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Sample records for k2cr2o7-induced renal dysfunction

  1. Pycnogenol prevents potassium dichromate K2Cr2O7-induced oxidative damage and nephrotoxicity in rats.

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    Parveen, Kehkashan; Khan, Mohd Rashid; Siddiqui, Waseem A

    2009-10-30

    Environmental and occupational exposure to chromium compounds, especially hexavalent chromium [Cr(VI)], is widely recognized as a potential nephrotoxic in humans and animals. Its toxicity is associated with overproduction of free radicals, which induces oxidative damage. Recent evidence indicates that Pycnogenol (PYC), French maritime pine bark extract, exhibits antioxidant potential and protects against various oxidative stressors. The aim of the present study was to examine the modulating impacts of PYC on potassium dichromate K2Cr2O7-induced oxidative damage and nephrotoxicity in rats. Male Wistar rats were divided into four groups. The first group was control, the second group was control plus pre-treated with PYC (10 mg/kg, body weight; in saline; intraperitoneally; once daily for 3 weeks) as drug control and the third group was saline pre-treated plus treated with a single injection of K2Cr2O7 (15 mg/kg, body weight; in saline; intraperitoneally) as toxicant group. The fourth group was PYC pre-treated plus K2Cr2O7 injected. Forty-eight hours after K2Cr2O7-treatment, blood was drawn for estimation of renal injury markers in serum. Rats were then sacrificed, and their kidneys were dissected for biochemical and histopathological assays. K2Cr2O7-treated rats showed significant increases in markers of renal injury in serum, including blood urea nitrogen (BUN), serum creatinine (Scr), and alkaline phosphatase (ALP), which were significantly (P rats with PYC significantly (P rats. These results were also supported and confirmed with histopathological findings. The study suggests that PYC is effective in preventing K2Cr2O7-induced oxidative mediated nephrotoxicity, but more studies are needed to confirm the effects of PYC as a nephroprotective agent.

  2. Time course study of oxidative and nitrosative stress and antioxidant enzymes in K2Cr2O7-induced nephrotoxicity

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    Saldívar Liliana

    2005-04-01

    Full Text Available Abstract Background Potassium dichromate (K2Cr2O7-induced nephrotoxicity is associated with oxidative and nitrosative stress. In this study we investigated the relation between the time course of the oxidative and nitrosative stress with kidney damage and alterations in the following antioxidant enzymes: Cu, Zn superoxide dismutase (Cu, Zn-SOD, Mn-SOD, glutathione peroxidase (GPx, glutathione reductase (GR, and catalase (CAT. Methods Nephrotoxicity was induced in rats by a single injection of K2Cr2O7. Groups of animals were sacrificed on days 1,2,3,4,6,8,10, and 12. Nephrotoxicity was evaluated by histological studies and by measuring creatinine clearance, serum creatinine, blood urea nitrogen (BUN, and urinary excretion of N-acetyl-β-D-glucosaminidase (NAG and total protein. Oxidative and nitrosative stress were measured by immunohistochemical localization of protein carbonyls and 3-nitrotyrosine, respectively. Cu, Zn-SOD, Mn-SOD, and CAT were studied by immunohistochemical localization. The activity of total SOD, CAT, GPx, and GR was also measured as well as serum and kidney content of chromium and urinary excretion of NO2 -/NO3-. Data were compared by two-way analysis of variance followed by a post hoc test. Results Serum and kidney chromium content increased reaching the highest value on day 1. Nephrotoxicity was made evident by the decrease in creatinine clearance (days 1–4 and by the increase in serum creatinine (days 1–4, BUN (days 1–6, urinary excretion of NAG (days 1–4, and total protein (day 1–6 and by the structural damage to the proximal tubules (days 1–6. Oxidative and nitrosative stress were clearly evident on days 1–8. Urinary excretion of NO2-/NO3- decreased on days 2–6. Mn-SOD and Cu, Zn-SOD, estimated by immunohistochemistry, and total SOD activity remained unchanged. Activity of GPx decreased on days 3–12 and those of GR and CAT on days 2–10. Similar findings were observed by immunohistochemistry of CAT

  3. Allium sativum aqueous extract prevents potassium dichromate-induced nephrotoxicity and lipid oxidation in rats

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    Sergio L. Becerra-Torres

    2014-04-01

    Full Text Available Context: The potassium dichromate (K2Cr2O7 induces nephrotoxicity by oxidative stress mechanisms. Aims: To study the potential protection of an aqueous extract of Allium sativum against the K2Cr2O7-induced nephrotoxicity and lipid oxidation in rats. Methods: Twenty four hours after treatment, biomarkers such as proteinuria, creatinine clearance, malondialdehyde production, specific enzyme activity of gamma glutamyl transpeptidase and alanine aminopeptidase, and renal clearance of para-aminohippuric acid and inulin were measured. Results: The K2Cr2O7 caused significant renal dysfunction, but A. sativum extract prevented this condition by improving all measured biomarkers. Conclusions: A single injection of K2Cr2O7 induced nephrotoxicity in rats, but the supply of an Allium sativum aqueous extract prevented the disorders caused by this metal.

  4. Acute renal dysfunction in liver diseases

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Renal dysfunction is common in liver diseases, either as part of multiorgan involvement in acute illness or secondary to advanced liver disease. The presence of renal impairment in both groups is a poor prognostic indicator. Renal failure is often multifactorial and can present as pre-renal or intrinsic renal dysfunction. Obstructive or post renal dysfunction only rarely complicates liver disease. Hepatorenal syndrome (MRS) is a unique form of renal failure associated with advanced liver disease or cirrhosis, and is characterized by functional renal impairment without significant changes in renal histology. Irrespective of the type of renal failure, renal hypoperfusion is the central pathogenetic mechanism, due either to reduced perfusion pressure or increased renal vascular resistance. Volume expansion, avoidance of precipitating factors and treatment of underlying liver disease constitute the mainstay of therapy to prevent and reverse renal impairment. Splanchnic vasoconstrictor agents, such as terlipressin, along with volume expansion, and early placement of transjugular intrahepatic portosystemic shunt (TIPS) may be effective in improving renal function in HRS. Continuous renal replacement therapy (CRRT) and molecular absorbent recirculating system (MARS) in selected patients may be life saving while awaiting liver transplantation.

  5. Endothelial Dysfunction in Renal Failure: Current Update.

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    Radenkovic, Miroslav; Stojanovic, Marko; Prostran, Milica

    2016-01-01

    Endothelial dysfunction is principally characterized by impaired endothelium- dependent transduction mechanisms related to vascular relaxation, as an outcome of decreased release of endothelium-derived relaxing factors, mainly nitric oxide, as well as augmented oxidative stress, increased inflammation and predominance of vascular action produced by endothelium-derived contracting factors. Current data strongly suggest that pathological development of different types of kidney impairment with further progression to renal failure includes notable vascular changes associated with endothelial dysfunction. In accordance, this scientific field represents an advancing area of investigation, involving different biomarkers of endothelial dysfunction linked to renal impairment, as well as clinical findings with new information that can provide a more comprehensive understanding of the role of endothelial dysfunction in kidney disease. With regards to quoted facts, the aim of this article was to review the latest data related to endothelial dysfunction and renal failure by selection of relevant articles released from 2010 to 2015.

  6. Renal dysfunction in African patients with acute heart failure

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    Sani, Mahmoud U.; Davison, Beth A.; Cotter, Gad; Sliwa, Karen; Edwards, Christopher; Liu, Licette; Damasceno, Albertino; Mayosi, Bongani M.; Ogah, Okechukwu S.; Mondo, Charles; Dzudie, Anastase; Ojji, Dike B.; Voors, Adrian A.

    2014-01-01

    Aims In Western countries with typically elderly ischaemic acute heart failure patients, predictors and clinical outcome of renal dysfunction and worsening renal function are well described. However, the prevalence, predictors and clinical outcome of renal dysfunction in younger, mainly hypertensive

  7. Sexual dysfunction in chronic renal failure.

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    Soffer, O

    1980-12-01

    Sexual dysfunction in end-stage renal disease is a troublesome, multifactorial disorder. Abnormality of the hypothalamo-pituitary-gonadal axis is but one of the causes leading to the impotence and infertility commonly encountered in chronic renal failure. Short of kidney transplantation, no therapy is available. Though infertility is the rule in end-stage renal disease, successful fatherhood and deliveries have occurred on rare occasions.

  8. Transient renal dysfunction with reversible splenial lesion.

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    Watanabe, Toru; Matsuda, Tomoka; Kitagata, Ryoichi; Tajima, Iwao; Ono, Hiroyuki; Hirano, Keiko; Shirai, Masami; Endoh, Akira; Hongo, Teruaki

    2014-10-01

    We report the case of a 6-month-old boy with transient renal dysfunction who had an intensified signal in the splenium of the corpus callosum on magnetic resonance imaging. He presented to hospital with fever and sudden disturbance of consciousness. Cerebrospinal fluid analysis did not show pleocytosis. The mild consciousness disturbance disappeared after 30 min, but the splenial signal persisted even after 8 days. Further, renal glucosuria, increased excretion of select amino acids, and abnormal fractional excretion of electrolytes were observed, indicating renal tubular dysfunction. The abnormal urinary findings spontaneously resolved by day 9 of hospitalization. The splenial lesion took 21 days to normalize. There were no signs of neurological complications 2 months later. This case suggests the possibility of renal involvement in splenial lesions.

  9. Sirolimus-associated proteinuria and renal dysfunction.

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    Rangan, Gopala K

    2006-01-01

    Sirolimus is a novel immunosuppressant with potent antiproliferative actions through its ability to inhibit the raptor-containing mammalian target of rapamycin protein kinase. Sirolimus represents a major therapeutic advance in the prevention of acute renal allograft rejection and chronic allograft nephropathy. Its role in the therapy of glomerulonephritis, autoimmunity, cystic renal diseases and renal cancer is under investigation. Because sirolimus does not share the vasomotor renal adverse effects exhibited by calcineurin inhibitors, it has been designated a 'non-nephrotoxic drug'. However, clinical reports suggest that, under some circumstances, sirolimus is associated with proteinuria and acute renal dysfunction. A common risk factor appears to be presence of pre-existing chronic renal damage. The mechanisms of sirolimus-associated proteinuria are multifactorial and may be due to an increase in glomerular capillary pressure following calcineurin inhibitor withdrawal. It has also been suggested that sirolimus directly causes increased glomerular permeability/injury, but evidence for this mechanism is currently inconclusive. The acute renal dysfunction associated with sirolimus (such as in delayed graft function) may be due to suppression of compensatory renal cell proliferation and survival/repair processes. Although these adverse effects occur in some patients, their occurrence could be minimised by knowledge of the molecular effects of sirolimus on the kidney, the use of sirolimus in appropriate patient populations, close monitoring of proteinuria and renal function, use of angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers if proteinuria occurs and withdrawal if needed. Further long-term analysis of renal allograft studies using sirolimus as de novo immunosuppression along with clinical and laboratory studies will refine these issues in the future.

  10. Renal dysfunctions in glomerulonephropathy with rapidly declined renal failure.

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    Futrakul, N; Pochanugool, C; Sitprija, V; Singkhwa, V; Futrakul, P; Yenrudi, S; Sensirivatana, R; Watana, D; Poshyachinda, M

    1996-07-01

    Eight patients aged between 5 and 26 years developed rapid deterioration of renal function and became oliguric/anuric with duration ranging from 1 to 21 days. The initial functional assessment revealed severe degree of glomerular, tubular, and vascular dysfunctions. The magnitude of renal dysfunction was quantified and expressed in terms of a clinical score. The degree of glomerular and tubular dysfunctions were inversely proportional to the renal plasma flow and peritubular capillary blood flow (PTCB), respectively. Similar findings have been observed in a variety of severe glomerulonephropathies. In this aspect, it is likely that the reduction of peritubular capillary blood flow and tubulointerstitial disease are interrelated. Further evidence to support the primary role of reduction of PTCB in inducing tubulointerstitial disease is provided by the following: (a) Reduction of PTCB is documented in mesangial proliferative nephrosis with steroid resistance prior to the detection of tubulointerstitial disease. (b) Ischemic insult can induce tubulointerstitial disease in experimental setting of renal artery occlusion in animal, (c) Improved tubular function can be achieved following the increase in PTCB with the enhanced renal perfusion therapy.

  11. Renal dysfunction and coronary disease: a high-risk combination.

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    Schiele, Francois

    2009-01-01

    Chronic kidney dysfunction is recognized as a risk factor for atherosclerosis and complicates strategies and treatment. Therefore, it is important for cardiologists not only to detect and measure potential kidney dysfunction, but also to know the mechanisms by which the heart and kidney interact, and recognize that in cases of acute coronary syndrome, the presence of renal dysfunction increases the risk of death. The detection and classification of kidney dysfunction into 5 stages is based on the estimated glomerular filtration rate (GFR). The presence of hypertension, endothelial dysfunction, dyslipidemia, inflammation, activation of the renin-angiotensin system and specific calcifications are the main mechanisms by which renal dysfunction can induce or compound cardiovascular disease. The magnitude of renal dysfunction is related to the cardiovascular risk; a linear relation links the extent of GFR decrease and the risk of cardiovascular events. Renal dysfunction and acute coronary syndromes are a dangerous combination: more common comorbidities, more frequent contraindications for effective drugs and higher numbers of drug-related adverse events such as bleeding partially explain the higher mortality in patients with renal dysfunction. In addition, despite higher risk, patients with renal dysfunction often receive fewer guideline-recommended treatments even in the absence of contraindications. Renal dysfunction induces and promotes atherosclerosis by various pathophysiologic pathways and is associated with other cardiovascular risk factors and underuse of appropriate therapy. Therefore, the assessment of renal function is an important step in the risk evaluation of patients with coronary artery disease.

  12. Efficacy of ultrasonography-guided renal biopsy for the evaluation of renal dysfunction following renal transplantation

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    Kim, Young Jae; Choi, Chul Soon; Min, Seon Jeong; Lee, Gyung Kyu; Lee, Eil Seong; Kang, Ik Won; Bae, Sang Hoon [Hallym University College of Medicine, Chuncheon (Korea, Republic of)

    2003-12-15

    To evaluate the usefulness and complications of renal biopsy under ultrasonography-guidance in renal dysfunction after renal transplantation. Ultrasonography-guided renal biopsy was done in 47 patients with the transplanted kidney. The subjects consisted of 30 males and 17 females, age ranged from 16 to 66 years (average age=38 years). Biopsies were done once in 27 patients, twice in 17 patients, three times in 3 patients, a total of 70 biopsies. The success rate of renal biopsy for the accurate pathologic diagnosis and the incidence and types of complications following biopsy were evaluated. The success rate of renal biopsy for the accurate pathologic diagnosis was 96%(67/70). Pathologic diagnosis included 27 cases of acute rejection (39%), 8 cases of acute tubular necrosis (11%), 4 cases of acute rejection and acute tubular necrosis (6%), 4 cases of cyclosporin toxicity (6%), 4 cases of primary disease recurrence (6%), 4 cases of infection (6%) and others. Complications after renal biopsy included 15 cases of microscopic hematuria (21%), 1 case of gross hematuria with spontaneous cessation and 1 case of life threatening hemorrhage. Ultrasonography-guided renal biopsy is a safe and effective diagnostic method for the evaluation of renal dysfunction following renal transplantation.

  13. Chemerin in renal dysfunction and cardiovascular disease.

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    Bonomini, Mario; Pandolfi, Assunta

    2016-02-01

    The potential involvement of chemerin in cardiovascular and renal dysfunction has recently been acknowledged. There are indeed many links between this protein and inflammation, atherosclerosis, and multiple obesity- and diabetes-related parameters such as body mass index, insulin resistance, and blood levels of insulin, cholesterol, triglycerides, and glucose. In addition, in the last few years, several reports have investigated the circulating chemerin levels and their pathophysiologic significance in chronic kidney disease populations. However, there are still gaps in our understanding of this matter, in particular as to whether elevated chemerin might be the cause behind, or simply mirror, a reduced renal function. The limitations of the present knowledge on chemerin may partly relate to the lack of specific antibodies for assessing the different active isoforms of the protein. Measuring its bioactive serum concentration, and achieving a precise overall pattern of the tissue-specific formation of different isoforms, with the use of suitable technology, will ultimately help define the role of chemerin in disease pathophysiology, or as a diagnostic or therapeutic marker. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. Modifying cyclosporine associated renal allograft dysfunction

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    Mohapatra N

    2009-01-01

    Full Text Available Transplantation is accepted therapy for chronic kidney disease. However the essential immuno-suppressive agents for graft survival have their own side-effects. Renal biopsy is a reliable tool for diagnosing cyclosporine (CsA nephrotoxicity. To present our observations on CsA toxicity in renal allograft biopsies, we studied prospectively 207 renal allograft biopsies performed for graft dysfunction as per Ahmedabad Tole-rance Induction Protocol (ATIP and compared them to 50 controls from January to October 2007. The ATIP comprised donor specific leucocyte infusions, low dose target specific irradiation; non-myeloablative condi-tioning with Anti-T ± B cell antibodies followed by intraportal administration of cultured donor bone marrow (BM ± adipose tissue derived mesenchymal stem cells. Renal transplantation was performed following nega-tive lymphocytotoxicity cross-matching. The post-transplant immunosuppressive agents included CsA 2.5 ± 0.5 mg/kg BW/day and prednisone 0.2 mg/kg BW/day. The controls were transplanted using standard triple immunosuppressive agents including CsA 5 ± 1 mg/Kg BW/day, prednisone 0.6 mg/kg BW/day, and MMF/ Azathioprine. The Institutional Review Board approved the ATIP. The biopsies were categorized into 2 groups; group A (N=97: performed < 6 months, group B (N= 160, > 6 months posttransplant. Acute CsA toxicity was observed in group A: 2.5% ATIP and 11.1% controls; group B: 16.2% ATIP and 8.8% controls. Chronic CsA toxicity was observed in group B: 10.8 % ATIP and 17.6 % controls. Acute toxicity was more in the ATIP, while chronic toxicity was more in the controls. CsA doses were reduced post-biopsy and resulted in improved graft function evaluated by serum creatinine. We conclude that CsA nephrotoxicity evaluated by allograft biopsy resulted in allograft function recovery by decreasing the cyclosporine dose, and the ATIP decreased the incidence of CsA nephrotoxicity.

  15. Late renal dysfunction in adult survivors of bone marrow transplantation

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    Lawton, C.A.; Cohen, E.P.; Barber-Derus, S.W.; Murray, K.J.; Ash, R.C.; Casper, J.T.; Moulder, J.E. (Medical College of Wisconsin Affiliated Hospitals, Milwaukee (USA))

    1991-06-01

    Until recently long-term renal toxicity has not been considered a major late complication of bone marrow transplantation (BMT). Late renal dysfunction has been described in a pediatric population status post-BMT which was attributable to the radiation in the preparatory regimen. A thorough review of adults with this type of late renal dysfunction has not previously been described. Fourteen of 103 evaluable adult patients undergoing allogeneic (96) or autologous (7) bone marrow transplantation, predominantly for leukemia and lymphomas, at the Medical College of Wisconsin (Milwaukee, WI) have had a syndrome of renal insufficiency characterized by increased serum creatinine, decreased glomerular filtration rate, anemia, and hypertension. This syndrome developed at a median of 9 months (range, 4.5 to 26 months) posttransplantation in the absence of specific identifiable causes. The cumulative probability of having this renal dysfunction is 20% at 1 year. Renal biopsies performed on seven of these cases showed the endothelium widely separated from the basement membrane, extreme thickening of the glomerular basement membrane, and microthrombi. Previous chemotherapy, antibiotics, and antifungals as well as cyclosporin may add to and possibly potentiate a primary chemoradiation marrow transplant renal injury, but this clinical syndrome is most analogous to clinical and experimental models of radiation nephritis. This late marrow transplant-associated nephritis should be recognized as a potentially limiting factor in the use of some intensive chemoradiation conditioning regimens used for BMT. Some selective attenuation of the radiation to the kidneys may decrease the incidence of this renal dysfunction.

  16. Renal vascular dysfunction precedes the development of renal damage in the hypertensive Fawn-Hooded rat

    NARCIS (Netherlands)

    Ochodnicky, Peter; Henning, Robert H.; Buikema, Hendrik J.; de Zeeuw, Dick; Provoost, Abraham P.; van Dokkum, Richard P. E.

    2010-01-01

    Ochodnicky P, Henning RH, Buikema HJ, de Zeeuw D, Provoost AP, van Dokkum RP. Renal vascular dysfunction precedes the development of renal damage in the hypertensive Fawn-Hooded rat. Am J Physiol Renal Physiol 298: F625-F633, 2010. First published December 9, 2009; doi:10.1152/ajprenal.00289.2009.-I

  17. Diffusion-weighted MRI in assessment of renal dysfunction

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    Ankur Goyal

    2012-01-01

    Full Text Available Background: Diffusion-weighted magnetic resonance imaging (DW-MRI in renal diseases is an evolving field and its potential is yet to be fully realized. Purpose: To study the relationship between apparent diffusion coefficient (ADC values of renal parenchyma and serum markers of renal function and stage of chronic kidney disease (CKD. Materials and Methods: A retrospective review was performed of all adult patients who underwent DW-MRI (at b-values of 0 and 500 s/mm 2 for renal lesions from January 2009 to September 2010 and revealed 88 patients, of which 22 patients had renal dysfunction and 66 had normal renal function. Of these 22, 15 patients were known cases of CKD and were staged depending on disease severity. ADC values were determined for renal parenchyma and compared. Receiver operating characteristic (ROC curves were drawn to establish cut-off ADC values. Pearson′s correlation coefficient (R was calculated between ADC and renal function parameters. Results: ADC values in patients with renal dysfunction were significantly lower than in patients with normal renal function (2.1133 ± 0.2851 vs. 2.3198 ± 0.1246 (×10 -3 mm 2 /s. ADC values lower than 2.0354 (×10 -3 mm 2 /s were seen only with renal dysfunction and higher than 2.4516 (×10 -3 mm 2 /s were seen only with normal function. There was significant inverse correlation between ADC and serum creatinine ( R = -0.530, blood urea (R= -0.502, and significant linear correlation ( R = 0.784 with estimated glomerular filtration rate (eGFR. ADC values showed a statistically significant decreasing trend with increasing stage of CKD. Conclusion: ADC values may serve as an additional marker for the presence and degree of renal dysfunction.

  18. The correct renal function evaluation in patients with thyroid dysfunction.

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    Simeoni, Mariadelina; Cerantonio, Annamaria; Pastore, Ida; Liguori, Rossella; Greco, Marta; Foti, Daniela; Gulletta, Elio; Brunetti, Antonio; Fuiano, Giorgio

    2016-05-01

    Thyroid dysfunction induces several renal derangements involving all nephron portions. Furthermore, dysthyroidism is a recognized risk factor associated with the development of chronic kidney disease. Current data, in fact, demonstrate that either subclinical or overt thyroid disease is associated with significant changes in creatinine, estimated glomerular filtration rate, measured glomerular filtration rate and Cystatin C. Herein, we systematically reviewed several relevant studies aiming at the identification of the most sensitive and specific parameter for the correct renal function evaluation in patients with thyroid dysfunction, that are usually treated as outpatients. Our systematic review indicates that estimated glomerular filtration rate, preferably with CKD-EPI equation, appears to be the most reliable and wieldy renal function parameter. Instead, Cystatin C should be better used in the grading of thyroid dysfunction severity.

  19. Risk factors for renal dysfunction after total hip joint replacement

    DEFF Research Database (Denmark)

    Hassan, Basim Kamil; Sahlström, Arne; Dessau, Ram Benny Christian

    2015-01-01

    BACKGROUND AND PURPOSE OF THE STUDY: Renal injury and dysfunction are serious complications after major surgery, which may lead to increased morbidity and mortality. The objective of our study was to identify the possible risk factors for renal dysfunction after total hip joint replacement surgery......, hypertension, general anesthesia, high ASA scores, low intra-operative systolic BP, and prophylactic dicloxacillin as significant risk factors. Low baseline systolic BP, low baseline diastolic blood pressure, and hip fracture diagnosis were independent risk factors for postoperative increase in serum...... creatinine. Smoking, diabetes mellitus, high BMI, gender, and duration of surgery were not identified as significant risk factors....

  20. 4. Prevalence and Factors Associated with Renal Dysfunction in HIV ...

    African Journals Online (AJOL)

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    hypotension were not significant factors associated with kidney disease after .... Diarrhea. 39 (13). 27 (19). 12 (8). 0.003. Vomiting. 49(16). 32(23). 17(11). 0.006. Anuria .... studies, a low CD4 count was a predictor of renal dysfunction and ...

  1. Nebulized Pentamidine-Induced Acute Renal Allograft Dysfunction

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    Siddhesh Prabhavalkar

    2013-01-01

    Full Text Available Acute kidney injury (AKI is a recognised complication of intravenous pentamidine therapy. A direct nephrotoxic effect leading to acute tubular necrosis has been postulated. We report a case of severe renal allograft dysfunction due to nebulised pentamidine. The patient presented with repeated episodes of AKI without obvious cause and acute tubular necrosis only on renal histology. Nebulised pentamidine was used monthly as prophylaxis for Pneumocystis jirovecii pneumonia, and administration preceded the creatinine rise on each occasion. Graft function stabilised following discontinuation of the drug. This is the first report of nebulized pentamidine-induced reversible nephrotoxicity in a kidney allograft. This diagnosis should be considered in a case of unexplained acute renal allograft dysfunction.

  2. Cyclosporine-induced renal dysfunction in human renal allograft recipients.

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    Kiberd, B A

    1989-12-01

    Cyclosporine-treated renal allograft recipients frequently suffer CsA-related nephrotoxicity and hypertension. This study demonstrates that glomerular filtration rate is reduced acutely by 13% (P less than 0.02) and renal vascular resistance increased by 30% (P less than 0.05), immediately after patients take their CsA dose. The reduction in GFR is directly related to their trough CsA level (r = 0.82; P less than 0.01). The lower the trough CsA level the greater the fall in GFR after the CsA dose. Plasma renin activity does not increase after the CsA dose (pre-CsA 0.6 +/- 0.2 ng/L/sec vs. post-CsA 0.4 +/- 0.1 ng/L/sec; P = NS), and therefore cannot be responsible for the reduction in renal function. Short-term nifedipine treatment is effective in preventing the acute reduction in GFR (P less than 0.05). This occurred despite no apparent effect of nifedipine in altering trough or post-dose CsA levels. Furthermore nifedipine was effective in lowering both the mean arterial blood pressure (109 mmHg to 94 mmHg; P less than 0.01) and the elevated renal vascular resistance (25% reduction; P less than 0.02) observed in these patients. These results suggest that nifedipine may be a suitable agent for limiting acute CsA nephrotoxicity and for treating CsA-associated hypertension in renal allograft recipients.

  3. Renal dysfunction after total-body irradiation. Significance of selective renal shielding blocks

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    Igaki, Hiroshi [Tokyo Metropolitan Komagome Hospital (Japan). Dept. of Radiation Center; University of Tsukuba, Ibaraki (Japan). Proton Medical Research Center; University of Tokyo (Japan). Dept. of Radiology; Karasawa, Katsuyuki [Tokyo Metropolitan Komagome Hospital (Japan). Dept. of Radiation Center; Sakamaki, Hisashi [Tokyo Metropolitan Komagome Hospital (Japan). Dept. of Hematology; Saito, Hiroshi [Tokyo Metropolitan Komagome Hospital (Japan). Dept. of Nephrology; Nakagawa, Keiichi; Ohtomo, Kuni [University of Tokyo (Japan). Dept. of Radiology; Tanaka, Yoshiaki [Nihon University School of Medicine, Tokyo (Japan). Dept. of Radiology

    2005-11-01

    Purpose: A retrospective analysis was conducted on the outcome of total-body irradiation (TBI) followed by bone marrow transplantation (BMT) on leukemia patients. Also studied was the risk of renal dysfunction after TBI/BMT with or without the use of selective renal shielding blocks. Patients and Methods: The cases of 109 leukemia patients who received TBI as a component of the conditioning regimen for their BMT were reviewed. They received 12 Gy of TBI in six fractions over 3 consecutive days. Doses to eyes and lungs were reduced to 7 Gy and 8 Gy, respectively, but customized organ shielding blocks. After March 1999, renal shielding blocks were used to constrain the renal dose to 10 Gy. The patients were followed for a median period of 16.6 months (range: 0.3-180.1 months). Results: The 2-year and 5-year overall survival rates were 55.4% and 43.2%, respectively. Renal dysfunction-free rates were different between those with and without renal shielding blocks: 100% and 78.5%, respectively, at 2 years. Overall survivals were not significantly different among these patients: 60.4% and 52.9%, respectively, at 2 years in patients with and without renal shielding blocks (p=0.53). Conclusion: The use of selective renal shielding blocks provided evidence for reducing radiation-induced renal toxicities without decreasing the overall survival rate. (orig.)

  4. Curcumin Pretreatment Prevents Potassium Dichromate-Induced Hepatotoxicity, Oxidative Stress, Decreased Respiratory Complex I Activity, and Membrane Permeability Transition Pore Opening

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    Wylly Ramsés García-Niño

    2013-01-01

    Full Text Available Curcumin is a polyphenol derived from turmeric with recognized antioxidant properties. Hexavalent chromium is an environmental toxic and carcinogen compound that induces oxidative stress. The objective of this study was to evaluate the potential protective effect of curcumin on the hepatic damage generated by potassium dichromate (K2Cr2O7 in rats. Animals were pretreated daily by 9-10 days with curcumin (400 mg/kg b.w. before the injection of a single intraperitoneal of K2Cr2O7 (15 mg/kg b.w.. Groups of animals were sacrificed 24 and 48 h later. K2Cr2O7-induced damage to the liver was evident by histological alterations and increase in the liver weight and in the activity of alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase, and alkaline phosphatase in plasma. In addition, K2Cr2O7 induced oxidative damage in liver and isolated mitochondria, which was evident by the increase in the content of malondialdehyde and protein carbonyl and decrease in the glutathione content and in the activity of several antioxidant enzymes. Moreover, K2Cr2O7 induced decrease in mitochondrial oxygen consumption, in the activity of respiratory complex I, and permeability transition pore opening. All the above-mentioned alterations were prevented by curcumin pretreatment. The beneficial effects of curcumin against K2Cr2O7-induced liver oxidative damage were associated with prevention of mitochondrial dysfunction.

  5. Delayed renal dysfunction after total body irradiation in pediatric malignancies.

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    Watanabe Nemoto, Miho; Isobe, Koichi; Togasaki, Gentaro; Kanazawa, Aki; Kurokawa, Marie; Saito, Makoto; Harada, Rintaro; Kobayashi, Hiroyuki; Ito, Hisao; Uno, Takashi

    2014-09-01

    The purpose of this study was to retrospectively evaluate the incidence of delayed renal dysfunction after total body irradiation (TBI) in long-term survivors of TBI/hematopoietic stem cell transplantation (HSCT). Between 1989 and 2006, 24 pediatric patients underwent TBI as part of the conditioning regimen for HSCT at Chiba University Hospital. Nine patients who survived for more than 5 years were enrolled in this study. No patient had any evidence of renal dysfunction prior to the transplant according to their baseline creatinine levels. The median age at the time of diagnosis was 6 years old (range: 1-17 years old). The follow-up period ranged from 79-170 months (median: 140 months). Renal dysfunction was assessed using the estimated glomerular filtration rate (eGFR). The TBI dose ranged from 8-12 Gy delivered in 3-6 fractions over 2-3 d. The patients were treated with linear accelerators in the supine position, and the radiation was delivered to isocentric right-left and left-right fields via the extended distance technique. The kidneys and the liver were not shielded except in one patient with a left adrenal neuroblastoma. No patient required hemodialysis. The eGFR of four patients (44.4%) progressively decreased. The remaining patients did not demonstrate any eGFR deterioration. Only one patient developed hypertension. By evaluating the changes in eGFR, renal dysfunction among long-term survivors of TBI/HSCT could be detected. Our results suggested that the TBI schedule of 12 Gy in 6 fractions over three consecutive days affects renal function.

  6. Epidemiology and importance of renal dysfunction in heart failure patients.

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    Giamouzis, Gregory; Kalogeropoulos, Andreas P; Butler, Javed; Karayannis, Georgios; Georgiopoulou, Vasiliki V; Skoularigis, John; Triposkiadis, Filippos

    2013-12-01

    Renal dysfunction (RD) is a frequent comorbid condition and a major determinant of outcomes in patients with heart failure (HF). It is likely that the etiology of RD in patients with HF is much more complex than we first thought and represents a matrix of independent, albeit interacting, pathophysiological pathways with effects on both the kidney and the heart that share a common denominator: aging and inflammation. Renal dysfunction in HF has been attributed, among others, to biochemical, hormonal, and hemodynamic factors, coupled with pharmacological interventions. Regardless of the cause, the development of RD or worsening renal function is common in patients with HF, and is associated with increased morbidity and mortality. There is increasing evidence, however, that transient increases in creatinine in the setting of acute HF are not prognostically important, whereas persistent deterioration does portend a higher mortality in this patient population. In addition, congestion seems to play an important role in the course of renal deterioration, and the combination of congestion and worsening renal function is the most significant clinical prognosticator in HF patients. This review aims to provide an update on the epidemiology and prognostic significance of RD in HF patients, in both the acute and the chronic setting.

  7. Current Concepts in the Diagnosis and Classification of Renal Dysfunction in Cirrhosis

    Science.gov (United States)

    Mindikoglu, Ayse L.; Weir, Matthew R.

    2013-01-01

    Background Renal dysfunction is one of the most common complications of cirrhosis with high morbidity and mortality. Summary In subjects with cirrhosis, renal dysfunction can present either as a direct consequence of cirrhosis (e.g. hepatorenal syndrome Type I and Type II) or secondary to etiologies other than cirrhosis (chronic kidney disease due to diabetic nephropathy, prerenal azotemia). Or, patients with cirrhosis may have renal dysfunction resulting directly from cirrhosis; and an underlying chronic kidney disease. Key Messages Given the challenges in the differential diagnosis of renal dysfunction and insufficient accuracy of serum creatinine and creatinine-based glomerular filtration rate estimating equations in cirrhosis, there is an urgent need for more accurate biomarkers of renal dysfunction in this population. This review will discuss novel concepts for the diagnosis and classification of renal dysfunction in cirrhosis to overcome at least some of the diagnostic and therapeutic challenges. Additionally, a new classification will be proposed for renal dysfunction in cirrhosis. PMID:24107793

  8. Perioperative renal outcome in cardiac surgical patients with preoperative renal dysfunction: aprotinin versus epsilon aminocaproic acid.

    Science.gov (United States)

    Maslow, Andrew D; Chaudrey, Alyas; Bert, Arthur; Schwartz, Carl; Singh, Arun

    2008-02-01

    The administration of aprotinin to patients with pre-existing renal dysfunction who are undergoing cardiac surgery is controversial. Therefore, the authors present their experience with the use of aprotinin for patients with preoperative renal dysfunction who underwent elective cardiac surgery requiring cardiopulmonary bypass (CPB). Retrospective analysis. University hospital. Consecutive cardiac surgical patients with preoperative serum creatinine (SCr) > or =1.8 mg/dL undergoing nonemergent cardiac surgery requiring CPB. None. One hundred twenty-three patients either received epsilon aminocaproic acid (EACA, n = 82) or aprotinin (n = 41) as decided by the attending anesthesiologist and surgeon. Data were collected from the Society of Thoracic Surgeons database and from automated intraoperative anesthesia records. Renal function was assessed from measured serum creatinine (SCr) and calculated creatinine clearances (CrCls). Acute perioperative renal dysfunction was defined as a worsening of perioperative renal function by > or =25% and/or the need for hemodialysis (HD). Data were recorded as mean and standard deviation or percentage of population depending on whether the data were continuous or not. Data were compared by using an analysis of variance, chi-square analysis, Student paired and unpaired t tests, Fisher exact test, Wilcoxon rank sum test, and Mann-Whitney U test. A p value or =3 months after surgery was significantly lower in the aprotinin group compared with the EACA group (1.8 v 2.2 mg/dL, p < 0.05). Acute perioperative renal dysfunction was associated with worse patient outcome and longer CPB and AoXCl times. Demographic and surgical variables indicated that the sicker patients undergoing more complex surgeries were more likely to be treated with aprotinin. Although aprotinin patients had a higher renal risk score, the administration of aprotinin did not negatively impact renal outcome.

  9. Linezolid-induced thrombocytopenia in two patients with renal dysfunction

    Directory of Open Access Journals (Sweden)

    Engin Melek

    2016-12-01

    Full Text Available Linezolid is an oxazolidinone antibiotic, active against gram positive bacteria that are resistant to other antibiotics including glycopeptides. Thrombocytopenia is an adverse effect of linezolid. Although various risk factors have been suggested, the mechanisms behind this side effect are largely unknown. Here, we report two adolescents with the diagnosis of chronic kidney disease who developed thrombocytopenia following treatment with linezolid. Our purpose in highlighting these cases is to increase the clinical awareness concerning this side effect of linezolid. While it is well known that thrombocytopenia may develop during linezolid treatment, it is relatively unknown that patients with renal dysfunction have an increased risk for the development of thrombocytopenia compared to patients without renal dysfunction. [Cukurova Med J 2016; 41(4.000: 808-810

  10. Cognitive dysfunction in patients with renal failure requiring hemodialysis

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    Rohini Thimmaiah

    2012-01-01

    Full Text Available Background and Objectives: Renal failure patients show significant impairment on measures of attention and memory, and consistently perform significantly better on neuropsychological measures of memory and attention, approximately 24 hours after hemodialysis treatment. The objectives are to determine the cognitive dysfunction in patients with renal failure requiring hemodialysis. Materials and Methods: A total of 60 subjects comprising of 30 renal failure patients and 30 controls were recruited. The sample was matched for age, sex, and socioeconomic status. The tools used were the Standardized Mini-Mental State Examination and the Brief Cognitive Rating Scale. Results: The patients showed high cognitive dysfunction in the pre-dialysis group, in all the five dimensions (concentration, recent memory, past memory, orientation and functioning, and self-care, and the least in the 24-hour post dialysis group. This difference was found to be statistically significant (P=0.001. Conclusion: Patients with renal failure exhibited pronounced cognitive impairment and these functions significantly improved after the introduction of hemodialysis.

  11. Renal dysfunction prevalence and clinical impact in heart failure

    Directory of Open Access Journals (Sweden)

    Palazzuoli A

    2011-09-01

    Full Text Available Alberto Palazzuoli, Susanna Benincasa, Stefanie Grothgar, Pasquale Di Sipio, Giovanni Paganini, Marco Pellegrini, Ranuccio NutiDepartment of Internal Medicine and Metabolic Diseases, Cardiology Section, Le Scotte Hospital, University of Siena, ItalyAbstract: Chronic kidney disease (CKD is associated with a significant increase in death and cardiovascular mortality. However the exact mechanism by which CKD impairs the cardiovascular outcome is not well established. Some reasons may lie in the association of CKD with several other cardiovascular and noncardiovascular disorders including accelerated systemic atherosclerosis, endothelial dysfunction, increased levels of inflammatory factors, anemic status, bone mineral dysfunction, electrolyte imbalance, and renin–angiotensin–aldosterone system (RAAS activation. Therefore several risk factors such as hypertension, diabetes, lipid disorders, and older age are common in both conditions. In patients affected with heart failure (HF a key role is represented by the neurohormonal activation. This condition causes fluid and sodium retention, peripheral vasoconstriction, as well as increased congestion and cardiac workload. Moreover, HF during the decompensated phases is often associated with a worsening renal function that leads to further RAAS activation, microvascular damage, and intrarenal flow redistribution. In order to clarify the interactions between these factors, several questions need to be answered: the universal definition of “worsening renal function,” the identification of the best laboratory parameters to investigate renal function in terms of sensitivity and specificity, and a better definition of the comorbidities’ role in the determination of the outcome, especially in patients with chronic HF. A clarification of these key points could lead to the individualization of new specific therapeutic targets and to a reduction in mortality and hospitalization in patients with HF and

  12. The use of major analgesics in patients with renal dysfunction.

    Science.gov (United States)

    Niscola, Pasquale; Scaramucci, Laura; Vischini, Gisella; Giovannini, Marco; Ferrannini, Michele; Massa, Pasquale; Tatangelo, Paola; Galletti, Massimo; Palumbo, Roberto

    2010-06-01

    Pain in patients with impaired renal function may be a significant problem requiring treatment with opioids. However, pharmacokinetic and metabolic changes associated with an impaired renal function may raise some concerns about side effects and overdosing associated with opioid agents in this patient's population. In order to give recommendations on this issue, we review the available evidences on the pharmacokinetics and side effects of most common opioids used to treat pain. The results of this review show that the half-life of the parent opioid compounds and of their metabolites is increased in the presence of renal dysfunction, for which careful monitoring of the patient, dose reduction and a longer time interval between doses are recommended. Among opioids, morphine and codeine used with very caution and possibly avoided in renal failure/dialysis patients; tramadol, hydromorphone and oxycodone can be used with caution and close patient's monitoring, whereas transdermal buprenorphine, methadone and fentanyl/sufentanil appear to be safe to use in patients with renal failure.

  13. BILATERAL RENAL ARTERY STENOSIS IN A HYPERTENSIVE LUPUS PATIENT WITHOUT RENAL DYSFUNCTION: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Giulio Geraci

    2014-04-01

    Full Text Available Systemic lupus erythematosus (SLE is associated with a high prevalence of atherosclero-sis and an enhanced cardiovascular mortality. In adult subjects, several studies have shown the coexistence of SLE and renal artery stenosis, most of them with unilateral in-volvement or with renal dysfunction. We observed a 62-year-old man with SLE and a 10-year history of moderate-to-severe hy-pertension who was admitted to our hospital because of uncontrolled blood pressure val-ues (152/95 mmHg, despite drug therapy. No signs of renal impairment were evident. After an initial physical examination, which presented a periumbilical bruit, a renal ultra-sound was performed with evidence of bilateral renal artery stenosis. An angio-MR study also confirmed the diagnosis and showed a double renal artery on the right side. Many different factors can contribute to the bilateral renal artery stenosis in this patient. Chronic inflammatory state associated to SLE, metabolic alterations with dyslipidemia and steroid therapy may all be involved in the development of the renal atherosclerotic le-sions.

  14. Impact of obesity on development of chronic renal allograft dysfunction

    Directory of Open Access Journals (Sweden)

    Jahromi Alireza

    2009-01-01

    Full Text Available Obesity in nontransplant patients has been associated with hypertension, hyperlipi-demia, diabetes, and proteinuria. To determine whether renal transplant recipients with an elevated BMI have worse long term graft survival, we prospectively studied 92 patients transplanted between April 1999 and July 2000. Weight (Wt and height of the patients were recorded prior to transplantation and two weeks, one, two and three years post transplantation. Blood urea nitrogen (BUN, creatinine (Cr and blood pressure were checked monthly, while triglyceride, cholesterol, high den-sity lipoprotein (HDL, and low density lipoprotein (LDL were obtained 3 monthly for 3 years post transplantation. Graft dysfunction was defined as serum Cr > 1.8 mg/dL. While BMI and Wt of the patients before transplantation did not show any significant correlation with chronic renal allograft dysfunction (CRAD, patients with higher Wt and BMI two weeks after transplantation showed an increased risk of developing CRAD during the three year post transplant independent of other risk factors (P< 0.05. Patients with greater Wt loss in the first two weeks post transplantation showed a decreased risk of developing CRAD in the following 3 years (P< 0.001. Our study suggests that high Wt and BMI are significantly associated with worse graft survival 3 years post renal trans-plantation.

  15. Connecting heart failure with preserved ejection fraction and renal dysfunction: the role of endothelial dysfunction and inflammation.

    Science.gov (United States)

    Ter Maaten, Jozine M; Damman, Kevin; Verhaar, Marianne C; Paulus, Walter J; Duncker, Dirk J; Cheng, Caroline; van Heerebeek, Loek; Hillege, Hans L; Lam, Carolyn S P; Navis, Gerjan; Voors, Adriaan A

    2016-06-01

    Renal dysfunction in heart failure with preserved ejection fraction (HFpEF) is common and is associated with increased mortality. Impaired renal function is also a risk factor for developing HFpEF. A new paradigm for HFpEF, proposing a sequence of events leading to myocardial remodelling and dysfunction in HFpEF, was recently introduced, involving inflammatory, microvascular, and cardiac components. The kidney might play a key role in this systemic process. Renal impairment causes metabolic and systemic derangements in circulating factors, causing an activated systemic inflammatory state and endothelial dysfunction, which may lead to cardiomyocyte stiffening, hypertrophy, and interstitial fibrosis via cross-talk between the endothelium and cardiomyocyte compartments. Here, we review the role of endothelial dysfunction and inflammation to explain the link between renal dysfunction and HFpEF, which allows for identification of new early risk markers, prognostic factors, and unique targets for intervention.

  16. Prospective evaluation of renal allograft dysfunction with 99mtechnetium-diethylenetriaminepentaacetic acid renal scans

    Energy Technology Data Exchange (ETDEWEB)

    McConnell, J.D.; Sagalowsky, A.I.; Lewis, S.E.; Gailiunas, P.; Helderman, J.H.; Dawidson, I.; Peters, P.C.

    1984-05-01

    A prospective, single-blinded study was done to determine the ability of serial 99mtechnetium-diethylenetriaminepentaacetic acid scans to diagnose renal allograft rejection. Among 28 transplant recipients 111 renal scans were obtained 1 day postoperatively and every 3 to 4 days thereafter for 3 weeks in all patients retaining an allograft. Computer-generated time-activity blood flow curves were analyzed semiquantitatively for the 1) interval between curve peaks of the allograft and iliac artery, 2) renal transit time and 3) renal washout of radionuclide. Excretory function was assessed by degree and interval to appearance of radionuclide in the calices and bladder. Deterioration of renal blood flow and excretion compared to the initial scan was considered rejection. Of 52 scans performed during clinical rejection 47 (90.4 per cent) were interpreted as showing rejection (sensitivity). Of 53 scans interpreted as showing rejection 47 (88.7 per cent) were positive for clinical rejection. The remaining 6 patients (initial false positive results) suffered clinical rejection within 24 to 72 hours. We conclude that 99mtechnetium-diethylenetriaminepentaacetic acid renal scans are useful in the differential diagnosis of renal allograft dysfunction.

  17. [Assessment of renal function, iatrogenic hyperkalemia and acute renal dysfunction in cardiology. Contrast-induced nephropathy].

    Science.gov (United States)

    Górriz Teruel, José Luis; Beltrán Catalán, Sandra

    2011-12-01

    Renal impairment influences the prognosis of patients with cardiovascular disease and increases cardiovascular risk. Renal dysfunction is a marker of lesions in other parts of the vascular tree and detection facilitates early identification of individuals at high risk of cardiovascular events. In patients with cardiovascular disease, renal function is assessed by measuring albuminuria in a spot urine sample and by estimating the glomerular filtration rate using creatinine-derived predictive formulas or equations. We recommend the Chronic Kidney Disease Epidemiology Collaboration or the Modification of Diet in Renal Disease formulas. The Cockcroft-Gault formula is a possible alternative. The administration of drugs that block the angiotensin-renin system can, on occasion, be associated with acute renal dysfunction or hyperkalemia. We need to know when risk of these complications exists so as to provide the best possible treatment: prevention. Given the growing number of diagnostic and therapeutic procedures in the field of cardiology that use intravenous contrast media, contrast-induced nephrotoxicity represents a significant problem. We should identify the risk factors and patients at greatest risk, and prevent it from appearing.

  18. Renal dysfunction in patients with cirrhosis: Where do we stand?

    Institute of Scientific and Technical Information of China (English)

    Chrysoula; Pipili; Evangelos; Cholongitas

    2014-01-01

    Patients with cirrhosis and renal failure are high-risk patients who can hardly be grouped to form precise instructions for diagnosis and treatment. When it comes to evaluate renal function in patients with cirrhosis,determination of acute kidney injury(AKI),chronic kidney disease(CKD) or AKI on CKD should be made. First it should be excluded the prerenal causes of AKI. All cirrhotic patients should undergo renal ultrasound for measurement of renal resistive index in every stage of liver dysfunction and urine microscopy for differentiation of all causes of AKI. If there is history of dehydration on the ground of normal renal ultrasound and urine microscopy the diuretics should be withdrawn and plasma volume expansion should be tried with albumin. If the patient does not respond,the correct diagnosis is HRS. In case there is recent use of nephrotoxic agents or contrast media and examination shows shock,granular cast in urinary sediment and proteinuria above 0.5 g daily,acute tubular necrosis is the prominent diagnosis. Renal biopsy should be performed when glomerular filtration rate is between 30-60 mL/min and there are signs of parenchymal renal disease. The acute renalfunction is preferable to be assessed with modified AKIN. Patients with AKIN stage 1 and serum creatinine ≥ 1.5 mg/dL should be at close surveillance. Management options include hemodynamic monitoring and management of fluid balance and infections,potentially driving to HRS. Terlipressin is the treatment of choice in case of established HRS,administered until there are signs of improvement,but not more than two weeks. Midodrine is the alternative for therapy continuation or when terlipressin is unavailable. Norepinephrine has shown similar effect with terlipressin in patients being in Intensive Care Unit,but with much lower cost than that of terlipressin. If the patient meets the requirements for transplantation,dialysis and transjugular intrahepatic portosystemic shunt are the bridging therapies

  19. Connecting heart failure with preserved ejection fraction and renal dysfunction : the role of endothelial dysfunction and inflammation

    NARCIS (Netherlands)

    ter Maaten, Jozine M.; Damman, Kevin; Verhaar, Marianne C.; Paulus, Walter J.; Duncker, Dirk J.; Cheng, Caroline; van Heerebeek, Loek; Hillege, Hans L.; Lam, Carolyn S. P.; Navis, Gerjan; Voors, Adriaan A.

    2016-01-01

    Renal dysfunction in heart failure with preserved ejection fraction (HFpEF) is common and is associated with increased mortality. Impaired renal function is also a risk factor for developing HFpEF. A new paradigm for HFpEF, proposing a sequence of events leading to myocardial remodelling and dysfunc

  20. Mild preoperative renal dysfunction as a predictor of longterm clinical outcome after coronary bypass surgery

    NARCIS (Netherlands)

    van de Wal, RMA; van Brussel, BL; Voors, AA; Smilde, TDJ; van Swieten, HA; van Gilst, WH; van Veldhuisen, DJ; Plokker, HWT

    2005-01-01

    Renal dysfunction is a prognostic marker in patients with cardiovascular disease. However, no long-term follow-up studies on the influence of mild renal dysfunction on mortality in patients undergoing coronary bypass grafting have been reported. Therefore, we aimed to identify the significance of pr

  1. Prognostic significance of cardiovascular biomarkers and renal dysfunction in outpatients with systolic heart failure

    DEFF Research Database (Denmark)

    Bosselmann, Helle; Egstrup, Michael; Rossing, Kasper

    2013-01-01

    To assess whether the prognostic significance of cardiovascular (CV) biomarkers, is affected by renal dysfunction (RD) in systolic heart failure (HF).......To assess whether the prognostic significance of cardiovascular (CV) biomarkers, is affected by renal dysfunction (RD) in systolic heart failure (HF)....

