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Kidney and diabetes

Jin Zhang, Jianhua Liu, Xiaosong Qin
Diabetic nephropathy is the main cause of chronic kidney disease, and represents the most common and serious complication of diabetes. The exact pathogenesis is complex and not elucidated. Several factors and mechanisms contribute to the development and outcome of diabetic nephropathy. An early diagnosis and intervention may slow down disease progression. A variety of biological markers associated with diabetic nephropathy were found in recent years, which was important for predicting the occurrence and development of the disease...
January 2018: Revista da Associação Médica Brasileira
Frank Palella, Xiuhong Li, Samir K Gupta, Michelle M Estrella, John P Phair, Joseph B Margolick, Roger Detels, Lawrence Kingsley, Lisa P Jacobson
BACKGROUND: Factors affecting kidney function and proteinuria among HIV+ and HIV- persons need better characterization. METHODS: We evaluated estimated glomerular filtration rate (eGFR, mL/min per 1.73 m) changes, proteinuria prevalence (a urine protein-to-creatinine ratio [UPCr] of ≥0.2 at two consecutive visits) and associated factors among HIV+ and HIV- men. RESULTS: There were 917 HIV+ men receiving HAART, 159 HIV+ men not receiving HAART, and 1305 HIV- men seen from 10/2003 to 9/2014...
March 20, 2018: AIDS
Sridevi Gutta, Nadja Grobe, Meenasri Kumbaji, Hassan Osman, Mohammad Saklayen, Gengxin Li, Khalid M Elased
ACE2 and NEP are metalloproteases which are highly expressed in the renal proximal tubules. ACE2 and NEP generate renoprotective angiotensin (1-7) from angiotensin II (Ang II) and Ang I, respectively, and therefore could have a major role in chronic kidney disease (CKD). Recent data demonstrated increased urinary ACE2 in diabetic patients with CKD and kidney transplants. We tested the hypothesis that urinary ACE2, NEP and ADAM17 are increased and could be risk predictors of CKD in diabetic patients. Urinary and plasma ACE2, NEP, and ADAM17 were investigated in twenty healthy nondiabetics (ND), and forty diabetic patients with normoalbuminuria (Dnormo), microalbuminuria (Dmicro) and macroalbuminuria (Dmacro) using ELISA, Western blot, fluorogenic and novel mass spectrometric-based enzyme assays...
March 21, 2018: American Journal of Physiology. Renal Physiology
Andreas Kompatscher, J H F de Baaij, Karam Aboudehen, Shayan Farahani, Lex H J Van Son, Susanne Milatz, Nina Himmerkus, Gert Jan C Veenstra, René J M Bindels, Joost G J Hoenderop
Mutations in HNF1β cause autosomal dominant tubulointerstitial kidney disease (ADTKD-HNF1β), and patients tend to develop renal cysts, maturity-onset diabetes of the young (MODY), and suffer from electrolyte disturbances, including hypomagnesemia, hypokalemia and hypocalciuria. Previous HNF1β research focused on the renal distal convoluted tubule (DCT) to elucidate the ADTKD-HNF1β electrolyte phenotype, although 70% of Mg2+ is reabsorbed in the thick ascending limb of Henle's loop (TAL). An important regulator of Mg2+ reabsorption in the TAL is the calcium-sensing receptor (CaSR)...
March 21, 2018: American Journal of Physiology. Renal Physiology
Jiantong Hou, Gaoliang Yan, Bo Liu, Boqian Zhu, Yong Qiao, Dong Wang, Ruifeng Li, Erfei Luo, Chengchun Tang
Background: Renal vasoconstriction, oxidative stress, endothelial dysfunction, and apoptosis are the major causes of contrast-induced nephropathy (CIN). The aim of this study was to evaluate the protective effects of enalapril maleate and folic acid tablets on CIN in diabetic rats. Methods: Thirty-two Sprague-Dawley rats were divided into four groups: CIN (C), CIN + enalapril maleate (CE), CIN + folic acid (CF), and CIN + enalapril maleate and folic acid tablets (CEF)...
2018: BioMed Research International
Pei-Chun Fan, Tien-Hsing Chen, Cheng-Chia Lee, Tsung-Yu Tsai, Yung-Chang Chen, Chih-Hsiang Chang
Acute kidney injury (AKI), a common and crucial complication of acute coronary syndrome (ACS) after receiving percutaneous coronary intervention (PCI), is associated with increased mortality and adverse outcomes. This study aimed to develop and validate a risk prediction model for incident AKI after PCI for ACS. We included 82,186 patients admitted for ACS and receiving PCI between 1997 and 2011 from the Taiwan National Health Insurance Research Database and randomly divided them into a training cohort (n = 57,630) and validation cohort (n = 24,656) for risk model development and validation, respectively...
