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Renal function reserve

Tiong Y Lim, Enoka Gonsalkorala, Mary D Cannon, Stella Gabeta, Leonie Penna, Nigel D Heaton, Michael A Heneghan
BACKGROUND: Liver transplantation (LT) is a successful treatment for both acute liver failure and end-stage liver disease. The number of women of reproductive age undergoing LT is increasing. Pregnancy outcomes are favourable but there is still a lack of prognostic markers. We aimed to identify factors predictive of adverse pregnancy outcomes in LT recipients. METHODS: An analysis of all pregnancies occurring in LT recipients from 1989-2016 at King's College Hospital was performed...
March 14, 2018: Liver Transplantation
Florence Wong, Peter Jepsen, Hugh Watson, Hendrik Vilstrup
BACKGROUND & AIMS: Acute episodes of renal dysfunction or acute kidney injury (AKI) in cirrhotic patients with ascites are mostly precipitated by an acute event. The prevalence of un-precipitated AKI in stable ascitic cirrhotic patients is unknown. The aims of this study were to determine i) the prevalence of un-precipitated AKI in stable cirrhotics with ascites, and ii) any predictive factors for its development. METHODS: 1115 stable cirrhotic patients with mild liver and renal dysfunction but varying degrees of ascites severity from 3 previous satavaptan versus placebo randomized controlled trials (group A: ascites requiring diuretics but not paracentesis; Group B: ascites requiring frequent paracentesis; Group C: refractory ascites) were included...
March 13, 2018: Liver International: Official Journal of the International Association for the Study of the Liver
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
Dieter Adelmann, Leonie Bicknell, Claus U Niemann, John Feiner, Garrett R Roll, Lyle Burdine, Elizabeth L Whitlock
BACKGROUND: During kidney transplantation, intraoperative fluid management can affect post-transplant graft function. It is unclear whether or not central venous pressure (CVP) monitoring is required to guide fluid therapy during kidney transplantation. METHODS: We compared post-transplant graft function in recipients of living donor kidney transplants between August 2006 and March 2009 based on the use or absence of intraoperative CVP monitoring. Graft function, assessed using the creatinine reduction ratio on postoperative day 2 (CCR2), was evaluated by multivariable linear regression analysis and in a propensity-matched cohort...
March 11, 2018: Clinical Transplantation
Yuesong Pan, Jing Jing, Weiqi Chen, Yongjun Wang, Yan He
BACKGROUND AND PURPOSE: Chronic kidney disease and atrial fibrillation (AF) are two commonly coexisting risk factors of stroke. The aim of this study is to compare the association between impaired renal function and poor prognosis in ischemic stroke patients with versus without AF. METHODS: Patients with ischemic stroke in the CNSR (China National Stroke Registry) were included. Low estimated glomerular filtration rate (eGFR) on admission was defined as <60 mL/min/1...
March 7, 2018: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
Salman Khan, Timothy Sullivan, Mohsin Ali, Dallas Dunn, Gopi Patel, Shirish Huprikar
BACKGROUND: Liver transplant recipients (LTR) who are seropositive for cytomegalovirus (CMV) (R+) are at intermediate-risk for CMV disease. A preventive strategy following transplant is considered standard of care. Current guidelines recommend high-dose valganciclovir (VGCV) (900 mg/day adjusted for renal function) for prophylaxis given limited data on the efficacy and safety of low-dose VGCV (450 mg/day adjusted for renal function). We describe our experience using low-dose VGCV prophylaxis for R+ LTR at our institution...
March 3, 2018: Liver Transplantation
Malou Friederich-Persson, Patrik Persson, Peter Hansell, Fredrik Palm
AIM: Uncoupling Protein-2 (UCP-2) can induce mitochondrial uncoupling in the diabetic kidney. Although mitochondrial uncoupling reduces oxidative stress originating from the mitochondria and can be regarded as a protective mechanism, the increased oxygen consumption occurring secondarily to increased mitochondria uncoupling, i.e. leak respiration, may contribute to kidney tissue hypoxia. Using UCP-2-/- mice we tested the hypothesis that UCP-2-mediated leak respiration is important for the development of diabetes-induced intrarenal hypoxia and proteinuria...