  2. [Risk factors for renal dysfunction in patients with hypothyroidism].

    Science.gov (United States)

    Didushko, O M

    2014-01-01

    SUMMARY In order to study the features of kidney function in patients with hypothyroidism, examined 84 patients with primary hypothyroidism. Of the patients 46 patients had postoperative hypothyroidism in 38--hypothyroidism is autoimmune thyroiditis in the background (AIT). According to our results, in patients with manifest hypothyroidism is present renal dysfunction, which is manifested by increased serum creatinine and a decrease in glomerular filtration rate (GFR),the development and progression of which contributes to the presence of risk factors in patients--hyperlipidemia, excessive body weight and abdominal obesity, which is a pronounced in patients with Hashimoto's thyroiditis. Stated that more meaningful indicators of dyslipidemia associated with major manifestations of abdominal obesity as defined by waist circumference (OT) ((96.58 ± 1.70) and (98.73 ± 3.35) cm) and higher body mass index (BMI).

  3. Chronic Renal Allograft Dysfunction Antibody-Mediated: An Update

    Directory of Open Access Journals (Sweden)

    Maurizio Salvadori,

    2014-07-01

    Full Text Available This paper reviews the most important studies on chronic antibody-mediated rejection (cABMR, which is an important cause of late graft dysfunction after renal transplantation. Several antibodies seem to be responsible for chronic rejection; new techniques have allowed us to identify these antibodies in circulation. The pathogenetic role of the antibodies generally includes the complement pathway, but may also be complement-independent. This paper also examines the pathogenesis of chronic endothelial lesions, as well as the histopathological aspects. Antibodies responsible for chronic rejection may preexist before transplantation or may develop after transplantation. The possible therapeutic approaches are poor and principally based on early identification and desensitisation techniques. New B cell targeting drugs are aimed at an improved control of the relevant condition.

  4. Catalase Deficiency Accelerates Diabetic Renal Injury Through Peroxisomal Dysfunction

    Science.gov (United States)

    Hwang, Inah; Lee, Jiyoun; Huh, Joo Young; Park, Jehyun; Lee, Hi Bahl; Ho, Ye-Shih; Ha, Hunjoo

    2012-01-01

    Mitochondrial reactive oxygen species (ROS) play an important role in diabetes complications, including diabetic nephropathy (DN). Plasma free fatty acids (FFAs) as well as glucose are increased in diabetes, and peroxisomes and mitochondria participate in FFA oxidation in an interconnected fashion. Therefore, we investigated whether deficiency of catalase, a major peroxisomal antioxidant, accelerates DN through peroxisomal dysfunction and abnormal renal FFA metabolism. Diabetes was induced by multiple injections of low-dose streptozotocin into catalase knock-out (CKO) and wild-type (WT) C57BL/6 mice. Murine mesangial cells (MMCs) transfected with catalase small interfering RNA followed by catalase overexpression were used to further elucidate the role of endogenous catalase. Despite equivalent hyperglycemia, parameters of DN, along with markers of oxidative stress, were more accelerated in diabetic CKO mice than in diabetic WT mice up to 10 weeks of diabetes. CKO mice and MMCs showed impaired peroxisomal/mitochondrial biogenesis and FFA oxidation. Catalase deficiency increased mitochondrial ROS and fibronectin expression in response to FFAs, which were effectively restored by catalase overexpression or N-acetylcysteine. These data provide unprecedented evidence that FFA-induced peroxisomal dysfunction exacerbates DN and that endogenous catalase plays an important role in protecting the kidney from diabetic stress through maintaining peroxisomal and mitochondrial fitness. PMID:22315314

  5. Doppler Ultrasound in Chronic Renal Allograft Dysfunction : Can Acute Rejection be Predicted

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Eun Kyung; Kim, Myeong Jin; Lee, Jong Tae; Yoo, Hyung Sik; Kim, Ki Whang; Park, Ki Ill; Chung, Hyun Joo [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    1995-12-15

    To investigate Doppler sonographic findings valuable for detecting acute rejection in transplanted kidney with chronic allograft dysfunction. Forty-three renal allografts who underwent renal Doppler sonography and renal biopsy due to chronic allograft dysfunction were included. According to histopathologic findings, patients were classified into 2 groups: chronic component only(group 1, n=30) and acute rejection with or without chronic component 2 groups were performed. No definite difference in radio of renal size, cortical echogenecity, corticomedullary differentiation was noted between group 1 and group 2.Resistive index was 0.61{+-}0.18 in group 1 and 0.64{+-}0.22 in group 2, which showed no statistically significant difference. Characteristic Doppler sonographic findings suggesting acute rejection in cases of chronic allograft dysfunction were not found inauther's study. Therefore, minimal invasive renal biopsy to determine histopathologic status of transplanted kidney is essential in evaluation of the chronic allograft dysfunction

  6. Association of renal failure with thyroid dysfunction: a retrospective cohort study.

    Science.gov (United States)

    Ahmed, Maimoona Mushtaq

    2014-09-01

    Chronic renal failure is often associated with multiple organ co-morbidities, including thyroid dysfunction. This has been associated with poorer prognosis, particularly in patients with end-stage renal disease. This study aimed to examine the relationship between renal failure and thyroid dysfunction in an outpatient setting at the King Abdulaziz University Hospital, Saudi Arabia, from January 2011 to June 2012. Demographic and biochemical data were extracted from medical records. Differences in the levels of thyroid hormones and lipids between the four renal function groups were analyzed using the chi-square test for categorical variables and Kruskal- Wallis test for binomial variables. A total of 486 patients were included in the study population, of whom approximately half were female, and the median (range) age was 61 (17-90) years. According to creatinine measurements, renal function was normal in 48 participants, 290 had mild renal failure, 122 had moderate renal failure and 26 had severe renal failure. No significant relationships were observed between renal failure and cardiac or pulmonary dysfunction. Free triiodothyronine (FT3) levels were significantly reduced (P = 0.005) and both free thyroxin (FT4; P = 0.034) and parathyroid hormone (PTH; P = 0.028) significantly increased with increasing severity of renal failure. Patients with moderate to severe renal failure displayed reduced hemoglobin levels and were significantly more likely to be anemic (P renal dysfunction. To conclude, it was observed that renal dysfunction is associated with notable changes to other organ systems, including the thyroid. Further studies may investigate the association of multiple organ co-morbidities with prognosis in patients with chronic renal failure.

  7. EPIDEMIOLOGY AND ETIOLOGICAL FACTORS OF ERECTILE DYSFUNCTION IN PATIENTS ON DIALYSIS AND AFTER RENAL TRANSPLANTATION

    Directory of Open Access Journals (Sweden)

    E. A. Efremov

    2011-01-01

    Full Text Available Today the problem of better life quality of patients with end stage renal disease and after renal transplantation and their sexual adaptation is considered to be more impotent. The clinical part of the investigation is the obser- vation of 205 patients – men with terminal stage renal disease. Erectile dysfunction is represented in 91,4% (64 of patients getting haemodialysis, 92,3% (24 of patients getting peritoneal dialysis, 61,5% (67 of patients after renal transplantation. According to International Index of Erectile Function the mean score of erectile function is 16,7 ± 5,2 in haemodialysis patients, 19,46 ± 3,6 in peritoneal dialysis patients, 21,9 ± 5,6 in patients after renal transplantation. The analysis revealed great prevalence of erectile dysfunction and interest in improvement among the patients with end stage renal disease and after renal transplantation. 

  8. Spironolactone ameliorates transplant vasculopathy in renal chronic transplant dysfunction in rats

    NARCIS (Netherlands)

    Waanders, Femke; Rienstra, Heleen; Boer, Mark Walther; Zandvoort, Andre; Rozing, Jan; Navis, Gerjan; van Goor, Harry; Hillebrands, Jan-Luuk

    2009-01-01

    Waanders F, Rienstra H, Walther Boer M, Zandvoort A, Rozing J, Navis G, van Goor H, Hillebrands JL. Spironolactone ameliorates transplant vasculopathy in renal chronic transplant dysfunction in rats. Am J Physiol Renal Physiol 296: F1072-F1079, 2009. First published February 25, 2009; doi:10.1152/aj

  9. Risk factors of the renal dysfunction formation in patients with ischemic chronic heart failure

    Directory of Open Access Journals (Sweden)

    V. D. Syvolap

    2015-02-01

    Full Text Available The aim was to study prevalence of some risk factors of the renal dysfunction. Methods and results. 344 patients with ischemic chronic heart failure were included. Clinical, medical history, laboratory and instrumental data were analyzed. It was established that renal dysfunction is accompanied by traditional (age, hyperlipidemia, hypertension, myocardial infarction, obesity, left ventricular hypertrophy and non-traditional risk factors (hyperuricemia, atrial fibrillation, left ventricular ejection fraction, left atrial volume index, cystatin C whose role increases with a decrease in glomerular filtration rate. Conclusion. This shows the close relationship between traditional and non-traditional risk factors that contribute to the development of cardio-renal complications.

  10. Prevalence of renal tubular dysfunction in beta thalassemia minor in shiraz

    Directory of Open Access Journals (Sweden)

    Ali Moradi Nakhodcheri

    2012-02-01

    Full Text Available  Background & objective: β-Thalassemia minor is an asymptomatic hereditary disease. The first study on the relation of renal tubular dysfunction and β-thalassemia minor was performed in 2002 but those studies seem inadequate.The main goal of this study is through evaluation of renal tubular function in 100 patients with thalassemia minor. Materials & Methods: 100 patients with β- thalassemia which confirmed by hemoglobin electrophoresis and CBC as well as RBC indices were studied.14 out of 100 cases exit because of Urinary Tract Infection, diabetes mellitus or hypertension.Complete chemistry profile was performed on serum and urine of all reminder 86 patients (46 female and 40 male. Patients classified into two groups: β-thalassemia minor with anemia and without anemia. Another control group include 50 healthy individuals also considered.Then data analyzed by proper statistical methods. Results: 20 out of 86 reminder cases e.g. 24% showed at least one index of renal tubular dysfunction.58% of patients was been anemic and 42% non anemic. The most prominent tubular dysfunction was seen in a 29 years old lady with glucosuria and without anemia. conclusion: β-Thalassemia minor is common in Iran specially in Fars province. This study revealed significant renal tubular dysfunction in patient with β-thalassemia minor. So it is necessary to check out thalassemic patients for renal function tests periodically. Key words: β-thalassemia, minor,renal tubular dysfunction

  11. Does renal function influence the prognostic impact of type 2 diabetes mellitus in patients with chronic heart failure and left ventricular dysfunction?

    Directory of Open Access Journals (Sweden)

    Giulia Russo

    2014-09-01

    Conclusions: In patients with CHF and reduced LVEF the prognostic impact of T2DM depends on the degree of renal dysfunction. Its contribution in all-cause mortality risk prediction is limited to mild–moderate renal dysfunction subgroup, while prognostic power is lost in normal renal function and in severe renal dysfunction patients.

  12. Relation between renal dysfunction and cardiovascular outcomes after myocardial infarction

    DEFF Research Database (Denmark)

    Anavekar, Nagesh S; McMurray, John J V; Velazquez, Eric J;

    2004-01-01

    BACKGROUND: The presence of coexisting conditions has a substantial effect on the outcome of acute myocardial infarction. Renal failure is associated with one of the highest risks, but the influence of milder degrees of renal impairment is less well defined. METHODS: As part of the Valsartan in A...

  13. Administration of tolvaptan with reduction of loop diuretics ameliorates congestion with improving renal dysfunction in patients with congestive heart failure and renal dysfunction.

    Science.gov (United States)

    Hanatani, Akihisa; Shibata, Atsushi; Kitada, Ryouko; Iwata, Shinichi; Matsumura, Yoshiki; Doi, Atsushi; Sugioka, Kenichi; Takagi, Masahiko; Yoshiyama, Minoru

    2017-03-01

    In patients with congestive heart failure and renal dysfunction, high dose of diuretics are necessary to improve congestion, which may progress to renal dysfunction. We examined the efficacy of tolvaptan with reduction of loop diuretics to improve renal function in patients with congestive heart failure and renal dysfunction. We conducted a multicenter, prospective, randomized study in 44 patients with congestive heart failure and renal dysfunction (serum creatinine concentration ≥1.1 mg/dl) treated with conventional diuretics. Patients were randomly divided into two groups: tolvaptan (15 mg) with a fixed dose of diuretics or with reducing to a half-dose of diuretics for 7-14 consecutive days. We examined the change of urine volume, body weight, serum creatinine and electrolyte concentrations in each group. Both groups demonstrated significant urine volume increase (724 ± 176 ml/day in the fixed-dose group and 736 ± 114 ml/day in the half-dose group) and body weight reduction (1.6 ± 1.5 kg and 1.6 ± 1.9 kg, respectively) from baseline, with no differences between the two groups. Serum creatinine concentration was significantly increased in the fixed-dose group (from 1.60 ± 0.47 to 1.74 ± 0.66 mg/dl, p = 0.03) and decreased in the half-dose group (from 1.98 ± 0.91 to 1.91 ± 0.97 mg/dl, p = 0.10). So the mean changes in serum creatinine concentration from baseline significantly differed between the two groups (0.14 ± 0.08 mg/dl in the fixed-dose group and -0.07 ± 0.19 mg/dl in the half-dose group, p = 0.006). The administration of tolvaptan with reduction of loop diuretics was clinically effective to ameliorate congestion with improving renal function in patients with congestive heart failure and renal dysfunction.

  14. Clinical observation of calcium dobesilate in the treatment of chronic renal allograft dysfunction

    Institute of Scientific and Technical Information of China (English)

    Zheng Xue-yang; Han Shu; Zhou Mei-sheng; Fu Shang-xi; Wang Li-ming

    2014-01-01

    Abstract BACKGROUND: Calcium dobesilate (calcium dihydroxy-2, 5-benzenesulfonate) has been widely used to treat chronic venous insufficiency and diabetic retinopathy, especialy many clinical studies showed that calcium dobesilate as vasoprotective compound ameliorates renal lesions in diabetic nephropathy. However, there are few literatures reported calcium dobesilate in the treatment of chronic renal alograft dysfunction after renal transplantation. OBJECTIVE:To observe the efficacy and safety of calcium dobesilate on chronic renal dysfunction after renal transplantation. METHODS:A total of 152 patients with chronic renal alograft dysfunction after renal transplantation were enroled from the Military Institute of Organ Transplantation, Changzheng Hospital, Second Military Medical University of Chinese PLA. They were randomly divided into the treatment group (n=78) and the control group (n=74). Patients in the treatment group received 500 mg of calcium dobesilate three times daily for eight weeks. Al patients were treated with calcineurin inhibitor-based triple immunosuppressive protocols and comprehensive therapies. RESULTS AND CONCLUSION: For patients receiving calcium dobesilate, serum creatinine, blood urea nitrogen and uric acid decreased significantly at two weeks after treatment and maintained a stable level (P 0.05). Administration of calcium dobesilate did not change the general condition of patients with renal insufficiency, nor did it affect blood concentrations of the immunosuppressive agents. Calcium dobesilate may help to delay the progress of graft injury in patients with chronic renal graft dysfunction by conjugating with creatinine, ameliorating the impaired microcirculation and its antioxidant property. The decline in serum creatinine aleviates patients’ anxiety and concern arising from the elevation of creatinine. However, the negative interference with serum creatinine caused by calcium dobesilate should be cautious in order to avoid

  15. Modulation of experimental renal dysfunction of hereditary fructose intolerance by circulating parathyroid hormone.

    Science.gov (United States)

    Morris, R C; McSherry, E; Sebastian, A

    1971-01-01

    In a woman with hereditary fructose intolerance and intact parathyroid function, the experimental administration of fructose at different dosage schedules invariably induced the dose-dependent, complex dysfunction of the proximal renal tubule now recognized as characteristic. But in a woman with hereditary fructose intolerance and hypoparathyroidism given similar amounts of fructose, the experimental dysfunction was strikingly attenuated or nondemonstrable unless or until fructose and parathyroid hormone were administered in sustained combination. Thereupon, a renal dysfunction of characteristic type and severity occurred invariably and almost immediately. Thus, the concentration of circulating parathyroid hormone can modulate the functional expression of the experimental renal disorder. This effect of parathyroid hormone, which appears to involve more than simple physiologic summation, may have important clinical implications.

  16. Deep Cerebral Microbleeds and Renal Dysfunction in Patients with Acute Lacunar Infarcts.

    Science.gov (United States)

    Saji, Naoki; Kimura, Kazumi; Yagita, Yoshiki; Uemura, Junichi; Aoki, Junya; Sato, Takahiro; Sakurai, Takashi

    2015-11-01

    Cerebral small-vessel disease (SVD) is associated with renal dysfunction such as chronic kidney disease. Although cerebral microbleeds (CMBs) are common in patients with acute lacunar infarcts (ALI), the association between renal dysfunction and CMBs in such patients remains unclear. Between April 2007 and March 2013, we evaluated consecutive first-ever ALI patients, who were admitted to our hospital within 24 hours of stroke onset. CMBs were defined as focal areas of signal loss in brain parenchyma less than 5 mm on T2(∗)-weighted gradient-echo imaging. Renal dysfunction was defined as an estimated glomerular filtration rate less than 60 mL/minute/1.73 m(2) on admission. Correlations between renal dysfunction and the presence (model 1) and location of CMBs (model 2; any deep or infratentorial CMBs) were determined by multivariable logistic regression analyses. Among 152 patients (33.6% men; mean age, 67.6 years), 53 had CMBs. Patients with CMBs were older (69.9 versus 66.3 years, P = .03) and had a higher frequency of white matter hyperintensity (WMH; 62.3% versus 25.3%, P CMBs. On multivariable analyses, renal dysfunction (odds ratio, 95% confidence interval; model 1: 2.38, 1.02-5.66; model 2: 2.78, 1.16-6.81), WMH (3.87, 1.76-8.80; 3.72, 1.64-8.71), SLI (3.85, 1.71-9.14; 4.20, 1.77-10.8), and diabetes mellitus (.26, .09-.63; .24, .08-.63) were independently associated with CMBs. In patients with ALI, renal dysfunction was positively associated with CMBs independent of cerebral SVD. Copyright © 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  17. Progressive subretinal fibrosis in patients with rheumatoid arthritis and renal dysfunction.

    Science.gov (United States)

    Matsuo, T; Matsuo, N

    1998-01-01

    We present two patients (56-year-old and 71-year-old women) who developed subretinal fibrosis in parallel with exacerbation of rheumatoid arthritis and deteriorated renal function. The first patient developed subretinal fibrosis in the right eye, coupled with multifocal choroiditis and serous retinal detachment in both eyes, in the course of rapidly progressive glomerulonephritis complicated with rheumatoid arthritis. Antineutrophil cytoplasmic antibody was positive in a perinuclear pattern (pANCA) and the increased dose of prednisolone to 40 mg/day resulted in subsidence of the subretinal inflammation. The second patient developed subretinal fibrosis in the left eye with mottled retinal pigment epithelium of both eyes, in the course of rheumatoid arthritis and stable chronic renal failure. Although the manifestations of subretinal fibrosis and concurrent renal dysfunction were different between these two patients, subretinal fibrosis might be noted as a complication of rheumatoid arthritis and renal dysfunction.

  18. [Renal dysfunction in heart failure and hypervolumenia : Importance of congestion and backward failure].

    Science.gov (United States)

    Druml, W

    2014-05-01

    Traditionally, renal dysfunction in congestive heart failure (cardiorenal syndrome type 1) has been attributed to reduced cardiac output and low mean arterial perfusion pressure, which elicit a series of neurohumoral activations resulting in increased renal vascular resistance and decreased renal function.During the last decade, several studies have shown that the extent of renal dysfunction is not so closely associated with indices of forward failure-such as the cardiac index or mean arterial pressure-but rather with indicators of congestion, such as left ventricular enddiasystolic pressure or central venous pressure (CVP), which are indicators of backward failure. The impact of backward failure on renal function is not confined to an elevation of CVP, the renal drainage pressure, but includes a broad spectrum of mechanisms. Involved are the organ systems right heart, lung, the liver, the proinflammatory signals originating from the intestines, but also renal interstitial edema (renal compartment syndrome) and the intraabdominal pressure.The therapeutic measures must focus on the modulation of the preload adapted to the specific situation of an individual patient. This includes diuretics aiming at different segments of the tubulus system including antagonists of aldosteron and ADH, extracorporeal fluid elimination by ultrafiltration or peritoneal dialysis.

  19. Mechanisms by which heme oxygenase rescue renal dysfunction in obesity

    Directory of Open Access Journals (Sweden)

    Joseph Fomusi Ndisang

    2014-01-01

    Collectively, these data suggest that hemin ameliorates nephropathy by potentiating the expression of proteins of repair/regeneration, abating oxidative/inflammatory mediators, reducing renal histo-pathological lesions, while enhancing nephrin, podocin, podocalyxin, CD2AP and creatinine clearance, with corresponding reduction of albuminuria/proteinuria suggesting improved renal function in hemin-treated ZFs. Importantly, the concomitant potentiation regeneration proteins and podocyte cytoskeletal proteins are novel mechanisms by which hemin rescue nephropathy in obesity.

  20. Early predictors of renal dysfunction in patients with chronic heart failure

    Directory of Open Access Journals (Sweden)

    Umida Kamilova

    2013-04-01

    Full Text Available Study was aimed at an early detection of subclinical disorders in renal function in patients with chronic heart failure (CHF. Fifty-two patients with ischemic heart disease (IHD with post-infarction cardiosclerosis were examined. All the patients were underwent complex clinical examination, a level of serum creatinine, residual nitrogen and urine enzymes. Determination of urine enzymes level in CHF patients may be considered as diagnostic approach for an early diagnosis of renal dysfunction.

  1. Renal dysfunction indicative of outcomes in hospitalized patients with takotsubo syndrome.

    Science.gov (United States)

    Ando, Kaoru; Sukekawa, Hiroyasu; Takahata, Aoi; Kobari, Yusuke; Tsuchiya, Hayato; Ishigaki, Daisuke; Tamabuchi, Toshiaki; Koyama, Yo

    2017-06-01

    Left ventricular dysfunction as part of takotsubo syndrome is reversible, and the long-term prognosis appears favorable. However, life-threatening complications are not uncommon during the acute phase, and it remains unclear whether renal dysfunction is a factor in complications suffered by hospitalized patients with takotsubo syndrome. The present study was conducted to investigate the implications of renal dysfunction in this setting. Data from 61 consecutive patients (male, 21; female, 40) diagnosed with takotsubo syndrome at our hospital between years 2010 and 2016 were evaluated retrospectively. In-hospital complications by definition were all-cause deaths and severe pump failure (Killip class ≥III). Overall, 30 patients (49%) developed renal dysfunction. In the 32 patients (52%) who suffered in-hospital complications (mortality, 10; severe pump failure, 22), estimated glomerular filtration rate (eGFR) was significantly lower by comparison (51.3±29.8 vs. 69.5±29.0; p=0.019). Low eGFR (60 ml/min per 1.73m(2)). Renal dysfunction is a simple but useful means of predicting complications in hospitalized patients with takotsubo syndrome, especially those with chronic kidney disease.

  2. Renal graft biopsy assists diagnosis and treatment of renal allograft dysfunction after kidney transplantation: a report of 106 cases.

    Science.gov (United States)

    Han, Yong; Guo, Hui; Cai, Ming; Xiao, Li; Wang, Qiang; Xu, Xiaoguang; Huang, Haiyan; Shi, Bingyi

    2015-01-01

    Acute antibody mediated rejection (AMR) is one of the most important complications after kidney transplantation. Renal graft biopsy is safe and reliable without adverse effects on the patients and transplanted kidneys, which was of great instructive significance in diagnosis and treatment of renal allograft dysfunction after renal transplantation. This paper reported a case series of 106 patients underwent renal allograft biopsies. All biopsies were evaluated according to the Banff 2007 schema. 52 examples were obtained within 1 month after transplantation, and there were another 20 examples in one to two months and other 34 examples in two to three months. Appropriate therapy was applied and clinical outcomes were observed. All patients received renal biopsies and anti-inflammatory and hemostasis treatment without complications. There were 2 cases of hyperacute rejection, and 15 cases of acute AMR. All Paraffin-embedded samples were stained by HE, periodic acid-Schiff (PAS), Masson, and immunohistochemistry (C4d, cd20, cd45RO, SV40). All samples were found C4d immunohistochemical staining positive. Patients with acute AMR were managed by steroid intravenous pulse therapy, Rabbit anti-thymocyte globulin intravenous pulse therapy, anti CD20 monoclonal antibody intravenous therapy and so on. Two cases of hyperacute rejection had renal failure, and received kidney excision; 12 cases in 15 cases of AMR recovered, another 2 cases did not recover with high-level creatine, and other 2 cases of renal allograft received excision.

  3. Evidence of Uncoupling between Renal Dysfunction and Injury in Cardiorenal Syndrome: Insights from the BIONICS Study

    Science.gov (United States)

    Legrand, Matthieu; De Berardinis, Benedetta; Gaggin, Hanna K.; Magrini, Laura; Belcher, Arianna; Zancla, Benedetta; Femia, Alexandra; Simon, Mandy; Motiwala, Shweta; Sambhare, Rasika; Di Somma, Salvatore; Mebazaa, Alexandre; Vaidya, Vishal S.; Januzzi, James L.; (GREAT), from the Global Research on Acute Conditions Team

    2014-01-01

    Objective The objective of the study was to assess urinary biomarkers of renal injury for their individual or collective ability to predict Worsening renal function (WRF) in patients with acutely decompensated heart failure (ADHF). Methods In a prospective, blinded international study, 87 emergency department (ED) patients with ADHF were evaluated with biomarkers of cardiac stretch (B type natriuretic peptide [BNP] and its amino terminal equivalent [NT-proBNP], ST2), biomarkers of renal function (creatinine, estimated glomerular filtration rate [eGFR]) and biomarkers of renal injury (plasma neutrophil gelatinase associated lipocalin [pNGAL], urine kidney injury molecule-1 [KIM-1], urine N-acetyl-beta-D-glucosaminidase [NAG], urine Cystatin C, urine fibrinogen). The primary endpoint was WRF. Results 26% developed WRF; baseline characteristics of subjects who developed WRF were generally comparable to those who did not. Biomarkers of renal function and urine biomarkers of renal injury were not correlated, while urine biomarkers of renal injury correlated between each other. Biomarker concentrations were similar between patients with and without WRF except for baseline BNP. Although plasma NGAL was associated with the combined endpoint, none of the biomarker showed predictive accuracy for WRF. Conclusions In ED patients with ADHF, urine biomarkers of renal injury did not predict WRF. Our data suggest that a weak association exists between renal dysfunction and renal injury in this setting (Clinicaltrials.gov NCT#0150153). PMID:25386851

  4. Evidence of uncoupling between renal dysfunction and injury in cardiorenal syndrome: insights from the BIONICS study.

    Directory of Open Access Journals (Sweden)

    Matthieu Legrand

    Full Text Available The objective of the study was to assess urinary biomarkers of renal injury for their individual or collective ability to predict Worsening renal function (WRF in patients with acutely decompensated heart failure (ADHF.In a prospective, blinded international study, 87 emergency department (ED patients with ADHF were evaluated with biomarkers of cardiac stretch (B type natriuretic peptide [BNP] and its amino terminal equivalent [NT-proBNP], ST2, biomarkers of renal function (creatinine, estimated glomerular filtration rate [eGFR] and biomarkers of renal injury (plasma neutrophil gelatinase associated lipocalin [pNGAL], urine kidney injury molecule-1 [KIM-1], urine N-acetyl-beta-D-glucosaminidase [NAG], urine Cystatin C, urine fibrinogen. The primary endpoint was WRF.26% developed WRF; baseline characteristics of subjects who developed WRF were generally comparable to those who did not. Biomarkers of renal function and urine biomarkers of renal injury were not correlated, while urine biomarkers of renal injury correlated between each other. Biomarker concentrations were similar between patients with and without WRF except for baseline BNP. Although plasma NGAL was associated with the combined endpoint, none of the biomarker showed predictive accuracy for WRF.In ED patients with ADHF, urine biomarkers of renal injury did not predict WRF. Our data suggest that a weak association exists between renal dysfunction and renal injury in this setting (Clinicaltrials.gov NCT#0150153.

  5. The effect of preoperative renal dysfunction with or without dialysis on early postoperative outcome following cardiac surgery.

    LENUS (Irish Health Repository)

    Al-Sarraf, Nael

    2011-01-01

    Although previous studies have shown increased mortality in renal dysfunction patients undergoing cardiac surgery, there is lack of data on the pattern of postoperative complications that occur in such patients and their distribution among dialysis and non-dialysis dependent renal dysfunction.

  6. Association between the glomerular filtration rate of renal dysfunction and metabolic syndrome: an age-stratified analysis

    Institute of Scientific and Technical Information of China (English)

    宋慧

    2014-01-01

    Objective To explore the relationship between the renal dysfunction rate and metabolic syndrome(MS),stratified by age.Methods People took part in physical check-up in a certain tertiary hospital from March 2010to September 2012,were enrolled in this study.Estimated glomerular filtration rate(e GFR),—a renal dysfunction indicator,was calculated by modified MDRD

  7. Effect of renal revascularization on the development of renal dysfunction in atherosclerotic ischemic nephropathy

    OpenAIRE

    Rodrigo Hagemann; Vanessa dos Santos Silva; Roberto Jorge da Silva Franco; Pasqual Barretti; Luis Cuadrado Martin

    2014-01-01

    Chronic kidney disease (CKD) is characterized by a progressive loss of renal function and its main causes are hypertension and diabetes mellitus. Among the causes of hypertension is atherosclerotic renal disease (ARD). The development of CKD in patients with ARD appears to be due not only to the involvement of the main renal arteries, but also of the renal microcirculation, which may explain the fact that the success of the procedure does not guarantee an improvement in the progression of CKD...

  8. The treatment strategies of breast cancer in patients with renal dysfunction

    Institute of Scientific and Technical Information of China (English)

    Meng Du; Hengyan Qu; Yue Wang; Shikai Wu; Zefei Jiang

    2010-01-01

    Objective:The aim of this study was to investigate renal insufficiency in patients with chemotherapy.Methods:Prescribing chemotherapy in a regular hemodialysis patient with renal failure,and monitoring of serum drug concentrations to determine its safety and effectiveness.Results:Chemotherapy assessment efficiency:SD(better),hemodialysis did not affect THP treatment,their safety was guaranteed.Conclusion:The chemotherapy of renal dysfunction is not an absolute contraindication to fully assess the patient's adverse effects and tolerability,the reasonable arrangements for hemodialysis and the timing of administration can be safe and effective chemotherapy.

  9. A systematic review on renal and bladder dysfunction after endoscopic treatment of infravesical obstruction in boys.

    Directory of Open Access Journals (Sweden)

    Pauline M L Hennus

    Full Text Available BACKGROUND: Posterior urethral valves (PUV may cause subtle to severe obstruction of the urethra, resulting in a broad clinical spectrum. PUV are the most common cause of chronic renal disease in boys. Our purpose was to report the incidences of kidney and bladder dysfunction in boys treated with endoscopic valve resection for PUV. METHODOLOGY: We searched MEDLINE and EMBASE databases until 1st of July 2011, to identify original papers that described outcome of endoscopic valve resection (EVR in boys. We extracted information on (1 patient characteristics and clinical presentation of PUV related to outcomes and (2 the post-treatment absolute risks for kidney and bladder dysfunction. PRINCIPAL FINDINGS: Thirty-four studies describing renal function, vesicoureteral reflux (VUR, incontinence, and urodynamic bladder function after EVR in 1474 patients were retrieved. Patients treated for PUV show high percentages of chronic kidney disease (CKD or end stage renal disease (ESRD, 22% (0-32% and 11% (0-20%, respectively. Elevated nadir serum creatinine was the only independent factor associated with renal failure. Before treatment, VUR was present in 43% of boys and after EVR, VUR was present in 22%. Post treatment, 19% (0-70% was reported to suffer from urinary incontinence. Urodynamic bladder dysfunction was seen in many patients (55%, 0-72% after treatment of PUV. CONCLUSIONS: The reported cumulative incidence of renal and bladder dysfunction in patients with PUV after endoscopic PUV treatment varies widely. This may reflect a broad clinical spectrum, which relates to the lack of a standardised quantification of obstruction and its severity. Moreover, the risk of bias is rather high, and therefore we put little confidence in the reported estimates of effect. We found elevated nadir serum creatinine as a predictor for renal dysfunction. In order to be able to predict outcomes for patients with PUV, an objective classification of severity of

  10. Assessment of renal dysfunction using urinary markers in canine babesiosis caused by Babesia rossi.

    Science.gov (United States)

    Defauw, P; Schoeman, J P; Smets, P; Goddard, A; Meyer, E; Liebenberg, C; Daminet, S

    2012-12-21

    Renal damage is deemed a common, yet poorly documented, complication in canine babesiosis. Serum urea and creatinine are insensitive and non-specific markers of early renal dysfunction and their measurements are influenced by hemolysis caused by babesiosis. Therefore, the aim of this study was to use urinary markers to assess the localization and degree of renal dysfunction in dogs with Babesia rossi infection. Urinary immunoglobulin G (uIgG) and urinary C-reactive protein (uCRP) were measured as markers for glomerular dysfunction, while urinary retinol-binding protein (uRBP) was used as a marker for tubular dysfunction. Eighteen dogs presenting with uncomplicated babesiosis were included and compared with eight clinically healthy dogs. Previously validated commercial ELISA kits were used for the measurement of uIgG, uCRP, and uRBP. Results were related to urinary creatinine concentrations (c). Dogs with babesiosis had significantly higher concentrations of all three measured urinary markers compared to healthy dogs. Except for urinary protein/c ratio (UPC), routine urinary and serum markers for renal function (urine specific gravity (USG), serum urea and creatinine (sCr)) were not significantly different between dogs with babesiosis and healthy dogs. All three urinary markers were positively correlated with each other and with UPC. The data supports the presence of both glomerular and tubular dysfunction in dogs suffering from uncomplicated B. rossi infection. Urinary markers were superior to USG, serum urea and creatinine concentrations for the early detection of renal dysfunction in dogs with babesiosis.

  11. Sida rhomboidea.Roxb leaf extract ameliorates gentamicin induced nephrotoxicity and renal dysfunction in rats.

    Science.gov (United States)

    Thounaojam, Menaka C; Jadeja, Ravirajsinh N; Devkar, Ranjitsinh V; Ramachandran, A V

    2010-10-28

    Sida rhomboidea.Roxb (SR) known as "Mahabala" in Ayurveda and marketed as "Shahadeyi" is used in ethnomedicine to treat ailments such as dysuria and urinary disorders. To evaluate nephroprotective potential of SR against gentamicin (GM) induced nephrotoxicity and renal dysfunction. Nephrotoxicity was induced in rats with GM (100 mg/kg bodyweight (i.p.) for 8 days) and were treated with SR extract (200 and 400 mg/kg bodyweight (p.o.) for 8 days) or 0.5% carboxymethyl cellulose (vehicle). Plasma and urine urea and creatinine, renal enzymatic and non-enzymatic antioxidants along with lipid peroxidation were evaluated in various experimental groups. GM treatment induced significant elevation (p<0.05) in plasma and urine urea, creatinine, renal lipid peroxidation along with significant decrement (p<0.05) in renal enzymatic and non-enzymatic antioxidants. SR treatment to GM treated rats (GM+SR) recorded significant decrement (p<0.05) in plasma and urine urea and creatinine, renal lipid peroxidation along with significant increment (p<0.05) in renal enzymatic and non-enzymatic antioxidants. SR leaf extract ameliorates GM induced nephrotoxicity and renal dysfunction and thus validates its ethnomedicinal use. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  12. Visceral leishmaniasis in a kidney transplant recipient: parasitic interstitial nephritis, a cause of renal dysfunction.

    Science.gov (United States)

    Dettwiler, S; McKee, T; Hadaya, K; Chappuis, F; van Delden, C; Moll, S

    2010-06-01

    Visceral leishmaniasis (VL) due to Leishmania infantum is an endemic parasitic infection in the Mediterranean area. It most commonly affects immunosuppressed individuals, especially HIV patients and less frequently organ transplant recipients. Renal involvement seems to be frequent and is mostly associated with tubulointerstitial nephritis, as described in autopsy reports. In the 61 cases of renal transplant recipients with VL reported in the literature, renal dysfunction was noted at clinical presentation and was more frequently observed as a complication of antiparasitic therapy. However, no pathological analysis of the allograft lesions was reported. We present the case of a Swiss renal transplant recipient who developed VL after vacations in Spain and Tunisia, complicated by acute parasitic nephritis in the renal allograft 3 months after a well-conducted treatment of liposomal amphotericin B.

  13. Transplant graft vasculopathy: an emerging target for prevention and treatment of renal allograft dysfunction.

    Science.gov (United States)

    Kang, Duk-Hee; Kang, Shin-Wook; Jeong, Hyeon Joo; Kim, Yu Seun; Yang, Chul Woo; Johnson, Richard J

    2004-12-31

    Maintenance of healthy endothelium is essential to vascular homeostasis, and preservation of endothelial cell function is critical for transplant allograft function. Damage of microvascular endothelial cells is now regarded as a characteristic feature of acute vascular rejection and chronic allograft nephropathy, which is an important predictor of graft loss and is often associated with transplant vasculopathy. In this review, we will discuss the role of microvascular endothelium, in renal allograft dysfunction, particularly as it relates to markers of endothelial dysfunction and endothelial repair mechanisms. We also discuss the potential for therapies targeting endothelial dysfunction and transplant graft vasculopathy.

  14. Renal dysfunction, restrictive left ventricular filling pattern and mortality risk in patients admitted with heart failure

    DEFF Research Database (Denmark)

    Schou, Morten; Kjaergaard, Jesper; Torp-Pedersen, Christian

    2013-01-01

    Renal dysfunction is associated with a variety of cardiac alterations including left ventricular (LV) hypertrophy, LV dilation, and reduction in systolic and diastolic function. It is common and associated with an increased mortality risk in heart failure (HF) patients. This study was designed to...

  15. The impact of renal dysfunction on outcomes in the ExTRACT-TIMI 25 trial.

    NARCIS (Netherlands)

    Fox, K.A.; Antman, E.M.; Montalescot, G.; Agewall, S.; SomaRaju, B.; Verheugt, F.W.A.; Lopez-Sendon, J.; Hod, H.; Murphy, S.A.; Braunwald, E.

    2007-01-01

    OBJECTIVES: The ExTRACT-TIMI 25 (Enoxaparin and Thrombolysis Reperfusion for Acute Myocardial Infarction Treatment-Thrombolysis In Myocardial Infarction 25) trial provided the opportunity to evaluate the impact of renal dysfunction on outcomes in patients with ST-segment elevation myocardial infarct

  16. A Combined-Biomarker Approach to Clinical Phenotyping Renal Dysfunction in Heart Failure

    NARCIS (Netherlands)

    Testani, Jeffrey M.; Damman, Kevin; Brisco, Meredith A.; Chen, Susan; Laur, Olga; Kula, Alexander J.; Tang, W. H. Wilson; Parikh, Chirag

    2014-01-01

    Background: Differentiating heart failure (HF) induced renal dysfunction (RD) from intrinsic kidney disease is challenging. It has been demonstrated that biomarkers such as B-type natriuretic peptide (BNP) or the blood urea nitrogen to creatinine ratio (BUN/creat) can identify high- vs low-risk RD.

  17. Is there a risk of permanent renal dysfunction after primary total hip and knee joint replacements?

    DEFF Research Database (Denmark)

    Hassan, Basim Kamil; Dessau, Ram Benny; Sahlström, Arne

    2016-01-01

    primary total hip and knee joint replacements. METHODS: Long-term postoperative renal dysfunction was analyzed in a retrospective study of 1301 consecutive primary total hip and knee joint replacements performed between January 2009 and December 2013. According to the RIFLE criteria, increased serum...

  18. Influence of renal dysfunction on clinical outcomes in patients with congestive heart failure complicating acute myocardial infarction.

    Science.gov (United States)

    Kim, Chang Seong; Kim, Min Jee; Kang, Yong Un; Choi, Joon Seok; Bae, Eun Hui; Ma, Seong Kwon; Ahn, Young-Keun; Jeong, Myung Ho; Kim, Young Jo; Cho, Myeong Chan; Kim, Chong Jin; Kim, Soo Wan

    2013-01-01

    The clinical course and medical treatment of patients with congestive heart failure (CHF) complicating acute myocardial infarction (AMI) are not well established, especially in patients with concomitant renal dysfunction. We performed a retrospective analysis of the prospective Korean Acute Myocardial Infarction Registry to assess the medical treatments and clinical outcomes of patients with CHF (Killip classes II or III) complicated by AMI, in the presence or absence of renal dysfunction. Of 13,498 patients with AMI, 2769 (20.5%) had CHF on admission. Compared to CHF patients with preserved renal function, in-hospital mortality and major adverse cardiac events were increased both at 1 month and at 1 year after discharge in patients with renal dysfunction (1154; 41.7%). Postdischarge use of aspirin, betablockers, calcium channel blockers, angiotensin-converting enzyme inhibitors, or angiotensin II receptor blockers and statins significantly reduced the 1-year mortality rate for CHF patients with renal dysfunction; such reduction was not observed for those without renal dysfunction, except in the case of aspirin. Patients with CHF complicating AMI, which is accompanied by renal dysfunction, are at higher risk for adverse cardiovascular outcomes than patients without renal dysfunction. However, they receive fewer medications proven to reduce mortality rates.

  19. Renal Dysfunction after Off-Pump Coronary Artery Bypass Surgery- Risk Factors and Preventive Strategies

    Directory of Open Access Journals (Sweden)

    Gaurab Maitra

    2009-01-01

    Full Text Available Postoperative renal dysfunction is a relatively common and one of the serious complications of cardiac surgery. Though off-pump coronary artery bypass surgery technique avoids cardiopulmonary bypass circuit induced adverse effects on renal function, multiple other factors cause postoperative renal dysfunction in these groups of patients. Acute kidney injury is generally defined as an abrupt and sustained decrease in kidney function. There is no consen-sus on the amount of dysfunction that defines acute kidney injury, with more than 30 definitions in use in the literature today. Although serum creatinine is widely used as a marker for changes in glomerular filtration rate, the criteria used to define renal dysfunction and acute renal failure is highly variable. The variety of definitions used in clinical studies may be partly responsible for the large variations in the reported incidence. Indeed, the lack of a uniform definition for acute kidney injury is believed to be a major impediment to research in the field. To establish a uniform definition for acute kidney injury, the Acute Dialysis Quality Initiative formulated the Risk, Injury, Failure, Loss, and End-stage Kidney (RIFLE classification. RIFLE , defines three grades of increasing severity of acute kidney injury -risk (class R, injury (class I and failure (class F - and two outcome classes (loss and end-stage kidney disease. Various perioperative risk factors for postoperative renal dysfunction and failure have been identified. Among the important preoperative factors are advanced age, reduced left ventricular function, emergency surgery, preoperative use of intraaortic balloon pump, elevated preoperative serum glucose and creatinine. Most important intraoperative risk factor is the intraoperative haemodynamic instability and all the causes of postoperative low output syndrome com-prise the postoperative risk factors. The most important preventive strategies are the identification of the

  20. Associations of Macro- and Microvascular Endothelial Dysfunction With Subclinical Ventricular Dysfunction in End-Stage Renal Disease.

    Science.gov (United States)

    Dubin, Ruth F; Guajardo, Isabella; Ayer, Amrita; Mills, Claire; Donovan, Catherine; Beussink, Lauren; Scherzer, Rebecca; Ganz, Peter; Shah, Sanjiv J

    2016-10-01

    Patients with end-stage renal disease (ESRD) suffer high rates of heart failure and cardiovascular mortality, and we lack a thorough understanding of what, if any, modifiable factors contribute to cardiac dysfunction in these high-risk patients. To evaluate endothelial function as a potentially modifiable cause of cardiac dysfunction in ESRD, we investigated cross-sectional associations of macro- and microvascular dysfunction with left and right ventricular dysfunction in a well-controlled ESRD cohort. We performed comprehensive echocardiography, including tissue Doppler imaging and speckle-tracking echocardiography of the left and right ventricle, in 149 ESRD patients enrolled in an ongoing prospective, observational study. Of these participants, 123 also underwent endothelium-dependent flow-mediated dilation of the brachial artery (macrovascular function). Microvascular function was measured as the velocity time integral of hyperemic blood flow after cuff deflation. Impaired flow-mediated dilation was associated with higher left ventricular mass, independently of age and blood pressure: per 2-fold lower flow-mediated dilation, left ventricular mass was 4.1% higher (95% confidence interval, 0.49-7.7; P=0.03). After adjustment for demographics, blood pressure, comorbidities, and medications, a 2-fold lower velocity time integral was associated with 9.5% higher E/e' ratio (95% confidence interval, 1.0-16; P=0.03) and 6.7% lower absolute right ventricular longitudinal strain (95% confidence interval, 2.0-12; P=0.003). Endothelial dysfunction is a major correlate of cardiac dysfunction in ESRD, particularly diastolic and right ventricular dysfunction, in patients whose volume status is well controlled. Future investigations are needed to determine whether therapies targeting the vascular endothelium could improve cardiac outcomes in ESRD.

  1. A case of primary renal allograft dysfunction due to myeloma cast nephropathy

    Directory of Open Access Journals (Sweden)

    Umesh Lingaraj

    2015-01-01

    Full Text Available We report a rare case of primary renal allograft dysfunction due to myeloma cast nephropathy in a patient with no overt clinical features of multiple myeloma preceding his transplantation. A 45-year-old man on hemodialysis for six months for end-stage kidney disease due to presumed chronic glomerulonephritis developed immediate graft dysfunction post-transplantation. The graft biopsy was diagnostic of myeloma cast nephropathy. Other criteria for lambda light chain multiple myeloma were fulfilled with immunofixation electrophoresis and bone marrow biopsy. He was treated with plasmapheresis, bortezomib and high-dose dexamethasone. However, the patient succumbed to septicemia on the 37 th post-operative day. This is probably the first report of primary renal allograft dysfunction due to myeloma cast nephropathy diagnosed within the first week posttransplanation in a patient with unrecognized multiple myeloma.

  2. A case of primary renal allograft dysfunction due to myeloma cast nephropathy.

    Science.gov (United States)

    Lingaraj, Umesh; Vankalakunti, Mahesha; Radhakrishnan, Hemachandar; Sreedhara, C G; Rajanna, Sunil

    2015-09-01

    We report a rare case of primary renal allograft dysfunction due to myeloma cast nephropathy in a patient with no overt clinical features of multiple myeloma preceding his transplantation. A 45-year-old man on hemodialysis for six months for end-stage kidney disease due to presumed chronic glomerulonephritis developed immediate graft dysfunction post-transplantation. The graft biopsy was diagnostic of myeloma cast nephropathy. Other criteria for lambda light chain multiple myeloma were fulfilled with immunofixation electrophoresis and bone marrow biopsy. He was treated with plasmapheresis, bortezomib and high-dose dexamethasone. However, the patient succumbed to septicemia on the 37 th post-operative day. This is probably the first report of primary renal allograft dysfunction due to myeloma cast nephropathy diagnosed within the first week post-transplanation in a patient with unrecognized multiple myeloma.

  3. Management of renal dysfunction following term perinatal hypoxia-ischaemia.

    LENUS (Irish Health Repository)

    Sweetman, Deirdre U

    2013-03-01

    Acute kidney injury frequently develops following the term perinatal hypoxia-ischaemia. Quantifying the degree of acute kidney injury is difficult, however, as the methods currently in use are suboptimal. Acute kidney injury management is largely supportive with little evidence basis for many interventions. This review discusses management strategies and novel biomarkers that may improve diagnosis and management of renal injury following perinatal hypoxia-ischaemia.

  4. Phosphodiesterase 5 inhibition ameliorates angiotensin II-dependent hypertension and renal vascular dysfunction.

    Science.gov (United States)

    Thieme, Manuel; Sivritas, Sema H; Mergia, Evanthia; Potthoff, Sebastian A; Yang, Guang; Hering, Lydia; Grave, Katharina; Hoch, Henning; Rump, Lars C; Stegbauer, Johannes

    2017-03-01

    Changes in renal hemodynamics have a major impact on blood pressure (BP). Angiotensin (Ang) II has been shown to induce vascular dysfunction by interacting with phosphodiesterase (PDE)1 and PDE5. The predominant PDE isoform responsible for renal vascular dysfunction in hypertension is unknown. Here, we measured the effects of PDE5 (sildenafil) or PDE1 (vinpocetine) inhibition on renal blood flow (RBF), BP, and renal vascular function in normotensive and hypertensive mice. During acute short-term Ang II infusion, sildenafil decreased BP and increased RBF in C57BL/6 (WT) mice. In contrast, vinpocetine showed no effect on RBF and BP. Additionally, renal cGMP levels were significantly increased after acute sildenafil but not after vinpocetine infusion, indicating a predominant role of PDE5 in renal vasculature. Furthermore, chronic Ang II infusion (500 ng·kg(-1)·min(-1)) increased BP and led to impaired NO-dependent vasodilation in kidneys of WT mice. Additional treatment with sildenafil (100 mg·kg(-1)·day(-1)) attenuated Ang II-dependent hypertension and improved NO-mediated vasodilation. During chronic Ang II infusion, urinary nitrite excretion, a marker for renal NO generation, was increased in WT mice, whereas renal cGMP generation was decreased and restored after sildenafil treatment, suggesting a preserved cGMP signaling after PDE5 inhibition. To investigate the dependency of PDE5 effects on NO/cGMP signaling, we next analyzed eNOS-KO mice, a mouse model characterized by low vascular NO/cGMP levels. In eNOS-KO mice, chronic Ang II infusion increased BP but did not impair NO-mediated vasodilation. Moreover, sildenafil did not influence BP or vascular function in eNOS-KO mice. These results highlight PDE5 as a key regulator of renal hemodynamics in hypertension. Copyright © 2017 the American Physiological Society.

  5. Renal tubular dysfunction with nephrocalcinosis in a patient with beta thalassemia minor

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    Prabahar Murugesan

    2008-01-01

    Full Text Available Thalassemia is a hereditary anemia resulting from defect in hemoglobin production. Beta thalassemia is due to impaired production of beta globin chains, leading to a relative excess of alpha globin chains. The term beta thalassemia minor is used to describe heterozygotes, who carry one normal beta globin allele and one beta thalassemic allele. The vast majority of these patients are asymptomatic. However, a variety of renal tubular abnormalities including hypercalciuria, hypo-magnesemia with renal magnesium wasting, decreased tubular absorption of phosphorus, hypo-uricemia with renal uric acid wasting, renal glycosuria and tubular proteinuria have been described even in patients with beta thalassemia minor. We here in report a 24-year old female patient who was found to have thalassemia minor and nephrocalcinosis with evidence of renal tubular dysfunction. Investigations revealed normal renal function, hypercalciuria, reduced tubular reabsorption of phos-phorus, hypomagnesemia and renal magnesium wasting. Screening for aminoaciduria was found to be negative. An acid loading test revealed normal urinary acidification. Ultrasonogram of the abdomen revealed nephrocalcinosis and splenomegaly. Detailed work up for anemia showed normal white cell and platelet count while peripheral smear showed microcytic hypochromic anemia with few target cells. Hemoglobin electrophoresis revealed hemoglobin A of 92%, hemoglobin A2 of 6.2% and hemo-globin F of 1.8% consistent with beta thalassemia minor. Her parental screening was normal. A diag-nosis of beta thalassemia minor with renal tubular dysfunction was made and the patient was started on thiazide diuretics to reduce hypercalciuria and advised regular follow-up.