2018: International Journal of Medical Sciences
Po-Ya Chang, Li-Nien Chien, Chyi-Huey Bai, Yuh-Feng Lin, Hung-Yi Chiou
Purpose: Effective management for type 2 diabetes mellitus (DM) can slow the progression of kidney outcomes and reduce hospital admissions. Better continuity of care (COC) was found to improve patients' adherence and self-management. This study examined the associations between COC, hospitalization, and end-stage renal disease (ESRD) in DM patients. Patients and methods: In the cohort study, data from 1996 to 2012 were retrieved from the Longitudinal Health Insurance Database, using inverse probability weighted analysis...
2018: Therapeutics and Clinical Risk Management
Sara Conti, Norberto Perico, Rubina Novelli, Camillo Carrara, Ariela Benigni, Giuseppe Remuzzi
Diabetic nephropathy (DN), the single strongest predictor of mortality in patients with type 2 diabetes, is characterized by initial glomerular hyperfiltration with subsequent progressive renal function loss with or without albuminuria, greatly accelerated with the onset of overt proteinuria. Experimental and clinical studies have convincingly shown that early interventions retard disease progression, while treatment if started late in the disease course seldom modifies the slope of GFR decline. Here we assessed whether the negligible renoprotection afforded by drugs in patients with proteinuric DN could be due to loss of glomerular structural integrity, explored by scanning electron microscopy (SEM)...
March 20, 2018: Scientific Reports
Ian H de Boer, George L Bakris
No abstract text is available yet for this article.
April 2018: Diabetes Care
Gaëlle Cheisson, Sophie Jacqueminet, Emmanuel Cosson, Carole Ichai, Anne-Marie Leguerrier, Bogdan Nicolescu-Catargi, Alexandre Ouattara, Igor Tauveron, Paul Valensi, Dan Benhamou
In diabetic patients undergoing surgery, we recommend assessing glycaemic control preoperatively by assessing glycated haemoglobin (HbA1c) levels and recent capillary blood sugar (glucose) levels, and to adjust any treatments accordingly before surgery, paying particular attention to specific complications of diabetes. Gastroparesis creates a risk of stasis and aspiration of gastric content at induction of anaesthesia requiring the use of a rapid sequence induction technique. Cardiac involvement can be divided into several types...
March 17, 2018: Anaesthesia, Critical Care & Pain Medicine
Dafang Zhang, Philip Blazar, Brandon E Earp
BACKGROUND: The purpose of this study was to determine the rates and types of complications and secondary surgeries after mini-open carpal tunnel release. METHODS: A retrospective cohort study was performed for 1,328 patients who underwent mini-open carpal tunnel release from August 2008 to July 2013. Patients were excluded for acute trauma, the index procedure being revision surgery, neoplasm, age less than 18 years, incomplete records, and postoperative follow-up less than 1 month, which yielded 904 patients who underwent 1,144 surgeries...
March 1, 2018: Hand: Official Journal of the American Association for Hand Surgery
Petter Bjornstad, David Z Cherney
PURPOSE OF REVIEW: Compared to adult-onset type 2 diabetes (T2D), youth with T2D have a more aggressive phenotype with greater insulin resistance (IR), more rapid β cell decline, and higher prevalence of diabetic kidney disease (DKD). RECENT FINDINGS: Hyperfiltration is common in youth with T2D and predicts progressive DKD. Hyperfiltration is a consequence of early changes in intrarenal hemodynamic function, including increased renal plasma flow (RPF) and glomerular pressure...
March 19, 2018: Current Diabetes Reports
J Aleksova, S Kurniawan, G J Elder
Fracture risk increases in end-stage kidney disease (ESKD), but bone mineral density (BMD) measurement is less predictive of risk than in the general population. In this study of patients with ESKD, a lower trabecular bone score (TBS), indicative of microarchitectural deterioration, was associated with higher bone turnover markers and prevalent non-vertebral fracture. INTRODUCTION: Declining renal function carries increased fracture risks, but BMD is less predictive of fracture for dialysis patients than the general population...
