OBJECTIVES: Our aim was to investigate the prevalence of apparent therapy-resistant hypertension (aTRH) in patients with clinical manifest cardiovascular disease (CVD), and to study clinical characteristics related to aTRH in this population. SETTING: The SMART (Second Manifestations of ARTerial disease) study is a large, single-centre cohort study in secondary care. PARTICIPANTS: Office blood pressure (BP) at inclusion was used to evaluate BP control in 6191 hypertensive patients with clinical manifest (cardio)vascular disease...
September 6, 2017: BMJ Open
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