  6. Gender Difference of Cadmium-induced Renal Tubular Dysfunction for Inhabitants in Toyama,Japan

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    Objective The aim of the present study was to compare the gender differencefor cadmium-induced renal tubular dysfunction between the male and female inhabitants. MethodsUrinary β2-microglobulin was measured in 299 male (94%) and 342 female (92%) inhabitants aged54 - 72 years,and the development of renal tubular dysfunction for 11 years was studied in the 62married couples from them. Results A significantly higher cumulative incidence was found in bothmen and women in cudmium-polluted area,showing 68. 4% in men and 64.8% in women compared to15.3 % in men and 5.9 % in women in the reference areas. Relative risk of renal tubular dysfunctionin females (11.0) was higher than males (4.5). The ratios of urinary β2-nicroglobulin and glucosewere higher in women than those in men in both the cadmium-polluted areas and the reference areas.Conclusion Although almost identical incidences were detected between men and wonen, the changesin excretion of β2-microglobulin and glucose was greater in women than those in men. These findings sug-gest that renal tubular dysfunction might be more progressive in women than that in men.

  7. Can Chronic Nitric Oxide Inhibition Improve Liver and Renal Dysfunction in Bile Duct Ligated Rats?

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    Mona Fouad Mahmoud

    2015-01-01

    Full Text Available The aims of the present work were to study the effects of chronic NO inhibition on liver cirrhosis and to analyze its relationship with liver and kidney damage markers. Two inhibitors of NO synthesis (inducible NO synthase (iNOS inhibitor, aminoguanidine (AG, and nonselective NOS inhibitor, L-nitroarginine methyl ester (L-NAME were administered for 6 weeks to bile duct ligated (BDL rats 3 days after surgery. The present study showed that BDL was associated with liver injury and renal impairment. BDL increased liver NO content and myeloperoxidase (MPO activity. This was corroborated by increased oxidative stress, TNF-α, TGF-1β, and MMP-13 genes overexpression. Although both drugs reduced NO synthesis and TNF-α gene overexpression, only AG improved renal dysfunction and liver damage and reduced liver oxidative stress. However, L-NAME exacerbated liver and renal dysfunction. Both drugs failed to modulate TGF-1β and MMP-13 genes overexpression. In conclusion, inhibition of NO production by constitutive nitric oxide synthase (cNOS plays a crucial role in liver injury and renal dysfunction while inhibition of iNOS by AG has beneficial effect. TNF-α is not the main cytokine responsible for liver injury in BDL model. Nitric oxide inhibition did not stop the progression of cholestatic liver damage.

  8. Noninvasive Staging of Kidney Dysfunction Enabled by Renal-Clearable Luminescent Gold Nanoparticles.

    Science.gov (United States)

    Yu, Mengxiao; Zhou, Jiancheng; Du, Bujie; Ning, Xuhui; Authement, Craig; Gandee, Leah; Kapur, Payal; Hsieh, Jer-Tsong; Zheng, Jie

    2016-02-18

    As a "silent killer", kidney disease is often hardly detected at an early stage but can cause lethal kidney failure later on. Thus, a preclinical imaging technique that can readily differentiate between the stages of kidney dysfunction is highly desired for improving our fundamental understanding of kidney disease progression. Herein, we report that in vivo fluorescence imaging, enabled by renal-clearable near-infrared-emitting gold nanoparticles, can noninvasively detect kidney dysfunction, report on the dysfunctional stages, and even reveal adaptive function in a mouse model of unilateral obstructive nephropathy, which cannot be diagnosed with routine kidney function markers. These results demonstrate that low-cost fluorescence kidney functional imaging is highly sensitive and useful for the longitudinal, noninvasive monitoring of kidney dysfunction progression in preclinical research.

  9. RELATIONSHIP OF HEPATIC AND RENAL DYSFUNCTION WITH HAEMORRHEOLOGICAL PARAMETERS IN PLASMODIUM FALCIPARUM MALARIA

    Directory of Open Access Journals (Sweden)

    Valluri Satya

    2015-04-01

    Full Text Available The clinical pattern of malaria has changed worldwide including India in last decade. Earlier cerebral malaria was the predominant manifestation of severe malaria, whereas now the combination of jaundice and renal failure are more common. Severe haemorrhage is seen in upto 5% of patients with severe malaria. Studies on renal and hepatic dys function in Plasmodium falciparum malaria are a plenty, but there is a paucity of studies correlating haemorrheological abnormalities with hepatic and renal dysfunction in Plasmodium falciparum malaria. METHODS : 100 patients of malaria with positive periph eral blood smear for plasmodium falciparum , out of which 50 cases with AKI and Hepatic failure during the period January 2012 - June 2013. I n department of general medicine, Government General Hospital, Kakinada. GROUP A : Comprising 50 consecutive adult pat ients of all age groups and both genders who had jaundice or renal failure or both at the time of admission. GROUP B: comprising 50 consecutive cases of plasmodium falciparum malaria and had no complications. RESULTS: In group A patients all parameters are significantly raised as compared to group B patients. CONCLUSION: 10% of patients had clinically overt bleeding manifestations, this indicates subclinical haemorrheological dysfunction in patients suffering from falciparum malaria with hepatic and renal d ysfunction, high incidence of subclinical DIC, evidenced by prolonged aPTT (56%, low total platelet count (58%, and PT (20%. An observational, screening, analytical prospective study. 100 cases of PF positive complicated and uncomplicated cases during t he period - January 2012 - June 2013

  10. Broken pump or leaky filter? Renal dysfunction in heart failure a contemporary review.

    Science.gov (United States)

    Petrie, Colin J; Mark, Partick B; Weir, Robin A P

    2008-08-18

    Renal dysfunction is a frequent and progressive complication of chronic heart failure and is a powerful predictor of cardiovascular mortality. It is intimately associated with cardiovascular disease even in its earliest stages. Although cardiovascular and renal disease share many risk factors, the prognostic implications do not simply reflect widespread atherosclerotic vascular disease as this appears to be as important in those with heart failure secondary to idiopathic dilated cardiomyopathy as it is in those with coronary artery disease. There may be a role in the progression of heart failure, as the deleterious effects of even "mild" renal impairment seem to be borne out in predicting outcome, in a broad range of heart failure patients including those with heart failure and preserved systolic function. Renal dysfunction is both an indication for, as well as frequently limiting intervention with intensive disease modifying therapy. Although renal impairment is common in heart failure and these patients are at higher risk for adverse events including death, they are under represented in clinical trials.

  11. Cadmium nephropathy: monitoring for early evidence of renal dysfunction

    Energy Technology Data Exchange (ETDEWEB)

    Murray, T. (Univ. of Pennsylvania, Philadelphia); Walker, B.R.; Spratt, D.M.; Chappelka, R.

    1981-07-01

    Prospective studies in humans comparing various tests of cadmium-induced nephropathy have not been reported. Consequently, it is not possible to ascertain which screening methods should be followed in order to detect early nephropathy at a reversible stage. To obtain such data, the authors studied 23 cadmium workers with periodic analyses of blood/urine cadmium levels, hair cadmium content, urinary cytologies, creatinine clearance and urinary levels of lysozyme, ..beta..-2-microglobulins, immunoglobulins, and aminoacids. Blood/urine levels were useful only as indices of acute environmental exposure and not as predictors of total body content or possible nephropathy. Hair content was elevated in most works. Urine cytology was not reliable. Until further data are available, it is suggested that all five measures of renal function be used in screening and follow-up of cadmium workers for preventing nephropathy.

  12. Inter-relationships between renal metabolism (both in physiology and renal dysfunction) and the liver.

    Science.gov (United States)

    Cano, N

    2001-07-01

    Recently, evaluation of organ-specific glucose release showed that renal glucose release is of the same order of magnitude as splanchnic glucose release during the postabsorptive period. Moreover, renal glucose release appeared to be more sensitive to hormone action than did hepatic glucose release, and appeared to have a pre-eminent role during the adaptation to various physiological and pathological conditions. The kidney is now recognized as playing a key role in interorgan glucose metabolism, and particularly in the Cori cycle and glutamine-glucose cycle. During chronic renal failure the suppression of renal glucose release, together with impaired hormone action, decreased glycogen storage and abnormal liver gluconeogenesis, are responsible for an increased risk for hypoglycaemia.

  13. Urinary aminopeptidase activities as early and predictive biomarkers of renal dysfunction in cisplatin-treated rats.

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    Andrés Quesada

    Full Text Available This study analyzes the fluorimetric determination of alanyl- (Ala, glutamyl- (Glu, leucyl-cystinyl- (Cys and aspartyl-aminopeptidase (AspAp urinary enzymatic activities as early and predictive biomarkers of renal dysfunction in cisplatin-treated rats. Male Wistar rats (n = 8 each group received a single subcutaneous injection of either saline or cisplatin 3.5 or 7 mg/kg, and urine samples were taken at 0, 1, 2, 3 and 14 days after treatment. In urine samples we determined Ala, Glu, Cys and AspAp activities, proteinuria, N-acetyl-β-D-glucosaminidase (NAG, albumin, and neutrophil gelatinase-associated lipocalin (NGAL. Plasma creatinine, creatinine clearance and renal morphological variables were measured at the end of the experiment. CysAp, NAG and albumin were increased 48 hours after treatment in the cisplatin 3.5 mg/kg treated group. At 24 hours, all urinary aminopeptidase activities and albuminuria were significantly increased in the cisplatin 7 mg/kg treated group. Aminopeptidase urinary activities correlated (p0.259 with plasma creatinine, creatinine clearance and/or kidney weight/body weight ratio at the end of the experiment and they could be considered as predictive biomarkers of renal injury severity. ROC-AUC analysis was made to study their sensitivity and specificity to distinguish between treated and untreated rats at day 1. All aminopeptidase activities showed an AUC>0.633. We conclude that Ala, Cys, Glu and AspAp enzymatic activities are early and predictive urinary biomarkers of the renal dysfunction induced by cisplatin. These determinations can be very useful in the prognostic and diagnostic of renal dysfunction in preclinical research and clinical practice.

  14. EARLY PREDICTORS OF RENAL DYSFUNCTION IN Β-THALASSEMIA MAJOR AND INTERMEDIA PATIENTS

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    Azza A.G. Tantawy

    2004-09-01

    Full Text Available Background: Better survival of thalassemia patients allowed previously unrecognized renal complications to emerge. Objectives: Assess prevalence and early predictors of renal dysfunction in young β-thalassemia major (β-TM and intermedia (β-TI patients. Subjects: 66 β-TM (group I, 26 β-TI (group II Egyptian patients and 40 healthy controls. Methods: History, examination and investigations that included kidney function tests, serum ferritin, serum bicarbonate, plasma osmolality and urinary total proteins, microalbuminuria (MAU, N-acetyl-β-D-glucosaminidase (NAG, retinol binding protein (RBP, α-1 microglobulin, bicarbonate, osmolality, Creatinine clearance (CrCl, % fractional excretion of bicarbonate (% FE-HCO3. Results: The most common renal abnormality was proteinuria (71%, followed by increased urinary level of RBP (69.4%, NAG (58.1%, α-1 microglobulin (54.8% and microalbumin (29% and also decreased urinary osmolality (58.1%. Although serum creatinine and BUN were not statistically different between thalassemia patients and control, CrCl were significantly lowered in thalassemia patients. Total serum protein and albumin was significant lower in splenectomized β-TM, whereas urinary total protein and MAU were significantly increased in all thalassemia patients. NAG, RBP and α-1 microglobulin were negatively correlated with CrCl and positively correlated with serum ferritin and urinary total protein. Z-score analysis for discrimination of patients with renal dysfunction proved superiority of urine total protein and RBP. Comparative statistics of different frequencies revealed significant difference between the urinary total protein and both MAU and % FE-HCO3. Conclusion: Asymptomatic renal dysfunctions are prevalent in young β-TM and β-TI patients that necessitate regular screening and urinary total protein and RBP may be cost-effective for early detection.

  15. Application of path analysis to urinary findings of cadmium-induced renal dysfunction.

    Science.gov (United States)

    Abe, T; Kobayashi, E; Okubo, Y; Suwazono, Y; Kido, T; Shaikh, Z A; Nogawa, K

    2001-01-01

    In order to identify some causal relations among various urinary indices of cadmium-induced renal dysfunction, such as glucose, total protein, amino nitrogen, beta 2-microglobulin (beta 2-m), metallothionein (MT), and cadmium (Cd), we applied path analysis method to previous epidemiological studies targeting the residents of the Cd-polluted Kakehashi River basin of Ishikawa Prefecture, Japan. We obtained a diagram-termed path model, representing some causal relations among the above urinary indices. It shows that urinary Cd is located at the beginning point in the diagram, and Cd-induced renal dysfunction develops in the following order: Cd exposure-->increase of beta 2-m and/or MT excretion-->increase of amino-N and/or total protein excretion-->increase of glucose excretion. It was proved mathematically, that in the case of both males and females, increased excretions of beta 2-m and/or MT were the most sensitive urinary indices of the early stage of chronic Cd-induced renal dysfunction.

  16. The significance of cytologic examination of urine in the diagnosis of renal allograft dysfunction

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    Tatomirović Željka

    2003-01-01

    Full Text Available Background. This paper presents our experience with cytologic examination of urine in diagnosing renal allograft dysfunction. Methods. The study group included 23 patients with renal allograft dysfunction, selected from 56 patients who underwent renal transplantation. Etiologic diagnosis was made according to the clinical picture, histological findings during allograft biopsy, and cytologic examination of urine. Urine sediment was obtained in cytocentrifuge and was air dried and stained with May Grunwald Giemsa. Results. Out of 23 patients with allograft dysfunction in 18 (78.3% patient it was caused by acute rejection, and in 5 (8.9% patients by allograft infarction, cyclosporine nephrotoxicity, acute tubular necrosis and chronic nephropathy. In eighteen patients (78.3% cytologic examination of urine was pathologic, while in 16 (70% clinical and histology findings coincided with urine cytology findings. Out of 18 patients with acute allograft rejection in 15 patients cytologic examination of urine coincided with acute rejection. Out of 7 patients with expressed cyclosporine nephrotoxicity, in 5 cytologic examination of urine confirmed the cause of allograft dysfunction, as well as in one of 2 patients with acute tubular necrosis. Cytologic examination of urine indicated parenchymal damage in 2 patients with reccurent disease (membranoproliferative and focal sclerosing glomerulonephritis. In 4 of 5 patients suffering from chronic rejection in a year’s monitoring period, urine sediment periodically consisted of lymphocytes, neutrophilic leucocytes, monocyte/macrophages, tubular cells and cilindres, without the predominance of any cell type. In 3 patients allograft dysfunction was caused by infective agents (bacteria, fungus cytomegalovirus. Conclusion. Cytologic examination of urine might be an alternative to histological in diagnosing acute allograft rejection and acute tubular necrosis or nephtotoxicity. Also it might indicate parenchymal

  17. Arterial stiffness and endothelial dysfunction independently and synergistically predict cardiovascular and renal outcome in patients with type 1 diabetes

    DEFF Research Database (Denmark)

    Theilade, S; Lajer, Maria Stenkil; Jorsal, Anders;

    2012-01-01

    To evaluate whether pulse pressure alone or with placental growth factor as estimates of arterial stiffness and endothelial dysfunction, predicts mortality, cardiovascular disease and progression to end-stage renal disease in patients with Type 1 diabetes.......To evaluate whether pulse pressure alone or with placental growth factor as estimates of arterial stiffness and endothelial dysfunction, predicts mortality, cardiovascular disease and progression to end-stage renal disease in patients with Type 1 diabetes....

  18. Prevalence and Factors Associated with Renal Dysfunction in HIV Positive and Negative Adults at the University Teaching Hospital, in Lusaka

    Science.gov (United States)

    Banda, Justor; Mweemba, Aggrey; Siziya, Seter; Mweene, Morgan; Andrews, Ben; Lakhi, Shabir

    2013-01-01

    Background Despite having the highest disease burden of HIV, Sub-Saharan Africa has limited data on HIV related kidney disease with most available data coming from the developed countries. Kidney disease is a recognised complication in HIV infected patients presenting with acute renal failure (ARF) or chronic kidney disease (CKD). This study investigated the prevalence and risk factors associated with renal dysfunction among hospitalised HIV infected patients at the University Teaching Hospital (UTH), Lusaka. Methodology We conducted a cross sectional study at the University Teaching Hospital Lusaka, in Zambia. Inclusion criteria were hospitalised patients aged 16years and above who consented to the study. Both HIV infected and uninfected patients were included in the study. After obtaining demographic information, study participants were screened for HIV upon their consenting for the test. A full clinical history and examination was done by study physician to determine factors associated with renal dysfunction. Results Of the 300 recruited hospitalised patients in this cross sectional study, 142(47%) were HIV infected. We observed a high prevalence of renal dysfunction among hospitalised HIV infected patients compared to uninfected patients (42% vs. 27%, adjusted OR 1.99, 95% CI 1.20–3.28). They had a twofold increased likelihood of developing kidney dysfunction (OR 1.96,95 CI%; 1.21–3.17). The presence of vomiting was strongly associated with renal dysfunction in both HIV positive (AOR 7.77, 95% CI 2.46-24-53) and negative (AOR4.83, 95%CI 1.40–16.66) subgroups. WHO stage III was associated with renal dysfunction in HIV infected patients. Tenofovir use, (a first line antiretroviral drug in Zambia) and hypotension were not significant factors associated with kidney disease after adjusting for other clinical parameters. Conclusion Renal dysfunction is significantly higher among hospitalised HIV infected compared to uninfected, however tenofovir and hypotension

  19. Renal dysfunction in patients with sickle cell anemia or sickle cell trait

    Directory of Open Access Journals (Sweden)

    R. Sesso

    1998-10-01

    Full Text Available Patients with sickle cell anemia (Hb SS or sickle cell trait (Hb AS may present several types of renal dysfunction; however, comparison of the prevalence of these abnormalities between these two groups and correlation with the duration of disease in a large number of patients have not been thoroughly investigated. In a cross-sectional study using immunoenzymometric assays to measure tubular proteinuria, microalbuminuria, measurement of creatinine clearance, urinary osmolality and analysis of urine sediment, we evaluated glomerular and tubular renal function in 106 adults and children with Hb SS (N = 66 or Hb AS (N = 40 with no renal failure (glomerular filtration rate (GFR >85 ml/min. The percentage of individuals with microalbuminuria was higher among Hb SS than among Hb AS patients (30 vs 8%, P85 ml/min.

  20. Cognitive Dysfunction in Chronic Renal Disease: Impact of Dialysis Modality

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    Recep AK

    2015-12-01

    Full Text Available OBJECTIVE: Cognitive dysfunction (CD is common among patients with chronic kidney disease (CKD and contributes to morbidity and mortality. We aimed to explore the factors involved in the development of CD in patients with CKD and to compare cognitive function between hemodialysis (HD and peritoneal dialysis (PD patients. MATERIAL and METHODS: We studied 122 patients with different stages of CKD, and divided them into two groups: Predialysis Group: included 60 CKD patients, (28 stage III and 34 stage IV; Dialysis Group: included 60 patients on dialysis therapy, (30 on HD and 30 on PD. Psychometric tests were done all patients. The results were compared with 41 healthy subjects. RESULTS: We found that the CD rate was higher in patients with CKD (24.6% than controls (0%, p<0.001. The Mini Mental Test score was found to be correlated with age (r=-0.428, hemoglobin (r=0.336, CRP (r=-0.311, and albumin (r=0.336; the Calculation Test score was found to be correlated with LDL cholesterol (r=-0.336; the Praxis Test Score was found to be correlated with duration of CKD (r=-0.204, HDL (r=0.188; and the Visual Memory Test score was found to be correlated with parathormone levels (r=-0.270. We found the CD rate to be higher in patients on HD (50% than on PD (23.3%, p=0.032. CONCLUSION: Our findings suggest that anemia, malnutrition and inflammation play an important role in the development of CD in our patients, and cognitive functions are better preserved in the PD group than the HD group.

  1. Associations between the number of natural teeth and renal dysfunction.

    Science.gov (United States)

    Choi, Hye Min; Han, Kyungdo; Park, Yong Gyu; Park, Jun-Beom

    2016-08-01

    The purpose of the present study was to investigate the association between the number of natural teeth and measures of kidney dysfunction, such as urinary albumin/creatinine ratio (ACR) and estimated glomerular filtration (eGFR) rate, using nationally representative data.The data used were from the Korea National Health and Nutrition Examination Survey with cross-sectional design, which was conducted between 2011 and 2012; the sample analyzed in this study consisted of a total of 10,388 respondents, each of whom was 19 years or older and had no missing outcome variables. The association between the number of natural teeth and kidney function was assessed by multiple logistic regression and model was adjusted for age, sex, waist conference, smoking, drinking, exercise, education, income, frequency of tooth brushing per day, diabetes, metabolic syndrome, urinary ACR, and eGFR.The mean age, body mass index, and waist circumference were significantly higher among those with lower kidney function (urinary ACR ≥30 mg/g and eGFR natural teeth. As urinary ACR increased, the number of natural teeth decreased accordingly. Conversely, the number of natural teeth increased with an increase in eGFR.This study showed that the number of natural teeth is inversely associated with the presence of kidney disease. Severity of tooth loss may be considered an independent risk indicator for kidney disease among Koreans. More epidemiological studies are warranted to investigate the role of tooth loss in kidney disease, to confirm this relationship and to test possible underlying mechanisms.

  2. Prenatal lipopolysaccharide exposure results in dysfunction of the renal dopamine D1 receptor in offspring.

    Science.gov (United States)

    Wang, Xinquan; Luo, Hao; Chen, Caiyu; Chen, Ken; Wang, Jialiang; Cai, Yue; Zheng, Shuo; Yang, Xiaoli; Zhou, Lin; Jose, Pedro A; Zeng, Chunyu

    2014-11-01

    Adverse environment in early life can modulate the adult phenotype, including blood pressure. Lipopolysaccharide (LPS) exposure in utero results in increased blood pressure in the offspring, but the exact mechanisms are not clear. Studies have shown that the renal dopamine D1 receptor (D1R) plays an important role in maintaining sodium homeostasis and normal blood pressure; dysfunction of D1R is associated with oxidative stress and hypertension. In this study, we determined if dysfunction of the renal D1R is involved in fetal-programmed hypertension, and if oxidative stress contributes to this process. Pregnant Sprague-Dawley (SD) rats were intraperitoneally injected with LPS (0.79 mg/kg) or saline at gestation days 8, 10, and 12. As compared with saline-injected (control) dams, offspring of LPS-treated dams had increased blood pressure, decreased renal sodium excretion, and increased markers of oxidative stress. In addition, offspring of LPS-treated dams had decreased renal D1R expression, increased D1R phosphorylation, and G protein-coupled receptor kinase type 2 (GRK2) and type 4 (GRK4) protein expression, and impaired D1R-mediated natriuresis and diuresis. All of the findings in the offspring of LPS-treated dams were normalized after treatment with TEMPOL, an oxygen free radical scavenger. In conclusion, prenatal LPS exposure, via an increase in oxidative stress, impairs renal D1R function and leads to hypertension in the offspring. Normalization of renal D1R function by amelioration of oxidative stress may be a therapeutic target of fetal programming of hypertension.

  3. Increased Blood Pressure Variability Prior to Chronic Kidney Disease Exacerbates Renal Dysfunction in Rats

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    Frederico Felipe Costa Tebas Freitas

    2016-09-01

    Full Text Available Increased blood pressure variability (BPV, which can be experimentally induced by sinoaortic denervation (SAD, has emerged as a new marker of the prognosis of cardiovascular and renal outcomes. Considering that increased BPV can lead to organ-damage, the goal of the present study was to evaluate the effects of SAD on renal function in an experimental model of chronic kidney disease (CKD. SAD was performed in male Wistar rats 2 weeks before 5/6 nephrectomy and the animals were evaluated 4 weeks after the induction of CKD. Our data demonstrated that BPV was increased in SAD and CKD animals and that the combination of both conditions (SAD+CKD exacerbated BPV. The baroreflex sensitivity index was diminished in the SAD and CKD groups; this reduction was more pronounced when SAD and CKD were performed together. 5/6 nephrectomy led to hypertension, which was higher in SAD+CKD animals. Regarding renal function, the combination of SAD and CKD resulted in reduced renal plasma and blood flow, increased renal vascular resistance and augmented uraemia when compared to CKD animals. Glomerular filtration rate and BPV were negatively correlated in SAD, CKD and SAD+CKD animals. Moreover, SAD+CKD animals presented a higher level of glomerulosclerosis when compared to all other groups. Cardiac and renal hypertrophy, as well as oxidative stress, was also further increased when SAD and CKD were combined. These results show that SAD prior to 5/6 nephrectomy exacerbates renal dysfunction, suggesting that previous augmented BPV should be considered as an important factor to the progression of renal diseases.

  4. Increased Blood Pressure Variability Prior to Chronic Kidney Disease Exacerbates Renal Dysfunction in Rats

    Science.gov (United States)

    Freitas, Frederico F. C. T.; Araujo, Gilberto; Porto, Marcella L.; Freitas, Flavia P. S.; Graceli, Jones B.; Balarini, Camille M.; Vasquez, Elisardo C.; Meyrelles, Silvana S.; Gava, Agata L.

    2016-01-01

    Increased blood pressure variability (BPV), which can be experimentally induced by sinoaortic denervation (SAD), has emerged as a new marker of the prognosis of cardiovascular and renal outcomes. Considering that increased BPV can lead to organ-damage, the goal of the present study was to evaluate the effects of SAD on renal function in an experimental model of chronic kidney disease (CKD). SAD was performed in male Wistar rats 2 weeks before 5/6 nephrectomy and the animals were evaluated 4 weeks after the induction of CKD. Our data demonstrated that BPV was increased in SAD and CKD animals and that the combination of both conditions (SAD+CKD) exacerbated BPV. The baroreflex sensitivity index was diminished in the SAD and CKD groups; this reduction was more pronounced when SAD and CKD were performed together. 5/6 nephrectomy led to hypertension, which was higher in SAD+CKD animals. Regarding renal function, the combination of SAD and CKD resulted in reduced renal plasma and blood flow, increased renal vascular resistance and augmented uraemia when compared to CKD animals. Glomerular filtration rate and BPV were negatively correlated in SAD, CKD, and SAD+CKD animals. Moreover, SAD+CKD animals presented a higher level of glomerulosclerosis when compared to all other groups. Cardiac and renal hypertrophy, as well as oxidative stress, was also further increased when SAD and CKD were combined. These results show that SAD prior to 5/6 nephrectomy exacerbates renal dysfunction, suggesting that previous augmented BPV should be considered as an important factor to the progression of renal diseases. PMID:27721797

  5. Renal dysfunction in a renal transplant patient treated concurrently with cyclosporine and imatinib.

    Science.gov (United States)

    Mulder, Karen E; Egorin, Merrill J; Sawyer, Michael B

    2012-12-01

    Imatinib mesylate has proven activity in treating locally advanced or metastatic gastrointestinal stromal tumors (GIST). Drug interactions are particularly concerning as imatinib is extensively metabolized by the cytochrome P450 enzyme system. We describe the clinical course of a 72 year-old male with a cadaveric renal transplant requiring cyclosporine that presented with a metastatic GIST and was started on imatinib at the standard dose of 400 mg daily. Imatinib initiation resulted in a decline in renal function with the serum creatinine increasing from 123 μmol/L to 196 μmol/L and an elevation in whole blood cyclosporine concentrations from 79 μg/L to 139 μg/L. No other imatinib toxicities were reported. With discontinuation of imatinib, the serum creatinine returned to baseline as did the whole blood cyclosporine levels. Ultimately, decreasing both the cyclosporine and imatinib dosing was associated with stabilized renal function (serum creatinine 150-186 μmol/L) and cyclosporine concentrations (53-97 μg/L). A prolonged partial response to therapy for 19 months was maintained despite low imatinib trough concentrations measured on two separate occasions (127.1 ng/ml and 139 ng/ml). In our patient, imatinib initiation resulted in renal toxicity most likely due to its interaction with cyclosporine resulting in elevation of the whole blood cyclosporine concentration.

  6. Anaemia and renal dysfunction are independently associated with BNP and NT-proBNP levels in patients with heart failure

    NARCIS (Netherlands)

    Hogenhuis, Jochern; Voors, Adriaan A.; Jaarsma, Tiny; Hoes, Arno W.; Hillege, Hans L.; Kragten, Johannes A.; van Veldhuisen, Dirk J.

    2007-01-01

    Background: Anaemia may affect 13-type natriuretic peptide (BNP) and N-terminal proBNP (NT-proBNP) levels, but this has not been well described in heart failure (1417) patients without the exclusion of patients with renal dysfunction. Aims: To study the influence of both anaemia and renal function o

  7. Transition from Cyclosporine-Induced Renal Dysfunction to Nephrotoxicity in an in Vivo Rat Model

    Directory of Open Access Journals (Sweden)

    José Sereno

    2014-05-01

    Full Text Available Cyclosporin A (CsA, a calcineurin inhibitor, remain the cornerstone of immunosuppressive regimens, regardless of nephrotoxicity, which depends on the duration of drug exposure. The mechanisms and biomarkers underlying the transition from CsA-induced renal dysfunction to nephrotoxicity deserve better elucidation, and would help clinical decisions. This study aimed to clarify these issues, using a rat model of short- and long-term CsA (5 mg/kg bw/day treatments (3 and 9 weeks, respectively. Renal function was assessed on serum and urine; kidney tissue was used for histopathological characterization and gene and/or protein expression of markers of proliferation, fibrosis and inflammation. In the short-term, creatinine and blood urea nitrogen (BUN levels increased and clearances decreased, accompanied by glomerular filtration rate (GFR reduction, but without kidney lesions; at that stage, CsA exposure induced proliferating cell nuclear antigen (PCNA, transforming growth factor beta 1 (TGF-β1, factor nuclear kappa B (NF-κβ and Tumor Protein P53 (TP53 kidney mRNA up-regulation. In the long-term treatment, renal dysfunction data was accompanied by glomerular and tubulointerstitial lesions, with remarkable kidney mRNA up-regulation of the mammalian target of rapamycin (mTOR and the antigen identified by monoclonal antibody Ki-67 (Mki67, accompanied by mTOR protein overexpression. Transition from CsA-induced renal dysfunction to nephrotoxicity is accompanied by modification of molecular mechanisms and biomarkers, being mTOR one of the key players for kidney lesion evolution, thus suggesting, by mean of molecular evidences, that early CsA replacement by mTOR inhibitors is indeed the better therapeutic choice to prevent chronic allograft nephropathy.

  8. Renal dysfunction and anemia in patients with heart failure with reduced versus normal ejection fraction.

    Science.gov (United States)

    Villacorta, Humberto; Saenz-Tello, Bolivar F; Santos, Eduarda Barcellos dos; Steffen, Ricardo; Wiefels, Christiane; Lima, Luiz Costa; Sales, Ana Luíza F; Soares, Pedro; Mesquita, Evandro Tinoco

    2010-03-01

    The presence of anemia and renal dysfunction grants a bad prognosis for patients with heart failure and reduced ejection fraction (HFREF). The impact on patients with heart failure and normal ejection fraction (HFNEF) is not widely studied. To study the prevalence and the prognosis of anemia and renal dysfunction (RD) in patients with heart failure according to the type of ventricular dysfunction. A total of 209 patients with chronic and stable heart failure were prospectively studied. Individuals with ejection fraction Anemia was defined, based on WHO criteria, as hemoglobin Renal function was calculated by means of the Simplified Modified Diet Renal Disease (sMDRD) formula. Hospitalizations, emergency admittances and obit by cardiac causes were considered as cardiac events. Ninety patients had HFREF and 119 had HFNEF. The glomerular filtration rate (GFR) was smaller in HFREF group (57.6 +/- 66.2 versus 94.8 +/- 36.6 ml/min/1.73m(2); p=0.01). There was no difference in the prevalence of anemia between groups (23.3% versus 18.5%; p=0.34). Moderate to severe RD prevalence was higher in HFREF group (32.2% versus 16.8%; p=0.01). RD was the only factor associated with anemia that was independently associated with cardiac events (HR 2.52; 95%CI=1.27-5.2; p=0.01). RD was less prevalent in HFNEF, while the prevalence of anemia did not differ between groups. RD was predictor of cardiac events independently on ejection fraction.

  9. Association of Kidney Tissue Barrier Disrupture and Renal Dysfunction in Resuscitated Murine Septic Shock.

    Science.gov (United States)

    Stenzel, Tatjana; Weidgang, Clair; Wagner, Katja; Wagner, Florian; Gröger, Michael; Weber, Sandra; Stahl, Bettina; Wachter, Ulrich; Vogt, Josef; Calzia, Enrico; Denk, Stephanie; Georgieff, Michael; Huber-Lang, Markus; Radermacher, Peter; McCook, Oscar

    2016-10-01

    Septic shock-related kidney failure is characterized by almost normal morphological appearance upon pathological examination. Endothelial barrier disrupture has been suggested to be of crucial importance for septic shock-induced organ dysfunction. Therefore, in murine resuscitated cecal ligation and puncture (CLP)-induced septic shock, we tested the hypothesis whether there is a direct relationship between the kidney endothelial barrier injury and renal dysfunction. Anesthetized mice underwent CLP, and 15 h later, were anesthetized again and surgically instrumented for a 5-h period of intensive care comprising lung-protective mechanical ventilation, fluid resuscitation, continuous i.v. norepinephrine to maintain target hemodynamics, and measurement of creatinine clearance (CrCl). Animals were stratified according to low or high CrCl. Nitrotyrosine formation, expression of the inducible isoform of the nitric oxide synthase, and blood cytokine (tumor necrosis factor, interleukin-6, interleukin-10) and chemokine (monocyte chemoattractant protein-1, keratinocyte-derived chemokine) levels were significantly higher in animals with low CrCl. When plotted against CrCl and neutrophil gelatinase-associated lipocalin levels, extravascular albumin accumulation, and tissue expression of the vascular endothelial growth factor and angiopoietin-1 showed significant mathematical relationships related to kidney (dys)function. Preservation of the constitutive expression of the hydrogen sulfide producing enzyme cystathione-γ-lyase was associated with maintenance of organ function. The direct quantitative relation between microvascular leakage and kidney (dys)function may provide a missing link between near-normal tissue morphology and septic shock-related renal failure, thus further highlighting the important role of vascular integrity in septic shock-related renal failure.

  10. Renal dysfunction and anemia in patients with heart failure — the cardio-renal anemia syndrome

    OpenAIRE

    Malić, Daniela; Matijević, Sanja; Bubić, Ivan; Rački, Sanjin; Zaputović, Luka

    2011-01-01

    Cardiovascular diseases are the leading cause of morbidity and mortality in patients with chronic kidney disease. The appearance of cardiovascular complications is strongly in positive correlation with the severity of kidney disease. About 40% of patients with moderate or severe kidney disease and even 60% of patients in the terminal phase have some degree of chronic heart failure. “The Cardio-Renal Syndrome” represents a variety of pathophysiological abnormalities of ...

  11. Chrysin, an anti-inflammatory molecule, abrogates renal dysfunction in type 2 diabetic rats

    Energy Technology Data Exchange (ETDEWEB)

    Ahad, Amjid [Lipid Metabolism Laboratory, Department of Biochemistry, Faculty of Science, Jamia Hamdard, Hamdard Nagar, New Delhi 110062 (India); Ganai, Ajaz Ahmad [Department of Biotechnology, Faculty of Science, Jamia Hamdard, Hamdard Nagar, New Delhi 110062 (India); Mujeeb, Mohd [Department of Pharmacognosy and Phytochemistry, Faculty of Pharmacy, Jamia Hamdard, Hamdard Nagar, New Delhi 110062 (India); Siddiqui, Waseem Ahmad, E-mail: was.sid121@gmail.com [Lipid Metabolism Laboratory, Department of Biochemistry, Faculty of Science, Jamia Hamdard, Hamdard Nagar, New Delhi 110062 (India)

    2014-08-15

    Diabetic nepropathy (DN) is considered as the leading cause of end-stage renal disease (ESRD) worldwide, but the current available treatments are limited. Recent experimental evidences support the role of chronic microinflammation in the development of DN. Therefore, the tumor necrosis factor-alpha (TNF-α) pathway has emerged as a new therapeutic target for the treatment of DN. We investigated the nephroprotective effects of chrysin (5, 7-dihydroxyflavone) in a high fat diet/streptozotocin (HFD/STZ)-induced type 2 diabetic Wistar albino rat model. Chrysin is a potent anti-inflammatory compound that is abundantly found in plant extracts, honey and bee propolis. The treatment with chrysin for 16 weeks post induction of diabetes significantly abrogated renal dysfunction and oxidative stress. Chrysin treatment considerably reduced renal TNF-α expression and inhibited the nuclear transcription factor-kappa B (NF-kB) activation. Furthermore, chrysin treatment improved renal pathology and suppressed transforming growth factor-beta (TGF-β), fibronectin and collagen-IV protein expressions in renal tissues. Chrysin also significantly reduced the serum levels of pro-inflammatory cytokines, interleukin-1beta (IL-1β) and IL-6. Moreover, there were no appreciable differences in fasting blood glucose and serum insulin levels between the chrysin treated groups compared to the HFD/STZ-treated group. Hence, our results suggest that chrysin prevents the development of DN in HFD/STZ-induced type 2 diabetic rats through anti-inflammatory effects in the kidney by specifically targeting the TNF-α pathway. - Highlights: • Chrysin reduced renal oxidative stress and inflammation in diabetic rats. • Chrysin reduced serum levels of pro-inflammatory in diabetic rats. • Chrysin exhibited renal protective effect by suppressing the TNF-α pathway.

  12. Utility of urinary markers in the assessment of renal dysfunction in canine babesiosis.

    Science.gov (United States)

    Winiarczyk, Dagmara; Adaszek, Łukasz; Bartnicki, Michał; Abramowicz, Beata; Łyp, Paweł; Madany, Jacek; Winiarczyk, Stanisław

    2017-04-19

    Canine babesiosis is a common and clinically significant tick-borne disease caused by haemoprotozoan parasites of the genus Babesia. Acute renal failure is considered to be one of the most prevalent complications of canine babesiosis. This complication leads to a decrease in the glomerular filtration rate and in consequence causes azotemia and uremia. The objective of this study was to assess the localization and extent of renal damage in dogs infected with Babesia canis using an urinary marker for glomerular (urinary immunoglobulin G, uIgG), proximal tubular dysfunction (urinary retinol binding protein, uRBP) and distal tubular dysfunction (urinary Tamm-Horsfal protein, uTHP). Material und methods: In 10 dogs naturally infected with B. canis and 10 healthy control dogs the levels of urinary biomarkers were measured using commercially available ELISA tests. Higher concentrations of uIgG, uRBP and uTHP were found in the urine of all dogs with babesiosis than in those from the control group. This indicates that in the course of the disease, the glomeruli as well as the renal tubules become damaged. The study results allow a better understanding of the pathogenesis of canine babesiosis. However, in order to fully determine the extent and the nature of the damage to the kidneys of the infected dogs, it is advisable to conduct additional histopathological examinations of these organs.

  13. Functional and histological improvement after everolimus rescue of chronic allograft dysfunction in renal transplant recipients

    Directory of Open Access Journals (Sweden)

    Chow KM

    2015-05-01

    Full Text Available Kai Ming Chow,1 Cheuk Chun Szeto,1 Fernand Mac-Moune Lai,2 Cathy Choi-Wan Luk,1 Bonnie Ching-Ha Kwan,1 Chi Bon Leung,1 Philip Kam-Tao Li1 1Department of Medicine and Therapeutics, 2Department of Anatomical and Cellular Pathology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong Background: We tested the strategy of mTOR inhibitors with calcineurin inhibitor minimization in renal transplant recipients with known chronic allograft dysfunction.Methods: In this open-label, single-arm study, renal transplant patients were recruited after biopsy-confirmed chronic allograft dysfunction in the absence of acute rejection episode within 2 months, with proteinuria <0.8 g/day, and serum creatinine <220 µmol/L or estimated glomerular filtration rate >40 mL/min/1.73 m2. They were converted to everolimus (aiming for trough everolimus level 3–8 ng/mL with cyclosporine minimization, to assess the effect on renal function, rate of glomerular filtration rate decline, and longitudinal transplant biopsy at 12 months.Results: Seventeen Chinese patients (median transplant duration, 4.2 years were recruited; no patients discontinued study medication. The mean slope of the glomerular filtration rate over time was -4.31±6.65 mL/min/1.73 m2 per year in the year before everolimus, as compared with 1.29±5.84 mL/min/1.73 m2 per year in the 12 months of everolimus therapy, a difference of 5.61 mL/min/1.73 m2 per year (95% confidence interval [CI], 0.40–10.8 favoring everolimus therapy (P=0.036. Serial renal biopsy histology showed significant decrease of tubular atrophy (15.7%±11.3% versus 7.1%±7.3%, P=0.005 and interstitial fibrosis (14.8%±11.5% versus 7.2%±8.2%, P=0.013. Intrarenal expression of TGF-β1 mRNA showed a nonsignificant decrease after everolimus treatment.Conclusion: In renal transplant recipients with biopsy-confirmed chronic allograft dysfunction, we found a significant beneficial effect of everolimus rescue therapy

  14. Utility of Iron Staining in Identifying the Cause of Renal Allograft Dysfunction in Patients with Sickle Cell Disease

    Directory of Open Access Journals (Sweden)

    Yingchun Wang

    2015-01-01

    Full Text Available Sickle cell nephropathy (SCN is associated with iron/heme deposition in proximal renal tubules and related acute tubular injury (ATI. Here we report the utility of iron staining in differentiating causes of renal allograft dysfunction in patients with a history of sickle cell disease. Case 1: the patient developed acute allograft dysfunction two years after renal transplant. Her renal biopsy showed ATI, supported by patchy loss of brush border and positive staining of kidney injury molecule-1 in proximal tubular epithelial cells, where diffuse increase in iron staining (2+ was present. This indicated that ATI likely resulted from iron/heme toxicity to proximal tubules. Electron microscope confirmed aggregated sickle RBCs in glomeruli, indicating a recurrent SCN. Case 2: four years after renal transplant, the patient developed acute allograft dysfunction and became positive for serum donor-specific antibody. His renal biopsy revealed thrombotic microangiopathy (TMA and diffuse positive C4d stain in peritubular capillaries. Iron staining was negative in the renal tubules, implying that TMA was likely associated with acute antibody-mediated rejection (AAMR, type 2 rather than recurrent SCN. These case reports imply that iron staining is an inexpensive but effective method in distinguishing SCN-associated renal injury in allograft kidney from other etiologies.

  15. Expression of GSK-3β in renal allograft tissue and its significance in pathogenesis of chronic allograft dysfunction

    Directory of Open Access Journals (Sweden)

    Yan Qiang

    2012-01-01

    Full Text Available Abstract Objective To explore the expression of Glycogen synthase kinase 3 beta (GSK-3β in renal allograft tissue and its significance in the pathogenesis of chronic allograft dysfunction. Methods Renal allograft biopsy was performed in all of the renal allograft recipients with proteinuria or increased serum creatinine level who came into our hospital from January 2007 to December 2009. Among them 28 cases was diagnosed as chronic allograft dysfunction based on pahtological observation, including 21 males with a mean age of 45 ± 10 years old and 7 females with a mean age of 42 ± 9 years old. The time from kidney transplantation to biopsy were 1-9 (3.5 years. Their serum creatinine level were 206 ± 122 umol/L. Immunohistochemical assay and computer-assisted genuine color image analysis system (imagepro-plus 6.0 were used to detect the expression of GSK-3β in the renal allografts of 28 cases of recipients with chronic allograft dysfunction. Mean area and mean integrated optical density of GSK-3β expression were calculated. The relationship between expression level of GSK-3β and either the grade of inflammatory cell infiltration or interstitial fibrosis/tubular atrophy in renal allograft was analyzed. Five specimens of healthy renal tissue were used as controls. Results The expression level of the GSK-3β was significantly increased in the renal allograft tissue of recipients with chronic allograft dysfunction, compared to normal renal tissues, and GSK-3β expression became stronger along with the increasing of the grade of either inflammatory cell infiltration or interstitial fibrosis/tubular atrophy in renal allograft tissue. Conclusion There might be a positive correlation between either inflammatory cell infiltration or interstitial fibrosis/tubular atrophy and high GSK-3β expression in renal allograft tissue. Virtual slides The virtual slide(s for this article can be found here: http

  16. Tenofovir is associated with increased tubular proteinuria and asymptomatic renal tubular dysfunction in Ghana.

    Science.gov (United States)

    Chadwick, David R; Sarfo, Fred S; Kirk, Elaine S M; Owusu, Dorcas; Bedu-Addo, George; Parris, Victoria; Owusu, Ann Lorraine; Phillips, Richard

    2015-12-01

    HIV infection is associated with increased risk of renal dysfunction, including tubular dysfunction (TD) related to antiretroviral therapy (ART). Tenofovir disoproxil fumarate (TDF) is becoming available for ART in sub-Saharan Africa, although data on its long-term safety there is limited. We aimed to study the prevalence of HIV-associated renal dysfunction in Ghana and explore associations between proteinuria or TD and potential risk factors, including TDF use. A single-centre cross-sectional observational study of patients taking ART was undertaken. Creatinine clearance (CrCl) was calculated and proteinuria detected with dipsticks. Spot urinary albumin and protein:creatinine ratios (uACR/uPCR) were measured and further evidence of TD (defined as having two or more characteristic features) sought. Logistic regression analysis identified factors associated with proteinuria or TD. In 330 patients, of whom 101 were taking TDF (median 20 months), the prevalence of CrCl proteinuria and TD was 7 %, 37 % and 15 %. Factors associated with proteinuria were baseline CD4-count [aOR 0.86/100 cell increment (95 % CI, 0.74-0.99)] and TDF use [aOR 2.74 (95 % CI, 1.38-5.43)]. The only factor associated with TD was TDF use [aOR 3.43 (95 % CI, 1.10-10.69)]. In a subset with uPCR measurements, uPCRs were significantly higher in patients taking TDF than those on other drugs (10.8 vs. 5.7 mg/mmol, p proteinuria and TD are common and associated with TDF use in Ghana. Further longitudinal studies to determine whether proteinuria, TD or TDF use are linked to progressive decline in renal function or other adverse outcomes are needed in Africa.

  17. Serelaxin as a potential treatment for renal dysfunction in cirrhosis: Preclinical evaluation and results of a randomized phase 2 trial

    Science.gov (United States)

    Hoy, Anna M.; Semple, Scott I.; Mungall, Will; Lennen, Ross J.; Moran, Carmel M.; Pellicoro, Antonella; Aucott, Rebecca L.; Severin, Thomas; Saini, Rajnish; Yates, Denise; Dongre, Neelesh; Duffield, Jeremy S.; Webb, David J.; Iredale, John P.; Hayes, Peter C.

    2017-01-01

    Background Chronic liver scarring from any cause leads to cirrhosis, portal hypertension, and a progressive decline in renal blood flow and renal function. Extreme renal vasoconstriction characterizes hepatorenal syndrome, a functional and potentially reversible form of acute kidney injury in patients with advanced cirrhosis, but current therapy with systemic vasoconstrictors is ineffective in a substantial proportion of patients and is limited by ischemic adverse events. Serelaxin (recombinant human relaxin-2) is a peptide molecule with anti-fibrotic and vasoprotective properties that binds to relaxin family peptide receptor-1 (RXFP1) and has been shown to increase renal perfusion in healthy human volunteers. We hypothesized that serelaxin could ameliorate renal vasoconstriction and renal dysfunction in patients with cirrhosis and portal hypertension. Methods and findings To establish preclinical proof of concept, we developed two independent rat models of cirrhosis that were characterized by progressive reduction in renal blood flow and glomerular filtration rate and showed evidence of renal endothelial dysfunction. We then set out to further explore and validate our hypothesis in a phase 2 randomized open-label parallel-group study in male and female patients with alcohol-related cirrhosis and portal hypertension. Forty patients were randomized 1:1 to treatment with serelaxin intravenous (i.v.) infusion (for 60 min at 80 μg/kg/d and then 60 min at 30 μg/kg/d) or terlipressin (single 2-mg i.v. bolus), and the regional hemodynamic effects were quantified by phase contrast magnetic resonance angiography at baseline and after 120 min. The primary endpoint was the change from baseline in total renal artery blood flow. Therapeutic targeting of renal vasoconstriction with serelaxin in the rat models increased kidney perfusion, oxygenation, and function through reduction in renal vascular resistance, reversal of endothelial dysfunction, and increased activation of the

  18. Virgin Coconut Oil: Remedial Effects on Renal Dysfunction in Diabetic Rats

    Directory of Open Access Journals (Sweden)

    A. M. Akinnuga

    2014-01-01

    Full Text Available Renal dysfunction is now a prevalent complication of diabetes mellitus. Therefore, this study was carried out to evaluate the remedial effects of virgin coconut oil (VCO on renal dysfunction in diabetic rats. Fifteen albino Wistar rats were divided into 3 groups that comprise normal control group (Group I and diabetic control group (Group II fed with normal rat chows and a diabetic test group (Group III fed with 10% VCO diet. Group II and Group III were made diabetic by single intraperitoneal injection of 150 mg/kg of freshly prepared alloxan monohydrate. After 72 hours of alloxan injection, fasting blood glucose was tested to confirm diabetes mellitus. After 3 weeks, the animals were anaesthetized and sacrificed to collect blood samples for renal function analysis. The creatinine, urea, and blood urea nitrogen values of Group II were significantly different from those of Group I and Group III at P<0.001. Also, there was significant difference (P<0.05 in total protein value between Group II (4.42  ±  0.47 mg/dL and Group I (5.78  ±  0.12 mg/dL as well as Group III (5.86  ±  0.19 mg/dL, but there was no significant difference between that of Group I and Group III (5.78  ±  0.12 mg/dL and 5.86  ±  0.19 mg/dL, resp.. Thus, VCO is effective in preventing renal damage in diabetic patients.

  19. Pleurotus ostreatus opposes mitochondrial dysfunction and oxidative stress in acetaminophen-induced hepato-renal injury.