March 19, 2018: Osteoporosis International
Oscar D Martín, Heilen Bravo, Marcos Arias, Diego Dallos, Yesica Quiroz, Luis G Medina, Giovanni E Cacciamani, Raul G Carlini
The objective of this review is to evaluate the factors that determine the development or deterioration of Chronic Kidney Disease (CKD) after partial nephrectomy (PN). When current literature is reviewed, it is found that factors that influence renal function after partial nephrectomy, are multifactorial. Those are divided into pre-surgical factors, such as hypertension, diabetes mellitus, urolithiasis, obesity, metabolic syndrome among others; intra-surgical factors, like the surgical technique used, the remaining healthy tissue, the experience of the surgeon, the time and type of ischemia among others...
January 2018: Oncoscience
Pankti A Gheewala, Gregory M Peterson, Syed Tabish R Zaidi, Matthew D Jose, Ronald L Castelino
BACKGROUND: Screening programs may help to address the burden of chronic kidney disease (CKD) in Australia. Public awareness is an important determinant of the uptake of screening programs. However, data on the public knowledge of CKD in Australia is lacking. The aim of this study was to develop a validated questionnaire and assess the Australian public knowledge of CKD. METHODS: A CKD knowledge questionnaire was developed after reviewing the literature and discussions with nephrology experts...
March 20, 2018: BMC Public Health
Vieux Momeme Mokoli, Ernest Kiswaya Sumaili, François Bompeka Lepira, Fiston Ikwa Ndol Mbutiwi, Jean Robert Rissassy Makulo, Justine Busanga Bukabau, Patrick Parmba Izeidi, Jeannine Losa Luse, Stéphane Kalambay Mukendi, Désiré Kulimba Mashinda, Nazaire Mangani Nseka
BACKGROUND: Decreased residual urine volume (RUV) is associated with higher mortality in hemodialysis (HD). However, few studies have examined RUV in patients on HD in Sub-Saharan Africa. The aim of this study was to identify predictors of RUV among incident hemodialysis patients in Kinshasa. METHODS: This historical cohort study enrolled 250 patients with ESRD undergoing hemodialysis between January 2007 and July 2013 in two hemodialysis centers in Kinshasa. RUV were collected over 24 h at the initiation of HD and 6 and 12 months later during the interdialytic period...
March 20, 2018: BMC Nephrology
Takao Okawa, Masaaki Murakami, Ryo Yamada, Satoshi Tanaka, Kiyoshi Mori, Noriko Mori
PURPOSE: The population of obese patients is increasing in general and also at hemodialysis initiation. For successful cannulation of arteriovenous fistula, the National Kidney Foundation-Dialysis Outcome Quality Initiative guidelines suggest that the required maturation parameters are at a depth of <6 mm. There are several reports describing two-stage superficialization of arteriovenous fistulas in obese cases. Therefore, we investigated the utility and complications of one-stage superficialization of radio-cephalic fistula...
March 1, 2018: Journal of Vascular Access
Shereen M Hamza, John E Hall
Renal sympathetic nerves contribute significantly to both physiological and pathophysiological phenomena. Evaluating renal sympathetic nerve activity (RSNA) is of great interest in many areas of research such as chronic kidney disease, hypertension, heart failure, diabetes and obesity. Unequivocal assessment of the role of the sympathetic nervous system is thus imperative for proper interpretation of experimental results and understanding of disease processes. RSNA has been traditionally measured in anesthetized rodents, including mice...
February 14, 2018: Journal of Visualized Experiments: JoVE
Vikram Thakur, Munmun Chattopadhyay
BACKGROUND: Nephropathy is a debilitating complication of diabetes associated with increased risk for renal failure, leading to poor quality of life of the affected patients and eventually to mortality. Early intervention is crucial to enhance the well-being of the patients with nephropathy. Albuminuria is a well-known predictor of weak renal outcomes in patients with diabetes and hypertension, unfortunately, it is not an early marker for kidney injury. OBJECTIVE: Assessment of new and precise markers is necessary to predict the early onset and progression of nephropathy...
March 19, 2018: Current Drug Targets
Michael E Reschen, Andrea Mazzella, Edward Sharples
Background and aims: Dysfunction of a kidney transplant often requires histological sampling by percutaneous ultrasound-guided core needle biopsy. Transplant biopsy is more specialized than native kidney biopsy, the indications and complications are less well defined and in England are performed mainly by nephrologists. The aims of the study were to evaluate the adequacy and complication rate in living and deceased donor recipients according to training status of the nephrologist, assess the accuracy of physicians in predicting rejection, the threshold creatinine rise for biopsy, and the change in drug management post-biopsy...
April 2018: Annals of Medicine and Surgery
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