February 26, 2018: Acta Physiologica
Yen-Sung Huang, Kuo-Cheng Lu, Tai-Kuang Chao, Jin-Shuen Chen, Ann Chen, Cheng-Yi Guo, Hsin-Yi Hsieh, Hsiu-Ming Shih, Huey-Kang Sytwu, Chia-Chao Wu
Membranous nephropathy (MN), a type of glomerular nephritis, is one of the most common causes of nephrotic syndrome in adults. Although it is known that melatonin plays a protective role in MN, the role of melatonin receptors in the pathophysiology of MN is unclear. Using an experimental MN model and clinical MN specimens, we studied melatonin receptor expression and found that melatonin receptor 1A (MTNR1A) expression was significantly downregulated in renal tubular epithelial cells. Molecular studies showed that the transcription factor pituitary homeobox-1 (PITX1) promoted MTNR1A expression via direct binding to its promoter...
February 26, 2018: Journal of Pineal Research
Henrik Dimke, Jürgen Schnermann
The thick ascending limb (TAL) extends from the border of the inner medulla to the renal cortex, thus ascending through regions with wide differences in tissue solute and electrolyte concentrations. Structural and functional differences between TAL cells in the medulla (mTAL) and the cortex (cTAL) would therefore be useful to adapt TAL transport function to a changing external fluid composition. While mechanisms common to all TAL cells play a central role in the reclamation of about 25% of the NaCl filtered by the kidney, morphological features, Na+ / K+ -ATPase activity, NKCC2 splicing and phosphorylation does vary between segments and cells...
February 24, 2018: Acta Physiologica
Paleerath Peerapen, Sakdithep Chaiyarit, Visith Thongboonkerd
Our previous expression study has reported a set of proteins with altered levels in renal tubular cells after exposure to calcium oxalate monohydrate (COM) crystals, which are the main composition of kidney stones. However, their functional significance remained largely unknown. In this study, protein network analysis revealed that the significantly altered proteins induced by COM crystals were involved mainly in three main functional networks, including i) cell proliferation and wound healing; ii) oxidative stress and mitochondrial function; and iii) cellular junction complex and integrity...
February 21, 2018: Proteomics
Maryse C J Osté, António W Gomes-Neto, Eva Corpeleijn, Rijk O B Gans, Martin H de Borst, Else van den Berg, Sabita S Soedamah-Muthu, Daan Kromhout, Gerjan J Navis, Stephan J L Bakker
Renal transplant recipients (RTR) are at risk of decline of graft function and premature mortality, with high blood pressure as important risk factor for both. To study the association of the Dietary Approach to Stop Hypertension (DASH) diet with these adverse events, we conducted a prospective cohort study of adult RTR. Dietary data was collected using a validated 177-item food frequency questionnaire and an overall DASH-score was obtained. We included 632 stable RTR (mean±SD age: 53.0±12.7 y, 57% men). Mean DASH score was 23...
February 21, 2018: American Journal of Transplantation
Sander Florman, Flavio Vincenti, Antoine Durrbach, Marwan Abouljoud, Barbara Bresnahan, Valter Duro Garcia, Laura Mulloy, Kim Rice, Lionel Rostaing, Carlos Zayas, Kellie Calderon, Ulf Meier-Kriesche, Martin Polinsky, Lingfeng Yang, Jose Medina Pestana, Christian P Larsen
Clinical outcomes are generally worse for black versus non-black renal allograft recipients. In BENEFIT and BENEFIT-EXT, recipients were randomized to belatacept more-intense-based, belatacept less-intense-based, or cyclosporine-based immunosuppression. At year 7, belatacept was associated with superior graft survival versus cyclosporine in BENEFIT (recipients of living or standard criteria deceased donor kidneys); belatacept was associated with similar graft survival versus cyclosporine in BENEFIT-EXT (recipients of extended criteria donor kidneys)...
February 20, 2018: Clinical Transplantation
Cecilia Becattini, Michela Giustozzi, Maria Giovanna Ranalli, Giulio Bogliari, Federica Cianella, Melina Verso, Giancarlo Agnelli, Maria Cristina Vedovati
BACKGROUND: Chronic kidney disease is a risk factor for major bleeding in patients with atrial fibrillation (AF) treated with warfarin. OBJECTIVE: To assess the effect of variations of renal function over time on the risk for major bleeding (MB) during treatment with direct anticoagulants (DOACs) in patients with non-valvular AF. METHODS: Consecutive AF patients were prospectively followed since they received the first DOACs prescription. Estimated glomerular filtration rate (eGFR) was periodically assessed and the incidence of MB recorded...
February 20, 2018: Journal of Thrombosis and Haemostasis: JTH
Paul Perco, Gert Mayer
BACKGROUND: An imbalance of renal damaging molecules and nephroprotective factors contributes to development and progression of kidney diseases. Molecules with renoprotective properties might serve as biomarkers, drug targets as well as therapeutic options themselves. MATERIALS AND METHODS: For this review, we generated a set of renoprotective factors based on GeneRIFs (Gene Reference Into Function) information available at NCBI's PubMed. The final set of manually curated renoprotective factors was investigated with respect to tissue specific expression, subcellular location distribution, and involvement in biological processes using information from Gene Ontology as well as information from protein-protein interaction databases...