    Science.gov (United States)

    Naguib, Yahya M; Azmy, Rania M; Samaka, Rehab M; Salem, Mohamed F

    2014-12-15

    Acetaminophen (APAP)-induced toxicity is a predominant cause of acute hepatic and renal failure. In both humans and rodents toxicity begins with a reactive metabolite that binds to proteins. This leads to mitochondrial dysfunction and nuclear DNA fragmentation resulting in necrotic cell death. Pleurotus ostreatus (an edible oyster mushroom) is well recognized as a flavourful food, as well as a medicinal supplement. In the present study, we evaluated the role of Pleurotus ostreatus in the protection against APAP-induced hepato-renal toxicity. We also explored the mechanism by which Pleurotus ostreatus exerts its effects. Ninety adult male Swiss albino mice were divided into three groups (30 mice/group). Mice were offered normal diet (control and APAP groups), or diet supplemented with 10% Pleurotus ostreatus (APAP + Pleurotus ostreatus) for 10 days. Mice were either treated with vehicle (control group, single intra-peritoneal injection.), or APAP (APAP and APAP + Pleurotus ostreatus groups, single intra-peritoneal injection, 500 mg/kg), 24 hours after the last meal. APAP increased serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST) glutamate dehydrogenase (GDH), creatinine, blood urea nitrogen (BUN), urinary kidney injury molecule-1 (KIM-1), and hepatic and renal malondialdehyde (MDA) content. APAP decreased hepatic and renal glutathione (GSH) content, as well as glutathione peroxidase (GSH-Px) and superoxide dismutase (SOD) activities. Supplementation with Pleurotus ostreatus significantly reduced APAP-induced elevated levels of ALT, AST, GDH, creatinine, BUN, KIM-1and MDA, while GSH level, and GSH-Px and SOD activities were significantly increased. Our findings were further validated by histopathology; treatment with Pleurotus ostreatus significantly decreased APAP-induced cell necrosis in liver and kidney tissues. We report here that the antioxidant effect of Pleurotus ostreatus opposes mitochondrial dysfunction and oxidative

  20. Treatment strategies to minimize or prevent chronic allograft dysfunction in pediatric renal transplant recipients: an overview.

    Science.gov (United States)

    Höcker, Britta; Tönshoff, Burkhard

    2009-01-01

    Long-term allograft survival poses a major problem in pediatric renal transplantation, with allograft nephropathy being the principal cause of graft failure after the first post-transplant year. The mechanisms of nephron loss resulting in graft dysfunction are multiple, comprising both immunologic factors such as acute and chronic antibody- or T-cell-mediated rejection and non-immunologic components. The latter include peri-transplant injuries and renovascular lesions (renal artery stenosis, thrombosis) as well as cardiovascular risk factors such as arterial hypertension and hyperlipidemia. Another relevant issue leading to progressive nephron loss and declining kidney transplant function is acute and chronic nephrotoxicity induced by the calcineurin inhibitors (CNIs) ciclosporin (cyclosporine microemulsion) and tacrolimus. Furthermore, the presence of an abnormal lower urinary tract as well as bacterial (recurrent pyelonephritis) and viral (cytomegalovirus [CMV], polyomavirus [BK virus; BKV]) infections are crucial factors involved in the incidence of chronic allograft dysfunction and graft failure. Renovascular lesions and lower urinary tract obstruction are typical indicators for surgical intervention. The aim of treatment in pediatric patients with renal failure secondary to a dysfunctional lower urinary tract is to create a sterile, continent, and nonrefluxive reservoir. Surgical techniques such as bladder augmentation and the introduction of intermittent catheterization and anticholinergic therapy have significantly improved graft outcome. Arterial hypertension, another factor responsible for graft function deterioration in pediatric renal transplant recipients, is controlled preferably by the use of angiotensin converting enzyme (ACE) inhibitors or angiotensin II receptor antagonists, which are known to possess nephroprotective properties in addition to their potent antihypertensive effects. Although treatment of subclinical rejection with augmented

  1. Thyroid dysfunction in 281 patients with metastatic melanoma or renal carcinoma treated with interleukin-2 alone.

    Science.gov (United States)

    Krouse, R S; Royal, R E; Heywood, G; Weintraub, B D; White, D E; Steinberg, S M; Rosenberg, S A; Schwartzentruber, D J

    1995-11-01

    The purpose of this prospective study was to determine the incidence of thyroid dysfunction in cancer patients receiving immunotherapy with interleukin-2 (IL-2) alone, and to assess the relationship of hypothyroidism to clinical response. A cohort of 281 consecutive patients with metastatic melanoma or renal carcinoma were treated with IL-2 alone from July 1, 1989 until June 30, 1993. The majority (n = 216) received high-dose IL-2 and the remainder (n = 65) received low-dose therapy. Thyroid function was measured before, during, and after immunotherapy. Forty-one percent of initially euthyroid patients developed thyroid dysfunction after starting high-dose IL-2-alone therapy. The most common abnormality was hypothyroidism, occurring in 35% of patients, although moderate or severe hypothyroidism requiring thyroid hormone replacement occurred in 9% of patients. Hypothyroidism was related to duration of IL-2 therapy and was not associated with clinical response. Hyperthyroidism developed in 7% of previously euthyroid patients receiving high-dose IL-2. Overall, the incidence of thyroid dysfunction was similar in the high- and low-dose IL-2 regimens. In conclusion, thyroid dysfunction is a common sequela of IL-2 therapy. Thyroid function should be measured routinely in cancer patients receiving IL-2-based treatment. It is recommended that thyroid hormone replacement be given to patients with moderate or severe hypothyroidism.

  2. Aortic Blood Flow Reversal Determines Renal Function: Potential Explanation for Renal Dysfunction Caused by Aortic Stiffening in Hypertension.

    Science.gov (United States)

    Hashimoto, Junichiro; Ito, Sadayoshi

    2015-07-01

    Aortic stiffness determines the glomerular filtration rate (GFR) and predicts the progressive decline of the GFR. However, the underlying pathophysiological mechanism remains obscure. Recent evidence has shown a close link between aortic stiffness and the bidirectional (systolic forward and early diastolic reverse) flow characteristics. We hypothesized that the aortic stiffening-induced renal dysfunction is attributable to altered central flow dynamics. In 222 patients with hypertension, Doppler velocity waveforms were recorded at the proximal descending aorta to calculate the reverse/forward flow ratio. Tonometric waveforms were recorded to measure the carotid-femoral (aortic) and carotid-radial (peripheral) pulse wave velocities, to estimate the aortic pressure from the radial waveforms, and to compute the aortic characteristic impedance. In addition, renal hemodynamics was evaluated by duplex ultrasound. The estimated GFR was inversely correlated with the aortic pulse wave velocity, reverse/forward flow ratio, pulse pressure, and characteristic impedance, whereas it was not correlated with the peripheral pulse wave velocity or mean arterial pressure. The association between aortic pulse wave velocity and estimated GFR was independent of age, diabetes mellitus, hypercholesterolemia, and antihypertensive medication. However, further adjustment for the aortic reverse/forward flow ratio and pulse pressure substantially weakened this association, and instead, the reverse/forward flow ratio emerged as the strongest determinant of estimated GFR (P=0.001). A higher aortic reverse/forward flow ratio was also associated with lower intrarenal forward flow velocities. These results suggest that an increase in aortic flow reversal (ie, retrograde flow from the descending thoracic aorta toward the aortic arch), caused by aortic stiffening and impedance mismatch, reduces antegrade flow into the kidney and thereby deteriorates renal function. © 2015 American Heart Association

  3. Positive correlations between cerebral choline and renal dysfunction in chronic renal failure

    Energy Technology Data Exchange (ETDEWEB)

    Sasaki, Osamu; Nakahama, Hajime; Nakamura, Satoko; Inenaga, Takashi; Kawano, Yuhei [National Cardiovascular Center, Division of Hypertension and Nephrology, Department of Internal Medicine, Osaka (Japan); Hattori, Noriaki; Inoue, Noriko; Sawada, Tohru [BF Research Institute, Osaka (Japan); Kohno, Shigeru [Nagasaki University School of Medicine, Second Department of Internal Medicine, Nagasaki (Japan)

    2006-05-15

    Cerebral metabolism in chronic renal failure (CRF) patients has not been fully evaluated. This study examined cerebral metabolites in CRF, using proton magnetic resonance spectroscopy (MRS). Subjects comprised 19 CRF patients and 21 healthy volunteers. Spectra were acquired from voxels of interest positioned in the parietal gray and white matter, and concentrations of the following cerebral metabolites were measured: N-acetyl group (NA), creatine + phosphocreatine (Cr), choline-containing compounds (Cho), myo-inositol and glutamate + glutamine. Among the 19 CRF patients, 9 who were started on hemodialysis (HD) underwent careful follow-up. Proton MRS was performed before and about 2 weeks after starting HD. In six patients in whom follow-up was possible, a third MRS was performed after about 18 months. The NA/Cr ratio was not significantly changed in CRF. However, elevations in the Cho/Cr ratio were found in both gray and white matter compared with controls. To the best of our knowledge, this is the first report of positive correlations between the Cho/Cr ratio in both regions and serum osmotic pressure. (orig.)

  4. Diffusion tensor imaging and tractography for assessment of renal allograft dysfunction - initial results

    Energy Technology Data Exchange (ETDEWEB)

    Hueper, Katja; Gutberlet, M.; Rodt, T.; Wacker, F.; Galanski, M.; Hartung, D. [Institute for Diagnostic and Interventional Radiology, Hannover Medical School - Germany, Hannover (Germany); Gwinner, W. [Clinic for Nephrology, Hannover Medical School - Germany, Hannover (Germany); Lehner, F. [Clinic for General, Abdominal and Transplant Surgery, Hannover Medical School - Germany, Hannover (Germany)

    2011-11-15

    To evaluate MR diffusion tensor imaging (DTI) as non-invasive diagnostic tool for detection of acute and chronic allograft dysfunction and changes of organ microstructure. 15 kidney transplanted patients with allograft dysfunction and 14 healthy volunteers were examined using a fat-saturated echo-planar DTI-sequence at 1.5 T (6 diffusion directions, b = 0, 600 s/mm{sup 2}). Mean apparent diffusion coefficient (ADC) and mean fractional anisotropy (FA) were calculated separately for the cortex and for the medulla and compared between healthy and transplanted kidneys. Furthermore, the correlation between diffusion parameters and estimated GFR was determined. The ADC in the cortex and in the medulla were lower in transplanted than in healthy kidneys (p < 0.01). Differences were more distinct for FA, especially in the renal medulla, with a significant reduction in allografts (p < 0.001). Furthermore, in transplanted patients a correlation between mean FA in the medulla and estimated GFR was observed (r = 0.72, p < 0.01). Tractography visualized changes in renal microstructure in patients with impaired allograft function. Changes in allograft function and microstructure can be detected and quantified using DTI. However, to prove the value of DTI for standard clinical application especially correlation of imaging findings and biopsy results is necessary. (orig.)

  5. Utility of captopril renography in diagnosis of renal dysfunction in liver cirrhosis

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    Kim, S. H.; Chung, Y. A.; Yoo, I. R.; Kim, E. N.; Park, Y. H.; Sohn, Y. H.; Chugn, S. K. [The Catholic Univ., Seoul (Korea, Republic of)

    2000-07-01

    To evaluate the utility of captopril renography (CR) to detect early renal dysfunction in patients with different grades of liver cirrhosis. Thirty cirrhotic patients(19 men and 11 women with mean age of 55.7 yr) were included. The degree of cirrhosis was evaluated according to Child-Pugh classification; grade A in 3, B in 19 and C in 8. Baseline renography (BR) and CR were performed using {sup 99m}Tc-MAG3, and serum creatinine (Cr), renin aldosterone and 24 hr urine sodium (U-Na) were measured on the same day or 1 day before CR. The peak time (PT) and 3 min to 20 min activity ratio(K20/3) were obtained from the whole-kidney (WK) and parenchymal(P) renograms. We evaluated the difference between renogram indices in different grades of liver cirrhosis, and correlated laboratory data with renogram indices. The results were shown in table. The renogram indices became abnormal on CR in 5 out of 19 patients with grade B and in 7 out of 8 with grade C. There are significant correlations between renin and WK-PT on CR(r=0.625, p<0.01), and aldosterone and PT on CR(r=0.755, p<0.01). Captopril renography is capable of detecting early renal dysfunction in cirrhotic patients, which may explain the related pathogenesis.

  6. Evaluation of renoprotective effect of Aphanizomenon flos-aquae on cisplatin-induced renal dysfunction in rats.

    Science.gov (United States)

    Kuriakose, Gini C; Kurup, Muraleedhara G

    2008-01-01

    Cisplatin is an effective chemotherapeutic agent used in the treatment of a wide array of both pediatric and adult malignancies. Dose-dependent and cumulative nephrotoxicity is the major toxicity of this compound, sometimes requiring a reduction in dose or discontinuation of treatment. Recent evidence has implicated oxidative and nitrosative stress in cisplatin-induced nephrotoxicity. Aphanizomenon flos-aquae (AFA), blue-green algae, is claimed to be a potential antioxidant. The present study was designed to explore the renoprotective potential of AFA against cisplatin-induced oxidative stress and renal dysfunction. The ethanolic extract of Aphanizomenon flos-aquae (EEAFA) (25, 50, 100 mg/kg(-1) p.o.) was administered two days before through three days after cisplatin challenge (5 mg/kg(-1) i.p.). Renal injury was assessed by measuring serum creatinine, blood urea nitrogen, creatinine and urea clearance, and serum nitrite levels. Renal oxidative stress was determined by renal TBARS levels, reduced glutathione levels, and enzymatic activity of superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPX), and glutathione transferase (GST). A single dose of cisplatin produced marked renal oxidative and nitrosative stress and significantly deranged renal functions. Chronic EEAFA treatment significantly and dose-dependently restored renal functions, reduced lipid peroxidation, and enhanced reduced glutathione levels, superoxide dismutase, and catalase activities. The results of the present study clearly demonstrate the pivotal role of reactive oxygen species and their relation to renal dysfunction and point to the therapeutic potential of AFA in cisplatin-induced nephrotoxicity.

  7. Job stress strengthens the link between metabolic risk factors and renal dysfunction in adult men.

    Science.gov (United States)

    Tsurugano, Shinobu; Nakao, Mutsuhiro; Takeuchi, Takeaki; Nomura, Kyoko; Yano, Eiji

    2012-01-01

    Chronic kidney disease (CKD) is an important risk factor for cardiovascular disease. The metabolic risk factors obesity, hypertension, diabetes, and dyslipidemia are closely associated with renal dysfunction. As psychosocial stress affects these risk factors, here, we examined relationships between metabolic risk factors and renal function, and their association with job stress. The participants were 1,231 Japanese male office workers attending annual health examinations. The estimated glomerular filtration rate (eGFR) was determined using the equation recommended by the Japanese Society for Nephrology: eGFR (mL/min/1.73 m(2)) = 194 × age(-0.287) × Cr(-1.094). Job stress was measured using the Job Content Questionnaire based on the job demand-control model. The job strain index equaled the job demand scores divided by the job control scores. The participants were classified into four ordinal groups of job strain index, based on previous studies (i.e., ≤ 0.4 the lowest, 0.4-0.5 lower, 0.5-0.6 higher, or ≥ 0.6 the highest). A significant correlation was found between lowered eGFR and each of the metabolic risk factors waist circumference, systolic and diastolic blood pressure, and total cholesterol (p job stress had an interactive effect on the relationships between eGFR and systolic and diastolic blood pressure, and triglycerides, depending on the job strain index (highest vs. lowest) (p < 0.05). The highly stressed workers exhibited a close association of eGFR with metabolic risk factors like hypertension and dyslipidemia. Therefore, intensive management may be important for preventing the progression of renal dysfunction and cardiovascular complications in those experiencing stress.

  8. Relationship of plasma creatinine and lactic acid in type 2 diabetic patients without renal dysfunction

    Institute of Scientific and Technical Information of China (English)

    LIU Fang; LU Jun-xi; TANG Jun-ling; LI Li; LU Hui-juan; HOU Xu-hong; JIA Wei-ping; XIANG Kun-san

    2009-01-01

    Background As one of most widely-used biguanides,metformin can induce the lactic acidosis in patients with renal failure though its incidence is very low.However,lactic acidemia induced by mefformin was reported in patients without renal dysfunction.It is unclear that whether lactatemia exists in diabetic patients with normal renal function in Chinese or not and its influencing factors.This study aimed to clarify the influencing factors of lactic acid,and identify a practiced clinical marker to predict the hyperlactacidemia in diabetics with normal renal function.Methods The clinical data and venous blood samples of 1024 type 2 diabetic patients treated with(n=426)or without metformin(n=599)were collected.The lactic acid was assayed by enzyme-electrode method.The biochemical indexes included creatinine(Cr)and hepatase were measured with enzymatic procedures.The lactic acid concentrations of different Cr subgroups were compared,and the correlation and receiver operating characteristic curve analysis were used.Results The mean lactic acid level and the proportion of hyperlactatemia of metformin group were significantly higher than that of non-metformin group(P<0.01),but no lactic acidosis was found in all patients.The correlation and multiple stepwise regression analysis indicated that the correlative factors of lactic acid in turn were Cr,metformin,alanine transferase(ALT),body mass index(BMI),Urine albumin(Ualb),and blood urea nitrogen(BUN)in total patients;and Cr,ALT,BMI and BUN in non-metformin treated patients;Cr and ALT in metformin-group.The lactate concentration increased with the increment of Cr levels,and reached its peak at Cr 111-130 μmol/L,and the optimal cutoff of Cr in predicting hyperlactacidemia was 96.5 μmol/L.Conclusions Metformin can increase the incidence of lactatemia in type 2 diabetic patients without renal dysfunction.Cr,ALT,and BMI are independent associated factors of blood lactic acid levels.There is low proportion of lactatemia in

  9. The Effect of Renal Dysfunction on Circulating Sclerostin Level in Patients with Type 2 Diabetes

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    Se Hwa Kim

    2014-01-01

    Full Text Available Objective. Sclerostin is a Wnt inhibitor produced specifically by osteocytes. However, it is not currently clear whether renal dysfunction has an effect on circulating sclerostin level in patients with type 2 diabetes. The aim of the study was to evaluate this relationship. Design and Patients. We conducted a cross-sectional observational study of 302 type 2 diabetic patients with or without chronic kidney disease. Serum sclerostin level was analyzed by ELISA, and renal function was assessed by estimated glomerular filtration rate (eGFR using chronic kidney disease epidemiology collaboration (CKD-EPI equation. Results. There was a strong correlation between sclerostin level with renal function presented as serum creatinine (r=0.745, P<0.001 and eGFR (r=-0.590, P<0.001. Serum sclerostin level was significantly higher in patients with CKD-G3 stage than those with CKD-G1/2 stages after adjusting for age, sex, and BMI (P=0.011. Patients with CKD-G4/5 stages had dramatically increased level of circulating sclerostin. Multiple regression analyses found that age, sex, and eGFR were independent determining factors for circulating sclerostin level. Conclusion. Our data showed that serum sclerostin levels start to increase in diabetic patients with CKD-G3 stage. Further studies are needed to establish the potential role of elevated sclerostin in diabetic patients with CKD.

  10. Ultrastructural changes of corpora cavernosa in men with erectile dysfunction and chronic renal failure.

    Science.gov (United States)

    Bellinghieri, Guido; Santoro, Giuseppe; Santoro, Domenico; Lo Forti, Bruno; Savica, Vincenzo; Favazzi, Pietro; Magaudda, Ludovico; Cohen, Arthur H

    2004-09-01

    Erectile dysfunction (ED) is a common and often distressing side effect of renal failure. Uremic men of different ages report a high variety of sexual problems, including sexual hormonal pattern alterations, reduced or loss of libido, infertility, and impotence, thereby influencing their well-being. The pathogenic mechanisms include physiologic, psychologic, and organic causes. To determine the contribution of morphologic factors to impotence we studied the ultrastructure of the corpora cavernosa in 20 patients with end-stage renal disease who were treated with chronic dialysis and compared the findings with 6 individuals with no clinical history of impotence. Our results indicated that in male uremic patients with sexual disturbances there were major changes in smooth muscle cells. This was characterized by reduction of dense bodies in the cytoplasm, thick basement membranes, and increased interstitial collagen fibers with resultant reduction of cell-to-cell contact. In addition, there was thickening and lamination of basement membranes of endothelial cells and increased accumulation of collagen between nerve fibers. These alterations were more evident in patients with longer time on dialysis and were independent of type of primary renal disease. We hypothesize that ED in dialysis patients is not related to the primary disease but to the uremic state.

  11. Renal tubular dysfunction in pediatric patients with beta-thalassemia major

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    Ali Ahmadzadeh

    2011-01-01

    Full Text Available To evaluate the prevalence of renal tubular dysfunction in children with β-thalassemia (β-T major, we studied the glomerular and tubular function in 140 children with β-T major and compared them to a healthy control group at our center from May 2007 to April 2008. Fresh first morning samples were collected from each patient and analyzed for sodium, potassium, calcium (Ca, protein, uric acid (UA, creatinine (Cr, urine osmolality and urinary N-acetyl-β-D-glucosaminidase (UNAG activity. Blood samples were also collected for complete blood count, blood urea nitrogen (BUN, fasting blood sugar, serum creatinine (SCr, electrolytes, and ferritin before transfusion. Among the study patients, 72 were males, and the mean age was 11.5 (ranging 7-16 years. SCr levels were all within normal limits and all of them had normal glomerular filtration rate (GFR. The mean UNAG was 17.8 IU/L in the study patients (normal 0.15-11.5 IU/L and 3.2 IU/L in the control group (P 0.21 (P = 0.006. Nine (6.4% thalassemic patients with a mean age of 12 years had proteinuria (Upr/UCr > 0.2. Sixty-nine (49.3% out of the 140 patients and 45 (65.2% of the patients having UNAG had uricosuria also (UUA/UCr > 0.26. Ten (7% patients had microscopic hematuria and 10 (7% patients with a mean age of 13.5 years had glucosuria or diabetes mellitus. We conclude that tubular dysfunction is a relative common complication of the β-T major; UNAG and its index are the best to detect renal tubular dysfunction in these patients. Currently, periodic measurement of UCa/UCr and UUA/UCr ratios as well as urinalysis are recommended.

  12. Bergenin attenuates renal injury by reversing mitochondrial dysfunction in ethylene glycol induced hyperoxaluric rat model.

    Science.gov (United States)

    Aggarwal, Deepika; Gautam, Diksha; Sharma, Minu; Singla, S K

    2016-11-15

    Bergenin, isolated from Bergenia ligulata is a potent antioxidant and antilithiatic agent. Present work was designed to establish the biochemical role of bergenin on mitochondrial dysfunction in the ethylene glycol induced hyperoxaluric rat model. Bergenin was administrated at a dose of 10mg/kg body wt i.p. from 14th day of establishing the 28 days hyperoxaluria rat model. α-Tocopherol was given as positive control at a dose of 100mg/kg body wt i.p. Mitochondrial dysfunction was studied by evaluating the activities of respiratory chain complexes, mitochondrial membrane potential and reactive oxygen species. Histopathological analysis of the kidney tissue was done after Pizzolato staining. Also, expression of monocyte chemoattractant protein -1(MCP-1) and kidney injury marker protein (KIM-1) were studied and the levels of IL-1β were evaluated in kidney tissue homogenate. Mitochondrial dysfunction during stone crystallization was evident by decreased activities of electron transport chain complexes I, II and IV and augmented mitochondrial oxidative stress in hyperoxaluric rats. Bergenin treatment significantly (Pproduction and expression of KIM-1 and MCP-1 in the renal tissue. The findings of the present study provide evidence that bergenin exerted protective effects in hyperoxaluria through mitochondrial protection that involves attenuation of oxidative stress. Hence, it presented itself as an effective remedy in combating urolithiasis. Copyright © 2016 Elsevier B.V. All rights reserved.

  13. Renal heparan sulfate proteoglycans modulate fibroblast growth factor 2 signaling in experimental chronic transplant dysfunction.

    Science.gov (United States)

    Katta, Kirankumar; Boersema, Miriam; Adepu, Saritha; Rienstra, Heleen; Celie, Johanna W A M; Mencke, Rik; Molema, Grietje; van Goor, Harry; Berden, Jo H M; Navis, Gerjan; Hillebrands, Jan-Luuk; van den Born, Jacob

    2013-11-01

    Depending on the glycan structure, proteoglycans can act as coreceptors for growth factors. We hypothesized that proteoglycans and their growth factor ligands orchestrate tissue remodeling in chronic transplant dysfunction. We have previously shown perlecan to be selectively up-regulated in the glomeruli and arteries in a rat renal transplantation model. Using the same model, here we present quantitative RT-PCR profiling data on proteoglycans and growth factors from laser-microdissected glomeruli, arterial tunicae mediae, and neointimae at 12 weeks after transplantation. In glomeruli and neointimae of allografts, selective induction of the matrix heparan sulfate proteoglycan perlecan was observed, along with massive accumulation of fibroblast growth factor 2 (FGF2). Profiling the heparan sulfate polysaccharide side chains revealed conversion from a non-FGF2-binding heparan sulfate phenotype in control and isografted kidneys toward a FGF2-binding phenotype in allografts. In vitro experiments with perlecan-positive rat mesangial cells showed that FGF2-induced proliferation is dependent on sulfation and can be inhibited by exogenously added heparan sulfate. These findings indicate that matrix proteoglycans such as perlecan serve as functional docking platforms for FGF2 in chronic transplant dysfunction. We speculate that heparin-like glycomimetics could be a promising intervention to retard development of glomerulosclerosis and neointima formation in chronic transplant dysfunction.

  14. Manifestation of renal disease in obesity: pathophysiology of obesity-related dysfunction of the kidney

    Directory of Open Access Journals (Sweden)

    John A D’Elia

    2009-11-01

    reflex arc in humans. Further understanding of obesityrelated renal dysfunction has been accomplished recently using experimental models. Rapid weight loss following bariatric surgery may reverse renal pathology of obesity with restoration of normal blood pressure.Keywords: glomerulomegaly, podocyte hypertrophy, obesity, albuminuria, adiponectin, insulin, leptin

  15. Assessment of early renal allograft dysfunction with blood oxygenation level-dependent MRI and diffusion-weighted imaging

    Energy Technology Data Exchange (ETDEWEB)

    Park, Sung Yoon [Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of); Kim, Chan Kyo, E-mail: chankyokim@skku.edu [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Park, Byung Kwan [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Kim, Sung Ju; Lee, Sanghoon [Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Huh, Wooseong [Department of Nephrology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2014-12-15

    Highlights: • R2* and ADC in renal allografts are moderately correlated with eGFR. • R2* and ADC are lower in early allograft dysfunction than normal allograft function. • No significant difference between AR and ATN was found in both R2* and ADC. - Abstract: Purpose: To investigate blood oxygenation level-dependent (BOLD) MRI and diffusion-weighted imaging (DWI) at 3 T for assessment of early renal allograft dysfunction. Materials and methods: 34 patients with a renal allograft (early dysfunction, 24; normal, 10) were prospectively enrolled. BOLD MRI and DWI were performed at 3 T. R2* and apparent diffusion coefficient (ADC) values were measured in cortex and medulla of the allografts. Correlation between R2* or ADC values and estimated glomerular filtration rate (eGFR) was investigated. R2* or ADC values were compared among acute rejection (AR), acute tubular necrosis (ATN) and normal function. Results: In all renal allografts, cortical or medullary R2* and ADC values were moderately correlated with eGFR (P < 0.05). Early dysfunction group showed lower R2* and ADC values than normal function group (P < 0.05). AR or ATN had lower R2* values than normal allografts (P < 0.05), and ARs had lower cortical ADC values than normal allografts (P < 0.05). No significant difference of R2* or ADC values was found between AR and ATN (P > 0.05). Conclusion: BOLD MRI and DWI at 3 T may demonstrate early functional state of renal allografts, but may be limited in characterizing a cause of early renal allograft dysfunction. Further studies are needed.

  16. The Protective Effect of Omega-3 Against Thioacetamide Induced Lipid and Renal Dysfunction in Male Rats

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    Davood Moghadamnia

    2016-10-01

    Full Text Available Background Thioacetamide causes lipid and kidney dysfunction.Omega-3 unsaturated fatty acids prevent the progression of renal diseases. Objectives This study aimed to assess the protective effects of omega-3 fish oil supplement on thioacetamide induced lipid and kidney dysfunction in male rats. Methods In this experimental study, 42 male rats were divided into 6 groups of 7: control group sham group which received 0.4 mL olive oil as a solvent, Thioacetamide group receiving thioacetamide at a dose of 150 mg/kg once as intraperitoneal injection, Experimental groups of 1, 2 and 3 which received omega-3 fish oil supplement at the doses of 100, 200, 300 mg/kg orally for 3 months respectively and then they received thioacetamide at the dose of 150 mg/kg intraperitoneally for once. The levels of serum creatinine, BUN, total cholesterol, LDL, HDL, FBS, triglyceride, sodium and potassium were measured. The pathological changes of tissue samples of the kidneys were studied after hematoxylin-eosin staining. The data were analyzed by SPSS-18 software and using one way ANOVA and Tukey as post hoc test. Significant level was considered to be P < 0.05. Results The mean serum levels of potassium in the second experimental group significantly decreased (5.26 ± 0.02 compared to the group receiving thioacetamide (6.50 ± 0. The mean serum sodium in all experimental groups decreased significantly compared to the group receiving thioacetamide. The mean serum levels of total cholesterol in experimental group 3 (66.80 ± 1.46 significantly decreased compared to the group receiving thioacetamide (84 ± 0.57. No significant changes were observed in the mean serum levels of FBS, BUN, HDL, LDL, triglycerides and creatinine in all experimental groups compared to the group receiving thioacetamide. All the experimental groups improved renal histological changes induced by thioacetamide and these protective effects were dose-dependent (P ≤ 0.05. Conclusions The results of

  17. Prevalence, correlative and statistical relationships of renal dysfunction in patients with chronic ischemic heart failure

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    D. A. Lashkul

    2014-02-01

    Full Text Available Chronic heart failure (CHF is one of the most common complications of cardiovascular disease. According multicenter studies conducted during recent years, coronary heart disease was the leading cause of heart failure and has been on average 64% of patients with chronic heart failure. The tight functional relationship of cardiovascular and urinary system causes a lot of interest to the functional state of kidneys in various cardiovascular diseases. Most risk factors for cardiovascular disease are common risk factors of renal failure. Causes significant differences in the prevalence of chronic kidney disease (CKD in patients with chronic heart failure, defined as coronary artery disease and hypertension remain unclear. Need clarification prevalence of CKD among patients with CHF in general and in specific groups of patients. The aim of the study was to examine the prevalence, correlation and statistical relationships of renal dysfunction with functional class, age and gender of patients with coronary heart disease and heart failure, were hospitalized. Materials and methods. Analyzed the medical cards 344 patients (286 men and 58 women with ischemic chronic heart failure, mean age 59.2±9.4 years. The etiology of heart failure in 298 (86.6% patients had a combination of coronary artery disease and essential hypertension in 46 (13.4% - CHD. Chronic heart failure 1 functional class (FC was diagnosed in 10 (2.9% patients, 2 FC - in 106 (31%, 3 FC - 207 (60.5% and 4 FC - 19 (5, 6% patients. Diabetes was 62 (18% patients. Myocardial infarction had a history of 245 (71.2% patients. Glomerular filtration rate was calculated using the formula MDRD (Modification of Diet in Renal Disease. Descriptive statistics are presented as mean±standard deviation for continuous variables and as percentages for categorical variables. Depending on the distribution of the analyzed parameters used unpaired Student's t-test or U-Mann-Whitney test. Comparisons among all

  18. Reversible anuric acute kidney injury secondary to acute renal autoregulatory dysfunction.

    Science.gov (United States)

    Imbriano, Louis J; Maesaka, John K; Drakakis, James; Mattana, Joseph

    2014-02-01

    Autoregulation of glomerular capillary pressure via regulation of the resistances at the afferent and efferent arterioles plays a critical role in maintaining the glomerular filtration rate over a wide range of mean arterial pressure. Angiotensin II and prostaglandins are among the agents which contribute to autoregulation and drugs which interfere with these agents may have a substantial impact on afferent and efferent arteriolar resistance. We describe a patient who suffered an episode of anuric acute kidney injury following exposure to a nonsteroidal anti-inflammatory agent while on two diuretics, an angiotensin-converting enzyme inhibitor, and an angiotensin receptor blocker. The episode completely resolved and we review some of the mechanisms by which these events may have taken place and suggest the term "acute renal autoregulatory dysfunction" to describe this syndrome.

  19. Renal sympathetic denervation prevents the development of pulmonary arterial hypertension and cardiac dysfunction in dogs.

    Science.gov (United States)

    Hu, Wei; Yu, Sheng-Bo; Chen, Liao; Guo, Rui-Qiang; Zhao, Qing-Yan

    2015-08-01

    The renin-angiotensin-aldosterone system is activated in pulmonary arterial hypertension (PAH) patients, and this activation may have long-term negative effects on the progression of PAH. The purpose of this study was to evaluate the effects of transcatheter renal sympathetic denervation (RSD) on the development of pulmonary arterial hypertension and cardiac dysfunction in dogs using two-dimensional speckle tracking imaging. Twenty-two dogs were randomly divided into three groups: control group (n = 7), PAH group (n = 8), and PAH + RSD group (n = 7). All dogs were assessed using two-dimensional speckle tracking imaging. The ventricular strain, ventricular synchrony, left ventricular (LV) twist, and torsion rate were analyzed to evaluate cardiac function. After 8 weeks, the right ventricular lateral longitudinal strain and the septum longitudinal strain were reduced in the PAH group compared with the control group (p dogs.

  20. Beneficial effects of thymoquinone and omega-3 on intestinal ischemia/reperfusion-induced renal dysfunction in rats

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    Ahmed M. Fayez

    2014-12-01

    Depending on the obtained results in the present study it could be concluded that thymoquinone and omega-3 have beneficial effects on II/R-induced renal dysfunction in rats. The protective potential could be attributed to the antioxidant, antiapoptotic and anti-inflammatory effects of test drugs.

  1. Plasma Cystatin C is a predictor of renal dysfunction, ACLF and mortality in patients with acutely decompensated liver cirrhosis

    DEFF Research Database (Denmark)

    Markwardt, Daniel; Holdt, Lesca M; Steib, Christian

    2017-01-01

    BACKGROUND: The development of acute-on-chronic liver failure (ACLF) in patients with liver cirrhosis is associated with high mortality rates. Renal failure is the most significant organ dysfunction that occurs in ACLF. So far there are no biomarkers predicting ACLF. AIM: To investigate whether C...

  2. Percutaneous coronary intervention for acute myocardial infarction in elderly patients with renal dysfunction: results from the Korea Acute Myocardial Infarction Registry.

    Science.gov (United States)

    Lim, Sang Yup; Bae, Eun Hui; Choi, Joon Seok; Kim, Chang Seong; Ma, Seong Kwon; Ahn, Youngkeun; Jeong, Myung Ho; Kim, Weon; Woo, Jong Shin; Kim, Young Jo; Cho, Myeong Chan; Kim, Chong Jin; Kim, Soo Wan

    2013-07-01

    This study aimed to evaluate the effects of percutaneous coronary intervention (PCI) on short- and long-term major adverse cardiac events (MACE) in elderly (>75 yr old) acute myocardial infarction (AMI) patients with renal dysfunction. As part of Korea AMI Registry (KAMIR), elderly patients with AMI and renal dysfunction (GFRrenal dysfunction, PCI therapy yields favorable in-hospital and short-term and long-term MACE-free survival.

  3. Aqueous garlic extract alleviates liver fibrosis and renal dysfunction in bile-duct-ligated rats.

    Science.gov (United States)

    Mahmoud, Mona F; Zakaria, Sara; Fahmy, Ahmed

    2014-01-01

    There is accumulating evidence that the renin-angiotensin system (RAS) is involved in hepatic inflammation and fibrogenesis. Garlic was found to lower the activity of the angiotensin converting enzyme (ACE) in the serum of rats in a diabetic model. We examined the effect of an aqueous garlic extract (AGE) on the ACE activity, cholestasis-induced liver fibrosis, and associated renal dysfunction in comparison with the effect of the standard drug enalapril. Both AGE and enalapril were administered orally for six weeks starting from the third day after bile duct ligation (BDL). BDL significantly increased the serum activities of liver enzymes, serum lactate dehydrogenase (LDH) activity, an indicator of liver cell death, serum total bilirubin (TB) level, liver myeloperoxidase (MPO) activity, and liver malondialdehyde (MDA) content. BDL was associated with elevation of serum urea and creatinine levels indicating renal dysfunction. BDL also caused an increase in the transcript levels of the genes coding for tumour necrosis factor alpha (TNF-alpha), transforming growth factor beta-1 (TGF-beta1), and matrix metalloproteinase-13 (MMP-13), a collagenase, in liver tissues. A significant decrease in hepatic reduced glutathione (GSH) was observed in BDL rats, while serum ACE activity was increased. Both AGE and enalapril counteracted all these deleterious changes, with the exception that only AGE reduced the MPO activity. These findings suggest that AGE possesses hepato- and renoprotective properties, similar to enalapril, probably by modulating the levels of proteins such as TNF-alpha, TGF-beta1 and MMP-13, and involving a reduction of ACE and of oxidative stress.

  4. Renal dysfunction and state of metabolic and hemodynamic factors in patients with arterial hypertension

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    Klochkov V.A.

    2011-12-01

    Full Text Available The aim of the investigation is to carry out comparative evaluation of metabolic and hemodynamic indices in patients with arterial hypertension (AH and renal dysfunction; to study the interrelation between arterial blood pressure level normalization and the presence or lack of microalbuminuria (MAU in the morning urine portion of patients with AH after therapy with antihypertensive preparations (APs of various groups. Methods. 121 persons have been investigated, 91 out — patients of both sexes, aged 33-55, with the diagnosis of arterial hypertension of stage II risk III, who have been taking Perindopril, Telmisartan and Bisoprolol for3 months. The control of arterial pressure level, biochemical analysis of metabolic indices and morning urine portion test for microalbuminuria has been carried out. Results. MAU has been revealed in 17,6% patients, occurring more frequently in men than in women. Microalbuminuria is accompanied by reliable decrease of total and ionized calcium and magnesium concentrations, an increase of potassium level in blood plasma, increase of cholesterol, triglycerides, glucose and levels. Patients with AH and renal dysfunction reliably demonstrate higher levels of systolic and diastolic arterial pressure in the morning and evening hours, their normalization effect after APs intake is significantly interconnected with MAU presence. Conclusion. In patients with AH and MAU the main risk factors of cardio-vascular diseases development are more expressed. Microalbuminuria is a risk factor in patients with arterial hypertension and may influence on the basic blood electrolyte balance. While carrying out antihypertensive therapy the presence of MAU should be taken into consideration

  5. Prognostic Relationships between Microbleed, Lacunar Infarction, White Matter Lesion, and Renal Dysfunction in Acute Ischemic Stroke Survivors.

    Science.gov (United States)

    Jeon, Jae Woong; Jeong, Hye Seon; Choi, Dae Eun; Ham, Young Rok; Na, Ki Ryang; Lee, Kang Wook; Shin, Jong Wook; Kim, Jei

    2017-02-01

    It is well known that renal dysfunction and cerebral small-vessel disease (SVD), including microbleed, lacunar infarction, and white matter lesion (WML), are associated with poor prognosis after ischemic stroke. However, the prognostic relationship between renal dysfunction and SVD has not been well evaluated in acute ischemic stroke survivors. Therefore, in this study, we evaluated the prognostic relationships between estimated glomerular filtration rate (eGFR) and cerebral SVD after acute ischemic stroke. We retrospectively reviewed the clinical and radiological data of acute ischemic stroke survivors with decreased eGFR (acute ischemic stroke survivors. Both renal impairment and the presence of SVD were predictors of poor poststroke survival. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  6. Anemia, renal dysfunction and malnutrition associated with heart failure in patients with valvulopathy.

    Science.gov (United States)

    Souza, Wysllenny Nascimento de; Araújo, Cristiane Maria Sá de; Silva, Silvia Alves da; Petribú, Marina de Moraes Vasconcelos

    2010-06-01

    Valvular disease can course with heart failure (HF), anemia and renal dysfunction (RD), increasing the nutritional risk and worsening patient prognosis. To evaluate the prevalence of anemia and RD in patients with valvulopathy with or without HF, as well as establish a correlation with the nutritional status. A total of 104 patients admitted at the Clinic of Valvulopathy of PROCAPE/UPE, during the period of Aug-Oct/2008. The data were obtained from the nutritional and medical follow-up files. The collected variables were: sex, age, nutritional status according to the body mass index (BMI), presence of HF, anemia and RD. Anemia was considered when hemoglobin values were prevalence of anemia and RD was 71.1% and 68.8%, and 48.1% and 60.0%, in patients with and without HF, respectively, with a statistically significant difference for anemia (p = 0.022). Of the patients, 48.1% were eutrophic, 26.9% had excess weight and 25.0% presented some degree of malnutrition. The patients with HF presented a higher frequency of low weight (p = 0.020). The nutritional status was not associated with anemia (p = 0.117), but it was associated with RD, with renal function being decreased more often in patients with low weight (p = 0.000). When the prevalence of malnutrition, anemia and RD was compared between patients with and without HF, it showed statistical significance.

  7. FTY720 prevents progression of renal fibrosis by inhibiting renal microvasculature endothelial dysfunction in a rat model of chronic kidney disease.

    Science.gov (United States)

    Ni, Haifeng; Chen, Junfeng; Pan, Mingming; Zhang, Minghui; Zhang, Jiandong; Chen, Pingsheng; Liu, Bicheng

    2013-12-01

    Recent studies have shown that chronic endothelial dysfunction can impair multiple aspects of renal physiology and, in turn, contribute to renal fibrosis. Sphingosine 1-phosphate (S1P) has been highlighted as an endothelial barrier-stabilizing mediator. The aim of our study was to investigate the effect of FTY720, an S1P analog, on the progression of renal fibrosis by inhibiting renal microvasculature endothelial dysfunction in a rat model of chronic kidney disease. Thirty male Sprague-Dawley rats were used in this study. Seven days after surgery, we placed the animals into three groups: sham surgery; 5/6 nephrectomized (Nx) rats; and 5/6Nx + FTY720 (1 mg/kg/day). All of the animals were sacrificed 12 weeks after surgery. We obtained and analyzed blood and kidney tissue samples from all of the groups. Glomerular capillary density and peritubular capillary (PTC) density were determined by CD31 immunostaining. The expression of transforming growth factor beta 1 (TGF-β1), collagen IV, fibronectin, endothelial nitric oxide synthase (eNOS) and vascular endothelial growth factor (VEGF) were analyzed by immunohistochemistry, reverse transcription-polymerase chain reaction and western blotting. The 5/6Nx group exhibited increased blood urea nitrogen and serum creatinine, visible renal histological changes, pro-fibrotic molecule (TGF-β1) and production of extracellular matrix proteins such as collagen IV and fibronectin and decreased glomerular and PTC density, compared to the sham controls (P kidney disease.

  8. Influence of pre-hydration and pharmacogenetics on plasma methotrexate concentration and renal dysfunction following high-dose methotrexate therapy.

    Science.gov (United States)

    Yanagimachi, Masakatsu; Goto, Hiroaki; Kaneko, Tetsuji; Naruto, Takuya; Sasaki, Koji; Takeuchi, Masanobu; Tanoshima, Reo; Kato, Hiromi; Yokosuka, Tomoko; Kajiwara, Ryosuke; Fujii, Hisaki; Tanaka, Fumiko; Goto, Shoko; Takahashi, Hiroyuki; Mori, Masaaki; Kai, Sumio; Yokota, Shumpei

    2013-12-01

    High-dose methotrexate therapy (HD-MTX) has been well established for the treatment of childhood acute lymphoblastic leukemia (ALL). The aims of this study were to investigate whether clinical and pharmacogenetic factors influence plasma MTX concentration and renal dysfunction in patients treated with HD-MTX. In a total of 127 courses of HD-MTX in 51 patients with childhood ALL, influence of clinical and pharmacogenetic factors on plasma MTX concentration and HD-MTX-related renal dysfunction was evaluated. Clinical factors included age, gender, duration of HD-MTX continuous-infusion and duration of pre-hydration before HD-MTX. Pharmacogenetic factors included 5 gene polymorphisms within the MTX pathway genes, namely, SLC19A1, MTHFR, ABCC2 and ABCG2. Short duration of pre-hydration before HD-MTX is the most important risk factor for prolonged high MTX concentration (p < 0.001, OR 6.40, 95 % CI 2.39-17.16) and renal dysfunction (p = 0.013, OR 3.15, 95 % CI 1.27-7.80). The T allele at MTHFR C677T was the risk factor for prolonged high MTX concentration (p = 0.009, OR 5.54, 95 % CI 1.54-19.85), but not for renal dysfunction. We found the influence of MTHFR C677T polymorphism on prolonged high MTX concentration. We reconfirmed the importance of adequate pre-hydration before HD-MTX to prevent prolonged high MTX concentration and MTX-related renal dysfunction.

  9. Anemia, renal dysfunction, and their interaction in patients with chronic heart failure.

    Science.gov (United States)

    de Silva, Ramesh; Rigby, Alan S; Witte, Klaus K A; Nikitin, Nikolay P; Tin, Lwin; Goode, Kevin; Bhandari, Sunil; Clark, Andrew L; Cleland, John G F

    2006-08-01

    Anemia and renal dysfunction (RD) are frequent complications seen in chronic heart failure (HF). However, the prevalence and interaction of these co-morbidities in a representative population of outpatients with chronic HF is poorly described. In this study, it was sought to determine the association between RD and anemia in patients with HF enrolled in a community-based HF program. Nine hundred fifty-five patients with HF due to left ventricular systolic dysfunction were investigated for the prevalence of anemia and its cause and followed for a median of 531 days. Anemia was defined as hemoglobin prevalence of anemia was 32%. Fifty-three percent of patients with and 27% of those without anemia had > or = 1 test suggesting hematinic deficiency. The prevalence of RD was 54%. Forty-one percent of patients with and 22% of patients without RD had anemia, with similar proportions associated with iron deficiency in the presence or absence of RD. Anemia and RD independently predicted a worse outcome, and this effect was additive. In conclusion, in outpatients with chronic HF, anemia and RD are common and co-exist but confer independent prognostic information. A deficiency of conventional hematinic factors may cause about 1/3 of anemia in this clinical setting.

  10. Reversal of renal dysfunction by targeted administration of VEGF into the stenotic kidney: a novel potential therapeutic approach.

    Science.gov (United States)

    Chade, Alejandro R; Kelsen, Silvia

    2012-05-15

    Renal microvascular (MV) damage and loss contribute to the progression of renal injury in renovascular disease (RVD). Whether a targeted intervention in renal microcirculation could reverse renal damage is unknown. We hypothesized that intrarenal vascular endothelial growth factor (VEGF) therapy will reverse renal dysfunction and decrease renal injury in experimental RVD. Unilateral renal artery stenosis (RAS) was induced in 14 pigs, as a surrogate of chronic RVD. Six weeks later, renal blood flow (RBF) and glomerular filtration rate (GFR) were quantified in vivo in the stenotic kidney using multidetector computed tomography (CT). Then, intrarenal rhVEGF-165 or vehicle was randomly administered into the stenotic kidneys (n = 7/group), they were observed for 4 additional wk, in vivo studies were repeated, and then renal MV density was quantified by 3D micro-CT, and expression of angiogenic factors and fibrosis was determined. RBF and GFR, MV density, and renal expression of VEGF and downstream mediators such as p-ERK 1/2, Akt, and eNOS were significantly reduced after 6 and at 10 wk of untreated RAS compared with normal controls. Remarkably, administration of VEGF at 6 wk normalized RBF (from 393.6 ± 50.3 to 607.0 ± 45.33 ml/min, P < 0.05 vs. RAS) and GFR (from 43.4 ± 3.4 to 66.6 ± 10.3 ml/min, P < 0.05 vs. RAS) at 10 wk, accompanied by increased angiogenic signaling, augmented renal MV density, and attenuated renal scarring. This study shows promising therapeutic effects of a targeted renal intervention, using an established clinically relevant large-animal model of chronic RAS. It also implies that disruption of renal MV integrity and function plays a pivotal role in the progression of renal injury in the stenotic kidney. Furthermore, it shows a high level of plasticity of renal microvessels to a single-dose VEGF-targeted intervention after established renal injury, supporting promising renoprotective effects of a novel potential therapeutic intervention to

  11. N-acetyl-seryl-aspartyl-lysyl-proline attenuates renal injury and dysfunction in hypertensive rats with reduced renal mass: council for high blood pressure research.

    Science.gov (United States)

    Liao, Tang-Dong; Yang, Xiao-Ping; D'Ambrosio, Martin; Zhang, Yanlu; Rhaleb, Nour-Eddine; Carretero, Oscar A

    2010-02-01

    N-acetyl-seryl-aspartyl-lysyl-proline (Ac-SDKP) is a naturally occurring peptide of which the plasma concentration is increased 4- to 5-fold by angiotensin-converting enzyme inhibitors. We reported previously that, in models of both hypertension and postmyocardial infarction, Ac-SDKP reduces cardiac inflammation and fibrosis. However, it is unknown whether Ac-SDKP can prevent or reverse renal injury and dysfunction in hypertension. In the present study, we tested the hypothesis that, in rats with 5/6 nephrectomy (5/6Nx)-induced hypertension, Ac-SDKP reduces renal damage, albuminuria, and dysfunction by decreasing inflammatory cell infiltration and renal fibrosis and by increasing nephrin protein. Ac-SDKP (800 microg/kg per day, SC via osmotic minipump) or vehicle was either started 7 days before 5/6Nx (prevention) and continued for 3 weeks or started 3 weeks after 5/6Nx (reversal) and continued for another 3 weeks. Rats with 5/6Nx developed high blood pressure, left ventricular hypertrophy, albuminuria, decreased glomerular filtration rate, and increased macrophage infiltration (inflammation) and renal collagen content (fibrosis). Ac-SDKP did not affect blood pressure or left ventricular hypertrophy in either group; however, it significantly reduced albuminuria, renal inflammation, and fibrosis and improved glomerular filtration rate in both prevention and reversal groups. Moreover, slit diaphragm nephrin protein expression in the glomerular filtration barrier was significantly decreased in hypertensive rats. This effect was partially prevented or reversed by Ac-SDKP. We concluded that Ac-SDKP greatly attenuates albuminuria and renal fibrosis and improves renal function in rats with 5/6Nx. These effects may be related to decreased inflammation (macrophages) and increased nephrin protein.

  12. Amla (Emblica officinalis Gaertn.) attenuates age-related renal dysfunction by oxidative stress.

    Science.gov (United States)

    Yokozawa, Takako; Kim, Hyun Young; Kim, Hyun Ju; Tanaka, Takashi; Sugino, Hidetoshi; Okubo, Tsutomu; Chu, Djong-Chi; Juneja, Lekh Raj

    2007-09-19

    To investigate the effects of amla on renal dysfunction involved in oxidative stress during the aging process, we employed young (2 months old) and aged (13 months old) male rats and administered SunAmla (Taiyo Kagaku Co., Ltd., Japan) or an ethyl acetate (EtOAc) extract of amla, a polyphenol-rich fraction, at a dose of 40 or 10 mg/kg body weight/day for 100 days. The administration of SunAmla or EtOAc extract of amla reduced the elevated levels of serum creatinine and urea nitrogen in the aged rats. In addition, the tail arterial blood pressure was markedly elevated in aged control rats as compared with young rats, while the systolic blood pressure was significantly decreased by the administration of SunAmla or EtOAc extract of amla. Furthermore, the oral administration of SunAmla or EtOAc extract of amla significantly reduced thiobarbituric acid-reactive substance levels of serum, renal homogenate, and mitochondria in aged rats, suggesting that amla would ameliorate oxidative stress under aging. The increases of inducible nitric oxide synthase (iNOS) and cyclooxygenase (COX)-2 expression in the aorta of aging rats were also significantly suppressed by SunAmla extract or EtOAc extract of amla, respectively. Moreover, the elevated expression level of bax, a proapoptotic protein, was significantly decreased after oral administration of SunAmla or EtOAc extract of amla. However, the level of bcl-2, an antiapoptotic protein, did not show any difference among the groups. The expressions of renal nuclear factor-kappaB (NF-kappaB), inhibitory kappaB in cytoplasm, iNOS, and COX-2 protein levels were also increased with aging. However, SunAmla or EtOAc extract of amla reduced the iNOS and COX-2 expression levels by inhibiting NF-kappaB activation in the aged rats. These results indicate that amla would be a very useful antioxidant for the prevention of age-related renal disease.

  13. Oxidative stress influence on renal dysfunction in patients with obstructive jaundice: A case and control prospective study

    Directory of Open Access Journals (Sweden)

    David Martínez-Cecilia

    2016-08-01

    Full Text Available Background: Obstructive Jaundice (OJ is associated with a significant risk of developing acute renal failure (ARF. The involvement of oxidative stress in the development of cholestasis has been demonstrated in different experimental models. However, its role in the morbidity of human cholestasis is far to be elucidated. The aim of the study was the evaluation of oxidative stress markers in blood from patients with OJ and its relation to complications and benign/malignant evolution of cholestasis. Methods: A prospective cross-sectional study of 105 patients with OJ and 34 control subjects were included. Several markers of liver function and oxidative stress, such as lipoperoxides (LPO, as well as reduced glutathione (GSH, catalase (CAT, superoxide dismutase (SOD and glutathione peroxidase (GSH-Px activities were assessed. Results: The patients with OJ showed a marked increase in plasma levels of LPO, SOD and GSH, while GSH-Px levels were decreased. The increase in lipid peroxidation products and the depletion of SOD activity in blood were also related to renal dysfunction. The highest level of LPO was associated with malignant etiology of the disease. The logistic regression analysis showed that the age of the patient and the levels of LPO in blood were predictors of renal dysfunction in OJ patients. Conclusions: This study demonstrates a correlation between oxidative stress and renal dysfunction patients with OJ.

  14. Hypermethylations of RASAL1 and KLOTHO is associated with renal dysfunction in a Chinese population environmentally exposed to cadmium

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Chen; Liang, Yihuai [School of Public Health, Fudan University, 130 DongAn Road, Shanghai 200032 (China); Key Laboratory of Public Health Safety, Ministry of Education, 130 DongAn Road, Shanghai 200032 (China); Lei, Lijian [Department of Epidemiology, School of Public Health, Shanxi Medical University, Shanxi (China); Zhu, Guoying; Chen, Xiao [Department of Bone Metabolism, Institute of Radiation Medicine, Fudan University, Shanghai (China); Jin, Taiyi, E-mail: tyjin@shmu.edu.cn [School of Public Health, Fudan University, 130 DongAn Road, Shanghai 200032 (China); Key Laboratory of Public Health Safety, Ministry of Education, 130 DongAn Road, Shanghai 200032 (China); Wu, Qing, E-mail: qingwu@fudan.edu.cn [School of Public Health, Fudan University, 130 DongAn Road, Shanghai 200032 (China); Key Laboratory of Public Health Safety, Ministry of Education, 130 DongAn Road, Shanghai 200032 (China)

    2013-08-15

    Exposure to cadmium (Cd) can affect both DNA methylation and renal function, but there are few examples of the association between epigenetic markers and Cd-induced kidney damage. It has been suggested that hypermethylation of the genes RASAL1 and KLOTHO is associated with renal fibrogenesis. To investigate whether hypermethylation of RASAL1 and KLOTHO in peripheral blood DNA can be associated with Cd exposure and/or Cd-induced renal dysfunction, the degrees of methylation of RASAL1 and KLOTHO in peripheral blood DNA from 81 residents in Cd-polluted and non-polluted areas were measured using bisulfate-PCR-pyrosequencing. Changes in blood cadmium (BCd), urinary cadmium (UCd), and kidney parameters were measured, and the glomerular filtration rate (eGFR) was estimated. The levels of BCd and UCd correlated positively with the levels of DNA methylation in RASAL1 and in KLOTHO. The more heavily exposed residents (BCd, 4.23–13.22 μg/L; UCd, 8.65–32.90 μg/g creatinine) exhibited obvious renal dysfunction. Notably, when Cd concentration in blood and urine was adjusted, the increased methylation level in RASAL1 was inversely correlated with eGFR (P < 0.01) but the relationship between hypermethylation of KLOTHO and eGFR was not statistically significant. The methylation of RASAL1 increased along with the increased abnormal prevalence of eGFR. Our findings suggest that Cd exposure can induce the hypermethylation of RASAL1 and KLOTHO. Hypermethylation of RASAL1 may be an indicator of the progress for chronic kidney disease. - Highlights: • A long term heavily Cd exposure induced renal dysfunction. • Cd exposure correlated positively with DNA methylation in RASAL1 and KLOTHO. • Hypermethylation of RASAL1 correlated with adjusted renal function indicators.

  15. Ahmedabad tolerance induction protocol and chronic renal allograft dysfunction: pathologic observations and clinical implications

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    Trivedi Hargovind L

    2009-01-01

    Full Text Available Abstract Background Chronic Renal Allograft Dysfunction (CRAD is responsible for a large number of graft failures. We have abrogated acute T-cell rejections using Ahmedabad Tolerance Induction Protocol (ATIP with hematopoietic stem cell transplantation (HSCT under non-myeloablative conditioning pre-transplant. However B-cell mediated rejections and CRAD continue to haunt us. We carried out retrospective analysis of renal allograft biopsies performed in the last 4 years to evaluate the effect of ATIP on CRAD. Materials and methods Biopsies diagnosed as per modified Banff criteria belonged to 2 groups: ATIP under low dose immunosuppression of cyclosporine/Azathioprine/Mycofenolate mofetil+ Prednisolone, subjected to donor leucocyte transfusion, anti-T/B cell antibodies, low dose target specific irradiation, cyclophosphamide, cyclosporin followed by HSCT pre-transplant; controls who opted out of ATIP were transplanted under standard triple drug immunosuppression. Demographics of both groups were comparable. Results Incidence of chronic changes was higher in controls (17.5% vs. 10.98% in ATIP over a mean follow up of 151.9 months in the former and 130.9 months in the latter. Proteinuria and hypertension were higher in controls (48.4% vs. ATIP (32.7% with chronic transplant glomerulopathy, focal global sclerosis in 67.7% in controls vs. 46.7% in ATIP, acute on chronic T/B cell rejection in 51.6% controls vs. 28.1% ATIP, with peritubular capillary C4d deposits in 19.4% controls vs. 1.9% ATIP biopsies. Acute on chronic calcineurin inhibitor toxicity was higher in ATIP (71.9% vs. 48.4% in controls. Conclusion Chronic immune injury was less with ATIP vs controls as compared to a higher incidence of chronic calcineurin inhibitor toxicity in the former.

  16. Renal sympathetic denervation prevents the development of pulmonary arterial hypertension and cardiac dysfunction in dogs

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    Wei Hu

    2015-08-01

    Full Text Available The renin–angiotensin–aldosterone system is activated in pulmonary arterial hypertension (PAH patients, and this activation may have long-term negative effects on the progression of PAH. The purpose of this study was to evaluate the effects of transcatheter renal sympathetic denervation (RSD on the development of pulmonary arterial hypertension and cardiac dysfunction in dogs using two-dimensional speckle tracking imaging. Twenty-two dogs were randomly divided into three groups: control group (n = 7, PAH group (n = 8, and PAH + RSD group (n = 7. All dogs were assessed using two-dimensional speckle tracking imaging. The ventricular strain, ventricular synchrony, left ventricular (LV twist, and torsion rate were analyzed to evaluate cardiac function. After 8 weeks, the right ventricular lateral longitudinal strain and the septum longitudinal strain were reduced in the PAH group compared with the control group (p < 0.001. However, these values were significantly restored in the PAH + RSD group compared with the PAH group (p < 0.01. The degree of LV and RV dyssynchrony was significantly higher in the PAH group compared with the control group (p < 0.001, but the degree of LV and RV dyssynchrony was significantly lower in the PAH + RSD group compared to the PAH group (p < 0.01. The LV twist was significantly restored in the PAH + RSD group compared to the PAH group (p < 0.01. Similarly, the rotation rate was markedly decreased in the PAH group, and strikingly improved in the PAH + RSD group (p < 0.01. These results indicate that RSD prevents the development of PAH and cardiac dysfunction in dogs.

  17. Mechanisms of endothelial dysfunction in resistance arteries from patients with end-stage renal disease.

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    Leanid Luksha

    Full Text Available The study focuses on the mechanisms of endothelial dysfunction in the uremic milieu. Subcutaneous resistance arteries from 35 end-stage renal disease (ESRD patients and 28 matched controls were studied ex-vivo. Basal and receptor-dependent effects of endothelium-derived factors, expression of endothelial NO synthase (eNOS, prerequisites for myoendothelial gap junctions (MEGJ, and associations between endothelium-dependent responses and plasma levels of endothelial dysfunction markers were assessed. The contribution of endothelium-derived hyperpolarizing factor (EDHF to endothelium-dependent relaxation was impaired in uremic arteries after stimulation with bradykinin, but not acetylcholine, reflecting the agonist-specific differences. Diminished vasodilator influences of the endothelium on basal tone and enhanced plasma levels of asymmetrical dimethyl L-arginine (ADMA suggest impairment in NO-mediated regulation of uremic arteries. eNOS expression and contribution of MEGJs to EDHF type responses were unaltered. Plasma levels of ADMA were negatively associated with endothelium-dependent responses in uremic arteries. Preserved responses of smooth muscle to pinacidil and NO-donor indicate alterations within the endothelium and tolerance of vasodilator mechanisms to the uremic retention products at the level of smooth muscle. We conclude that both EDHF and NO pathways that control resistance artery tone are impaired in the uremic milieu. For the first time, we validate the alterations in EDHF type responses linked to kinin receptors in ESRD patients. The association between plasma ADMA concentrations and endothelial function in uremic resistance vasculature may have diagnostic and future therapeutic implications.

  18. Prevalence and influential factors of erectile dysfunction in male renal transplant recipients: a multiple center survey

    Institute of Scientific and Technical Information of China (English)

    TIAN Ye; DU Lin-dong; AO Jian-hua; MA Lin-lin; CHEN Li-sheng; XU Yuan-cheng; JI Zheng-guo; TANG Ya-wang; ZHANG Lei; L(U) Wen-cheng; LIN Jun; GUO Hong-bo; XIE Ze-lin; SUN Wen

    2008-01-01

    Background Renal transplants can improve the quality of life for recipients, but the quality of their sexual life might not be improved. This study was conducted to research the prevalence of erectile dysfunction (ED) and the influential factors in male renal transplant recipients (RTRs).Methods A cross-sectional survey was conducted in three renal transplantation centers. Structured questionnaires were administrated by trained interviewers to 824 male renal transplant patients, who had active sexual lives in the last 6 months.Results Complaints of ED were reported by 75.5% of the 809 RTRs (age range 19-75 years, mean age (45±10) years),whose questionnaires were completed. Mild, moderate and severe ED were reported at 53.6%, 8.3% and 13.6%,respectively. The mean age and the graft duration were significantly higher in male RTRs with ED compared to potent graft recipients (P=-0.00 and 0.04, respectively). The prevalence of ED increased with the increase in age. It was 60.7%, 65.8%,75.2%, 87.5% and 92.2% in patients with age below 30 years, 31-40 years, 41-50 years, 51-60 years and over 60 years,respectively (P=0.000). Moreover, the severity of ED increased with aging. The percentage of moderate and severe cases of ED increased from 6.7% in patients below 40 years to 28.9% in those over 40 years (P=0.000). The prevalence of ED in the RTR who had no occupation was higher than in those who were holding a position (P=0.001). The prevalence of ED decreased with the increase in the education level. The prevalence of ED was 94.3%, 86.4%, 74.0% and 67.8% in men with elementary school or lower, middle school, high school, and college or higher degrees, respectively (P=0.000). Patients,whose distal end of arteria iliaca interna was interrupted and underwent iterative transplantation, worried transplanted kidney function was impacted by sexual life, and received cyclosporine (CsA)-based immunosuppressive regimens, were more likely to have ED (P=0.000, 0.001, 0.000, 0

  19. Effect of tadalafil in chronic renal failure rabbits: relevance to erectile dysfunction

    Institute of Scientific and Technical Information of China (English)

    Meng-yuan ZHANG; Qiang FU; Wei BIAN

    2011-01-01

    It is of great importance to investigate an effective and reliable medication against chronic renal failure (CRF)-related erectile dysfunction (ED), which aims to improve patients' life qualities. The concentrations of cyclic guanosine monophosphate (cGMP) in the corpus cavernosal smooth muscle of both CRF and control rabbits were measured. The effects of various concentrations of tadalafil, papaverine, and sodium nitroprusside on the relaxation responses of corpus cavernosal smooth muscle pre-contracted with phenylephrine in CRF rabbits were observed. There was significant difference in the concentration of cGMP between CRF and control rabbits (P<0.01). Tadalafil had the greatest impacts on CRF rabbits when given the same concentration of papaverine or sodium nitroprusside and particularly significant differences were identified under the concentration levels of 10-5 and 10-4 mol/L (P<0.01). The results suggest that the cGMP concentrations of the corpus cavernosum had been greatly reduced in CRF rabbits compared with control rabbits and that tadalafil may be an ideal medication for use in the treatment of CRF-related ED.

  20. Renal provider perceptions and practice patterns regarding the management of pain, sexual dysfunction, and depression in hemodialysis patients.

    Science.gov (United States)

    Green, Jamie A; Mor, Maria K; Shields, Anne Marie; Sevik, Mary Ann; Palevsky, Paul M; Fine, Michael J; Arnold, Robert M; Weisbord, Steven D

    2012-02-01

    Although pain, sexual dysfunction, and depression are common in patients receiving chronic hemodialysis, these symptoms frequently remain untreated. We sought to characterize renal provider perceptions and practice patterns regarding the treatment of these symptoms. We surveyed renal providers whose patients were participating in a clinical trial of symptom management at nine hemodialysis units in southwestern Pennsylvania. We used Spearman's correlation to assess the association of provider characteristics with the reported frequency of providing treatment. Overall, 27 of 35 (77%) providers completed the survey. While 21 (78%) believed symptom management to be "very" important and 23 (85%) reported spending a "moderate" to "a lot" of time managing symptoms, <50% reported treating pain and <20% reported treating sexual dysfunction or depression "most" or "all" of the time. Most providers believed it was nonrenal providers' responsibility to treat these symptoms. A greater reported comfort level managing symptoms was associated with a higher reported frequency of treating pain (r=0.6; p<0.01), sexual dysfunction (r=0.67; p<0.01), and depression (r=0.43; p<0.03). Providers who believed it was nonrenal providers' responsibility to treat these symptoms reported treating pain (r=-0.62; p<0.01) and depression (r=-0.48; p=0.02) less frequently. Despite reporting considerable importance and substantial time managing symptoms in general, renal providers commonly describe not treating pain, sexual dysfunction, and depression in hemodialysis patients. Given renal providers' beliefs that nonrenal clinicians are primarily responsible for treating these symptoms, multidisciplinary approaches to symptom management in these patients are needed.

  1. Mild preoperative renal dysfunction as a predictor of long-term clinical outcome after coronary bypass surgery.

    Science.gov (United States)

    van de Wal, Ruud M A; van Brussel, Ben L; Voors, Adriaan A; Smilde, Tom D J; Kelder, Johannes C; van Swieten, Henry A; van Gilst, Wiek H; van Veldhuisen, Dirk Jan; Plokker, H W Thijs

    2005-02-01

    Renal dysfunction is a prognostic marker in patients with cardiovascular disease. However, no long-term follow-up studies on the influence of mild renal dysfunction on mortality in patients undergoing coronary bypass grafting have been reported. Therefore, we aimed to identify the significance of preoperative (mild) renal dysfunction as a long-term predictor of clinical outcome after coronary bypass surgery. In 358 patients who underwent isolated saphenous vein aorta-coronary artery bypass grafting, estimated glomerular filtration rates were calculated with the Cockroft-Gault equation (GFRc). Patients were categorized into 2 groups (group 1, GFRc >71.1 mL x min (-1) x 1.73 m (-2) ; group 2, GFRc <71.1 mL x min (-1) x 1.73 m (-2) ). Multivariate Cox proportional hazard analyses were performed to determine the independent prognostic value of GFRc. During a median follow-up of 18.2 years, 233 patients (65.1%) died. Patients who died had lower GFRc and were older. Multivariate analysis demonstrated that total mortality in patients with lower GFRc was significantly increased (lower GFRc group vs normal GFRc group: hazard ratio, 1.44; P = .019). Lower GFRc was also an independent predictor of cardiac mortality (hazard ratio, 1.51; P = .032). No significant differences were observed between groups in the occurrence of myocardial infarction and the need for reintervention. Our study demonstrates that after long-term follow-up, preoperative mild renal dysfunction is an independent predictor of long-term (cardiac) mortality in patients who undergo coronary artery bypass grafting.

  2. Endothelial dysfunction and increased responses to renal nerve stimulation in rat kidneys during rhabdomyolysis-induced acute renal failure: role of hydroxyl radical.

    Science.gov (United States)

    Cil, Onur; Ertunc, Mert; Gucer, Kadri Safak; Ozaltin, Fatih; Iskit, Alper Bektas; Onur, Rustu

    2012-01-01

    Rhabdomyolysis is an important cause of acute renal failure (ARF) and renal vasoconstriction is the main mechanism in the pathogenesis of ARF. Lipid peroxidation due to hydroxyl radical (.OH) formation and redox cycling of myoglobin also have a role. We investigated the disturbance in renal vascular reactivity to reveal the mechanisms leading to ARF. Female Wistar rats (n = 7) were injected with glycerol (10 mL/kg, 50% in saline) intramuscularly to induce rhabdomyolysis, and then the kidneys were isolated and perfused. We investigated acetylcholine (ACh)-induced endothelium-dependent and papaverine (PAP)-induced endothelium-independent vasodilation responses and renal nerve stimulation (RNS)-induced vasoconstrictions. These were also investigated both in rats which received either .OH scavenger, dimethylthiourea (DMTU: 500 mg/kg before glycerol injection and 125 mg/kg 8 h after glycerol injection, n = 7), or myoglobin redox cycling inhibitor, acetaminophen (ApAP: 100 mg/kg 2 h before glycerol injection and 100 mg/kg each 4 h, and 22 h after glycerol injection, n = 7). ACh-induced responses in glycerol group were decreased (p group. DMTU restored both endothelium-dependent vasodilation and RNS-induced vasoconstriction. ApAP had no effect on vascular responses. Both DMTU and ApAP exerted a partial protective effect in renal histology without restoring serum creatinine and blood urea nitrogen (BUN) levels or creatinine clearance. This study showed that endothelial dysfunction and increased vasoconstriction developed during rhabdomyolysis. .OH plays an important role in the development of these vascular responses. These findings suggest that decreased endothelium-dependent vasodilation and augmented renal sympathetic tonus contribute to the development of renal vasoconstriction during rhabdomyolysis-induced ARF.

  3. Current limits and future challenges in the management of renal dysfunction in patients with cirrhosis: report from the International Club of Ascites

    DEFF Research Database (Denmark)

    Angeli, Paolo; Sanyal, Arun; Møller, Søren

    2013-01-01

    is based either on the more recent knowledge on renal dysfunction in advanced cirrhosis or current opinions among the members of the International Club of Ascites (ICA) on the management of this complication, obtained through a survey and discussed during the EASL-ICA Joint Meeting in Berlin in March 2011....... It reviews critically our current knowledge and it outlines future perspectives, on the management of renal dysfunction in patients with cirrhosis....

  4. Renal Dysfunction Is an Independent Risk Factor for Mortality after Liver Resection and the Main Determinant of Outcome in Posthepatectomy Liver Failure

    Directory of Open Access Journals (Sweden)

    M. G. Wiggans

    2013-01-01

    Full Text Available Introduction. The aim of this study was to assess the interaction of liver and renal dysfunction as risk factors for mortality after liver resection. Materials and Methods. A retrospective analysis of 501 patients undergoing liver resection in a single unit was undertaken. Posthepatectomy liver failure (PHLF was defined according to the International Study Group of Liver Surgery (ISGLS definition (assessed on day 5 and renal dysfunction according to RIFLE criteria. 90-day mortality was recorded. Results. Twenty-three patients died within 90 days of surgery (4.6%. The lowest mortality occurred in patients without evidence of PHLF or renal dysfunction (2.7%. The mortality rate in patients with isolated PHLF or renal dysfunction was 20% compared to 45% in patients with both. Diabetes (, renal dysfunction (, and PHLF on day 5 ( were independent predictors of 90-day mortality. Discussion. PHLF and postoperative renal dysfunction are independent predictors of 90-day mortality following liver resection but the predictive value for mortality is significantly higher when failure of both organ systems occurs simultaneously.

  5. Risk factors for chronic transplant dysfunction and cardiovascular disease are related to accumulation of advanced glycation end-products in renal transplant recipients

    NARCIS (Netherlands)

    Hartog, Jasper W. L.; de Vries, Aiko P. J.; Bakker, Stephan J. L.; Graaff, Reindert; van Son, Willem J.; van der Heide, Jaap J. Homan; Gans, Reinold O. B.; Wolffenbuttel, Bruce H. R.; de Jong, Paul E.; Smit, Andries J.

    2006-01-01

    Background. Accumulation of advanced glycation end-products (AGEs) has been implicated in the pathogenesis of chronic transplant dysfunction and cardiovascular disease in renal transplant recipients. We aimed to investigate which factors are associated with tissue AGE accumulation in renal transplan

  6. Is a Long Term Work in Automotive Industry a Risk Factor for Renal Dysfunction?

    OpenAIRE

    Assadi, Seyedeh Negar

    2015-01-01

    Background: Disorders of renal system can cause renal failure; therefore screening is necessary especially in workers who are exposed to harmful materials. Hypertension, diabetes mellitus, and hazardous exposures are non-occupational and occupational risk factors for renal diseases. Aim: The objective of this study was to determine the effects of working in automotive industry on renal function in Iran. Subjects and Methods: In a historical cohort study, workers of automotive industry who wor...

  7. Renal proximal tubular dysfunction is a major determinant of urinary connective tissue growth factor excretion.

    NARCIS (Netherlands)

    Gerritsen, K.G.; Peters, H.P.E.; Nguyen, T.Q.; Koeners, M.P.; Wetzels, J.F.M.; Joles, J.A.; Christensen, E.I.; Verroust, P.J.; Li, D.; Oliver, N.; Xu, L.; Kok, R.J.; Goldschmeding, R.

    2010-01-01

    Connective tissue growth factor (CTGF) plays a key role in renal fibrosis. Urinary CTGF is elevated in various renal diseases and may have biomarker potential. However, it is unknown which processes contribute to elevated urinary CTGF levels. Thus far, urinary CTGF was considered to reflect renal ex

  8. Therapeutic effects of continuous renal replacement in patients with multiple organ dysfunction syndrome in ICU

    Directory of Open Access Journals (Sweden)

    Shuang-qing LIU

    2013-05-01

    Full Text Available Objective  To investigate the effects of continuous renal replacement therapy (CRRT on patients with multiple organ dysfunction syndrome (MODS. Methods  Forty-seven patients with MODS, admitted to the Department of SICU of First Affiliated Hospital of General Hospital of PLA, were divided into two groups according to the causative agents: the sepsis group (n=28 and the non-sepsis group (n=19. All the patients involved were treated with CRRT therapy. The systemic and brain hemodynamic parameters, and oxygenation and metabolic variables were assessed immediately before and 12 hours after CRRT. The expected mortality was obtained by APACHE Ⅱ score, and it was compared with the actual mortality to obtain the standard mortality, of which less than 0.9 was defined as an improved survival rate. Results  After 12 hours of CRRT treatment, all the variables (except mean arterial pressure and brain hemodynamics were significantly improved in the sepsis group (P<0.05. The survival rate in ICU was 60.7% with a standard mortality of 0.70. In the non-sepsis group, the survival rate in ICU was only 15.8% and the standard mortality was 1.77. Only the FiO2 was found to be significantly improved in the non-sepsis group. Conclusion  CRRT may significantly improve the clinical outcome and survival rate of patients with sepsis-caused MODS, but no obvious effect is found among the patients with MODS caused by non-sepsis factors.

  9. Chronic renal dysfunction and anaemia are associated with cognitive impairment in older patients with heart failure.

    Science.gov (United States)

    Pulignano, Giovanni; Del Sindaco, Donatella; Di Lenarda, Andrea; Tinti, Maria Denitza; Tarantini, Luigi; Cioffi, Giovanni; Tolone, Stefano; Pero, Gaetano; Minardi, Giovanni

    2014-06-01

    Cognitive impairment, anaemia and chronic kidney disease (CKD) are associated with mortality and disability in chronic heart failure patients. We hypothesized that anaemia and CKD are independent predictors of cognitive impairment in older patients with heart failure. One hundred and ninety community-living elderly patients aged at least 70 years, treated with optimized therapy for heart failure in stable clinical conditions, were prospectively studied. They underwent clinical and multidimensional assessment. Cognitive status was assessed by the Mini Mental State Examination. Cognitive impairment was defined as the Mini Mental State Examination score adjusted by age and educational level below 24. CKD was defined as the Cockcroft-Gault glomerular filtration rate below 60  ml/min and anaemia as haemoglobin below 12  g/dl. Cognitive impairment was diagnosed in 38.9% of patients, CKD in 85.7% and anaemia in 42.6%. Age, female sex, BMI, education less than 5 years, depressive symptoms, anaemia, CKD, disability and worse quality of life were significantly associated with cognitive impairment. Cognitive impairment involved primarily global cognitive deficit, memory, mental speed, attention, calculation and language. A significant relationship between haemoglobin levels and cognitive impairment was found, with the range of 15-16.5  g/dl having the lower prevalence of cognitive impairment (19.4%). At multivariate analysis, advanced age, low education level, anaemia and CKD were independently associated with cognitive impairment. Cox analysis showed that cognitive impairment was an independent predictor of hospitalization for worsening heart failure alone and combined with all-cause death. Cognitive impairment is common in elderly heart failure patients and is independently associated with anaemia and renal dysfunction. Further studies are needed to assess whether optimal treatment of anaemia and CKD may prevent the development of cognitive impairment in heart failure

  10. Mitochondrial DNA is Released in Urine of Sirs Patients with Acute Kidney Injury and Correlates with Severity of Renal Dysfunction.

    Science.gov (United States)

    Jansen, Marcel P B; Pulskens, Wilco P; Butter, Loes M; Florquin, Sandrine; Juffermans, Nicole P; Roelofs, Joris J T H; Leemans, Jaklien C

    2017-08-23

    be related to intra-renal inflammation, coagulation processes, and renal dysfunction in the pathophysiology of SIRS.

  11. Oxidative stress causes renal dopamine D1 receptor dysfunction and salt-sensitive hypertension in Sprague-Dawley rats.

    Science.gov (United States)

    Banday, Anees A; Lau, Yuen-Sum; Lokhandwala, Mustafa F

    2008-02-01

    Renal dopamine plays an important role in maintaining sodium homeostasis and blood pressure (BP) during increased sodium intake. The present study was carried out to determine whether renal dopamine D1 receptor (D1R) dysfunction contributes to increase in salt sensitivity during oxidative stress. Male Sprague-Dawley rats, divided into various groups, received tap water (vehicle); 1% NaCl (high salt [HS]); L-buthionine sulfoximine (BSO), an oxidant; and HS plus BSO with or without Tempol, an antioxidant, for 12 days. Compared with vehicle, HS intake increased urinary dopamine production and decreased basal renal Na/K-ATPase activity but did not affect BP. BSO-treated rats exhibited oxidative stress and a mild increase in BP. In these rats, D1R expression and G protein coupling were reduced, and SKF38393, a D1R agonist, failed to inhibit Na/K-ATPase activity and promote sodium excretion. Concomitant administration of BSO and HS caused oxidative stress, D1R dysfunction, and a marked increase in BP. Although renal dopamine production was increased, it failed to reduce the basal Na/K-ATPase activity in these animals. Treatment of BSO plus HS rats with Tempol decreased oxidative stress and restored endogenous, as well as exogenous, D1R agonist-mediated Na/K-ATPase inhibition and normalized BP. In conclusion, during HS intake, the increased dopamine production via Na/K-ATPase inhibition prevents an increase in BP. During oxidative stress, D1R function is defective, and there is mild hypertension. However, in the presence of oxidative stress, HS intake causes marked elevation in BP, which results from a defective renal D1R function leading to the failure of dopamine to inhibit Na/K-ATPase and promote sodium excretion.

  12. Influence of Age-Related Versus Non-Age-Related Renal Dysfunctionon Survival in Patients with Left Ventricular Dysfunction

    Science.gov (United States)

    Testani, Jeffrey M.; Brisco, Meredith A.; Han, Gang; Laur, Olga; Kula, Alexander J.; Cheng, Susan J.; Tang, W. H. Wilson; Parikh, Chirag R.

    2013-01-01

    Normal aging results in a predictable decline in glomerular filtration rate (GFR) and low GFR is associated with worsened survival. If this survival disadvantage is directly caused by the low GFR, as opposed to the disease causing the low GFR, the risk should be similar regardless of the underlying mechanism. Our objective was to determine if age related declines in estimated GFR (eGFR) carry the same prognostic importance as disease attributable losses in patients with ventricular dysfunction. We analyzed the Studies Of Left Ventricular Dysfunction (SOLVD) limited data set (n=6337). The primary analysis focused on determining if the eGFR mortality relationship differed by the extent the eGFR was consistent with normal ageing. Mean eGFR was 65.7 ± 19.0ml/min/1.73m2. Across the range of age in the population (27 to 80 years), baseline eGFR decreased by 0.67 ml/min/1.73m2 per year (95% CI 0.63 to 0.71). The risk of death associated with eGFR was strongly modified by the degree to which the low eGFR could be explained by aging (p interaction <0.0001). For example, in a model incorporating the interaction, uncorrected eGFR was no longer significantly related to mortality (adjusted HR=1.0 per 10 ml/min/1.73m2, 95% CI 0.97–1.1, p=0.53) whereas a disease attributable decrease in eGFR above the median carried significant risk (adjusted HR=2.8, 95% CI 1.6–4.7, p<0.001). In conclusion, in the setting of LV dysfunction, renal dysfunction attributable to normal aging had a limited risk for mortality, suggesting that the mechanism underlying renal dysfunction is critical in determining prognosis. PMID:24216124

  13. Diabetic nephropathy and endothelial dysfunction: Current and future therapies, and emerging of vascular imaging for preclinical renal-kinetic study.

    Science.gov (United States)

    Leung, Wilson Kc; Gao, L; Siu, Parco M; Lai, Christopher Wk

    2016-12-01

    An explosion in global epidemic of type 2 diabetes mellitus poses major rise in cases with vascular endothelial dysfunction ranging from micro- (retinopathy, nephropathy and neuropathy) to macro-vascular (atherosclerosis and cardiomyopathy) conditions. Functional destruction of endothelium is regarded as an early event that lays the groundwork for the development of renal microangiopathy and subsequent clinical manifestation of nephropathic symptoms. Recent research has shed some light on the molecular mechanisms of type 2 diabetes-associated comorbidity of endothelial dysfunction and nephropathy. Stemming from currently proposed endothelium-centered therapeutic strategies for diabetic nephropathy, this review highlighted some most exploited pathways that involve the intricate coordination of vasodilators, vasoconstrictors and vaso-modulatory molecules in the pathogenesis of diabetic nephropathy. We also emphasized the emerging roles of oxidative and epigenetic modifications of microvasculature as our prospective therapeutics for diabetic renal diseases. Finally, this review in particular addressed the potential use of multispectral optoacoustic tomography in real-time, minimally-invasive vascular imaging of small experimental animals for preclinical renal-kinetic drug trials.

  14. Nephroprotective activity ofSolanum xanthocarpum fruit extract against gentamicin-induced nephrotoxicity and renal dysfunction in experimental rodents

    Institute of Scientific and Technical Information of China (English)

    Talib Hussain; Ramesh K Gupta; K Sweety; Bavani Eswaran; M Vijayakumar; Chandana Venkateswara Rao

    2012-01-01

    Objective:To evaluate nephroprotective potential ofSolanum xanthocarpum(S. xanthocarpum) fruit extract(SXE) against gentamicin(GM) induced nephrotoxicity and renal dysfunction. Methods:Twenty-fourWistar rats were divided into four groups(n=6).Control rats that received normal saline(i.p.) and0.5% carboxymethyl cellulose(p.o.) per day for8 d.Nephrotoxicity was induced in rats by intraperitoneal administration ofGM(100 mg/kg/d for8 d) and were treated withSXE(200 and400 mg/kg/d(p.o.) for8 d).Plasma and urine urea and creatinine, kidney weight, urine output, blood urea nitrogen, renal enzymatic and non-enzymatic antioxidants and lipid peroxidation was evaluated along with histopathological investigation in various experimental groupsof rats.Results:It was observed that theGM treatment induced significant elevation(P<0.001) in plasma and urine urea, creatinine, kidney weight, blood urea nitrogen, renal lipid peroxidation along with significant decrement(P<0.001) in urine output, renal enzymatic and non-enzymatic antioxidants.SXE200 and400 mg/kg treatment toGM treated rats recorded significant decrement(up toP<0.001) in plasma and urine urea and creatinine, renal lipid peroxidation along with significant increment(up toP<0.001) in renal enzymatic and non-enzymatic antioxidants.Histological observations of kidney tissues too correlated with the biochemical observations.Conclusions:These finding powerfully supports thatS. xanthocarpum fruit extract acts in the kidney as a potent scavenger of free radicals to prevent the toxic effects ofGM both in the biochemical and histopathological parameters and thus validates its ethnomedicinal use.

  15. Proinflammatory Cytokines, Adiponectin, and Increased Risk of Primary Cardiovascular Events in Diabetic Patients With or Without Renal Dysfunction

    Science.gov (United States)

    Schöttker, Ben; Herder, Christian; Rothenbacher, Dietrich; Roden, Michael; Kolb, Hubert; Müller, Heiko; Brenner, Hermann

    2013-01-01

    OBJECTIVE Inflammatory processes contribute to both diabetes and cardiovascular risk. We wanted to investigate whether circulating concentrations of proinflammatory immune mediators and adiponectin in diabetic patients are associated with incident cardiovascular events. RESEARCH DESIGN AND METHODS In 1,038 participants with diabetes of the population-based ESTHER study, of whom 326 showed signs of renal dysfunction, Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% CIs for the association of increasing concentrations of C-reactive protein (CRP), interleukin-6 (IL-6), IL-18, macrophage migration inhibitory factor (MIF), adiponectin, and leptin with cardiovascular events (myocardial infarction, stroke, or fatal cardiovascular event) during a follow-up period of 8 years. RESULTS During follow-up, 161 subjects with diabetes experienced a primary cardiovascular event. Proinflammatory markers were not associated with a higher risk for primary cardiovascular events in the total study population after adjustment for multiple confounders. However, IL-6 and MIF were associated with cardiovascular events in subjects with renal dysfunction (HR for the comparison of top vs. bottom tertile 1.98 [95% CI 1.12–3.52], P [trend] = 0.10 for IL-6; 1.48 [0.87–2.51], P [trend] = 0.04 for MIF). Adiponectin levels were associated with cardiovascular events in the total population (1.48 [1.01–2.21], P [trend] = 0.03), and the association was even more pronounced in the subgroup with renal dysfunction (1.97 [1.08–3.57], P [trend] = 0.02). CONCLUSIONS In particular, the absence of an association between CRP and a U-shaped association of adiponectin levels with incident cardiovascular events show that associations between circulating immune mediators and cardiovascular risk differ between diabetic patients and subjects of the general population. PMID:23378623

  16. Introduction of MMF in conjunction with stepwise reduction of calcineurin inhibitor in stable liver transplant patients with renal dysfunction.

    Science.gov (United States)

    Kornberg, Arno; Küpper, Bernadette; Hommann, Merten; Scheele, Johannes

    2005-01-01

    Mycophenolat mofetil (MMF) is a new imunosuppressant without nephrotoxic adverse effects. The aim of this study was to evaluate feasibility and effect of MMF introduction in conjunction with stepwise reduction of calcineurin inhibitors (CNI) in stable liver transplant patients with chronic CNI-induced renal dysfunction (RDF). In the MMF-group (n=27) but not in the controls (n=16), mean serum level of creatinine fell from a baseline of 227.4+/-67.9 micromol/l to 159.2+/-48.2 micromol/l (PMMF. Additionally, systolic and diastolic blood pressure values improved. In 52% of patients, dose reduction (n=11) or withdrawal (n=3) of MMF was necessary due to gastrointestinal or hematologic adverse effects. But also in patients on low dose MMF, there was a significant improvement of renal function without increased immunological risk.

  17. Urinary excretion of fatty acid-binding protein 4 is associated with albuminuria and renal dysfunction.

    Directory of Open Access Journals (Sweden)

    Yusuke Okazaki

    Full Text Available Fatty acid-binding protein 4 (FABP4/A-FABP/aP2 is expressed in not only adipocytes and macrophages but also peritubular capillaries in the normal kidney. We recently demonstrated that ectopic expression of FABP4, but not FABP1 known as liver FABP (L-FABP, in the glomerulus is associated with progression of proteinuria and renal dysfunction. However, urinary excretion of FABP4 has not been investigated.Subjects who participated in the Tanno-Sobetsu Study, a study with a population-based cohort design, in 2011 (n = 392, male/female: 166/226 were enrolled. Urinary FABP4 (U-FABP4 and urinary albumin-to-creatinine ratio (UACR were measured. Change in estimated glomerular filtration rate (eGFR was followed up one year later.In 93 (23.7% of the 392 subjects, U-FABP4 level was below the sensitivity of the assay. Subjects with undetectable U-FABP4 were younger and had lower UACR and higher eGFR levels than subjects with measurable U-FABP4. U-FABP4 level was positively correlated with age, systolic blood pressure and levels of serum FABP4 (S-FABP4, triglycerides, hemoglobin A1c (HbA1c, urinary FABP1 (U-FABP1 and UACR (r = 0.360, p<0.001. Age, S-FABP4, U-FABP1 and UACR were independent predictors of U-FABP4. On the other hand, systolic blood pressure, HbA1c and U-FABP4 were independently correlated with UACR. Reduction in eGFR after one year was significantly larger in a group with the highest tertile of baseline U-FABP4 than a group with the lowest tertile.Urinary FABP4 level is independently correlated with level of albuminuria and possibly predicts yearly decline of eGFR. U-FABP4 would be a novel biomarker of glomerular damage.

  18. Nordihydroguaiaretic acid attenuates potassium dichromate-induced oxidative stress and nephrotoxicity.

    Science.gov (United States)

    Yam-Canul, Paola; Chirino, Yolanda I; Sánchez-González, Dolores Javier; Martínez-Martínez, Claudia María; Cruz, Cristino; Villanueva, Cleva; Pedraza-Chaverri, José

    2008-03-01

    Larrea tridentata also known as Creosote bush, Larrea, chaparral, greasewood or gobernadora has been used in the folk medicine for the treatment of several illnesses. The primary product that is present at high concentrations in the leaves from this plant is nordihydroguaiaretic acid (NDGA) which is a powerful antioxidant. On the other hand, potassium dichromate (K(2)Cr(2)O(7))-induced nephrotoxicity is associated with oxidative stress. The aim of this work was to study the effect of NDGA on K(2)Cr(2)O(7)-induced nephrotoxicity and oxidative stress. Nephrotoxicity was induced by a single injection of K(2)Cr(2)O(7) (15 mg/Kg). A group of K(2)Cr(2)O(7)-treated rats was administered NDGA by mini osmotic pumps (17 mg/Kg/day). The results show that NDGA was able to ameliorate the structural and functional renal damage evaluated by histopathological analysis and by measuring proteinuria, urinary excretion of N-acetyl-beta-d-glucosaminidase, serum creatinine, and serum glutathione peroxidase activity. In addition, immunostaining of 4-hydroxy-2-nonenal and 3-nitrotyrosine, markers of oxidative and nitrosative stress, respectively, was ameliorated by the NDGA treatment. These data strongly suggest that the antioxidant properties of NDGA are involved in its renoprotective effect in K(2)Cr(2)O(7)-treated rats.

  19. Right ventricular dysfunction in patients with end-stage renal disease on regular hemodialysis

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    Mohamed Momtaz

    2013-01-01

    Conclusion Subclinical RV dysfunction - as estimated by RV function indices; tricuspid plane systolic excursion, right ventricle fractional area change, and LTDISº - is increased among HD patients. A high prevalence of pulmonary hypertension was found among HD patients and this was not associated significantly with RV or left ventricular dysfunction in these patients.

  20. Impact of small body weight on tenofovir-associated renal dysfunction in HIV-infected patients: a retrospective cohort study of Japanese patients.

    Directory of Open Access Journals (Sweden)

    Takeshi Nishijima

    Full Text Available BACKGROUND: Treatment with tenofovir is sometimes associated with renal dysfunction. Limited information is available on this side effect in patients with small body weight, although the use of tenofovir will spread rapidly in Asia and Africa, where patients are likely to be of smaller body weight. METHODS: In a single-center cohort, Japanese patients with HIV infection who started tenofovir-containing antiretroviral therapy were retrospectively analyzed. The incidence of tenofovir-associated renal dysfunction, defined as more than 25% decrement of estimated glomerular filtration rate (eGFR from the baseline, was determined. The effects of small body weight and body mass index (BMI on tenofovir-associated renal dysfunction, respectively, were estimated in univariate and multivariate Cox hazards models as the primary exposure. Other possible risk factors were evaluated by univariate analysis and those found significant were entered into the multivariate analysis. RESULTS: The median weight of 495 patients was 63 kg. Tenofovir-related renal dysfunction occurred in 97 (19.6% patients (incidence: 10.5 per 100 person-years. Univariate analysis showed that the incidence of tenofovir-related renal dysfunction was significantly associated with smaller body weight and BMI, respectively (per 5 kg decrement, HR = 1.23; 95% CI, 1.10-1.37; p<0.001(per 1 kg/m(2 decrement, HR = 1.14; 95% CI, 1.05-1.23; p = 0.001. Old age, high baseline eGFR, low serum creatinine, low CD4 count, high HIV viral load, concurrent nephrotoxic drugs, hepatitis C infection, and current smoking were also associated with tenofovir-related renal dysfunction. Multivariate analysis identified small body weight as a significant risk (adjusted HR = 1.13; 95% CI, 1.01-1.27; p = 0.039, while small BMI had marginal significance (adjusted HR = 1.07; 95% CI 1.00-1.16; p = 0.058. CONCLUSION: The incidence of tenofovir-associated renal dysfunction in Japanese patients

  1. Doppler assessment of brachial artery flow as a measure of endothelial dysfunction in pediatric chronic renal failure.

    Science.gov (United States)

    Hussein, Gehan; Bughdady, Yasser; Kandil, Manal E; Bazaraa, Hafez M; Taher, Heba

    2008-11-01

    Cardiovascular morbidity and mortality are highly prevalent among patients with chronic renal failure (CRF). Endothelial dysfunction is regarded as the initial reversible step in the development of atherosclerosis and has been demonstrated in all stages of renal failure. Non-invasive techniques to assess endothelial function have been recently developed and have been proven to predict future mortality in adults. We aimed to assess endothelial function in children with stage 4 chronic kidney disease (CKD 4) on conservative treatment, using a-non invasive, high-resolution, ultrasound Doppler study of the brachial artery flow, correlating it with other clinical and laboratory parameters. This study included 34 children with CKD 4 on conservative treatment who were compared with 30 healthy controls. Flow-mediated dilatation (FMD), nitroglycerin-mediated dilatation (NTG-MD) and FMD/NTG-MD ratio were estimated. FMD was abnormal (< 5%) in 24 patients (71%). FMD and FMD/NTG-MD ratio were significantly lower in patients than in controls (P = 0.001 and P = 0.01, respectively). FMD correlated positively with serum calcium and negatively with alkaline phosphatase. We concluded that endothelial dysfunction is present in children with CKD 4 on conservative treatment and may reflect increased atherogenic and thrombogenic properties of the endothelium, contributing to subsequent adverse cardiovascular outcome.

  2. Low Incidence of Renal Dysfunction among HIV-Infected Patients on a Tenofovir-Based First Line Antiretroviral Treatment Regimen in Myanmar

    Science.gov (United States)

    Kyaw, Nang Thu Thu; Antierens, Annick; Soe, Kyi Pyar; Woodman, Mike; Das, Mrinalini; Zuu, Moe Khine Lwin; Htwe, Pyae Sone

    2015-01-01

    Background Since 2004, Médecins Sans Frontières-Switzerland has provided treatment and care for people living with HIV in Dawei, Myanmar. Renal function is routinely monitored in patients on tenofovir (TDF)-based antiretroviral treatment (ART), and this provides an opportunity to measure incidence and risk factors for renal dysfunction. Methods We used routinely collected program data on all patients aged ≥15 years starting first-line TDF-based ART between January 2012 and December 2013. Creatinine clearance (CrCl) was assessed at base line and six-monthly, with renal dysfunction defined as CrCl Myanmar, the low incidence of renal toxicity in our patient cohort suggests that routine assessment of CrCl may not be needed and could be targeted to high risk groups if resources permit. PMID:26301416

  3. Quantitative Evaluation of Acute Renal Transplant Dysfunction with Low-Dose Three-dimensional MR Renography

    OpenAIRE

    Yamamoto, Akira; Zhang, Jeff L.; Rusinek, Henry; Chandarana, Hersh; Vivier, Pierre-Hugues; Babb, James S.; Diflo, Thomas; John, Devon G.; Benstein, Judith A.; Barisoni, Laura; Stoffel, David R.; Lee, Vivian S.

    2011-01-01

    Our new quantitative analysis method of MR renography, which includes our multicompartmental tracer kinetic renal model, may help to diagnose noninvasively acute rejection or acute tubular necrosis after kidney transplantation.

  4. Pathophysiology of obesity-related renal dysfunction contributes to diabetic nephropathy.

    Science.gov (United States)

    Bayliss, George; Weinrauch, Larry A; D'Elia, John A

    2012-08-01

    Recent studies have demonstrated the role of insulin resistance in renal injury related to obesity, with hyperfiltration leading to glomerulomegaly in a pattern similar to that found in diabetic nephropathy. Similarities in the histologic patterns of damage from obesity and diabetes point to overlapping mechanisms of injury. In this review, we will examine the hormonal mechanisms, signaling pathways and injury patterns in renal injury resulting from obesity and attempt to draw conclusions on the reasons for these similarities.

  5. The functional state of neutrophils correlates with the severity of renal dysfunction in children with hemolytic uremic syndrome.

    Science.gov (United States)

    Fernandez, Gabriela C; Gomez, Sonia A; Ramos, Maria V; Bentancor, Leticia V; Fernandez-Brando, Romina J; Landoni, Veronica I; Lopez, Laura; Ramirez, Flavia; Diaz, Mario; Alduncin, Marta; Grimoldi, Irene; Exeni, Ramon; Isturiz, Martin A; Palermo, Marina S

    2007-01-01

    Hemolytic Uremic Syndrome (HUS) is the main cause of acute renal failure in children. The high percentage of patients who develop long-term sequelae constitutes an important medical concern. The identification of parameters that correlate with the degree of renal failure may be useful to plan the best treatment soon after hospitalization. Here, we investigated the functional state of neutrophils (PMN) from HUS patients on admission, before dialysis and/or transfusion, in relation to the severity of renal impairment reached during the acute period (AP). We found that all PMN activation parameters measured in severe cases of HUS (HUS AP3) were statistically lower comparing to children with mild cases of HUS (HUS AP1). As HUS PMN phenotype and dysfunction is compatible with that of cells undergoing cell death, we also studied spontaneous apoptosis. Not only were HUS PMN not apoptotic, but HUS AP3 PMN showed an increased survival. Almost all phenotypic and functional parameters measured on PMN correlated with severity. Our results revealed a marked deactivation of PMN in severe cases of HUS, and suggest that studying the functional state of PMN could be of prognostic value.

  6. In-line Filtration Decreases Systemic Inflammatory Response Syndrome, Renal and Hematologic Dysfunction in Pediatric Cardiac Intensive Care Patients.

    Science.gov (United States)

    Sasse, Michael; Dziuba, Friederike; Jack, Thomas; Köditz, Harald; Kaussen, Torsten; Bertram, Harald; Beerbaum, Philipp; Boehne, Martin

    2015-08-01

    Cardiac surgery with cardiopulmonary bypass (CPB) frequently leads to systemic inflammatory response syndrome (SIRS) with concomitant organ malfunction. Infused particles may exacerbate inflammatory syndromes since they activate the coagulation cascade and alter inflammatory response or microvascular perfusion. In a randomized, controlled, prospective trial, we have previously shown that particle-retentive in-line filtration prevented major complications in critically ill children. Now, we investigated the effect of in-line filtration on major complications in the subgroup of cardiac patients. Children admitted to tertiary pediatric intensive care unit were randomized to either control or filter group obtaining in-line filtration throughout complete infusion therapy. Risk differences and 95 % confidence intervals (CI) of several complications such as SIRS, sepsis, mortality, various organ failure and dysfunction were compared between both groups using the Wald method. 305 children (n = 150 control, n = 155 filter group) with cardiac diseases were finally analyzed. The majority was admitted after cardiac surgery with CPB. Risk of SIRS (-11.3 %; 95 % CI -21.8 to -0.5 %), renal (-10.0 %; 95 % CI -17.0 to -3.0 %) and hematologic (-8.1 %; 95 % CI -14.2 to -0.2 %) dysfunction were significantly decreased within the filter group. No risk differences were demonstrated for occurrence of sepsis, any other organ failure or dysfunctions between both groups. Infused particles might aggravate a systemic hypercoagulability and inflammation with subsequent organ malfunction in pediatric cardiac intensive care patients. Particle-retentive in-line filtration might be effective in preventing SIRS and maintaining renal and hematologic function. In-line filtration offers a novel therapeutic option to decrease morbidity in cardiac intensive care.