February 20, 2018: European Journal of Clinical Investigation
Jose Yeste, Laura Martínez-Gimeno, Xavi Illa, Pablo Laborda, Anton Guimerà, Juan P Sánchez-Marín, Rosa Villa, Ignacio Giménez
Transepithelial electrical measurements in the renal tubule have provided a better understanding of how kidney regulates electrolyte and water homeostasis through the reabsorption of molecules and ions (e.g., H2 O and NaCl). While experiments and measurement techniques using native tissue are difficult to prepare and to reproduce, cell cultures conducted largely with the Ussing chamber lack the effect of fluid shear stress which is a key physiological stimulus in the renal tubule. To overcome these limitations, we present a modular perfusion chamber for long-term culture of renal epithelial cells under flow that allows the continuous and simultaneous monitoring of both transepithelial electrical parameters and transepithelial NaCl transport...
February 20, 2018: Biotechnology and Bioengineering
Silke R Brix, Mercedes Noriega, Elisabeth M Herden, Birgit Goldmann, Ulrike Langbehn, Martin Busch, Wolfram J Jabs, Oliver M Steinmetz, Ulf Panzer, Tobias B Huber, Rolf A K Stahl, Thorsten Wiech
AIMS: Renal involvement in anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis contributes to significant morbidity and mortality in patients. In chronic inflammation, B cells are recruited to the inflamed tissue and organised lymphoid structures have been described in several autoimmune diseases. Aim of this study was to correlate the lymphoid organisation in renal biopsies with renal outcome in ANCA-associated glomerulonephritis (GN). METHODS AND RESULTS: We investigated 112 renal biopsies from patients with newly diagnosed ANCA-associated necrotizing GN...
February 17, 2018: Histopathology
Nair Anupama, G Sindhu, K G Raghu
Metabolic syndromes (MS) are a cluster of disorders like obesity, hypertension, dyslipidemia, and diabetes. Cardiometabolic syndrome (CMS), a branch of MS, is a group of diseases affecting cardiovascular, renal, metabolic, prothrombotic and inflammatory abnormalities due to defects in energy metabolism. Since the emergence of molecular biology and the discovery of pathogenic mitochondrial DNA defect in the 1980s, research advances has revealed a number of common human disease involving mitochondrial dysfunction...
February 17, 2018: Fundamental & Clinical Pharmacology
Josefine Tecklenborg, David Clayton, Stefan Siebert, Shana M Coley
The immune system and the kidneys are closely linked. In health the kidneys contribute to immune homeostasis, while components of the immune system mediate many acute forms of renal disease and play a central role in progression of chronic kidney disease. A dysregulated immune system can have either direct or indirect renal effects. Direct immune-mediated kidney diseases are usually a consequence of autoantibodies directed against a constituent renal antigen, such as collagen IV in anti-glomerular basement membrane disease...
February 17, 2018: Clinical and Experimental Immunology
Alvin So, Owen Pointon, Richard Hodgson, John Burgess
CONTEXT: Bronchopulmonary neuroendocrine tumours (bpNETs) and thymic carcinoid (ThC) are features of Multiple Endocrine Neoplasia Type 1 (MEN 1) and surveillance guidelines recommend periodic thoracic imaging. The optimal thoracic imaging modality and screening frequency remains uncertain as does the prognosis of small lung nodules when identified. OBJECTIVES: To evaluate fluorodeoxyglucose positron emission tomography/computed tomography (18 F-FDG PET/CT) for identification and prognostic assessment of thoracic lesions in MEN 1...
February 15, 2018: Clinical Endocrinology
Hailin Zhao, Han Huang, Azeem Alam, Qian Chen, Ka Chuen Suen, Jiang Cui, Qizhe Sun, Rele Ologunde, Wenwen Zhang, Qingquan Lian, Daqing Ma
Clinical evidence indicated a possible link between renal injury and remote liver injury. Herein, we investigated whether extracellular histone mediates remote hepatic damage following renal graft ischemia-reperfusion injury, whilst vascular endothelial growth factor (VEGF) is protective against remote hepatic injury. In vitro, hepatocyte HepG2 cultures were treated with histone. In vivo, the Brown-Norway renal graft was stored in 4°C preserving solution for 24 hours and then transplanted into Lewis rat recipient; blood samples and livers from recipients were harvested 24 hours after surgery...
February 15, 2018: American Journal of Transplantation
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