  7. Associations of Anemia and Renal Dysfunction with Outcomes among Patients Hospitalized for Acute Decompensated Heart Failure with Preserved or Reduced Ejection Fraction

    Science.gov (United States)

    Sato, Naoki; Keida, Takehiko; Sakata, Yasushi; Takano, Teruo

    2014-01-01

    Background and objectives The relationship among anemia, renal dysfunction, left ventricular ejection fraction, and outcomes of patients hospitalized for acute decompensated heart failure is unclear. The aim of this study was to evaluate the association between cardiorenal anemia syndrome and postdischarge outcomes in patients hospitalized for heart failure with a preserved or reduced ejection fraction. Design, setting, participants, & measurements Of 4842 patients enrolled in the Acute Decompensated Heart Failure Syndromes Registry between April 1, 2007 and December 31, 2011, 4393 patients were evaluated to investigate the association among anemia, renal dysfunction, preserved or reduced ejection fraction, and the primary end point (mortality and readmission for heart failure since discharge). The patients were divided into four groups on the basis of eGFR and hemoglobin at discharge. The median follow-up period after discharge was 432 (range=253–659) days. Results The primary end point was reached in 37.6% and 34.8% of the preserved and reduced ejection fraction groups, respectively. After adjustment for multiple comorbidities, there was no significant association of either renal dysfunction or anemia alone with the primary end point in patients with preserved ejection fraction, but the combination of renal dysfunction and anemia was associated with a significantly higher risk than that without either condition (hazard ratio, 1.54; 95% confidence interval, 1.12 to 2.12; P<0.01). In patients with reduced ejection fraction, adjusted analysis showed that a significantly higher risk of the primary end point was associated with renal dysfunction alone (hazard ratio, 1.65; 95% confidence interval, 1.21 to 2.25; P=0.002) and also, renal dysfunction plus anemia relative to the risk without either condition (hazard ratio, 2.19; 95% confidence interval, 1.62 to 2.96; P<0.001). Conclusions The findings show that renal dysfunction combined with anemia is associated with an

  8. Is a long term work in automotive industry a risk factor for renal dysfunction?

    Science.gov (United States)

    Assadi, Seyedeh Negar

    2015-01-01

    Disorders of renal system can cause renal failure; therefore screening is necessary especially in workers who are exposed to harmful materials. Hypertension, diabetes mellitus, and hazardous exposures are non-occupational and occupational risk factors for renal diseases. The objective of this study was to determine the effects of working in automotive industry on renal function in Iran. In a historical cohort study, workers of automotive industry who worked in production and had low exposure to metal fumes were selected and divided to three groups with 5-10, 11-20, and 21-30 years work duration. risk factors for renal diseases were collected and analyzed with SPSS using one-way ANOVA, correlation coefficient and with P risk with a confidence interval (CI). The means of work duration in Groups (A), (B) and (C) were 9.8 (0.6), 13.8 (2.0), 22.3 (1.6) years respectively with ANOVA (F) =187.864 and P risk of creatinine clearance, uric acid and mean blood pressure were the highest in Group (B); 1.970 - CI, 0.541-7.169, 1.571 95% CI: 0.198-12.470, and 1.519 95% CI: 0.425-5.426, but the differences were not significant. GFRs were decreased with work duration, but the differences were not significant. Working in automotive Industry with low exposure to toxic metals and solvents has no significant effect on GFR, creatinine clearance, uric acid, and mean blood pressure.

  9. An unusual cause of gross hematuria and renal dysfunction in a young male

    Directory of Open Access Journals (Sweden)

    M Rathi

    2013-01-01

    Full Text Available Monoclonal immunoglobulin deposition disease (MIDD is an uncommon disease with a peak incidence between the 5 th and 6 th decades of life. It is characterized by non-fibrillar, Congo red negative deposition of monoclonal immunoglobulins in various organs, including in the kidneys. MIDD can be of three types depending on the composition of the deposits, and includes light chain deposition disease (LCDD, heavy chain deposition disease and light and heavy chain deposition disease, of which LCDD is the most common. Renal involvement is a universal finding in MIDD, and is in the form of renal insufficiency, microscopic hematuria and nephrotic range proteinuria. Gross hematuria is a rare occurrence. Renal biopsy usually shows nodular sclerosing glomerulopathy on light microscopy and diffuse linear staining of glomerular and tubular basement membrane on immunofluorescence microscopy. We report a young male who presented with rapidly progressive renal failure and gross hematuria and was diagnosed as LCDD with nodular glomerulopathy and crescents on renal biopsy.

  10. Calcineurin-inhibitor minimization in liver transplant patients with calcineurin-inhibitor-related renal dysfunction: a meta-analysis.

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    Yuan Kong

    Full Text Available BACKGROUND: Introduction of calcineurin-inhibitor (CNI has made transplantation a miracle in the past century. However, the side effects of long-term use of CNI turn out to be one of the major challenges in the current century. Among these, renal dysfunction attracts more and more attention. Herein, we undertook a meta-analysis to evaluate the efficacy and safety of calcineurin-inhibitor (CNI minimization protocols in liver transplant recipients with CNI-related renal dysfunction. METHODS: We included randomized trials with no year and language restriction. All data were analyzed using random effect model by Review Manager 5.0. The primary endpoints were glomerular filtration rate (GFR, serum creatinine level (sCr and creatinine clearance rate (CrCl, and the secondary endpoints were acute rejection episodes, incidence of infection and patient survival at the end of follow-up. RESULTS: GFR was significantly improved in CNI minimization group than in routine CNI regimen group (Z = 5.45, P<0.00001; I(2 = 0%. Likely, sCr level was significantly lower in the CNI minimization group (Z = 2.84, P = 0.005; I(2 = 39%. However, CrCl was not significantly higher in the CNI minimization group (Z = 1.59, P = 0.11; I(2 = 0%. Both acute rejection episodes and patient survival were comparable between two groups (rejection: Z = 0.01, P = 0.99; I(2 = 0%; survival: Z = 0.28, P = 0.78; I(2 = 0%, respectively. However, current CNI minimization protocols may be related to a higher incidence of infections (Z = 3.06, P = 0.002; I(2 = 0%. CONCLUSION: CNI minimization can preserve or even improve renal function in liver transplant patients with renal impairment, while sharing similar short term acute rejection rate and patient survival with routine CNI regimen.

  11. 临床表现为肾功能异常患者肾活检的病理分析及风险评估%Pathological Analysis and Risk Assessment of Renal Biopsy in Patients with Renal Dysfunction

    Institute of Scientific and Technical Information of China (English)

    张磊; 蔡广研; 孙雪峰; 张雪光; 吴镝; 张利; 吴杰; 陈香美

    2011-01-01

    Objective: To analyze renal pathology and complications of renal biopsy in patients with renal dysfunction and its diagnostic value and risk factors. Methods:We retrospectively analyzed clinical data, ultrasound imaging and laboratory data of 311 patients clinically manifestating as renal dysfunction ( acute or chronic ). 1 717 cases with normal renal function over the same period were as control. The pathological results and complications, of renal biopsy as well as the risk factors were analyzed by multivariate analysis method. Results:89 patients with acute renal dysfunction and 222 with chronic renal dysfunction were enrolled. The top three pathological types of acute renal dysfunction were ANCA associated glomerulonephritis, acute tubular necrosis and acute interstitial nephritis. The top three pathological types of chronic renal dysfunction were IgA nephropathy, chronic tubulointerstitial damage and hypertensive nephropathy. Incidence of renal biopsy complications in acute or chronic renal dysfunction were 2.2% and 5.8%, respectively,which were higher than those with normal renal function ( 1.3% ). However, there was no nephrectomy, death or other serious complications. Multivariate analysis showed that glomerular filtration rate was significantly associated with incidence of complications ( P < 0.05 ). Conclusion: Performance of renal biopsy carefully in patients with renal dysfuntcion brings benefit for pathological diagnosis and therapeutic strategy. Glomerular filtration rate is closely related with occurrence of the complications.%目的:通过分析临床表现为肾功能异常患者肾活检的病理构成与并发症发生情况,明确肾活检在肾功能异常中的诊断价值及风险.方法:回顾性分析行肾活检的311例临床表现为肾功能异常(急性或慢性)患者和同期1 717例肾功能正常患者的临床资料、超声影像与实验室检查数据,分析急性或慢性肾功能异常的肾活检病理结果以及

  12. A case of ceftriaxone-associated biliary pseudolithiasis in an elderly patient with renal dysfunction

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    Shuichi Abe

    2017-01-01

    Full Text Available Prior literature suggests that ceftriaxone causes formation of gallbladder stones at a relatively high frequency, and when abdominal symptoms occur, prompt investigation of the gallbladder is required with institution of appropriate treatment. Aging, malnutrition, renal impairment, and sepsis are risk factors for pseudolithiasis, and prevention of these is important to suppress gallstone development.

  13. Hypercholesterolemia promotes early renal dysfunction in apolipoprotein E-deficient mice

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    Balarini Camille M

    2011-11-01

    Full Text Available Abstract Background Aging and dyslipidemia are processes which can lead to deleterious consequences to renal function. Therefore, the aim of this study was to determine the effects of both hypercholesterolemia and aging on renal function in mice. Methods Male hypercholesterolemic apolipoprotein E-deficient mice (ApoE, n = 13 and age-matched C57BL/6 control mice (C57, n = 15 were studied at 2 (young and 8 (adult month-old. At each time point, animals were placed in metabolic cages for 24 hours to urine volume and urinary creatinine quantification. Blood samples were collected for serum cholesterol, urea and creatinine measurements. Glomerular filtration rate (GFR was estimated through creatinine clearance determination. Mesangial expansion was evaluated by Periodic Acid Schiff staining, renal fibrosis was determined through Masson's trichrome staining and neuronal nitric oxide synthase (nNOS expression in the kidney was performed by Western Blotting. To statistical analysis two-way ANOVA followed by Fisher's post hoc test was used. Results Total plasma cholesterol was increased about 5-fold in ApoE mice at both time points compared to C57 animals. At 2-month-old, GFR was already markedly reduced in ApoE compared to C57 mice (187 ± 28 vs 358 ± 92 μL/min, p Conclusions These data show that both hypercholesterolemia and aging contribute to the loss of renal function in mice.

  14. Renal dysfunction in patients with heart failure with preserved versus reduced ejection fraction

    DEFF Research Database (Denmark)

    McAlister, Finlay A; Ezekowitz, Justin; Tarantini, Luigi

    2012-01-01

    Prior studies in heart failure (HF) have used the Modification of Diet in Renal Disease (MDRD) equation to calculate estimated glomerular filtration rate (eGFR). The Chronic Kidney Disease-Epidemiology Collaboration Group (CKD-EPI) equation provides a more-accurate eGFR than the MDRD when compare...

  15. Mild systemic thermal therapy ameliorates renal dysfunction in a rodent model of chronic kidney disease.

    Science.gov (United States)

    Iwashita, Yoshihiro; Kuwabara, Takashige; Hayata, Manabu; Kakizoe, Yutaka; Izumi, Yuichiro; Iiyama, Junichi; Kitamura, Kenichiro; Mukoyama, Masashi

    2016-06-01

    Thermal therapy has become a nonpharmacological therapy in clinical settings, especially for cardiovascular diseases. However, the practical role of thermal therapy on chronic kidney disease remains elusive. We performed the present study to investigate whether a modified thermal protocol, repeated mild thermal stimulation (MTS), could affect renal damages in chronic kidney disease using a mouse renal ablation model. Mice were subjected to MTS or room temperature (RT) treatment once daily for 4 wk after subtotal nephrectomy (Nx) or sham operation (Sh). We revealed that MTS alleviated renal impairment as indicated by serum creatinine and albuminuria in Nx groups. In addition, the Nx + MTS group showed attenuated tubular histological changes and reduced urinary neutrophil gelatinase-associated lipocalin excretion approximately by half compared with the Nx + RT group. Increased apoptotic signaling, such as TUNEL-positive cell count and cleavage of caspase 3, as well as enhanced oxidative stress were significantly reduced in the Nx + MTS group compared with the Nx + RT group. These changes were accompanied with the restoration of kidney Mn-SOD levels by MTS. Heat shock protein 27, a key molecular chaperone, was phosphorylated by MTS only in Nx kidneys rather than in Sh kidneys. MTS also tended to increase the phosphorylation of p38 MAPK and Akt in Nx kidneys, possibly associated with the activation of heat shock protein 27. Taken together, these results suggest that modified MTS can protect against renal injury in a rodent model of chronic kidney disease.

  16. Taurine Ameliorates Renal Oxidative Damage and Thyroid Dysfunction in Rats Chronically Exposed to Fluoride.

    Science.gov (United States)

    Adedara, Isaac A; Ojuade, Temini Jesu D; Olabiyi, Bolanle F; Idris, Umar F; Onibiyo, Esther M; Ajeigbe, Olufunke F; Farombi, Ebenezer O

    2017-02-01

    Excessive exposure to fluoride poses several detrimental effects to human health particularly the kidney which is a major organ involved in its elimination from the body. The influence of taurine on fluoride-induced renal toxicity was investigated in a co-exposure paradigm for 45 days using five groups of eight rats each. Group I rats received normal drinking water alone, group II rats were exposed to sodium fluoride (NaF) in drinking water at 15 mg/L alone, group III received taurine alone at a dose of 200 mg/kg group IV rats were co-administered with NaF and taurine (100 mg/kg), while group V rats were co-administered with NaF and taurine (200 mg/kg). Administration of taurine significantly reversed the fluoride-mediated decrease in absolute weight and organo-somatic index of the kidney in the exposed rats. Taurine significantly prevented fluoride-induced elevation in plasma urea and creatinine levels in the exposed rats. Moreover, taurine restored fluoride-mediated decrease in the circulatory concentrations of triiodothyronine, thyroxine, and the ratio of triiodothyronine to thyroxine. Taurine ameliorated fluoride-mediated decrease in renal antioxidant status by significantly enhancing the antioxidant enzyme activities as well as glutathione level in the exposed rats. Additionally, taurine inhibited fluoride-induced renal oxidative damage by markedly decreasing the hydrogen peroxide and malondialdehyde levels as well as improved the kidney architecture in the treated rats. Collectively, taurine protected against fluoride-induced renal toxicity via enhancement of thyroid gland function, renal antioxidant status, and histology in rats.

  17. Prevalence of renal dysfunction and its influence on functional capacity in elderly patients with stable chronic heart failure

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    Stanojević Dragana

    2012-01-01

    Full Text Available Bacground/Aim. Chronic heart failure (CHF is highly prevalent and constitutes an important public health problem around the world. In spite of a large number of pharmacological agents that successfully decrease mortality in CHF, the effects on exercise tolerance and quality of life are modest. Renal dysfunction is extremely common in patients with CHF and it is strongly related not only to increased mortality and morbidity but to a significant decrease in exercise tolerance, as well. The aim of our study was to investigate the prevalence and influence of the renal dysfunction on functional capacity in the elderly CHF patients. Methods. We included 127 patients aged over 65 years in a stable phase of CHF. The diagnosis of heart failure was based on the latest diagnostic principles of the European Society of Cardiology. The estimated glomerular filtration rate (eGRF was determined by the abbreviated Modification of Diet in Renal Disease (MDRD2 formula, and patients were categorized using the Kidney Disease Outcomes Quality Initiative (K/DOQI classification system. Functional capacity was determined by the 6 minute walking test (6MWT. Results. Among 127 patients, 90 were men. The average age was 72.5 ± 4.99 years and left ventricular ejection fraction (LVEF was 40.22 ± 9.89%. The average duration of CHF was 3.79 ± 4.84 years. Ninty three (73.2% patients were in New York Heart Association (NYHA class II and 34 (26.8% in NYHA class III. Normal renal function (eGFR ≥ 90 mL/min had 8.9% of participants, 57.8% had eGFR between 60-89 mL/min (stage 2 or mild reduction in GFR according to K/DOQI classification, 32.2% had eGFR between 30-59 mL/min (stage 3 or moderate reduction in GFR and 1.1% had eGFR between 15-29 mL/min (stage 4 or severe reduction in GFR. We found statistically significant correlation between eGFR and 6 minute walking distance (6MWD (r = 0.390, p < 0.001, LVEF (r = 0.268, p < 0.05, NYHA class (ς = -0.269, p < 0.05 and age (r = - 0

  18. Renal heparan sulfate proteoglycans modulate fibroblast growth factor 2 signaling in experimental chronic transplant dysfunction

    NARCIS (Netherlands)

    Katta, K.; Boersema, M.; Adepu, S.; Rienstra, H.; Celie, J.W.; Mencke, R.; Molema, G.; Goor, H. van; Berden, J.H.M.; Navis, G.; Hillebrands, J.L.; Born, J. van den

    2013-01-01

    Depending on the glycan structure, proteoglycans can act as coreceptors for growth factors. We hypothesized that proteoglycans and their growth factor ligands orchestrate tissue remodeling in chronic transplant dysfunction. We have previously shown perlecan to be selectively up-regulated in the glom

  19. Vimentin expression is a predictor of renal dysfunction after kidney transplantation

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    Ana Cristina Carvalho de Matos

    2007-06-01

    Full Text Available renal function, long-term prognostic markers of renal function. Methods:We followed a protocol for renal biopsies in 32 patients at a mediantime of 180 days (min: 90 – max: 690 days after the renal transplant.According to Banff’s classification (1997, biopsies were classifiedaccording to the presence or absence of chronic allograft nephropathy(CAN, and the sum of each chronic alteration produced the chronicscore. All biopsy specimens were stained with picrosirius and observedunder polarized light, and fibrotic tissue identified was quantifiedby histomorphometry. Using immunohistochemistry techniques,markers involved in the epithelium-mesenchymal transdifferentiationphenomenon were evaluated: vimentin (mesenchymal cell marker,alpha-SMA (myofibroblast marker, and cytokeratin (epithelial cellmarker. Renal function was evaluated by serum creatinine levels atthe time of biopsy, one and two years after the transplant, and currentlevels (36.5 ± 8.42 months after the biopsy. Statistical tests usedwere Mann-Whitney, Kruskal-Wallis, Spearman, and Fisher’s exact test.Results: Tubular expression of vimentin correlated with creatinine levelat biopsy (r = 0.390 p = 0.033, at one year (r = 0.405 p = 0.026,two years (r = 0.474 p = 0.008, and current (r = 0.415 p = 0.028.The interstitial expression of alpha-SMA correlated with creatinine atbiopsy (r = 0.442 p = 0.014, at two years (r = 0.364 p = 0.047, andcurrent (r = 0.376 p = 0.048. The interstitial expression of alpha-SMAwas associated with chronic changes (r = 0.412 p = 0.029, with theexpression of vimentin (r = 0.502 p = 0.004, with fibrosis estimated bypicrosirius (r = 0.402 p = 0.003, and the presence of chronic allograftnephropathy (p = 0.04. Tubular expression of vimentin correlated withchronic allograft nephropathy (p = 0.001 and was the marker with thestrongest association to chronic tubulointerstitial changes (r = 0.513p = 0.003. Conclusions: The increased expression of vimentin intubules may

  20. Influence of Different Doses of Levofloxacin on Antioxidant Defense Systems and Markers of Renal and Hepatic Dysfunctions in Rats

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    Ebenezer Tunde Olayinka

    2015-01-01

    Full Text Available Levofloxacin (LFX is a broad spectrum fluoroquinolone antibiotic used in the treatment of infections such as pneumonia, chronic bronchitis, and sinusitis. The present study assessed the likely toxic effect of LFX on hepatic and renal tissues in rats. Twenty male Wistar rats were randomly divided into four treatment groups: A: control, B: 5 mg/kg bw LFX (half therapeutic dose, C: 10 mg/kg bw LFX (therapeutic dose, and D: 20 mg/kg bw LFX (double therapeutic dose. After seven days of administration, result indicated significant (P<0.05 increase in plasma ALT, AST, and ALP activities in the treated groups compared to control. Also, there was a significant increase in plasma creatinine, urea, and total bilirubin in the treated groups relative to control. Plasma total cholesterol, HDL-cholesterol, LDL-cholesterol, and triglycerides also increased significantly in the treated groups relative to control. Also, hepatic MDA level increased significantly in all the treated groups. However, hepatic SOD, catalase, and GST activities were significantly reduced in the LFX-treated animals. Moreover, GSH and ascorbic acid levels were significantly decreased in the LFX-treated groups relative to control. In conclusion, three doses of levofloxacin depleted antioxidant defense system and induced oxidative stress and hepatic and renal dysfunctions in rats.

  1. Long term prognosis of acute coronary syndrome with chronic renal dysfunction treated in different therapy units at department of cardiology: a retrospective cohort study.

    Science.gov (United States)

    Fu, Cong; Sheng, Zulong; Yao, Yuyu; Wang, Xin; Yu, Chaojun; Ma, Genshan

    2015-01-01

    Coronary care unit is common in hospitals and clinical centers which offer intensive care and therapy for severe coronary artery disease patients. However, if coronary care unit could improve the long term prognosis of acute coronary syndrome patients with renal dysfunction remain unknown. Accordingly, we designed this study to evaluate the differences of incidence of major adverse cardiovascular events for acute coronary syndromes patients with renal dysfunction who treated in coronary care unit or normal unit. The primary end point was all cause mortality. A total of 414 acute coronary syndromes patients with renal dysfunction involved in the study. The results showed that during 12-48 months follow-up, death of any cause occurred in 1.8% patients (4 of 247) in coronary care unit group, as compared with 1.8% in the normal group (3 of 167) (hazard ratio, 1.098; 95% confidence interval, 0.246 to 4.904; P=0.903). Kaplan-Meier survival analysis showed that there were no significant differences between the two groups with respect to the risk of death (P=0.903), revascularization (P=0.948), stroke (P=0.542), heart failure (P=0.198). This trial firstly revealed that acute coronary syndromes patients with renal dysfunction treated in coronary care unit and normal units. Our study showed that acute coronary syndromes patients with renal dysfunction treated in coronary care unit obtained no significant benefits compared with patients in normal units, although there was a declining tendency of the risk of major adverse cardiovascular effectswith patients in coronary care unit.

  2. Long term prognosis of acute coronary syndrome with chronic renal dysfunction treated in different therapy units at department of cardiology: a retrospective cohort study

    Science.gov (United States)

    Fu, Cong; Sheng, Zulong; Yao, Yuyu; Wang, Xin; Yu, Chaojun; Ma, Genshan

    2015-01-01

    Coronary care unit is common in hospitals and clinical centers which offer intensive care and therapy for severe coronary artery disease patients. However, if coronary care unit could improve the long term prognosis of acute coronary syndrome patients with renal dysfunction remain unknown. Accordingly, we designed this study to evaluate the differences of incidence of major adverse cardiovascular events for acute coronary syndromes patients with renal dysfunction who treated in coronary care unit or normal unit. The primary end point was all cause mortality. A total of 414 acute coronary syndromes patients with renal dysfunction involved in the study. The results showed that during 12-48 months follow-up, death of any cause occurred in 1.8% patients (4 of 247) in coronary care unit group, as compared with 1.8% in the normal group (3 of 167) (hazard ratio, 1.098; 95% confidence interval, 0.246 to 4.904; P=0.903). Kaplan-Meier survival analysis showed that there were no significant differences between the two groups with respect to the risk of death (P=0.903), revascularization (P=0.948), stroke (P=0.542), heart failure (P=0.198). This trial firstly revealed that acute coronary syndromes patients with renal dysfunction treated in coronary care unit and normal units. Our study showed that acute coronary syndromes patients with renal dysfunction treated in coronary care unit obtained no significant benefits compared with patients in normal units, although there was a declining tendency of the risk of major adverse cardiovascular effectswith patients in coronary care unit. PMID:26770436

  3. Effects of the Adenosine A(1) Receptor Antagonist Rolofylline on Renal Function in Patients With Acute Heart Failure and Renal Dysfunction Results From PROTECT (Placebo-Controlled Randomized Study of the Selective A(1) Adenosine Receptor Antagonist Rolofylline for Patients Hospitalized With Acute Decompensated Heart Failure and Volume Overload to Assess Treatment Effect on Congestion and Renal Function)

    NARCIS (Netherlands)

    Voors, Adriaan A.; Dittrich, Howard C.; Massie, Barry M.; DeLucca, Paul; Mansoor, George A.; Metra, Marco; Cotter, Gad; Weatherley, Beth D.; Ponikowski, Piotr; Teerlink, John R.; Cleland, John G. F.; O'Connor, Christopher M.; Givertz, Michael M.

    2011-01-01

    Objectives This study sought to assess the effects of rolofylline on renal function in patients with acute heart failure (AHF) and renal dysfunction randomized in PROTECT (Placebo-Controlled Randomized Study of the Selective A(1) Adenosine Receptor Antagonist Rolofylline for Patients Hospitalized Wi

  4. Belatacept conversion in African American kidney transplant recipients with severe renal dysfunction

    Directory of Open Access Journals (Sweden)

    Heather S Snyder

    2016-10-01

    Full Text Available Objectives: Conversion from calcineurin inhibitor–based maintenance immunosuppression to belatacept in kidney transplant recipients has been demonstrated to improve renal function while maintaining efficacy against rejection. However, conversion studies to date have excluded patients with an estimated glomerular filtration rate < 35 mL/min/1.73 m2. Methods: We describe two patients with an estimated glomerular filtration rate < 30 mL/min/1.73 m2 who underwent conversion from maintenance calcineurin inhibitor to belatacept. Results: Both patients experienced improvement in renal function following conversion. Conclusions: These results suggest that patients with more severe degrees of allograft impairment may benefit from conversion of maintenance calcineurin inhibitor to belatacept-based immunosuppression. Larger, randomized studies are warranted to evaluate the impact of such an approach.

  5. Role Of Adhesion Molecules Vcam-1 And Ve-Cadherin In Endothelium Dysfunction Development At Hemorrhagic Fever With Renal Syndrome

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    А.А. Baygildina

    2009-12-01

    Full Text Available The research goal is to determine the changes in concentration of both sVCAM-1 and VE-cadherin in blood serum of patients suffered from hemorrhagic fever with renal syndrome (HFRS. 87 patients aged 15-65 were examined. Concentrations of both sVCAM-1 and VE- cadherin in blood serum by means of "Bender MedSystems" (Austria ELISA test were determined. It was shown that in both medium severe and severe forms of HFRS statistically the significant rise of sVCAM-1 concentration in blood with high indices in oliguric period took place. Complicated form was characterized by high indices of sVCAM-1 level in fever period, extremely decreasing in concentration in oliguric period and tendency to normalizing in clinical convalescence period. VE-cadherin level in blood was predominantly lower than control in all the observed groups with the exception of fever period in group with medium severe disease form. Negative correlation of normal intensity between adhesion molecules levels in blood was revealed. In conclusion it is necessary to point out that high VCAM-1 expression by endotheliocytes evidences the development of an adhesion form of endothelial dysfunction, low VE-cadherin production in a base for development of angiogenic form of endothelial dysfunction and changes in expression of these adhesion molecules that have adaptive metabolic response to macroorganism of HFRS pathogenic action

  6. Prevalence and Factors Associated with Renal Dysfunction Among HIV-Infected Patients

    Science.gov (United States)

    2010-01-01

    the use of an antihypertensive medication. Diabetes mellitus was defined by physician di- agnosis or receipt of an antidiabetic agent. Chronic...2007;21:813-824. 10. Gallant JE, Parish MA, Keruly JC, Moore RD. Changes in renal function associated with tenofovir disoproxil fumarate treatment ...compared with nucleoside reverse-transcriptase inhibitor treatment . Clin Infect Dis 2005;40:1194-1198. 11. Winston A, Amin J, Mallon P, et al. Minor

  7. Metformin improves metabolic memory in high fat diet (HFD)-induced renal dysfunction.

    Science.gov (United States)

    Tikoo, Kulbhushan; Sharma, Ekta; Amara, Venkateswara Rao; Pamulapati, Himani; Dhawale, Vaibhav Shrirang

    2016-08-22

    Recently, we have shown that high fat diet (HFD) in vivo and in vitro generates metabolic memory by altering H3K36me2 and H3K27me3 on the promoter of FOXO1 (transcription factor of gluconeogenic genes) (Kumar et al., 2015). Here we checked the hypothesis, whether concomitant diet reversal and metformin could overcome HFD-induced metabolic memory and renal damage. Male adult Sprague Dawley rats were rendered insulin resistant by feeding high fat diet for 16 weeks. Then the rats were subjected to diet reversal (REV) alone and along with metformin (REV+MET) for 8 weeks. Biochemical and histological markers of insulin resistance and kidney function were measured. Blood pressure and in vivo vascular reactivity to Angiotensin II (200 mgkg-1) were also checked. Diet reversal could improve lipid profile but could not prevent renal complications induced by HFD. Interestingly, metformin along with diet reversal restored the levels of blood glucose, triglycerides, cholesterol, blood urea nitrogen and creatinine. In kidney, metformin increased the activation of AMPK, decreased inflammatory markers-COX-2, IL-1β and apoptotic markers-PARP, Caspase3. Metformin was effective in lowering the elevated basal blood pressure, acute change in mean arterial pressure (ΔMAP) in response to Ang II. It also attenuated the tubulointerstitial fibrosis and glomerulosclerosis induced by HFD-feeding in kidney. Here we report for the first time, that metformin treatment overcomes metabolic memory and prevents HFD-induced renal damage.

  8. The association of early combined lactate and glucose levels with subsequent renal and liver dysfunction and hospital mortality in critically ill patients.

    Science.gov (United States)

    Freire Jorge, Pedro; Wieringa, Nienke; de Felice, Eva; van der Horst, Iwan C C; Oude Lansink, Annemieke; Nijsten, Maarten W

    2017-08-21

    The development of renal and liver dysfunction may be accompanied by initially subtle derangements in the gluconeogenetic function. Discrepantly low glucose levels combined with high lactate levels might indicate an impaired Cori cycle. Our objective was to examine the relation between early lactate and glucose levels with subsequent renal and liver dysfunction and hospital mortality in critically ill patients. Over a 4-year period (2011 to 2014), all adult patients admitted to our adult 48-bed teaching hospital intensive care unit (ICU) for at least 12 h were retrospectively analyzed. Lactate and glucose were regularly measured with point-of-care analyzers in all ICU patients. Lactate and glucose measurements were collected from 6 h before to 24 h after ICU admission. Patients with fewer than four lactate/glucose measurements were excluded. Patients received insulin according to a computer-guided control algorithm that aimed at a glucose level 2.3 mmol/L) and glucose quintiles (≤7.0; 7.0-7.6; 7.6-8.2; 8.2-9.0; >9.0 mmol/L) were related with outcome in univariate analysis (p < 0.001). Acute Physiology and Chronic Health Evaluation (APACHE) IV, lactate, and glucose were associated with renal and liver dysfunction in multivariate analysis (p < 0.001), with a U-shaped relationship for glucose. The combination of the highest lactate quintile with the lowest glucose quintile was associated with the highest rates of renal dysfunction, liver dysfunction, and mortality (p < 0.001) with a significant interaction between lactate and glucose (p ≤ 0.001). Abnormal combined lactate and glucose measurements may provide an early indication of organ dysfunction. In critically ill patients a 'normal' glucose with an elevated lactate should not be considered desirable, as this combination is related with increased mortality.

  9. Sprengel's Deformity Associated with Musculoskeletal Dysfunctions and Renal Anomalies: A Case Report

    Directory of Open Access Journals (Sweden)

    Mohammad Hossein Kariminasab

    2012-01-01

    Full Text Available Background. Sprengel's deformity is a rare congenital anomaly of the shoulder girdle. The deformity is due to failure of descent of the scapula in intrauterine life. Case Presentation. We report a case of unilateral Sprengel's deformity associated with several other musculoskeletal and renal disorders consisting of absence of pectoralis major, weakness of trapezius and serratus anterior muscles, one kidney agenesis, and severe hydronephrosis of the other kidney in a 7-year-old boy. Conclusion. Sprengel's deformity can be associated with other musculoskeletal abnormalities and it is much more than a cosmetic problem.

  10. Renal Dysfunction in the Presence of Normoalbuminuria in Type 2 Diabetes

    DEFF Research Database (Denmark)

    Dwyer, Jamie P; Parving, Hans-Henrik; Hunsicker, Lawrence G

    2012-01-01

    BACKGROUND/AIMS: Microalbuminuria is associated with diabetes and is an independent risk factor for developing diabetic nephropathy. We have previously reported the overall prevalence of normoalbuminuria, microalbuminuria, and macroalbuminuria to be 51, 39, and 9.8%, respectively, in an unselected...... in type 2 diabetes. METHODS: In the DEMAND (Developing Education on Microalbuminuria for Awareness of Renal and Cardiovascular Risk in Diabetes) study, a global, cross-sectional study which described the prevalence and risk factors for albuminuria in a clinic-based cohort, kidney function was assessed...

  11. Chronic nitric oxide synthase inhibition ecacerbates renal dysfunction in cirrhotic rats

    DEFF Research Database (Denmark)

    Græbe, Martin; Miller, Lone Brønd; Christensen, Sten;

    2004-01-01

    (CBL). Three weeks of daily sodium balance studies showed that CBL rats developed sodium retention compared with sham-operated rats and that l-NAME treatment dose dependently deteriorated cumulative sodium balance by reducing urinary sodium excretion. Five weeks after CBL, renal clearance studies were...... performed, followed by Western blotting of the electroneutral type 3 sodium/proton exchanger (NHE3) and the Na-K-ATPase present in proximal tubules. Untreated CBL rats showed a decreased proximal reabsorption with a concomitant reduction of NHE3 and Na-K-ATPase levels, indicating that tubular segments...

  12. Exercise attenuates renal dysfunction with preservation of myocardial function in chronic kidney disease.

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    Rafael da Silva Luiz

    Full Text Available Previous studies have suggested that exercise improves renal and cardiac functions in patients with chronic kidney disease. The aim of this study was to evaluate the effects of long-term aerobic swimming exercise with overload on renal and cardiac function in rats with 5/6 nefrectomy (5/6Nx. Eight Wistar rats were placed into 4 groups: Control (C, Control+Exercise (E, Sedentary 5/6Nx (NxS and 5/6Nx+Exercise (NxE. The rats were subjected to swimming exercise sessions with overload for 30 min five days per week for five weeks. Exercise reduced the effect of 5/6Nx on creatinine clearance compared to the NxS group. In addition, exercise minimized the increase in mean proteinuria compared to the NxS group (96.9±10.0 vs. 51.4±9.9 mg/24 h; p<0.05. Blood pressure was higher in the NxS and NxE groups compared to the C and E groups (216±4 and 178±3 vs. 123±2 and 124±2 mm Hg, p<0.05. In the 200 glomeruli that were evaluated, the NxS group had a higher sclerosis index than did the NxE group (16% vs. 2%, p<0.05. Echocardiography demonstrated a higher anterior wall of the left ventricle (LV in diastole in the NxS group compared with the C, E and NxE groups. The NxS group also had a higher LV posterior wall in diastole and systole compared with the E group. The developed isometric tension in Lmax of the heart papillary muscle was lower in the NxS group compared with the C, E and NxE groups. These results suggested that exercise in 5/6Nx animals might reduce the progression of renal disease and lessen the cardiovascular impact of a reduction in renal mass.

  13. Post-procedural hemodiafiltration in acute coronary syndrome patients with associated renal and cardiac dysfunction undergoing urgent and emergency coronary angiography.

    Science.gov (United States)

    Marenzi, Giancarlo; Mazzotta, Gianfranco; Londrino, Francesco; Gistri, Roberto; Moltrasio, Marco; Cabiati, Angelo; Assanelli, Emilio; Veglia, Fabrizio; Rombolà, Giuseppe

    2015-02-15

    We investigated the use of a 3-hr treatment with hemodiafiltration, initiated soon after emergency or urgent coronary angiography in acute coronary syndrome (ACS) patients with associated severe renal and cardiac dysfunction. Patients with ACS and severe combined renal and cardiac dysfunction have a particularly high mortality risk. In them, the ideal strategy to both optimize treatment of coronary disease and minimize renal injury risk is currently unknown. This was an interventional study. ACS patients (STEMI and NSTEMI) with associated severe renal (eGFR ≤30 ml/min/1.73 m(2) ) and cardiac (LVEF ≤40%) dysfunction, admitted at La Spezia Hospital emergency coronary procedure. Controls were patients matched for age, gender, Mehran's risk score, and kind of ACS, admitted at the Centro Cardiologico Monzino Milan. In-hospital and 1-year outcomes were evaluated. Sixty patients (30% STEMI), 30 hemodiafiltration-treated patients and 30 controls, with similar baseline characteristics, were included. In-hospital and cumulative 1-year mortality rates were significantly lower in hemodiafiltration-treated patients than in controls (3% vs. 23%; P = 0.05, and 10% vs. 53%; P emergency coronary angiography seems to be associated with a relevant improvement in survival. © 2014 Wiley Periodicals, Inc.

  14. Prevention of renal dysfunction by nutraceuticals prepared from oil rich plant foods

    Institute of Scientific and Technical Information of China (English)

    Sahar Y Al-Okbi; Doha A Mohamed; Thanaa E Hamed; Reham SH Esmail; Souria M Donya

    2014-01-01

    Objective:To investigate the protective effect of extracts prepared from avocado, walnut, flaxseed and Eruca sativa seeds in a rat model of kidney dysfunction induced by intraperitoneal cisplatin. Methods:Ethanol and petroleum ether extracts mixture was prepared from each plant. Six groups of rats were conducted;control healthy, cisplatin group and four test groups where rats were given daily oral dose of each extract mixture before cisplatin injection. Different biochemical and cytogenetic parameters and kidney histopathology were determined. Acute toxicity was tested for the nutraceuticals. Total phenolic contents, fatty acids (FA) and unsaponifiable matter were assessed in the extracts. Results:Walnut ethanol extract showed the highest content of total phenolic. FA analysis revealed that all the studied plants were rich in unsaturated FA. Gas-liquid chromatographic investigation of the unsaponifiable matter showed the presence of campesterol, stigmasterol andβ-sitosterol in all the studied plants. Cisplatin treatment induced significant increase in plasma urea, creatinine and malondialdehyde along with significant reduction of plasma albumin, total protein, catalase and total antioxidant as well as reduction in creatinine clearance. Histopathological examination proved the induction of kidney dysfunction. Some sorts of chromosomal aberration and sperm-shape abnormalities were noticed after cisplatin treatment. Administration of extracts mixtures produced improvements in biochemical, histopathological and cytogenetic parameters. Conclusions: Administration of the studied nutraceuticals proved to possess protective role against cisplatin-induced nephrotoxicity, chromosomal aberration and abnormal sperms. All studied nutraceuticals showed complete safety.

  15. Prevention of renal dysfunction by nutraceuticals prepared from oil rich plant foods

    Science.gov (United States)

    Al-Okbi, Sahar Y.; Mohamed, Doha A.; Hamed, Thanaa E.; Esmail, Reham SH.; Donya, Souria M.

    2014-01-01

    Objective To investigate the protective effect of extracts prepared from avocado, walnut, flaxseed and Eruca sativa seeds in a rat model of kidney dysfunction induced by intraperitoneal cisplatin. Methods Ethanol and petroleum ether extracts mixture was prepared from each plant. Six groups of rats were conducted; control healthy, cisplatin group and four test groups where rats were given daily oral dose of each extract mixture before cisplatin injection. Different biochemical and cytogenetic parameters and kidney histopathology were determined. Acute toxicity was tested for the nutraceuticals. Total phenolic contents, fatty acids (FA) and unsaponifiable matter were assessed in the extracts. Results Walnut ethanol extract showed the highest content of total phenolic. FA analysis revealed that all the studied plants were rich in unsaturated FA. Gas-liquid chromatographic investigation of the unsaponifiable matter showed the presence of campesterol, stigmasterol and β-sitosterol in all the studied plants. Cisplatin treatment induced significant increase in plasma urea, creatinine and malondialdehyde along with significant reduction of plasma albumin, total protein, catalase and total antioxidant as well as reduction in creatinine clearance. Histopathological examination proved the induction of kidney dysfunction. Some sorts of chromosomal aberration and sperm-shape abnormalities were noticed after cisplatin treatment. Administration of extracts mixtures produced improvements in biochemical, histopathological and cytogenetic parameters. Conclusions Administration of the studied nutraceuticals proved to possess protective role against cisplatin-induced nephrotoxicity, chromosomal aberration and abnormal sperms. All studied nutraceuticals showed complete safety. PMID:25183331

  16. [A young patient of acute encephalitis complicated with acyclovir encephalopathy without renal dysfunction].

    Science.gov (United States)

    Tomori, Koji; Isozumi, Kazuo; Motohashi, Sachiko; Komatsumoto, Satoru; Fukuuchi, Yasuo

    2003-08-01

    A previously healthy 30-year-old woman was admitted to our hospital because of impaired consciousness after convulsion. A temporary diagnosis of herpes simplex encephalitis was made, and intravenous acyclovir (ACV) therapy (250 mg four times daily in normal saline over 2 hours) was started. Three days later, she became confused, and was having hallucinations, dysarthria and generalized painful seizures occurred without focal neurologic deficit. Whether the neuropsychiatric symptoms were related to herpes simplex encephalitis or acyclovir neurotoxity was initially unclear. The brain MRI and lumbar puncture findings were initially normal, but abnormal FLAIR lesions appeared later. ACV-associated encephalopathy was considered. ACV was discontinued, and she recovered from the neurological disorder within 24 hours. Although blood levels of acyclovir were not determined, it is unlikely that they were in a toxic range, in view of her normal renal function.

  17. Postconditioning with cyclosporine a reduces early renal dysfunction by inhibiting mitochondrial permeability transition.

    Science.gov (United States)

    Lemoine, Sandrine; Pillot, Bruno; Rognant, Nicolas; Augeul, Lionel; Rayberin, Maud; Varennes, Annie; Laville, Maurice; Ovize, Michel; Juillard, Laurent

    2015-04-01

    Ischemia-reperfusion (IR) injury leads to mitochondrial permeability transition pore opening, which contributes to cell death. The aim of this study is to determine whether ischemic or pharmacological postconditioning with cyclosporine A (CsA) might protect the kidney from lethal reperfusion injury. Male mice underwent a unilateral (right) nephrectomy followed by 30 minutes of contralateral (left) clamping of the renal artery. We studied 4 groups at 20 minutes and 24 hours of reperfusion: a sham group (n = 4), an ischemic group (n = 6), CsA-postconditioned group (postcond-CsA, injection of 3 mg/kg of CsA 5 minutes before the end of ischemia, (n = 6), and an ischemic postconditioning (IPC) group (n = 6), consisting of 3 cycles of 30 seconds of renal ischemia with 30 seconds intervening reperfusion. After 24 hours of reperfusion, we measured plasma creatinine, urea, and histological kidney injury. The kidney mitochondria were isolated to assess the mitochondria calcium retention capacity and oxidative phosphorylation. At 24 hours after reperfusion, serum creatinine decreased in postcond-CsA and IPC compared to ischemic group. The histological score was also significantly improved with postcond-CsA and IPC. At 20 minutes and 24 hours of reperfusion, calcium retention capacity was decreased significantly in the ischemic group. The mitochondrial respiration stay decreased in the ischemic group at 24 hours of reperfusion, whereas the respiration was improved significantly in the postcond-CsA and IPC group. Bax and cleaved caspase 3 decreased in PostCsA and IPC group. Our results suggest that IPC and CsA, administered immediately before reperfusion, protect the kidney from lethal injury.

  18. Genetic polymorphisms located in TGFB1, AGTR1, and VEGFA genes are associated to chronic renal allograft dysfunction.

    Science.gov (United States)

    Jiménez-Sousa, María A; Fernández-Rodríguez, Amanda; Heredia, María; Tamayo, Eduardo; Guzmán-Fulgencio, María; Lajo, Carmen; López, Elisabeth; Gómez-Herreras, José I; Bustamante, Jesús; Bermejo-Martín, Jesús F; Resino, Salvador

    2012-06-01

    Persistent inflammation and fibrosis have been related to active progression of renal deterioration and reduced survival of kidney transplant. The aim of this study was to determine the impact of single-nucleotide polymorphisms (SNPs) located in regions related to inflammatory and immune processes on the development of chronic renal allograft dysfunction (CRAD). A retrospective study was carried out on 276 patients who received kidney transplant (KT). SNPs were genotyped via the SNPlex platform. Statistical analysis was performed with SNPstat and regression logistic analyses were adjusted by age and gender of recipients and donors, cold ischemia time and the number of human leukocyte antigen (HLA) mismatches. From 276 patients with KT, 118 were non-CRAD and 158 were CRAD. Three SNPs showed significant associations with CRAD development: rs1800471 in transforming growth factor beta 1 (TGFB1), rs5186 in angiotensin II receptor type 1 (AGTR1), and rs699947 in vascular endothelial growth factor A (VEGFA). GC genotype of rs1800471 was associated with increased odds of CRAD compared to GG genotype (OR=2.65 (95% confidence interval (CI)=1.09; 6.47), p=0.025), as well as AC and AA genotype of rs699947 assuming a dominant model (OR=1.80 (95% CI=1.02; 3.20), p=0.044). Besides, AC and CC genotypes of rs5186 were associated with reduced odds of CRAD assuming a dominant model (OR=0.56 (95% CI=0.33; 0.96), p=0.033). Our findings suggest that three genes related to immunity and inflammation (rs1800471, rs5186 and rs699947) are associated to susceptibility or protection to CRAD, and might have diagnostic utility in predicting the likelihood of developing CRAD. Copyright © 2012 Elsevier Ltd. All rights reserved.

  19. Plantar Fascia Thickness is Longitudinally Associated with Retinopathy and Renal Dysfunction: A Prospective Study from Adolescence to Adulthood

    Science.gov (United States)

    Benitez-Aguirre, Paul Z.; Craig, Maria E.; Jenkins, Alicia J.; Gallego, Patricia H.; Cusumano, Janine; Duffin, Anthony C.; Hing, Stephen; Donaghue, Kim C.

    2012-01-01

    Aim The aim was to study the longitudinal relationship between plantar fascia thickness (PFT) as a measure of tissue glycation and microvascular (MV) complications in young persons with type 1 diabetes (T1DM). Methods We conducted a prospective longitudinal cohort study of 152 (69 male) adolescents with T1DM who underwent repeated MV complications assessments and ultrasound measurements of PFT from baseline (1997–2002) until 2008. Retinopathy was assessed by 7-field stereoscopic fundal photography and nephropathy by albumin excretion rate (AER) from three timed overnight urine specimens. Longitudinal analysis was performed using generalized estimating equations (GEE). Results Median (interquartile range) age at baseline was 15.1 (13.4–16.8) years, and median follow-up was 8.3 (7.0–9.5) years, with 4 (3–6) visits per patient. Glycemic control improved from baseline to final visit [glycated hemoglobin (HbA1c) 8.5% to 8.0%, respectively; p = .004]. Prevalence of retinopathy increased from 20% to 51% (p 7.5 µg/min) increased from 26% to 29% (p = .2). A greater increase in PFT (mm/year) was associated with retinopathy at the final assessment (ΔPFT 1st vs. 2nd–4th quartiles, χ2 = 9.87, p = .02). In multivariate GEE, greater PFT was longitudinally associated with retinopathy [odds ratio (OR) 4.6, 95% confidence interval (CI) 2.0–10.3] and early renal dysfunction (OR 3.2, CI 1.3–8.0) after adjusting for gender, blood pressure standard deviation scores, HbA1c, and total cholesterol. Conclusions In young people with T1DM, PFT was longitudinally associated with retinopathy and early renal dysfunction, highlighting the importance of early glycemic control and supporting the role of metabolic memory in MV complications. Measurement of PFT by ultrasound offers a noninvasive estimate of glycemic burden and tissue glycation. PMID:22538146

  20. prevention of renal dysfunction by nutraceuticals prepared from oil rich plant foods

    Institute of Scientific and Technical Information of China (English)

    Sahar; Y.Al-Okbi; Doha; A.Mohamed; Thanaa; E.Hamed; Reham; SH.Esmail; Souria; M.Donya

    2014-01-01

    Objective:To investigate the protective effect of extracts prepared from avocado,walnut,flaxseed and Eruca sativa seeds in a rat model of kidney dysfunction induced by intraperitoneal cisplatin.Methods:Ethanol and petroleum ether extracts mixture was prepared from each plant.Six groups of rats were conducted:control healthy,cisplatin group and four test groups where rats were given daily oral dose of each extract mixture before cisplatin injection.Different biochemical and cytogenetic parameters and kidney histopathology were determined.Acute toxicity was tested for the nutraceuticals.Total phenolic contents,faity acids(FA) and unsaponifiable matter were assessed in the extracts.Results:Walnut ethanol extract showed the highest content of total phenolic.FA analysis revealed that all the studied plants were rich in unsaturated FA.Gas-liquid chromatographic investigation of the unsaponifiable matter showed the presence of campeslerol.stigmaslerol and β—sitosterol in all the studied plants.Cisplatin treatment induced significant increase in plasma urea,creatinine and malondialdehyde along with significant reduction of plasma albumin,total protein,calalase and total antioxidant as well as reduction in creatinine clearance.Histopathological examination proved the induction of kidney dysfunction.Some sorts of chromosomal aberration and spermshape abnormalities were noticed after cisplatin treatment.Administration of extracts mixtures produced improvements in biochemical,histopathological and cytogenetic parameters.Conclusions:Administration of the studied nutraceuticals proved to possess protective role against cisplatin—induced nephrotoxicity,chromosomal aberration and abnormal sperms.All studied uutraceuticals showed complete safety.

  1. Interferon-free regimens in patients with hepatitis C infection and renal dysfunction or kidney transplantation

    Science.gov (United States)

    Cholongitas, Evangelos; Pipili, Chrysoula; Papatheodoridis, George V

    2017-01-01

    Treatment of patients with chronic kidney disease (CKD) and chronic hepatitis C (CHC) differs from that used in the general CHC population mostly when glomerular filtration rate (GFR) is below 30 mL/min, as sofosbuvir, the backbone of several current regimens, is officially contraindicated. Given that ribavirin free regimens are preferable in CKD, elbasvir/grazoprevir is offered in CHC patients with genotype 1 or 4 and ombitasvir/paritaprevir and dasabuvir in genotype 1b for 12 wk. Although regimens containing peginterferon with or without ribavirin are officially recommended for patients with CKD and genotype 2, 3, 5, 6, such regimens are rarely used because of their low efficacy and the poor safety and tolerance profile. In this setting, especially in the presence of advanced liver disease, sofosbuvir-based regimens are often used, despite sofosbuvir contraindication. It seems to have good overall safety with only 6% or 3.4% of CKD patients to discontinue therapy or develop serious adverse events without drug discontinuation. In addition, sustained virological response (SVR) rates with sofosbuvir based regimens in CKD patients appear to be comparable with SVR rates in patients with normal renal function. Treatment recommendations for kidney transplant recipients are the same with those for patients with CHC, taking into consideration potential drug-drug interactions and baseline GFR before treatment initiation. This review summarizes recent data on the current management of CHC in CKD patients highlighting their strengths and weaknesses and determining their usefulness in clinical practice. PMID:28217256

  2. Dietary inclusion of local salt substitutes induces oxidative stress and renal dysfunction in rats.

    Science.gov (United States)

    Akinyemi, Ayodele J; Oboh, Ganiyu; Ademiluyi, Adedayo O; Araoye, Obafemi O; Oyeleye, Sunday I

    2014-01-01

    Our earlier report has shown that salt substitutes (Obu-Otoyo) contain some toxic heavy metals. This study, therefore, investigated the effect of the dietary inclusion of salt substitutes (Obu-Otoyo), namely, salt "A" and "B", on biomarkers of oxidative stress and renal function in rats. Salt "A", which has a gray color, is the product of a process in which ash is produced by burning palm kernel shaft soaked in water overnight and extracting the residue to produce the salt substitute while Salt "B", which has a white color, is a rock salt mined from a local site at Ilobu town, Osun-State, Nigeria. Salt substitutes were fed to normal rats as dietary inclusion at 0.5% and 1.0% for 21 days. The dietary inclusion of the salt substitutes caused a significant (psalt substitutes caused a significant (psalt substitute Obu-Otoyo. Therefore, this finding indicates that Obu-Otoyo induces nephrotoxicity in rats. The nephrotoxicity of Obu-Otoyo could be attributed to the induction of oxidative stress as a result of the presence of some heavy metals, suggesting possible health hazards in subjects who consume it.

  3. Immune cell dysfunction and inflammation in end-stage renal disease.

    Science.gov (United States)

    Betjes, Michiel G H

    2013-05-01

    Uraemia causes inflammation and reduces immune system function as evidenced by an increased risk of viral-associated cancers, increased susceptibility to infections and decreased vaccination responses in patients with end-stage renal disease (ESRD). The substantially increased risk of atherosclerosis in these patients is also probably related to uraemia-associated inflammation. Uraemia is associated with a reduction in the number and function of lymphoid cells, whereas numbers of myeloid cells in uraemic patients are normal or increased with increased production of inflammatory cytokines and reactive oxygen species. Similar to healthy elderly individuals, patients with ESRD have increased numbers of specific proinflammatory subsets of T cells and monocytes, suggesting the presence of premature immunological ageing in these patients. These cells might contribute to inflammation and destabilization of atherosclerotic plaques, and have, therefore, been identified as novel nonclassical cardiovascular risk factors. The cellular composition of the immune system does not normalize after successful kidney transplantation despite a rapid reduction in inflammation and oxidative stress. This finding suggests that premature ageing of the immune system in patients with ESRD might be related to a permanent skewing of the haematopoetic stem cell population towards myeloid-generating subsets, similar to that seen in healthy elderly individuals.

  4. A Randomized, Controlled Trial of Rituximab in IgA Nephropathy with Proteinuria and Renal Dysfunction.

    Science.gov (United States)

    Lafayette, Richard A; Canetta, Pietro A; Rovin, Brad H; Appel, Gerald B; Novak, Jan; Nath, Karl A; Sethi, Sanjeev; Tumlin, James A; Mehta, Kshama; Hogan, Marie; Erickson, Stephen; Julian, Bruce A; Leung, Nelson; Enders, Felicity T; Brown, Rhubell; Knoppova, Barbora; Hall, Stacy; Fervenza, Fernando C

    2017-04-01

    IgA nephropathy frequently leads to progressive CKD. Although interest surrounds use of immunosuppressive agents added to standard therapy, several recent studies have questioned efficacy of these agents. Depleting antibody-producing B cells potentially offers a new therapy. In this open label, multicenter study conducted over 1-year follow-up, we randomized 34 adult patients with biopsy-proven IgA nephropathy and proteinuria >1 g/d, maintained on angiotensin-converting enzyme inhibitors or angiotensin receptor blockers with well controlled BP and eGFRIgA1 or antibodies against galactose-deficient IgA1 did not change. In this trial, rituximab therapy did not significantly improve renal function or proteinuria assessed over 1 year. Although rituximab effectively depleted B cells, it failed to reduce serum levels of galactose-deficient IgA1 and antigalactose-deficient IgA1 antibodies. Lack of efficacy of rituximab, at least at this stage and severity of IgA nephropathy, may reflect a failure of rituximab to reduce levels of specific antibodies assigned salient pathogenetic roles in IgA nephropathy. Copyright © 2017 by the American Society of Nephrology.

  5. Attenuation of hyperlipidemia- and diabetes-induced early-stage apoptosis and late-stage renal dysfunction via administration of fibroblast growth factor-21 is associated with suppression of renal inflammation.

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    Chi Zhang

    Full Text Available BACKGROUND: Lipotoxicity is a key feature of the pathogenesis of diabetic kidney disease, and is attributed to excessive lipid accumulation (hyperlipidemia. Increasing evidence suggests that fibroblast growth factor (FGF21 has a crucial role in lipid metabolism under diabetic conditions. OBJECTIVE: The present study investigated whether FGF21 can prevent hyperlipidemia- or diabetes-induced renal damage, and if so, the possible mechanism. METHODS: Mice were injected with free fatty acids (FFAs, 10 mg/10 g body weight or streptozotocin (150 mg/kg to establish a lipotoxic model or type 1 diabetic model, respectively. Simultaneously the mice were treated with FGF21 (100 µg/kg for 10 or 80 days. The kidney weight-to-tibia length ratio and renal function were assessed. Systematic and renal lipid levels were detected by ELISA and Oil Red O staining. Renal apoptosis was examined by TUNEL assay. Inflammation, oxidative stress, and fibrosis were assessed by Western blot. RESULTS: Acute FFA administration and chronic diabetes were associated with lower kidney-to-tibia length ratio, higher lipid levels, severe renal apoptosis and renal dysfunction. Obvious inflammation, oxidative stress and fibrosis also observed in the kidney of both mice models. Deletion of the fgf21 gene further enhanced the above pathological changes, which were significantly prevented by administration of exogenous FGF21. CONCLUSION: These results suggest that FFA administration and diabetes induced renal damage, which was further enhanced in FGF21 knock-out mice. Administration of FGF21 significantly prevented both FFA- and diabetes-induced renal damage partially by decreasing renal lipid accumulation and suppressing inflammation, oxidative stress, and fibrosis.

  6. The association between MMF and risk of progressive renal dysfunction and death in adult liver transplant recipients with HCV.

    Science.gov (United States)

    Lake, John; Patel, Dharmesh; David, Kristin; Richwine, Jason; Morris, Jonathan

    2009-01-01

    The impact of a three-drug regimen including mycophenolate mofetil (MMF) vs. a two-drug (no MMF) regimen on progressive renal dysfunction (PRD) in liver transplant recipients with hepatitis C virus (HCV) infection has not been well described. Adults with HCV who received a primary liver transplant between January 1, 2000 and December. 31, 2005 and were discharged from the hospital on a three-drug regimen [CNI+MMF+steroids (S)] (n = 4 946) were compared with those discharged on two-drug regimen (CNI+S) (n = 3 884). Time to PRD (defined by a post-transplant 25% decline in estimated GFR, based on the four-variable MDRD equation) and recipient death were evaluated using Kaplan-Meier analysis. Cox proportional hazards regression was used to estimate the risk for post-transplant PRD and death after controlling for baseline characteristics and extended steroid use. The two groups were similar in baseline characteristics. The percentage of recipients on three- vs. two-drug regimen without PRD was higher, 36.8% vs. 31.9%, (p MMF-containing regimen are at a lower risk for PRD and death compared with recipients on a regimen not including MMF.

  7. The exenatide analogue AC3174 attenuates hypertension, insulin resistance, and renal dysfunction in Dahl salt-sensitive rats

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    Fernandez Rayne

    2010-08-01

    Full Text Available Abstract Background Activation of glucagon-like peptide-1 (GLP-1 receptors improves insulin sensitivity and induces vasodilatation and diuresis. AC3174 is a peptide analogue with pharmacologic properties similar to the GLP-1 receptor agonist, exenatide. Hypothetically, chronic AC3174 treatment could attenuate salt-induced hypertension, cardiac morbidity, insulin resistance, and renal dysfunction in Dahl salt-sensitive (DSS rats. Methods DSS rats were fed low salt (LS, 0.3% NaCl or high salt (HS, 8% NaCl diets. HS rats were treated with vehicle, AC3174 (1.7 pmol/kg/min, or GLP-1 (25 pmol/kg/min for 4 weeks via subcutaneous infusion. Other HS rats received captopril (150 mg/kg/day or AC3174 plus captopril. Results HS rat survival was improved by all treatments except GLP-1. Systolic blood pressure (SBP was lower in LS rats and in GLP-1, AC3174, captopril, or AC3174 plus captopril HS rats than in vehicle HS rats (p Conclusions Thus, AC3174 had antihypertensive, cardioprotective, insulin-sensitizing, and renoprotective effects in the DSS hypertensive rat model. Furthermore, AC3174 improved animal survival, an effect not observed with GLP-1.

  8. High Avidity dsDNA Autoantibodies in Brazilian Women with Systemic Lupus Erythematosus: Correlation with Active Disease and Renal Dysfunction

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    Rodrigo C. Oliveira

    2015-01-01

    Full Text Available We investigated in Brazilian women with SLE the prevalence and levels of high avidity (HA dsDNA antibodies and tested their correlation with lupus activity and biomarkers of renal disease. We also compared these correlations to those observed with total dsDNA antibodies and antibodies against nucleosome (ANuA. Autoantibodies were detected by ELISA, while C3 and C4 levels were determined by nephelometry. Urine protein/creatinine ratio was determined, and lupus activity was measured by SLEDAI-2K. The prevalence of total and HA dsDNA antibodies was similar to but lower than that verified for ANuA. The levels of the three types of antibodies were correlated, but the correlation was more significant between HA dsDNA antibodies and ANuA. High avidity dsDNA antibodies correlated positively with ESR and SLEDAI and inversely with C3 and C4. Similar correlations were observed for ANuA levels, whereas total dsDNA antibodies only correlated with SLEDAI and C3. The levels of HA dsDNA antibodies were higher in patients with proteinuria, but their levels of total dsDNA antibodies and ANuA were unaltered. High avidity dsDNA antibodies can be found in high prevalence in Brazilian women with SLE and are important biomarkers of active disease and kidney dysfunction.

  9. Oral administration of both tetrahydrobiopterin and L-arginine prevents endothelial dysfunction in rats with chronic renal failure.

    Science.gov (United States)

    Yamamizu, Kohei; Shinozaki, Kazuya; Ayajiki, Kazuhide; Gemba, Munekazu; Okamura, Tomio

    2007-03-01

    We examined the mechanism of endothelial dysfunction in chronic renal failure (CRF), with reference to NO synthase. CRF was induced by 5/6 nephrectomy in rats. Either L-arginine (1.25 g/L in drinking water), tetrahydrobiopterin (BH4, 10 mg/kg per day in food), or a combination of the 2 were orally administered to CRF rats for 9 weeks. CRF rats showed elevation of systolic blood pressure compared with sham-operated rats. Endothelium-dependent relaxation induced by acetylcholine or A23187 in the isolated aorta was significantly reduced, and in vitro treatment with L-arginine, BH4, or superoxide dismutase restored the relaxation. Aortic segments from CRF rats showed significantly higher superoxide production in response to A23187, which was inhibited by L-NAME. Plasma concentrations of asymmetric dimethylarginine and symmetric dimethylarginine were higher in CRF rats. These changes in CRF rats were totally or partially decreased by L-arginine or BH4 supplementation in vivo. Interestingly, the combined treatment showed additive effects in certain parameters. These results suggest that vascular disorders in CRF rats may be partly due to NOS uncoupling caused by a relative deficiency of BH4 and partially due to accumulation of endogenous inhibitors of NOS and L-arginine uptake, resulting in the decrease of NO production and the increase of reactive oxygen species.

  10. Protective effect of Petroselinum crispum extract in abortion using prostadin-induced renal dysfunction in female rats

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    Maryam Rezazad

    2014-09-01

    Full Text Available Objective: Present study investigated the effects of parsley extract on pregnant rat kidneys which have undergone clinical abortion using prostaglandins. The renal protective effect of parsley extract was evaluated in pregnant rats which had an abortion. Parsley was used due to its antioxidant properties. Materials and Methods:  Fifty-four female rats were divided in 9 groups of 6: control pregnant, two pregnant groups which received parsley extract and prostadin, two non-pregnant groups treated with parsley extract and prostadin, a group administered with both treatments, and three groups which received parsley extract in pre-implantation, implantation, and post-implantation periods of embryos. Ethanolic extract (5 mg/kg was given daily to animals for 18 days of pregnancy period. Parameters such as malondialdehyde (MDA, total antioxidant statues (TAS, creatinine, and urea were measured using biochemical assays. Histopathologic studies were also done with Hematoxylin-Eosin staining method. Results: After 18 days of treatment, significant differences were observed in serum creatinine, urea, and MDA and TAS levels. Kidney cross-sections showed edema in prostadin-treated rats while improvements in parsley + prostadin -treated rats were observed. Conclusion: These results suggested that ethanolic extract of Petroselinum crispum reduced the dysfunction in rats kidney caused by prostadin-induced abortion and could have beneficial effect in reducing the progression of prostaglandin-induced edema.

  11. Fever, Haematuria, and Acute Graft Dysfunction in Renal Transplant Recipients Secondary to Adenovirus Infection: Two Case Reports

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    J. Ramírez

    2013-01-01

    Full Text Available We report two cases of adenoviral infection in kidney transplant recipients that presented with different clinical characteristics under similar demographic and posttransplant conditions. The first case presented with fever, gross haematuria, and acute graft dysfunction 15 days following renal transplantation. A graft biopsy, analyzed with immunohistochemistry, yielded negative results. However, the diagnosis was confirmed with blood and urine real-time PCR for adenovirus 3 days after the initial clinical manifestations. The immunosuppression dose was reduced, and ribavirin treatment was started, for which the patient quickly developed toxicity. Antiviral treatment allowed for transient response; however, a relapse occurred. The viral real-time PCR became negative upon immunosuppression reduction and administration of IVIG; graft function normalized. In the second case, the patient presented with fever and dysuria 1 month after transplantation. The initial imaging studies revealed graft enlargement and areas of hypoperfusion. In this case, the diagnosis was also confirmed with blood and urine real-time PCR for adenovirus 3 days after the initial clinical manifestations. Adenoviral nephritis was confirmed through a graft biopsy analyzed with light microscopy, immunohistochemistry, and PCR in frozen tissue. The immunosuppression dose was reduced, and IVIG was administered obtaining excellent clinical results along with a negative real-time PCR.

  12. Relationship of endothelial dysfunction with degree of renal function damage and lipidemic profile in patients with type 2 diabetes mellitus and hypertension

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    Pertseva N.O.

    2014-09-01

    Full Text Available In the article defining relationship between endothelial dysfunction, the degree of renal and lipidemic profile damage in 234 patients with type 2 diabetes mellitus with hypertension was carried depending on the quality of glycemic control. It is shown that the deepening of endothelial dysfunction in patients with insufficient and poor compensation tightly correlates with the degree of renal and lipidemic disorders. In these patients there was a significant increase in the level of albuminuria, reduction in glomerular filtration rate, increase of concentrations of urea and creatinine. Against the background of poor hyperglycemia, compensation total cholesterol, low density lipoprotein content increases by 73,3% (p<0.05, hype¬rtriglyceridemia twice exceeds the control values. In patients with type 2 diabetes mellitus with poor compensation the most significant correlation links were observed between the concentration of endothelin-1 and the level of microalbuminuria (r=+0,79, as well as the content of low density lipoprotein cholesterol (r=+0.81. Thrombomodulin concentration is in direct correlation with microalbuminuria (r=+0.76, hypercholesterolemia (r=+0.80 and hypertriglyceridemia (r=+0.83, indicating to increasing interaction between the pathogenetic mechanisms which cause depression of endothelial dysfunction, renal and dyslipidemic disorders with increasing hyperglycemia.

  13. Influence of consumption of cadmium-polluted rice or Jinzu River water on occurrence of renal tubular dysfunction and/or Itai-itai disease.

    Science.gov (United States)

    Kobayashi, Etsuko; Suwazono, Yasushi; Dochi, Mirei; Honda, Ryumon; Kido, Teruhiko

    2009-03-01

    The aim of this study was to clarify whether consumption of cadmium (Cd)-polluted rice or Jinzu River water exerted any influence on the occurrence of renal tubular dysfunction and/or Itai-itai disease. From the participants of health examinations conducted in 1967 and 1968, 3,078 subjects who had resided for >30 years in the present hamlet and were aged >50 years were selected as the target population and were divided according to their residence in 55 hamlets. In a multiple regression analysis, the regression coefficients between rice-Cd concentration and prevalence of abnormal urinary findings (proteinuria, glucosuria, or proteinuria with glucosuria) or patients with Itai-itai disease were statistically significant between both sexes. The correlation between the prevalence of users of Jinzu River water and the occurrence of glucosuria in men as well as abnormal urinary findings in women was not statistically significant. We surmise that eating Cd-polluted rice and drinking and/or cooking with Jinzu River water influenced the occurrence of Itai-itai disease. The occurrence of renal tubular dysfunction is likely to have also been influenced by both factors, with eating Cd-polluted rice having a greater impact on the occurrence of renal tubular dysfunction as compared to drinking and/or cooking with Jinzu River water.

  14. Silymarin and Nigella sativa extract ameliorate paracetamol induced oxidative stress and renal dysfunction in male mice

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    Reham Zakaria Hamza

    2015-06-01

    Full Text Available Objective: To evaluate the ameliorative role of silymarin or/and Nigella sativa (N. sativa water extract against N-acetyl-p-aminophenol (APAP-induced renal function deterioration in male mice at the biochemical levels. Methods: The mice were divided into seven groups (10/group. The first group was served as control. The second group was treated with dose of APAP. The third and fourth groups were treated with silymarin alone and N. sativa water extract alone, respectively. The fifth and sixth groups were treated with combination of APAP with silymarin and APAP with N. sativa water extract, respectively. The seventh group was treated with a combination of both ameliorative compounds (silymarin and N. sativa water extract with APAP and all animals were treated for a period of 30 days. Results: Exposure to APAP at the treated dose for mice led to an alteration of kidney function parameters, increase in the level of serum urea and creatinine. Also, paracetamol administration induced oxidative stress in kidney homogenates by increasing malondialdhyde level and decreasing superoxide dismutase and catalase activities and this stress was ameliorated by administration of either silymarin or N. sativa water extract. Conclusions: Administration of silymarin or/and N. sativa water extract to APAP-treated mice alleviate the toxicity of APAP, and this appeared clearly by biochemical improvement of kidney function parameters and antioxidant parameters. But, the alleviation is more pronounced with the both antioxidants. Thus, the pronounce effect of silymarin and N. sativa water extract is most effective in reducing the toxicity induced by APAP and improving the kidney function parameters and antioxidant status of kidney of male mice.

  15. 2-Methoxyestradiol Reduces Angiotensin II-Induced Hypertension and Renal Dysfunction in Ovariectomized Female and Intact Male Mice.

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    Pingili, Ajeeth K; Davidge, Karen N; Thirunavukkarasu, Shyamala; Khan, Nayaab S; Katsurada, Akemi; Majid, Dewan S A; Gonzalez, Frank J; Navar, L Gabriel; Malik, Kafait U

    2017-06-01

    Cytochrome P450 1B1 protects against angiotensin II (Ang II)-induced hypertension and associated cardiovascular changes in female mice, most likely via production of 2-methoxyestradiol. This study was conducted to determine whether 2-methoxyestradiol ameliorates Ang II-induced hypertension, renal dysfunction, and end-organ damage in intact Cyp1b1(-/-), ovariectomized female, and Cyp1b1(+/+) male mice. Ang II or vehicle was infused for 2 weeks and administered concurrently with 2-methoxyestradiol. Mice were placed in metabolic cages on day 12 of Ang II infusion for urine collection for 24 hours. 2-Methoxyestradiol reduced Ang II-induced increases in systolic blood pressure, water consumption, urine output, and proteinuria in intact female Cyp1b1(-/-) and ovariectomized mice. 2-Methoxyestradiol also reduced Ang II-induced increase in blood pressure, water intake, urine output, and proteinuria in Cyp1b1(+/+) male mice. Treatment with 2-methoxyestradiol attenuated Ang II-induced end-organ damage in intact Cyp1b1(-/-) and ovariectomized Cyp1b1(+/+) and Cyp1b1(-/-) female mice and Cyp1b1(+/+) male mice. 2-Methoxyestradiol mitigated Ang II-induced increase in urinary excretion of angiotensinogen in intact Cyp1b1(-/-) and ovariectomized Cyp1b1(+/+) and Cyp1b1(-/-) female mice but not in Cyp1b1(+/+) male mice. The G protein-coupled estrogen receptor 1 antagonist G-15 failed to alter Ang II-induced increases in blood pressure and renal function in Cyp1b1(+/+) female mice. These data suggest that 2-methoxyestradiol reduces Ang II-induced hypertension and associated end-organ damage in intact Cyp1b1(-/-), ovariectomized Cyp1b1(+/+) and Cyp1b1(-/-) female mice, and Cyp1b1(+/+) male mice independent of G protein-coupled estrogen receptor 1. Therefore, 2-methoxyestradiol could serve as a therapeutic agent for treating hypertension and associated pathogenesis in postmenopausal females, and in males. © 2017 American Heart Association, Inc.

  16. Effect of Unripe Plantain (Musa paradisiaca) and Ginger (Zingiber officinale) on Renal Dysfunction in Streptozotocin-Induced Diabetic Rats.

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    Iroaganachi, Mercy; Eleazu, Chinedum; Okafor, Polycarp

    2015-03-20

    Although unripe plantain (Musa paradisiaca) and ginger (Zingiber officinale) are used as single plants to manage diabetes mellitus in Nigeria, the possibility of combining them in a typical diabetic diet and the glycemic response elicited as a result of such combination has not been investigated. To determine the effect of unripe plantain and ginger on serum total proteins, albumin, creatinine and urea levels of streptozotocin induced diabetic rats. Twenty four male albino rats were used and were divided into 4 groups of 6 rats each. Group 1 (non-diabetic) received standard rat feeds; Group 2 (diabetic) received standard rat feeds; Group 3 received unripe plantain pellets and Group 4 received unripe plantain+ginger pellets. There were significant increases (P=0.045) of both serum urea and creatinine, but significant decreases (P=0.045) of both serum total protein and albumin levels, in Group 2 rats compared with Group 1. There were significant decreases (P=0.033) of both serum urea and creatinine levels of Group 3 and 4 rats compared with Group 2. In addition, there were significant increases of both serum total protein and albumin levels (P=0.033) in Group 3 rats compared with Group 2, but the comparison of serum total protein and albumin levels between Group 4 and Group 2 did not reach the significant level (P=0.056 and P=0.065 for serum total protein and albumin levels, respectively. Combination of unripe plantain and ginger at the ratio used in the management of renal dysfunction in diabetics was not very effective compared with unripe plantain alone.

  17. Risk of Cardiovascular Death in the Remote Period after Myocardial Revascularization and in Association with Renal Dysfunction

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    Ekaterina S. Levitskaya

    2016-03-01

    Full Text Available The aim of the present study was to assess the effectiveness of standard medical therapy in lowering the risk of cardiovascular death (rCVD in the remote period after myocardial revascularization (MR, taking into account the presence of renal dysfunction (RD. Material and Methods: The study included 90 patients with coronary heart disease (CHD and indications for revascularization. We evaluated a drug therapy obtained at different stages of revascularization, as well as the severity of patients’ condition and the prevalence of RD. Results: In the remote period after MR (5.8±0.05 years, 71/78.9% patients participated in the study; death occurred in 10/12.3% patients. The duration of therapy for chronic myocardial ischemia before MR (P=0.005, as well as compliance with prescribed therapy during 6 months (P=0.008 after this procedure, affected CVD in the remote period after MR. Using statins before MR reduced rCVD by 17.2% (P=0.01, beta-blockers -14.95% (P=0.04, and ACE inhibitors (ACEIs - 15.75% (P=0.03. The lack of regular use of acetylsalicylic acid (ASA for 6 months after RM was associated with an increase in rCVD up to 36.2% (P=0.005. Statins and ACEIs are drugs that reduce rCVD in the presence of RD (P<0.05. Conclusion: An efficient drug regimen for patients after MR is important in reducing a long-term prognosis of CVD and for an efficient correction of coronary artery patency.

  18. Prognostic value of new-onset anemia as a marker of hemodilution in patients with acute decompensated heart failure and severe renal dysfunction.

    Science.gov (United States)

    Hong, Namki; Youn, Jong-Chan; Oh, Jaewon; Lee, Hye Sun; Park, Sungha; Choi, Donghoon; Kang, Seok-Min

    2014-07-01

    In patients with acute decompensated heart failure (ADHF), the prognostic value of new-onset anemia with regard to renal function has not been investigated. Consecutive 299 ADHF patients (162 men, 62 ± 14 years) were enrolled. Cardiovascular (CV) events composite of CV mortality and rehospitalization occurred in 113 patients (37.8%) during 2 years of follow-up. Baseline anemia was prevalent (n = 124, 41.5%) and 43 patients (14.4%) had new-onset anemia at 1 month after discharge. Baseline anemia was strongly associated with CV events risk in overall [hazard ratio (HR): 1.79, 95% CI: 1.17-2.74, p = 0.006] and those with preserved renal function [estimated glomerular filtration rate (eGFR)≥ 45 mL/min/1.73 m(2)] (HR: 1.81, 95% CI: 1.05-3.12, p = 0.031). In patients with severe renal dysfunction (eGFRanemia independently predicted CV events (HR: 2.72, 95% CI: 1.09-6.76, p = 0.031) whereas baseline anemia did not (HR: 1.28, 95% CI: 0.61-2.65, p = 0.505). New-onset anemia was significantly associated with hemodilution, which may reflect inadequate decongestion in ADHF patients. Baseline anemia was an independent prognostic factor in overall ADHF patients and those with preserved renal function. New-onset anemia as a surrogate for hemodilution better predicted CV events than baseline anemia in ADHF patients with severe renal dysfunction. Copyright © 2013. Published by Elsevier Ltd.

  19. Heart Rate Variability in Patients with Acute Ischemic Stroke at Different Stages of Renal Dysfunction: A Cross-sectional Observational Study

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    Wei, Lin; Zhao, Wen-Bo; Ye, Huan-Wen; Chen, Yan-Hua; Zhang, Xiao-Pei; Huang, Yan; Cai, Ye-Feng; Chen, Quan-Fu; Pan, Su-Yue

    2017-01-01

    Background: Renal function is associated with mortality and functional disabilities in stroke patients, and impaired autonomic function is common in stroke, but little is known regarding its effects on stroke patients with renal dysfunction. This study sought to evaluate the association between autonomic function and stroke in patients with renal dysfunction. Methods: This study comprised 232 patients with acute ischemic stroke consecutively enrolled from February 2013 to November 2014 at Guangdong Provincial Hospital of Chinese Medicine in China. All patients recruited underwent laboratory evaluation and 24 h Holter electrocardiography (ECG). Autonomic function was measured based on the heart rate variability (HRV) using 24 h Holter ECG. Renal damage was assessed through the estimated glomerular filtration rate (eGFR), and stroke severity was rated according to the National Institutes of Health Stroke Scale (NIHSS). The Barthel index and modified Rankin score were also determined following admission. All the clinical covariates that could potentially affect autonomic outcome variables were adjusted with linear regression. Results: In the patients with a mild or moderate decreased eGFR, the values for the standard deviation of the averaged normal-to-normal RR interval (SDANN) index (P = 0.022), very low frequency (VLF) (P = 0.043), low frequency (LF) (P = 0.023), and ratio of low-to-high frequency power (LF/HF) (P = 0.001) were significantly lower than those in the patients with a normal eGFR. A multinomial linear regression indicated that eGFR (t = 2.47, P = 0.014), gender (t = −3.60, P < 0.001), and a history of hypertension (t = −2.65, P = 0.008) were the risk factors of LF/HF; the NIHSS score (SDANN index: t = −3.83, P < 0.001; VLF: t = −3.07, P = 0.002; LF: t = −2.79, P = 0.006) and a history of diabetes (SDANN index: t = −3.58, P < 0.001; VLF: t = −2.54, P = 0.012; LF: t = −2.87, P = 0.004) were independent factors for the SDANN index, VLF

  20. Catheter dysfunction and dialysis performance according to vascular access among 736 critically ill adults requiring renal replacement therapy: a randomized controlled study.

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    Parienti, Jean-Jacques; Mégarbane, Bruno; Fischer, Marc-Olivier; Lautrette, Alexandre; Gazui, Nicole; Marin, Nathalie; Hanouz, Jean-Luc; Ramakers, Michel; Daubin, Cédric; Mira, Jean-Paul; Charbonneau, Pierre; du Cheyron, Damien

    2010-04-01

    To compare dialysis catheter function according to catheter site. Multicenter, open, randomized controlled trial. Nine university-affiliated hospitals and three general hospitals in France. Seven hundred thirty-six patients in intensive care units who required a first venous catheterization to perform either intermittent hemodialysis (470 patients with 1275 sessions) or continuous renal replacement therapy (266 patients with 1003 days). Patients randomly received either femoral (n = 370) or jugular (n = 366) catheterization. For the jugular site, right-side position (n = 252) was recommended. Time to catheter ablation for dysfunction, urea reduction ratio (intermittent hemodialysis), and downtime (continuous renal replacement therapy) were assessed for all participants and evaluated by randomly assigned catheterization site (femoral or jugular). Baseline demography and dialysis prescriptions were similar between the site arms. In modified intent-to-treat, catheter dysfunction occurred in 36 of 348 (10.3%) and 38 of 342 (11.1%) patients in the femoral and jugular groups, respectively. The risk of catheter dysfunction did not significantly differ between randomized groups (hazard ratio, 1.06; 95% confidence interval, 0.67-1.68; p = .80). Compared to the femoral site, the observed risk of dysfunction decreased in the right jugular position (15 of 226; 6.6%; adjusted hazard ratio, 0.58; 95% confidence interval, 0.31-1.07; p = .09) and significantly increased in the left jugular position (23 of 118; 19.5%; adjusted hazard ratio, 1.89; 95% confidence interval, 1.12-3.21; p hemodialysis mean urea reduction ratio per session was 50.8% (standard deviation, 16.1) for femoral vs. 52.8% (standard deviation, 15.8) for jugular (p = .30) sites, and the median continuous renal replacement therapy downtime per patient-day was 1.17 hrs (interquartile range, 0.75-1.50) for both sites (p = .98). In terms of catheter dysfunction and dialysis performance among critically ill adults

  1. CD44-deficiency attenuates the immunologic responses to LPS and delays the onset of endotoxic shock-induced renal inflammation and dysfunction.

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    Elena Rampanelli

    Full Text Available Acute kidney injury (AKI is a common complication during systemic inflammatory response syndrome (SIRS, a potentially deadly clinical condition characterized by whole-body inflammatory state and organ dysfunction. CD44 is a ubiquitously expressed cell-surface transmembrane receptor with multiple functions in inflammatory processes, including sterile renal inflammation. The present study aimed to assess the role of CD44 in endotoxic shock-induced kidney inflammation and dysfunction by using CD44 KO and WT mice exposed intraperitoneally to LPS for 2, 4, and 24 hours . Upon LPS administration, CD44 expression in WT kidneys was augmented at all time-points. At 2 and 4 hours, CD44 KO animals showed a preserved renal function in comparison to WT mice. In absence of CD44, the pro-inflammatory cytokine levels in plasma and kidneys were lower, while renal expression of the anti-inflammatory cytokine IL-10 was higher. The cytokine levels were associated with decreased leukocyte influx and endothelial activation in CD44 KO kidneys. Furthermore, in vitro assays demonstrated a role of CD44 in enhancing macrophage cytokine responses to LPS and leukocyte migration. In conclusion, our study demonstrates that lack of CD44 impairs the early pro-inflammatory cytokine response to LPS, diminishes leukocyte migration/chemotaxis and endothelial activation, hence, delays endotoxic shock-induced AKI.

  2. Mitochondrial dysfunction contributes to the cytotoxicity induced by tentacle extract from the jellyfish Cyanea capillata in rat renal tubular epithelial NRK-52E cells.

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    Wang, Tao; He, Qian; Xiao, Liang; Wang, Qianqian; Zhang, Bo; Wang, Beilei; Liu, Guoyan; Zheng, Jiemin; Yu, Bentong; Zhang, Liming

    2013-11-01

    Our previous studies have shown that tentacle extract (TE) from the jellyfish Cyanea capillata could induce a delayed jellyfish envenomation syndrome with severe multiple organ dysfunctions, among which renal injury with tubular necrosis seemed to be most serious. So, in this study, we aimed to explore the toxic effect of TE on rat renal tubular epithelial NRK-52E cells. Based on the previous findings that TE could cause oxidative damage in erythrocytes, the effects of TE on cell oxidative stress conditions, including ROS production and lipid peroxidation, and mitochondrial dysfunction associated with cell death were investigated in NRK-52E cells. The results showed that TE caused cell morphological change and decreased cell viability through induction of apoptosis and necrosis in NRK-52E cells. Meanwhile, ROS overproduction and mitochondrial membrane potential decrease were found before the cell death occurred. It was concluded that TE could induce cytotoxicity, especially apoptosis and necrosis, in NRK-52E cells, and mitochondrial dysfunction and ROS overproduction might play important roles in the process of cell injury and death.

  3. Relation between preoperative renal dysfunction and cardiovascular events (stroke, myocardial infarction, or heart failure or death) within three months of isolated coronary artery bypass grafting.

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    Holzmann, Martin J; Sartipy, Ulrik

    2013-11-01

    Renal dysfunction is related to long-term mortality and myocardial infarction after coronary artery bypass grafting (CABG). We aimed to investigate the association between preoperative renal dysfunction and early risk of stroke, myocardial infarction, or heart failure after CABG. From the Swedish Web-system for Enhancement and Development of Evidence-based care in Heart disease Evaluated According to Recommended Therapies registry, we included all 36,284 patients who underwent primary isolated CABG from 2000 to 2008 in Sweden. The Swedish National Inpatient Registry was used to obtain the primary end point, which was rehospitalization for stroke, myocardial infarction, or heart failure ≤90 days after CABG. Logistic regression models were used to estimate the risk for the primary outcome and the secondary outcome of death from any cause, while adjusting for confounders. During 90 days of follow-up, there were 2,462 cardiovascular events and 617 deaths. In total, 17% of patients developed acute kidney injury postoperatively. Odds ratios with 95% confidence intervals for cardiovascular events after adjustment for age, gender, atrial fibrillation, left ventricular ejection fraction, diabetes mellitus, peripheral vascular disease, and history of myocardial infarction, heart failure, or stroke was 1.24 (1.06 to 1.45) in patients with an estimated glomerular filtration rate of 15 to 45 ml/min/1.73 m(2) but became nonsignificant after acute kidney injury was introduced into the statistical model. The risk of death was significantly increased in patients with estimated glomerular filtration rate of 15 to 45 ml/min/1.73 m(2) (odds ratio 1.76, 95% confidence interval 1.38 to 2.25) even after adjustment for all confounders. Renal dysfunction was associated with all-cause mortality but not with cardiovascular events during the first 3 postoperative months after primary isolated CABG.

  4. Hyperglycemia, acute insulin resistance, and renal dysfunction in the early phase of ST-elevation myocardial infarction without previously known diabetes: impact on long-term prognosis.

    Science.gov (United States)

    Lazzeri, Chiara; Valente, Serafina; Chiostri, Marco; Attanà, Paola; Mattesini, Alessio; Nesti, Martina; Gensini, Gian Franco

    2014-11-01

    We evaluated the relationship between admission renal function (as assessed by estimated glomerular filtration rate (eGFR)), hyperglycemia, and acute insulin resistance, indicated by the homeostatic model assessment (HOMA) index, and their impact on long-term prognosis in 825 consecutive patients with ST-elevation myocardial infarction (STEMI) without previously known diabetes who underwent primary percutaneous coronary intervention (PCI). Admission eGFR showed a significant indirect correlation with admission glycemia (Spearman's ρ -0.23, P renal function and glucose values and acute insulin resistance in the early phase of STEMI was detectable, since a significant, indirect correlation between eGFR, insulin values, and glycemia was observed. Patients with renal dysfunction (eGFR renal function (eGFR ≥60 ml/min/1.73 m(2)). The prognostic role of glucose values for 1-year mortality was confined to patients with eGFR ≥60 ml/min/m(2), who represent the large part of our population and are thought to be at lower risk. In these patients, an independent relationship between 1-year mortality and glucose values was detectable not only for admission glycemia but also for glucose values measured at discharge.

  5. Correction of renal dysfunction under the influence of dietary management, exercises and lisinopril in patients with abdominal obesity and hypertension

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    Rokutova М.К.

    2015-11-01

    Full Text Available The purpose of research is to assess the impact of diet therapy, physical activity and an ACE inhibitor (lisinopril on renal dysfunction in patients with abdominal obesity and hypertension. The study involved 14 patients with abdominal obesity, 2-3 degrees in BMI, hypertension, I-II stage, 1 degree, and severe insulin resistance. Men were 9 (64.3% patients, women - 5 (35.7% persons. The average age of the patients was 37,0±1,7 years, mean BMI - 44.7 [35.5; 46.5] kg/m2. BP was between 140-158/90-98 mm Hg. Diroton (lisinopril, Richter Gedeon Ltd, Hungary was administered 1 time per day in the morning at a dose of 10 mg. The effect of diet therapy, exercise and lisinopril on parameteres of renal function (glomerular filtration rate, urine protein, urine albumin, urine І2 microglobulin, urine albumin / creatinine ratio, І2- microglobulin / urine creatinine ratio. After 6 months of treatment there was a significant decrease in body weight (p<0.001 from 123.5 [110.0; 154.0] to 120.0 [105.0; 142.0] kg, with a BMI from 44.7 [35.5; 46.5] to 42.7 [33.9; 45.2] kg/m2 (p <0.001 and waist from 118.0 [105.0; 142.0] to 116.0 [105.0; 135.0] cm (p<0.05. Normalization of blood pressure was achieved in 71,4% (n=10 patients and a significant decrease in blood pressure - in 28,7% (n=4 persons in the 6th week of treatment. The level of GFR was significantly (p<0.01 decreased from 202.2 [156.1; 254.6] to 200.3 [148.8; 220.6] ml/min, the level of І2-mg decreased from 3.4 [1.1, 4.8] to 2.8 [1.4; 3.6] mg/24 h, the І2-mg / Cr urine ratio - from 2.3 [0.9, 4.0] to 1.9 [1.0, 2.7] mg/g, which is a positive point prognosis of obesity-associated nephropathy in these patients. GFR normalized in 2 (14.3% patients, І2-mg and І2-mg / Сr ratio - only in 1 (7.1% patients. GFR decreased in 10 (71.4% patients, І2-mg and І2-mg / Cr ratio – in 12 (85.7% patients. It is the result of complex treatment of diet, exercises and lisinopril. A significant reduction (p<0.01 of leptin

  6. Renal Dysfunction Induced by Kidney-Specific Gene Deletion of Hsd11b2 as a Primary Cause of Salt-Dependent Hypertension.

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    Ueda, Kohei; Nishimoto, Mitsuhiro; Hirohama, Daigoro; Ayuzawa, Nobuhiro; Kawarazaki, Wakako; Watanabe, Atsushi; Shimosawa, Tatsuo; Loffing, Johannes; Zhang, Ming-Zhi; Marumo, Takeshi; Fujita, Toshiro

    2017-07-01

    Genome-wide analysis of renal sodium-transporting system has identified specific variations of Mendelian hypertensive disorders, including HSD11B2 gene variants in apparent mineralocorticoid excess. However, these genetic variations in extrarenal tissue can be involved in developing hypertension, as demonstrated in former studies using global and brain-specific Hsd11b2 knockout rodents. To re-examine the importance of renal dysfunction on developing hypertension, we generated kidney-specific Hsd11b2 knockout mice. The knockout mice exhibited systemic hypertension, which was abolished by reducing salt intake, suggesting its salt-dependency. In addition, we detected an increase in renal membrane expressions of cleaved epithelial sodium channel-α and T53-phosphorylated Na(+)-Cl(-) cotransporter in the knockout mice. Acute intraperitoneal administration of amiloride-induced natriuresis and increased urinary sodium/potassium ratio more in the knockout mice compared with those in the wild-type control mice. Chronic administration of amiloride and high-KCl diet significantly decreased mean blood pressure in the knockout mice, which was accompanied with the correction of hypokalemia and the resultant decrease in Na(+)-Cl(-) cotransporter phosphorylation. Accordingly, a Na(+)-Cl(-) cotransporter blocker hydrochlorothiazide significantly decreased mean blood pressure in the knockout mice. Chronic administration of mineralocorticoid receptor antagonist spironolactone significantly decreased mean blood pressure of the knockout mice along with downregulation of cleaved epithelial sodium channel-α and phosphorylated Na(+)-Cl(-) cotransporter expression in the knockout kidney. Our data suggest that kidney-specific deficiency of 11β-HSD2 leads to salt-dependent hypertension, which is attributed to mineralocorticoid receptor-epithelial sodium channel-Na(+)-Cl(-) cotransporter activation in the kidney, and provides evidence that renal dysfunction is essential for developing the

  7. Cephaloridine induces translocation of protein kinase C delta into mitochondria and enhances mitochondrial generation of free radicals in the kidney cortex of rats causing renal dysfunction.

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    Kohda, Yuka; Gemba, Munekazu

    2005-05-01

    We have previously reported that the enhancement of free radical generation in mitochondria isolated from the kidney cortex of rats exposed to cephaloridine (CER) is probably mediated by the activation of protein kinase C (PKC). We examined which isoenzymes of PKC might be involved in the development of nephrotoxicity induced by CER in rats. The CER-induced renal dysfunction observed 24 h after its injection was prevented by a potent antioxidant DPPD and well-known PKC inhibitors like H-7 and rottlerin. At 1.5 and 3.5 h after the CER injection, the free radical generation was increased markedly and this was associated with translocation of PKCdelta into the mitochondria of renal cortex tissue. Pretreatment of rats with H-7, a PKC inhibitor, significantly inhibited the CER-derived increase in mitochondrial generation of free radicals, suggesting that H-7 probably gets into the mitochondria and inhibits the activity of translocated PKC within the mitochondria. It was also shown that pretreatment of rats with rottlerin, a specific inhibitor of PKCdelta, suppressed the early translocation of PKCdelta into mitochondria and inhibited the CER-derived development of renal dysfunction. These results suggest that the CER-derived early translocation of PKCdelta into mitochondria probably leads to the enhanced production of free radicals through the mitochondrial respiratory chain during the development of the nephrotoxicity caused by CER. Understanding the role of PKCdelta in mitochondria may provide an important clue to the molecular mechanisms of mitochondrial production of reactive oxygen species and the free radical-induced renal failure in rats treated with CER.

  8. Modeling and Simulation for Estimating the Influence of Renal Dysfunction on the Hypouricemic Effect of Febuxostat in Hyperuricemic Patients Due to Overproduction or Underexcretion of Uric Acid.

    Science.gov (United States)

    Hirai, Toshinori; Kimura, Toshimi; Echizen, Hirotoshi

    2016-01-01

    Whether renal dysfunction influences the hypouricemic effect of febuxostat, a xanthine oxidase (XO) inhibitor, in patients with hyperuricemia due to overproduction or underexcretion of uric acid (UA) remains unclear. We aimed to address this question with a modeling and simulation approach. The pharmacokinetics (PK) of febuxostat were analyzed using data from the literature. A kinetic model of UA was retrieved from a previous human study. Renal UA clearance was estimated as a function of creatinine clearance (CLcr) but non-renal UA clearance was assumed constant. A reversible inhibition model for bovine XO was adopted. Integrating these kinetic formulas, we developed a PK-pharmacodynamic (PK-PD) model for estimating the time course of the hypouricemic effect of febuxostat as a function of baseline UA level, febuxostat dose, treatment duration, body weight, and CLcr. Using the Monte Carlo simulation method, we examined the performance of the model by comparing predicted UA levels with those reported in the literature. We also modified the models for application to hyperuricemia due to UA overproduction or underexcretion. Thirty-nine data sets comprising 735 volunteers or patients were retrieved from the literature. A good correlation was observed between the hypouricemic effects of febuxostat estimated by our PK-PD model and those reported in the articles (observed) (r=0.89, p<0.001). The hypouricemic effect was estimated to be augmented in patients with renal dysfunction irrespective of the etiology of hyperuricemia. While validation in clinical studies is needed, the modeling and simulation approach may be useful for individualizing febuxostat doses in patients with various clinical characteristics.

  9. Genetic polymorphisms of angiotensin-2 type 1 receptor and angiotensinogen and risk of renal dysfunction and coronary heart disease in type 2 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Hu Frank B

    2009-03-01

    Full Text Available Abstract Background Increased activation of the renin-angiotensin system (RAS may be important in promoting coronary heart disease (CHD and renal dysfunction, but limited data are available on associations between angiotensin type 1 receptor (AGT1R and angiotensinogen (AGT genotypes in type 2 diabetes. Methods Study participants were diabetics from the Health Professionals Follow-Up Study (HPFS and the Nurses' Health Study (NHS. We analyzed single nucleotide polymorphisms (SNPs associated with cardiovascular pathophysiology (including AGT1R T573C, AGT1R A1166C, and AGT M235T and presence of renal dysfunction (eGFR2 or history of CHD. Results The AGT1R 1166 C-allele was associated with eGFR2 (multivariable OR 1.63 [1.01, 2.65] in the HPFS men (n = 733 and in the combined dataset (n = 1566 (OR 1.42 [1.02, 1.98]. The AGT1R 1166 C-allele was also associated with CHD in men (OR 1.57 [1.10, 2.24]. In NHS women (n = 833, AGT 235T-allele was associated with CHD (OR 1.72 [1.20, 2.47]. Removal of hypertension from the fully adjusted models did not influence results, suggesting that the associations may not be mediated by hypertension. There were significant interactions between sex and AGT1R 1166 C-allele (p = 0.008 and AGT M235T (p = 0.03 in models for CHD. No significant associations were seen between AGT1R T573 C-allele and renal dysfunction or CHD. Conclusion Polymorphisms in AGT1R and AGT genes are associated with renal dysfunction and CHD in type 2 diabetes and further support the important role of the RAS in these complications. Sex may modify associations between AGT1R 1166 C-allele and AGT 235T and CHD in type 2 diabetes.

  10. Glyoxalase-1 overexpression reduces endothelial dysfunction and attenuates early renal impairment in a rat model of diabetes

    DEFF Research Database (Denmark)

    Brouwers, Olaf; Niessen, Petra M G; Miyata, Toshio

    2014-01-01

    AIMS/HYPOTHESIS: In diabetes, advanced glycation end-products (AGEs) and the AGE precursor methylglyoxal (MGO) are associated with endothelial dysfunction and the development of microvascular complications. In this study we used a rat model of diabetes, in which rats transgenically overexpressed...... and endothelium dysfunction markers. In fully differentiated cultured podocytes incubation with MGO resulted in apoptosis. CONCLUSIONS/INTERPRETATION: This study shows that effective regulation of the GLO-I enzyme is important in the prevention of vascular intracellular glycation, endothelial dysfunction...

  11. Single-dose pharmacokinetics and safety of pegylated interferon-alpha2b in patients with chronic renal dysfunction.

    Science.gov (United States)

    Gupta, Samir K; Pittenger, Amy L; Swan, Suzanne K; Marbury, Thomas C; Tobillo, Emlyn; Batra, Vijay; Sack, Marshall; Glue, Paul; Jacobs, Sheila; Affrime, Melton

    2002-10-01

    This study evaluates the pharmacokinetics and safety of pegylated interferon-alpha2b (PEG-Intron) following a single-dose subcutaneous injection into subjects with normal renal function, subjects with chronic renal impairment, and patients on hemodialysis. In this open-label, single-dose, parallel group study, subjects were divided into five groups according to their degree of renal function: four groups as defined by measured creatinine clearance and a fifth hemodialysis dependent group. They received 1 microg/kg PEG-Intron subcutaneously after a 10-hour fast. Pharmacokinetic and safety assessments were performed up to 168 hours postdose. Hemodialysis patients had a second PEG-Intron dose 12 hours prior to a hemodialysis session. PEG-Intron pharmacokinetic parameters (AUCtf, Cmax, and t1/2) increased progressively as CL(CR) declined. All subjects reported at least one adverse event, which were typical of those reported after alpha-interferon administration (e.g., flu-like symptoms, headache). Single-dose PEG-Intron administration to volunteers with normal renal function and chronic renal impairment was safe and well tolerated. In patients with CL(CR) < 30 ml/min, AUCand Cmax values were increased 90% compared with controls, while half-life was increased by up to 40% over controls. Based on the relationship between PEG-Intron apparent clearance and CL(CR), renal clearance accountsfor less than half of its total clearance. Hemodialysis did not affect PEG-Intron apparent clearance.

  12. Sorting nexin 1 loss results in D5 dopamine receptor dysfunction in human renal proximal tubule cells and hypertension in mice.

    Science.gov (United States)

    Villar, Van Anthony M; Jones, John Edward; Armando, Ines; Asico, Laureano D; Escano, Crisanto S; Lee, Hewang; Wang, Xiaoyan; Yang, Yu; Pascua-Crusan, Annabelle M; Palmes-Saloma, Cynthia P; Felder, Robin A; Jose, Pedro A

    2013-01-04

    The peripheral dopaminergic system plays a crucial role in blood pressure regulation through its actions on renal hemodynamics and epithelial ion transport. The dopamine D5 receptor (D(5)R) interacts with sorting nexin 1 (SNX1), a protein involved in receptor retrieval from the trans-Golgi network. In this report, we elucidated the spatial, temporal, and functional significance of this interaction in human renal proximal tubule cells and HEK293 cells stably expressing human D(5)R and in mice. Silencing of SNX1 expression via RNAi resulted in the failure of D(5)R to internalize and bind GTP, blunting of the agonist-induced increase in cAMP production and decrease in sodium transport, and up-regulation of angiotensin II receptor expression, of which expression was previously shown to be negatively regulated by D(5)R. Moreover, siRNA-mediated depletion of renal SNX1 in C57BL/6J and BALB/cJ mice resulted in increased blood pressure and blunted natriuretic response to agonist in salt-loaded BALB/cJ mice. These data demonstrate a crucial role for SNX1 in D(5)R trafficking and that SNX1 depletion results in D(5)R dysfunction and thus may represent a novel mechanism for the pathogenesis of essential hypertension.

  13. Association between left ventricular dysfunction, anemia, and chronic renal failure. Analysis of the Heart Failure Prevalence and Predictors in Turkey (HAPPY) cohort.

    Science.gov (United States)

    Kepez, A; Mutlu, B; Degertekin, M; Erol, C

    2015-06-01

    Anemia and chronic renal failure (CRF) are frequent comorbidities in patients with heart failure (HF), and they have been reported to be associated with increased mortality and hospitalization rates. HF, anemia, and CRF have been reported to interact with each other forming a vicious cycle termed cardio-renal-anemia syndrome. The aim of the present study was to evaluate the association of HF, anemia, and CRF using data from the large-scale"Heart Failure Prevalence and Predictors in Turkey (HAPPY)" study. Among the HAPPY cohort, 3,369 subjects who had either left ventricular dysfunction (LVD) or normal left ventricular function on echocardiography or normal serum NT-proBNP levels were included in this analysis. The prevalence of anemia and CRF was significantly higher in patients with LVD compared with subjects with normal ventricular function (20.7 % vs. 4.0 % and 19.0 % vs. 3.7 %, respectively; p anemia, and CRF demonstrated that each one was an independent predictor for the presence of the others. These findings point to the presence of cardio-renal-anemia syndrome and the necessity of treating these comorbidities in patients with HF.

  14. Podocyturia parallels proximal tubule dysfunction in type 2 diabetes mellitus patients independently of albuminuria and renal function decline: A cross-sectional study.

    Science.gov (United States)

    Petrica, Ligia; Vlad, Mihaela; Vlad, Adrian; Gluhovschi, Gheorghe; Gadalean, Florica; Dumitrascu, Victor; Popescu, Roxana; Gluhovschi, Cristina; Matusz, Petru; Velciov, Silvia; Bob, Flaviu; Ursoniu, Sorin; Vlad, Daliborca

    2017-09-01

    Detection of podocytes in the urine of patients with type 2 diabetes may indicate severe injury to the podocytes. In the course of type 2 diabetes the proximal tubule is involved in urinary albumin processing. We studied the significance of podocyturia in relation with proximal tubule dysfunction in type 2 diabetes. A total of 86 patients with type 2 diabetes (34-normoalbuminuria; 30-microalbuminuria; 22-macroalbuminuria) and 28 healthy subjects were enrolled in the study and assessed concerning urinary podocytes, podocyte-associated molecules, and biomarkers of proximal tubule dysfunction. Urinary podocytes were examined in cell cultures by utilizing monoclonal antibodies against podocalyxin and synaptopodin. Podocytes were detected in the urine of 10% of the healthy controls, 24% of the normoalbuminuric, 40% of the microalbuminuric, and 82% of the macroalbuminuric patients. In multivariate logistic regression analysis, urinary podocytes correlated with urinary albumin:creatinine ratio (p=0.006), urinary nephrin/creat (p=0.001), urinary vascular endothelial growth factor/creat (p=0.001), urinary kidney injury molecule-1/creat (p=0.003), cystatin C (p=0.001), urinary advanced glycation end-products (p=0.002), eGFR (p=0.001). In patients with type 2 diabetes podocyturia parallels proximal tubule dysfunction independently of albuminuria and renal function decline. Advanced glycation end-products may impact the podocytes and the proximal tubule. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Evaluation of renal allograft dysfunction employing dynamic SPECT with {sup 99m}Tc-MAG3 and graph plot analysis

    Energy Technology Data Exchange (ETDEWEB)

    Akahira, Hideaki [Oyokyo Kidney Research Inst., Hirosaki, Aomori (Japan). Hirosaki Hospital

    1996-11-01

    To estimate renal blood flow and tubular function in transplanted kidneys, we applied the 4 compartments model and the graphic analysis method to {sup 99m}Tc-MAG3 dynamic SPECT and calculated some parameters, i.e. K1 (renal influx rate constant), K3 (tubular transporting rate constant), Vd12 (intrarenal distribution volume), and others. Twenty-three renal transplant recipients were examined and divided into following 3 groups according to their serum creatinine levels (SCr); Group I: less than 13 mg/dl (1.1{+-}0.3, n=7), Group II: 1.4-2.5 mg/dl (1.8{+-}0.3, n=11), and Group III more than 2.6 mg/dl (3.9{+-}0.9, n=5). The K3 value became lower in the order of Group I>II>III, and well correlated with blood urea nitrogen (BUN, r=-0.95, p<0.001) and creatinine clearance (Ccr, r=0.78, p<0.001). The K1 value reduced markedly in Group III despite of no difference between Group I and II. Although the K1 value also correlated with SCr, BUN and Ccr, correlation coefficients were smaller than those with the K3. Effective renal plasma flow derived from K1 and K3 showed a good correlation with the tubular extraction rate by Bubeck`s method. From these results and clinical conditions including histopathological findings, it is suggested that K1, K3 and Vd12 are useful parameters of renal central arterial blood flow, renal peripheral arteriolar blood flow and renal {sup 99m}Tc-MAG3 uptake function, respectively. (author)

  16. High-fat diet amplifies renal renin angiotensin system expression, blood pressure elevation, and renal dysfunction caused by Ceacam1 null deletion.

    Science.gov (United States)

    Li, Caixia; Culver, Silas A; Quadri, Syed; Ledford, Kelly L; Al-Share, Qusai Y; Ghadieh, Hilda E; Najjar, Sonia M; Siragy, Helmy M

    2015-11-01

    Carcinoembryonic antigen-related cell adhesion molecule 1 (CEACAMl), a substrate of the insulin receptor tyrosine kinase, regulates insulin action by promoting insulin clearance. Global null mutation of Ceacam1 gene (Cc1(-/-)) results in features of the metabolic syndrome, including insulin resistance, hyperinsulinemia, visceral adiposity, elevated blood pressure, and albuminuria. It also causes activation of the renal renin-angiotensin system (RAS). In the current study, we tested the hypothesis that high-fat diet enhances the expression of RAS components. Three-month-old wild-type (Cc1(+/+)) and Cc1(-/-) mice were fed either a regular or a high-fat diet for 8 wk. At baseline under regular feeding conditions, Cc1(-/-) mice exhibited higher blood pressure, urine albumin-to-creatinine ratio (UACR), and renal expression of angiotensinogen, renin/prorenin, angiotensin-converting enzyme, (pro)renin receptor, angiotensin subtype AT1 receptor, angiotensin II, and elevated PI3K phosphorylation, as detected by p85α (Tyr(508)) immunostaining, inflammatory response, and the expression of collagen I and collagen III. In Cc1(+/+) mice, high-fat diet increased blood pressure, UACR, the expression of angiotensin-converting enzyme and angiotensin II, PI3K phosphorylation, inflammatory response, and the expression of collagen I and collagen III. In Cc1(-/-) mice, high-fat intake further amplified these parameters. Immunohistochemical staining showed increased p-PI3K p85α (Tyr(508)) expression in renal glomeruli, proximal, distal, and collecting tubules of Cc1(-/-) mice fed a high-fat diet. Together, this demonstrates that high-fat diet amplifies the permissive effect of Ceacam1 deletion on renal expression of all RAS components, PI3K phosphorylation, inflammation, and fibrosis.

  17. Effect of Hachimijiogan against Renal Dysfunction and Involvement of Hypoxia-Inducible Factor-1α in the Remnant Kidney Model

    Directory of Open Access Journals (Sweden)

    Hiroshi Oka

    2011-01-01

    Full Text Available In chronic renal failure, hypoxia of renal tissue is thought to be the common final pathway leading to end-stage renal failure. In this study the effects of hachimijiogan, a Kampo formula, were studied with respect to hypoxia-inducible factor (HIF. Using remnant kidney rats, we studied the effects of hachimijiogan on renal function in comparison with angiotensin II receptor blocker. The result showed that oral administration of hachimijiogan for seven days suppressed urinary protein excretion and urinary 8-OHdG, a marker of antioxidant activity, equally as well as oral administration of candesartan cilexetil. In contrast, the protein volume of HIF-1α in the renal cortex was not increased in the candesartan cilexetil group, but that in the hachimijiogan group was increased. In immunohistochemical studies as well, the expression of HIF-1α of the high-dose hachimijiogan group increased compared to that of the control group. Vascular endothelial growth factor and glucose transporter 1, target genes of HIF-1α, were also increased in the hachimijiogan group. These results suggest that hachimijiogan produces a protective effect by a mechanism different from that of candesartan cilexetil.

  18. A Nitric Oxide-Donor Furoxan Moiety Improves the Efficacy of Edaravone against Early Renal Dysfunction and Injury Evoked by Ischemia/Reperfusion

    Directory of Open Access Journals (Sweden)

    Fausto Chiazza

    2015-01-01

    Full Text Available Edaravone (5-methyl-2-phenyl-2,4-dihydro-3H-pyrazol-3-one, EDV is a free-radical scavenger reduces organ ischemic injury. Here we investigated whether the protective effects of EDV in renal ischemia/reperfusion (I/R injury may be enhanced by an EDV derivative bearing a nitric oxide- (NO- donor furoxan moiety (NO-EDV. Male Wistar rats were subjected to renal ischemia (45 minutes, followed by reperfusion (6 hours. Administration of either EDV (1.2–6–30 µmol/kg, i.v. or NO-EDV (0.3–1.2–6 µmol/kg, i.v. dose-dependently attenuated markers of renal dysfunction (serum urea and creatinine, creatinine clearance, urine flow, urinary N-acetyl-β-D-glucosaminidase, and neutrophil gelatinase-associated lipocalin/lipocalin-2. NO-EDV exerted protective effects in the dose-range 1.2–6 µmol/kg, while a higher dose (30 µmol/kg was needed to obtain protection by EDV. Both EDV and NO-EDV modulated tissue markers of oxidative stress and lipid peroxidation. NO-EDV, but not EDV, activated endothelial NO synthase (NOS and blunted I/R-induced upregulation of inducible NOS, secondary to modulation of Akt and NF-κB activation, respectively. Besides NO-EDV administration inhibited I/R-induced IL-1β, IL-18, IL-6, and TNF-α overproduction. Overall, these findings demonstrate that the NO-donor moiety contributes to the protection against early renal I/R injury and suggest that NO-donor EDV codrugs are worthy of additional study as innovative pharmacological tools.

  19. Detection of renal dysfunction based on serum creatinine levels in a Brazilian community: the Bambuí Health and Ageing Study.

    Science.gov (United States)

    Passos, V M A; Barreto, S M; Lima-Costa, M F F

    2003-03-01

    There are few population-based studies of renal dysfunction and none conducted in developing countries. In the present study the prevalence and predictors of elevated serum creatinine levels (SCr > or = 1.3 mg/dl for men and 1.1 mg/dl for women) were determined among Brazilian adults (18-59 years) and older adults (>60 years). Participants included all older adults (N = 1742) and a probabilistic sample of adults (N = 818) from Bambu town, MG, Southeast Brazil. Predictors were investigated using multiple logistic regression. Mean SCr levels were 0.77 +/- 0.15 mg/dl for adults, 1.02 +/- 0.39 mg/dl for older men, and 0.81 +/- 0.17 mg/dl for older women. Because there were only 4 cases (0.48%) with elevated SCr levels among adults, the analysis of elevated SCr levels was restricted to older adults. The overall prevalence of elevated SCr levels among the elderly was 5.09% (76/1494). The prevalence of hypercreatinemia increased significantly with age (chi = 26.17, P = 0.000), being higher for older men (8.19%) than for older women (5.29%, chi = 5.00, P = 0.02). Elevated SCr levels were associated with age 70-79 years (odds ratio [OR] = 2.25, 95% confidence interval [CI]: 1.15-4.42), hypertension (OR = 3.04, 95% CI: 1.34-6.92), use of antihypertensive drugs (OR = 2.46, 95% CI: 1.26-4.82), chest pain (OR = 3.37, 95% CI: 1.31-8.74), and claudication (OR = 3.43, 95% CI: 1.30-9.09) among men, and with age >80 years (OR = 4.88, 95% CI: 2.24-10.65), use of antihypertensive drugs (OR = 4.06, 95% CI: 1.67-9.86), physical inactivity (OR = 2.11, 95% CI: 1.11-4.02) and myocardial infarction (OR = 3.89, 95% CI: 1.58-9.62) among women. The prevalence of renal dysfunction observed was much lower than that reported in other population-based studies, but predictors were similar. New investigations are needed to confirm the variability in prevalence and associated factors of renal dysfunction among populations.

  20. Glucosamine-induced Sp1 O-GlcNAcylation ameliorates hypoxia-induced SGLT dysfunction in primary cultured renal proximal tubule cells.

    Science.gov (United States)

    Suh, Han Na; Lee, Yu Jin; Kim, Mi Ok; Ryu, Jung Min; Han, Ho Jae

    2014-10-01

    The aim of this study is to determine whether GlcN could recover the endoplasmic reticulum (ER) stress-induced dysfunction of Na(+) /glucose cotransporter (SGLT) in renal proximal tubule cells (PTCs) under hypoxia. With the rabbit model, the renal ischemia induced tubulointerstitial abnormalities and decreased SGLTs expression in tubular brush-border, which were recovered by GlcN. Thus, the protective mechanism of GlcN against renal ischemia was being examined by using PTCs. Hypoxia decreased the level of protein O-GlcNAc and the expression of O-GlcNAc transferase (OGT) while increased O-GlcNAcase (OGA) and these were reversed by GlcN. Hypoxia also decreased the expression of SGLTs (SGLT1 and 2) and [(14) C]-α-methyl-D-glucopyranoside (α-MG) uptake which were recovered by GlcN and PUGNAc (OGA inhibitor). Hypoxia enhanced reactive oxygen species (ROS) and then ER stress proteins, glucose-regulated protein 78 (GRP78), and C/EBP-homologous protein (CHOP). However, the expression of GRP78 increased till 6 h and then decreased whereas CHOP increased gradually. Moreover, decreased GRP78 and increased CHOP were reversed by NAC (antioxidant) and GlcN. GlcN ameliorated hypoxia-induced decrease of O-GlcNAc modification of Sp1 but OGT or Sp1 siRNAs blocked the recovery effect of GlcN on SGLT expression and α-MG uptake. In addition, hypoxia-decreased GRP78 and HIF-1α expression was reversed by GlcN but OGT siRNA or Sp1 siRNA ameliorated the effect of GlcN. When PTCs were transfected with GRP78 siRNA or HIF-1α siRNA, SGLT expression and α-MG uptake was decreased. Taken together, these data suggest that GlcN-induced O-GlcNAc modified Sp1 with stimulating GRP78 and HIF-1α activity ameliorate hypoxia-induced SGLT dysfunction in renal PTCs. J. Cell. Physiol. 229: 1557-1568, 2014. © 2014 Wiley Periodicals, Inc.

  1. Biochemical Changes in the Serum of Patients with Chronic Toxigenic Mold Exposures: A Risk Factor for Multiple Renal Dysfunctions

    Directory of Open Access Journals (Sweden)

    Ebere Anyanwu

    2003-01-01

    Full Text Available This paper analyzes and presents the biochemical abnormalities in the sera of patients presenting with chronic mycosis in order to investigate the relationship with the risks of multiple renal disorders. The study population (n = 10 consisted of six females and four males (mean age 36.3 years exposed by toxic molds in their homes and offices for an average of 2.8 years. The control group comprised ten people, five males and five females (mean age 35.9 years without any known exposures to toxic molds. Blood samples were obtained from both the patients and the controls and were processed using specific biochemical methods that included enzyme-linked immunoabsorbent assay (ELISA. There were biochemical abnormal concentrations in creatinine, uric acid, phosphorus, alkaline phosphotase, cholesterol, HDH, SGOT/AST, segmented neutrophils, lymphocytes, total T3, IgG and IgA immunoglobulins with significant differences between patients and controls. These abnormalities were consistent with multiple renal disorders. The major complaints of the mycosis patients were headaches, pulmonary symptoms, allergic reactions, memory loss, skin rashes, blurred vision symptoms, fatigue, and runny nose. These findings were depictive of a strong association of chronic mycosis with abnormal renal indicators. It was concluded that, although this research was a pilot investigation, based on the overall results, people exposed to chronic indoor environmental toxic molds were at risk of multiple renal complications.

  2. Adenosine A{sub 1} receptors in contrast media-induced renal dysfunction in the normal rat

    Energy Technology Data Exchange (ETDEWEB)

    Liss, Per; Palm, Fredrik [Department of Diagnostic Radiology, University Hospital, 75185, Uppsala (Sweden); Department of Medical Cell Biology, University Hospital, 75185, Uppsala (Sweden); Carlsson, Per-Ola [Department of Medical Cell Biology, University Hospital, 75185, Uppsala (Sweden); Department of Medical Sciences, University Hospital, 75185, Uppsala (Sweden); Hansell, Peter [Department of Medical Cell Biology, University Hospital, 75185, Uppsala (Sweden)

    2004-07-01

    Renal vasoconstriction with resultant tissue hypoxia, especially in the renal medulla, has been suggested to play a role in contrast media (CM)-induced nephropathy. In this study we investigated the effects of injection of the non-ionic low-osmolar CM iopromide with and without pretreatment with the selective adenosine A{sub 1}-receptor antagonist DPCPX. The effects were evaluated on regional renal blood flow, outer medullary oxygen tension (PO{sub 2}) and urine output in normal anaesthetised rats. A laser-Doppler technique was used for recording haemodynamic changes while oxygen microelectrodes were used for oxygen measurements. The A{sub 1}-receptor antagonist per se elevated glomerular filtration rate (+44%), cortical blood flow (+15%) and urine output (threefold) while reducing outer medullary PO{sub 2} (-24%). Administration of CM reduced outer medullary blood flow (OMBF; -26%) and PO{sub 2} (-80%) but did not affect cortical blood flow. Urine output increased 28-fold by CM while arterial blood pressure was reduced. The CM-mediated effect on haemodynamics, PO{sub 2}, urine output and blood pressure was unaffected by the A{sub 1}-receptor antagonist. Adenosine A{sub 1}-receptors are not important mediators of the depression of outer medullary blood flow and PO{sub 2} caused by the CM iopromide in the normal rat; however, A{sub 1}-receptors are tonically active to regulate renal haemodynamics, PO{sub 2} and urine production during normal physiological conditions. (orig.)

  3. Proximal tubular dysfunction is associated with chronic allograft nephropathy and decreased long-term renal-graft survival

    NARCIS (Netherlands)

    Camara, N.O.S.; Silva, M.S.; Nishida, S.; Pereira, A.B.; Pacheco-Silva, A.

    2004-01-01

    Background: Chronic allograft nephropathy is the major cause of graft loss after the first year of transplantation. Although many conditions are associated with its development, there is no method that can anticipate its risk in patients with good renal function. Methods: We prospectively studied 92

  4. Rimonabant-mediated changes in intestinal lipid metabolism and improved renal vascular dysfunction in the JCR:LA-cp rat model of prediabetic metabolic syndrome.

    Science.gov (United States)

    Russell, James C; Kelly, Sandra E; Diane, Abdoulaye; Wang, Ye; Mangat, Rabban; Novak, Susan; Vine, Donna F; Proctor, Spencer D

    2010-08-01

    Rimonabant (SR141716) is a specific antagonist of the cannabinoid-1 receptor. Activation of the receptor initiates multiple effects on central nervous system function, metabolism, and body weight. The hypothesis that rimonabant has protective effects against vascular disease associated with the metabolic syndrome was tested using JCR:LA-cp rats. JCR:LA-cp rats are obese if they are cp/cp, insulin resistant, and exhibit associated micro- and macrovascular disease with end-stage myocardial and renal disease. Treatment of obese rats with rimonabant (10 mg.kg(-1).day(-1), 12-24 wk of age) caused transient reduction in food intake for 2 wk, without reduction in body weight. However, by 4 wk, there was a modest, sustained reduction in weight gain. Glycemic control improved marginally compared with controls, but at the expense of increased insulin concentration. In contrast, rimonabant normalized fasting plasma triglyceride and reduced plasma plasminogen activator inhibitor-1 and acute phase protein haptoglobin in cp/cp rats. Furthermore, these changes were accompanied by reduced postprandial intestinal lymphatic secretion of apolipoprotein B48, cholesterol, and haptoglobin. While macrovascular dysfunction and ischemic myocardial lesion frequency were unaffected by rimonabant treatment, both microalbuminuria and glomerular sclerosis were substantially reduced. In summary, rimonabant has a modest effect on body weight in freely eating obese rats and markedly reduces plasma triglyceride levels and microvascular disease, in part due to changes in intestinal metabolism, including lymphatic secretion of apolipoprotein B48 and haptoglobin. We conclude that rimonabant improves renal disease and intestinal lipid oversecretion associated with an animal model of the metabolic syndrome that appears to be independent of hyperinsulinemia or macrovascular dysfunction.

  5. Renal disease in pregnancy.

    Science.gov (United States)

    Thorsen, Martha S; Poole, Judith H

    2002-03-01

    Anatomic and physiologic adaptations within the renal system during pregnancy are significant. Alterations are seen in renal blood flow and glomerular filtration, resulting in changes in normal renal laboratory values. When these normal renal adaptations are coupled with pregnancy-induced complications or preexisting renal dysfunction, the woman may demonstrate a reduction of renal function leading to an increased risk of perinatal morbidity and mortality. This article will review normal pregnancy adaptations of the renal system and discuss common pregnancy-related renal complications.

  6. Serum major-histocompatibility-complex class Ⅰ-related chain A antibody detection for the evaluation of graft dysfunction in renal allograft recipients

    Institute of Scientific and Technical Information of China (English)

    ZHANG Ming; LU Fu-ming; QU Lian-xi; HE Jun; YUAN Xiao-niao; GU Yong

    2011-01-01

    Background In addition to the well-known antibodies against human leukocyte antigens (HLA)-induced kidney-graft rejection, polymorphic major-histocompatibility-complex (MHC) class Ⅰ-related chain A (MICA) antigens can elicit antibodies and have been suggested to play a role in the antibody-mediated allograft rejection (AMR). We carded out a prospective study of MICA antibodies in post-renal transplant patients to determine the association between MICA antibodies, C4d staining, histological features, and graft outcome.Methods We tested 52 patients who had biopsy results due to graft dysfunction. The MICA antibodies in concurrent sera were determined by Luminex. All patients were followed up for one year after renal biopsy. The influence of antibody production on the function of graft was analyzed.Results Antibodies against MICA were positive in 15 out of the 52 patients (28.9%). The presence of MICA antibodies was associated with renal-allograft deterioration. During one-year follow-up, the estimated glomerular filtration rate (eGFR) decreased (24.0±3.4)% among recipients with anti-MICA antibodies. However, among recipients without anti-MICA antibodies, the eGFR has declined only (8.4+3.0)% (P=0.017). The association between C4d staining,histological features and MICA antibody production was found no significant difference.Conclusion Besides anti-HLA antibodies, the presence of post-transplant MICA antibody is associated with poor graft outcome and increases the risk of graft failure.

  7. Quiescent interplay between inducible nitric oxide synthase and tumor necrosis factor-alpha: influence on transplant graft vasculopathy in renal allograft dysfunction.

    Science.gov (United States)

    Elahi, Maqsood M; Matata, Bashir M; Hakim, Nadey S

    2006-06-01

    A healthy endothelium is essential for vascular homeostasis, and preservation of endothelial cell function is critical for maintaining transplant allograft function. Damage to the microvascular endothelial cells is now regarded as a characteristic feature of acute vascular rejection, an important predictor of graft loss. It is also linked with transplant vasculopathy, often associated with chronic allograft nephropathy. Large bursts of nitric oxide in infiltrating monocytes/macrophages modulated by inducible nitric oxide synthase are considered pivotal in driving this mechanism. Indeed, it has been shown recently that increased circulating levels of tumor necrosis factor-alpha in the rejecting kidneys are largely responsible for triggering inducible nitric oxide synthase expression. This in turn suggests that several structural and functional features of graft rejection could be mediated by tumor necrosis factor-alpha. Despite the large body of evidence that supports immunologic involvement, knowledge concerning the cellular and biochemical mechanisms for nephritic cell dysfunction and death is incomplete. The role of tumor necrosis factor-alpha in mediating pathophysiological activity of inducible nitric oxide synthase during transplant vasculopathy remains contentious. Here, we discuss the effect of inducible nitric oxide synthase and tumor necrosis factor-alpha interaction on progressive damage to glomerular and vascular structures during renal allograft rejection. Selective inhibition of inducible nitrous oxide synthase and tumor necrosis factor-alpha as a potential therapy for ameliorating endothelial dysfunction and transplant graft vasculopathy is also discussed.

  8. Renal failure

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    2008463 Protective effect of recombination rat augmenter of liver regeneration on kidney in acute renal failure rats. TANG Xiaopeng(唐晓鹏), et al. Dept Nephrol, 2nd Affili Hosp Chongqing Med Univ, Chongqing 400010.Chin J Nephrol 2008;24(6):417-421. Objective To investigate the protective effects of recombination rat augmenter of liver regeneration (rrALR) on tubular cell injury and renal dysfunction

  9. Effect of remote ischemic preconditioning on renal dysfunction after complex valvular heart surgery: a randomized controlled trial.

    Science.gov (United States)

    Choi, Yong Seon; Shim, Jae Kwang; Kim, Jong Chan; Kang, Kyu-Sik; Seo, Yong Han; Ahn, Ki-Ryang; Kwak, Young Lan

    2011-07-01

    Acute kidney injury after cardiac surgery with cardiopulmonary bypass is closely related to systemic inflammatory reactions and oxidative stresses. Remote ischemic preconditioning is a systemic protective strategy whereby brief limb ischemia confers systemic protection against prolonged ischemia and inflammatory reactions in distant organs. This study investigated whether remote ischemic preconditioning provides systemic protective effect on kidneys that are not directly exposed to ischemia-reperfusion injury during complex valvular heart surgery. Seventy-six adult patients undergoing complex valvular heart surgery were randomly assigned to either remote ischemic preconditioning group (n = 38) or control group (n = 38). Remote ischemic preconditioning consisted of 3 10-minute cycles of lower limb ischemia and reperfusion with an automated cuff inflator. Primary end points were comparisons of biomarkers of renal injury including serum creatinine, cystatin C and neutrophil gelatinase-associated lipocalin, and incidence of acute kidney injury. Secondary end points were comparisons of myocardial enzyme release and pulmonary parameters. There were no significant differences in serum levels of biomarkers of renal injury between groups throughout the study period. The incidence of acute kidney injury did not differ between groups. Creatine kinase isoenzyme MB at 24 hours after surgery was lower, and intensive care unit stay was shorter in the remote ischemic preconditioning group than in the control group. In patients undergoing complex valvular heart surgery, remote ischemic preconditioning did not reduce degree of renal injury or incidence of acute kidney injury whereas it did reduce myocardial injury and intensive care unit stay. Copyright © 2011 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

  10. 核因子-κB在慢性移植肾失功中作用机制的研究%Expression of NF-κB p65 in Renal Tissue from Patients with Chronic Renal Allograft Dysfunction

    Institute of Scientific and Technical Information of China (English)

    杨俊; 李淦洪; 刘璐璐; 姜华; 晏强; 李乾伟

    2015-01-01

    Objective To investigate the expression of NF-κB p65 and its downstream signal molecules in renal tissue with chronic renal allograft dysfunction (CRAD), and explore their relationship with interstitial fibrosis and tubular atrophy(IF/TA) and urine protein. Methods Immunohistochemical assay and computer-assisted genuine col-ored image analysis system were used to detect the expression of NF-κB p65, regulated on activation normal T cells expressed and secreted (RANTES) and monocyte chemoattractant protein 1 (MCP-1) in 103 renal allografts with CRAD. The relationship of NF-κB p65, RANTES, MCP-1 in renal allografts with IF/TA, serum creatinine and 24h urine protein were analyzed. Ten specimens from healthy renal tissue were used as controls. Results Com-pared to normal tissue, the expressions of NF-κB p65 were significantly higher in renal tissue with CRAD (IF/TA-I: 22.63%±6.37%, IF/TA-II: 38.59%±5.36%, IF/TA-III: 53.36%±8.77% vs control: 7.83%±0.57%, P<0.001), and the expressions were positively related to the pathological grade of IF/TA and RANTES and MCP-1 (r=0.904, 0.736, and 0.857, respectively, all P<0.001). The expression of NF-κB p65 was positively related with inflammato-ry cellular infiltration (r=0.851, P<0.001); serum creatinine level and 24h urine protein were increased with IF/TA grades (r=0.902 and 0.870, all P<0.001). Conclusion The expression of NF-κB p65 in renal allografts is in-creased and is closely related to up-regulated RANTES and MCP-1, inflammatory cellular infiltration, IF/TA, and chronic allograft dysfunction. This may indicate the involvement of NF-κB p65 and its downstream signal molecules in progression of chronic renal allograft dysfunction.%目的 探讨核因子-κB(NF-κB)及其下游信号分子调节激活正常T细胞表达和分泌的细胞因子(RANTES)和单核细胞趋化蛋白-1(MCP-1)在慢性移植肾失功(CRAD)患者移植肾组织的表达及与肾间质纤维化/小管萎缩(IF/TA)和

  11. The efficacy and safety of dual blockage of the renin-angiotensin-aldosterone system in patients with type 2 diabetes, hypertension and obesity without renal dysfunction

    Directory of Open Access Journals (Sweden)

    S A Savelyeva

    2012-09-01

    Full Text Available The purpose of the study was to evaluate the clinical efficacy and safety of dual RAAS blockage during treatment with angiotensin-converting enzyme (ACE inhibitors in combination with a direct renin inhibitor (PIR aliskiren versus combination therapy with ACE inhibitors and angiotensin receptor blocker II (ARB valsartan in patients with type 2 diabetes mellitus (T2DM, arterial hypertension (AH and obesity, without renal dysfunction. Materials and methods. The study included 26 patients with T2DM (10 men and 16 women, mean age 59,0±6,2 years with inadequate control of blood pressure (over 130 and/or 80 mm Hg on prior antihypertensive therapy and without renal dysfunctions (glomerular filtration rate (GFR> 60 ml/min/1, 73 m2 and the of albumin/creatinine (A/C ratio in the morning urine sample <10 mg/mol. After screening with the continuation of the initial therapy, including ACE inhibitors, 14 patients were added aliskiren 150–300 mg/day, 12 patients – valsartan 80–160 mg/day. Evaluation of the treatment effectiveness in terms of blood pressure (mean of three consecutive measurements in the sitting position and the parameters of renal function (serum creatinine and potassium, GFR, A/C ratio in the urine was performed at 4, 12 and 24 weeks of therapy. Results. In the group of patients treated with aliskiren, after 4 weeks of treatment a significant decrease in systolic and diastolic blood pressure (SBP and DBP, respectively was noted as compared to baseline: 146,1 and 138,9 mm Hg, p<0,05, 87,1 and 81,1 mm Hg, p <0,05, respectively; with systolic BP after 24 weeks of treatment decreased to 127,8 (-18,2 mm Hg, p<0,05, diastolic BP to 75,0 (-12, 1 mm Hg, p<0,05, the target blood pressure (≤130/80 mm Hg was achieved in 83% of patients. The group of patients treated with valsartan, after 4 weeks of therapy showed a significant reduction in systolic BP 148 and 141,6 mm Hg, p <0,05, diastolic BP - to 85,8 and 81,7 mm Hg, p=0,059; after 24 weeks

  12. Ectopia renal cruzada con fusión, reflujo vesicoureteral y riñón ectópico afuncional:: informe de un caso Crossed renal ectopia with fusion, vesicoureteral reflux and dysfunctional ectopic kidney:: A case report

    Directory of Open Access Journals (Sweden)

    Sandalio Durán Álvarez

    2010-03-01

    due to the no-obstructive pelvic dilation or right kidney, crossed renal ectopia with fusion of dysfunctional left kidney and II degree bilateral vesicoureteral reflux from right kidney and of V degree from the crossed ectopic left kidney. At eleven months life he undergoes a lumbotomy and the hydronephrosis big sac was fused with lower pole of the right kidney. This big sac was resected and a low ureter ligature was carried out.

  13. Diuretic Strategies in Acute Heart Failure and Renal Dysfunction: Conventional vs Carbohydrate Antigen 125-guided Strategy. Clinical Trial Design.

    Science.gov (United States)

    García-Blas, Sergio; Bonanad, Clara; Llàcer, Pau; Ventura, Silvia; Núñez, José María; Sánchez, Ruth; Chamorro, Carlos; Fácila, Lorenzo; de la Espriella, Rafael; Vaquer, Juana María; Cordero, Alberto; Roqué, Mercè; Ortiz, Víctor; Racugno, Paolo; Bodí, Vicent; Valero, Ernesto; Santas, Enrique; Moreno, María Del Carmen; Miñana, Gema; Carratalá, Arturo; Bondanza, Lourdes; Payá, Ana; Cardells, Ingrid; Heredia, Raquel; Pellicer, Mauricio; Valls, Guillermo; Palau, Patricia; Bosch, María José; Raso, Rafael; Sánchez, Andrés; Bertomeu-González, Vicente; Bertomeu-Martínez, Vicente; Montagud-Balaguer, Vicente; Albiach-Montañana, Cristina; Pendás-Meneau, Jezabel; Marcaida, Goitzane; Cervantes-García, Sonia; San Antonio, Rodolfo; de Mingo, Elisabet; Chorro, Francisco J; Sanchis, Juan; Núñez, Julio

    2017-03-21

    The optimal treatment of patients with acute heart failure (AHF) and cardiorenal syndrome type 1 (CRS-1) is far from being well-defined. Arterial hypoperfusion in concert with venous congestion plays a crucial role in the pathophysiology of CRS-I. Plasma carbohydrate antigen 125 (CA125) has emerged as a surrogate of fluid overload in AHF. The aim of this study was to evaluate the clinical usefulness of CA125 for tailoring the intensity of diuretic therapy in patients with CRS-1. Multicenter, open-label, parallel clinical trial, in which patients with AHF and serum creatinine ≥ 1.4mg/dL on admission will be randomized to: a) standard diuretic strategy: titration-based on conventional clinical and biochemical evaluation, or b) diuretic strategy based on CA125: high dose if CA125 > 35 U/mL, and low doses otherwise. The main endpoint will be renal function changes at 24 and 72hours after therapy initiation. Secondary endpoints will include: a) clinical and biochemical changes at 24 and 72hours, and b) renal function changes and major clinical events at 30 days. The results of this study will add important knowledge on the usefulness of CA125 for guiding diuretic treatment in CRS-1. In addition, it will pave the way toward a better knowledge of the pathophysiology of this challenging situation. We hypothesize that higher levels of CA125 will identify a patient population with CRS-1 who could benefit from the use of a more intense diuretic strategy. Conversely, low levels of this glycoprotein could select those patients who would be harmed by high diuretic doses. Copyright © 2017 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  14. "Assessment of RIFLE and AKIN criteria to define acute renal dysfunction for HIPEC procedures for ovarian and non ovarian peritoneal malignances".

    Science.gov (United States)

    Arjona-Sánchez, A; Cadenas-Febres, A; Cabrera-Bermon, J; Muñoz-Casares, F C; Casado-Adam, A; Sánchez-Hidalgo, J M; López-Andreu, M; Briceño-Delgado, J; Rufián-Peña, S

    2016-06-01

    The acute renal dysfunction (ARD) is a common complication in cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC). Our aim is evaluate the ARD post-HIPEC procedures using the RIFLE and AKIN criteria. Evaluate the risk factors and analyze ARD's impact on postoperative course. From 2011 to 2014, in a retrospective way using a prospective database were operated by HIPEC procedure. The ARD was analyzed by RIFLE and AKIN criteria. The perioperative features were analyzed and a multivariate analysis was performed to define the risk factors to develop the ARD. 141 patients were treated and analyzed. The ARD was detected in 30.5% (Injury 18.4% and Failure 12.1%) when RIFLE criteria were applied. The multivariate analysis detected that decrease of pH during HIPEC [OR = 29.39 (5.09-169.76)], PCI [OR = 1.07 (1.01-1.15)] and ureteral catheters [OR = 12.71 (1.44-111.85)] were associated to the development of acute renal injury (ARI) post-HIPEC. Decrease of Na during HIPEC [OR = 1.15 (1.01-1.30)], intraoperative inotrope use [OR = 3.83 (1.12-13.09)] and PCI [OR = 1.06 (1.0-1.14)] were associated to acute renal failure (ARF) post-HIPEC. The ARD was related to a higher length of stay hospital (17.2 ± 11 vs. 13.8 ± 8 days) (p = 0.05) but no impact in early survival was observed in ARD group. The widespread use of RIFLE criteria for ARD would have major benefits in terms of accurately diagnosing patients undergone HIPEC procedures. The ARD has a detrimental impact in length of stay hospital. The knowledge of risk factors helps us to prevent the ARD post-HIPEC by means of an aggressive and multidisciplinary perioperative management. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. Anemia, disfunção renal e desnutrição associadas à insuficiência cardíaca em pacientes valvopatas Anemia, renal dysfunction and malnutrition associated with heart failure in patients with valvulopathy

    Directory of Open Access Journals (Sweden)

    Wysllenny Nascimento de Souza

    2010-06-01

    Full Text Available FUNDAMENTO: A doença valvar pode cursar com insuficiência cardíaca (IC, anemia e disfunção renal (DR, aumentando o risco nutricional e piorando o prognóstico dos pacientes. OBJETIVO: Avaliar a prevalência de anemia e DR em pacientes portadores de valvopatias com ou sem IC, bem como estabelecer correlação com o estado nutricional. MÉTODOS: Foram avaliados 104 pacientes internados na enfermaria de valvopatias do PROCAPE/UPE, no período de ago-out/2008. Os dados foram obtidos das fichas de acompanhamento nutricional e dos prontuários. As variáveis coletadas foram: sexo, idade, estado nutricional segundo o índice de massa corpórea (IMC, presença de IC, anemia, DR. Considerou-se como anemia valores de hemoglobina BACKGROUND: Valvular disease can course with heart failure (HF, anemia and renal dysfunction (RD, increasing the nutritional risk and worsening patient prognosis. OBJECTIVE: To evaluate the prevalence of anemia and RD in patients with valvulopathy with or without HF, as well as establish a correlation with the nutritional status. METHODS: A total of 104 patients admitted at the Clinic of Valvulopathy of PROCAPE/UPE, during the period of Aug-Oct/2008. The data were obtained from the nutritional and medical follow-up files. The collected variables were: sex, age, nutritional status according to the body mass index (BMI, presence of HF, anemia and RD. Anemia was considered when hemoglobin values were < 13 g/dl in men and < 12 g/dl in women. RD was established according to the glomerular filtration rate (GFR and it was calculated through the formula proposed by Cockcroft and Gault. RESULTS: The prevalence of anemia and RD was 71.1% and 68.8%, and 48.1% and 60.0%, in patients with and without HF, respectively, with a statistically significant difference for anemia (p = 0.022. Of the patients, 48.1% were eutrophic, 26.9% had excess weight and 25.0% presented some degree of malnutrition. The patients with HF presented a higher

  16. Effect on short- and long-term major adverse cardiac events of statin treatment in patients with acute myocardial infarction and renal dysfunction.

    Science.gov (United States)

    Lim, Sang Yup; Bae, Eun Hui; Choi, Joon Seok; Kim, Chang Seong; Park, Jeong Woo; Ma, Seong Kwon; Jeong, Myung Ho; Kim, Soo Wan

    2012-05-15

    The 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors (statins) reduce major adverse cardiac events (MACE) and mortality in patients with acute coronary syndrome. We investigated the effectiveness of statin therapy in reducing MACE in patients with acute myocardial infarction (AMI) and renal dysfunction (RD). In the present retrospective study of 12,853 patients with AMI, the patients were categorized into 4 groups: group I, statin therapy and no RD (estimated glomerular filtration rate ≥60 ml/min/1.73 m(2)); group II, neither statin therapy nor RD; group III, statin therapy and RD; group IV, no statin therapy but RD. The primary end points were death and complications during the hospital course. The secondary end points were MACE during 1 year of follow-up after AMI. Significant differences in the composite MACE during 12 months of follow-up were observed among the 4 groups (group I, 11.7%; group II, 19.0%; group III, 26.7%; and group IV, 45.5%; p <0.001). In a Cox proportional hazards model, mortality at 12 months increased stepwise from group II to IV compared to group I. Moreover, MACE-free survival in the severe RD group (estimated glomerular filtration rate <30 mL/min/1.73 m(2)) was also greater in the statin-treated group. In conclusion, statin therapy reduced MACE at 1 year of follow-up in patients with AMI regardless of RD.

  17. Selective Opioid Usage for Cancer Pain in Patients with Hepatic or Renal Dysfunction%阿片类药物在肝肾功能不全癌痛患者中的选择应用

    Institute of Scientific and Technical Information of China (English)

    程熠; 于世英

    2011-01-01

    Opioid is essential drug for cancer pain. It should be very careful to choose opioid drugs for patients with hepatic or renal dysfunction. Dose and dosing interval of the sustained-released formulation of morphine should be adjusted, while the immediate-released formulation could be prescribed temporarily. Codeine should be forbidden. Oxycodone is safe for patients with mild or moderate hepatic or renal dysfunction, but should not be used in ones with severe renal dysfunction. Transdermal fentanyl is the first choice for patients with severe hepatic or renal dysfunction, and for dialytic patients. However, in some cases buprenorphine could replace it for dialytic patients.%阿片类药物是控制癌痛的必备药物.对于癌症合并有肝肾功能不全的患者,阿片类药物的选择应慎重.吗啡的缓释剂型应注意调整剂量和给药的间隔时间,即释剂型可临时应用.应禁用可待因.轻中度的肝肾功能不全患者,羟考酮的应用是安全的;但重度肾功能不全者禁用羟考酮.芬太尼透皮贴剂是重度肝肾功能不全患者和透析患者的首选.丁丙诺啡在某些情况下可代替芬太尼应用于透析患者.

  18. EFFECT IMBALANCE AQUEOUS BODY FLUIDS, AND RENAL DYSFUNCTION, CARDIOVASCULAR SURVIVAL IN PATIENTS AFTER AN ACUTE CORONARY SYNDROME, MYOCARDIAL REVASCULARIZATION

    Directory of Open Access Journals (Sweden)

    E. S. Levitskaya

    2017-01-01

    Full Text Available Objective. Analysis imbalance aqueous body fluids on the prognosis of cardiovascular events in the late period after an acute coronary syndrome (ACS and myocardial revascularization based on indicators of renal function.Materials and methods. The study included 120 patients with ACS, including unstable angina was diagnosed in 68 patients, 52 patients — acute myocardial infarction. All patients underwent myocardial revascularization. To register the presence of albuminuria in the range of 30-300 mg/l, and glomerular filtration rate (GFR. It makes calculations indicators aqueous body fluids — the total volume of water (TVW, the total fluid, intracellular fluid (IF, extracellular fluid. The endpoint of the study was the presence of cardiovascular complications within 6 months after ACS.Results. It is found that the presence and magnitude of albuminuria was significantly increase the risk of the end point of the study. In patients with GFR less than 60 mL/min/1,73m2 studied the risk is higher by 17.1%, compared with patients with a GFR above this limit. Analysis of the distribution of the water body fluids showed a significant increase in the average TVW and IF. Through statistical analysis of survival found an increased risk of cardiovascular complications in the late period after ACS in patients who have an increase IF on the stage of development of coronary catastrophe.Conclusion. The study demonstrated the predictive value to stratify cardiovascular disease risk, not only the presence of albuminuria, but its level and value of GFR less than 60 mL/min/1,73m2. Redistribution of aqueous body fluids in the form of increased IF is a marker of adverse cardiovascular events in the late period after ACS. These data indicate the need for a comprehensive and integrated analysis of existing pathogenetic changes occurring in ACS, as well as the status of the patients premorbid factor for improving risk stratification of cardiovascular

  19. Impact of the combined presence of left ventricular systolic and renal dysfunction on the 5-year outcome after ST-elevation myocardial infarction

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    Savić Lidija

    2015-01-01

    Full Text Available Background/Aim. The coincidence of left ventricular systolic dysfunction (LVSD and renal dysfunction (RD is a strong independent predictor of adverse events in the short-term and mid-term follow-ups of patients with ST-elevation myocardial infarction (STEMI treated with primary percutaneous coronary intervention (pPCI. The aim of this study was primarily to assess the prognostic impact of the LVSD-RD combination on the 5-year all-cause mortality in patients with STEMI treated with pPCI, as well as to assess the prognostic impact of the LVSD-RD combination on the occurrence of major adverse cardiovascular events (MACEs: cardiovascular death, reinfarction, stroke and target vessel revascularization in these patients. Methods. We analyzed 951 patients divided into 4 groups according to the presence of LVSD (ejection fraction < 40% and/or baseline RD (creatinine clearance < 60 mL/min: group I (no LVSD, no RD; group II (LVSD, no RD; group III (RD, no LVSD; group IV (LVSD+RD. Results. The 5-year mortality rates were 2.3%, 17.6%, 11.7% and 38.3%, while the 5-year MACE rates were 8.8%, 28.4%, 18.3% and 44.4% in the groups I, II, III and IV, respectively (p < 0.001. The highest percentage of lethal outcomes and MACE was registered in the first year of follow-up in all the groups. The 1-year landmark analysis confirmed that the patients with LVSD-RD combination had the highest percentage of lethal outcomes in the period of 1 to 5 years (p = 0.028. There was a strong trend toward the significance in the occurrence of MACE among the analyzed groups in the period of 1 to 5 years (p = 0.085. In the Cox regression model the LVSD-RD combination was a strong independent predictor of 5-year mortality and the occurrence of MACE: mortality hazard ratio (HR 4.5 (95%CI 1.9-10.8; MACE HR 2.5 (95%CI 1.4-4.5. Conclusion. The strong negative independent prognostic impact of the LVSD-RD combination persisted in the long-term follow-up of the patients with STEMI treated

  20. Cardiac, renal, and neurological benefits of preoperative levosimendan administration in patients with right ventricular dysfunction and pulmonary hypertension undergoing cardiac surgery: evaluation with two biomarkers neutrophil gelatinase-associated lipocalin and neuronal enolase

    Science.gov (United States)

    Guerrero-Orriach, José Luis; Ariza-Villanueva, Daniel; Florez-Vela, Ana; Garrido-Sánchez, Lourdes; Moreno-Cortés, María Isabel; Galán-Ortega, Manuel; Ramírez-Fernández, Alicia; Alcaide Torres, Juan; Fernandez, Concepción Santiago; Navarro Arce, Isabel; Melero-Tejedor, José María; Rubio-Navarro, Manuel; Cruz-Mañas, José

    2016-01-01

    Purpose To evaluate if the preoperative administration of levosimendan in patients with right ventricular (RV) dysfunction, pulmonary hypertension, and high perioperative risk would improve cardiac function and would also have a protective effect on renal and neurological functions, assessed using two biomarkers neutrophil gelatinase-associated lipocalin (N-GAL) and neuronal enolase. Methods This is an observational study. Twenty-seven high-risk cardiac patients with RV dysfunction and pulmonary hypertension, scheduled for cardiac valve surgery, were prospectively followed after preoperative administration of levosimendan. Levosimendan was administered preoperatively on the day before surgery. All patients were considered high risk of cardiac and perioperative renal complications. Cardiac function was assessed by echocardiography, renal function by urinary N-GAL levels, and the acute kidney injury scale. Neuronal damage was assessed by neuron-specific enolase levels. Results After surgery, no significant variations were found in mean and SE levels of N-GAL (14.31 [28.34] ng/mL vs 13.41 [38.24] ng/mL), neuron-specific enolase (5.40 [0.41] ng/mL vs 4.32 [0.61] ng/mL), or mean ± SD creatinine (1.06±0.24 mg/dL vs 1.25±0.37 mg/dL at 48 hours). RV dilatation decreased from 4.23±0.7 mm to 3.45±0.6 mm and pulmonary artery pressure from 58±18 mmHg to 42±19 mmHg at 48 hours. Conclusion Preoperative administration of levosimendan has shown a protective role against cardiac, renal, and neurological damage in patients with a high risk of multiple organ dysfunctions undergoing cardiac surgery. PMID:27143905

  1. Can a structured questionnaire identify patients with reduced renal function?

    DEFF Research Database (Denmark)

    Azzouz, Manal; Rømsing, Janne; Thomsen, Henrik

    2014-01-01

    To evaluate a structured questionnaire in identifying outpatients with renal dysfunction before MRI or CT in various age groups.......To evaluate a structured questionnaire in identifying outpatients with renal dysfunction before MRI or CT in various age groups....

  2. 镉致作业工人肾功能损害可逆性研究初探%Study on the Reversibility of Renal Dysfunction in Workers Exposed to Cadmium

    Institute of Scientific and Technical Information of China (English)

    吴训伟; 黄波; 等

    2001-01-01

    [Objective] This study was to explore the reversibility of renal dysfunction induced by cadmium in workers. [Methods] The changes of urinary cadmium (UCd) and renal dysfunction in cadmium-exposed workers treated by ethylenediaminetetracetic acid (EDTA) promoting excretion of cadmium in urine were observed. From 1986,the annual records of UCd and β2-microglobulin (β2-MG) of pre- and post- treatment of EDTA were collected from 17 workers (male:14,female:3) in this study. [Results] It is shown that levels of urinary cadmium in workers,whose urinary β2-MG excretion was always abnormal (≥0.8 mg/g Cr) or became abnormal during the treatment period,were above 10 μg/gCr basically. Conversely,UCd concentration was below 10 μg/gCr in those workers whose urinary β2-MG excretion was always normal (<0.8 mg/gCr) or became normal during this treatment period. The prevalence of renal dysfunction increased regardless of UCd increasing or not,and didn’t decreased with the increasing of the time of removal from cadmium exposure. The renal dysfunction will be reversible if UCd<10 μg/gCr,or be irreversible when UCd>10 μg/gCr. [Conclusion] The level of urinary cadmium is a major factor,which affects the change of renal dysfunction caused by cadmium in workers,and no significant curative effect of EDTA treatment on renal dysfunction resulted from cadmium exposure was found.%[目的]观察接受依地酸二钠(EDTA)治疗慢性镉接触工人尿镉和肾功能改变,以探讨镉接触致肾损害的可逆性。[方法]收集1986年以来某冶炼厂接受EDTA治疗的17名镉接触工人(其中男14名,女3名)每年治疗前后尿镉和尿β2-微球蛋白(β2-MG)的记录,分析其变化的情况。[结果]尿β2-MG一直异常(≥0.8 mg/g*Cr)或由正常转为异常的工人,尿镉平均水平基本高于10 μg/g*Cr,治疗期间尿β2-MG一直正常或出现异常又转为正常的工人,尿镉平均水平在10 μg/g*Cr以下;

  3. Subclinical renal abnormalities in young thalassemia major and intermedia patients and its relation to chelation therapy

    Directory of Open Access Journals (Sweden)

    Amira A.M. Adly

    2014-10-01

    Conclusion: Subclinical renal affection can start earlier in TM patients compared to TI. Poor chelation is associated with early signs of renal affection. Periodic renal assessment of those patients is mandatory as they may be affected by hidden renal dysfunction.

  4. Disfunção renal e anemia em pacientes com insuficiência cardíaca com fração de ejeção reduzida versus normal Renal dysfunction and anemia in patients with heart failure with reduced versus normal ejection fraction

    Directory of Open Access Journals (Sweden)

    Humberto Villacorta

    2010-03-01

    Full Text Available FUNDAMENTO: A presença de anemia e de disfunção renal confere mau prognóstico em pacientes com insuficiência cardíaca (IC e fração de ejeção reduzida (ICFER. O impacto em pacientes com IC e fração de ejeção normal (ICFEN é pouco estudado. OBJETIVOS: Estudar a prevalência e o prognóstico da anemia e da disfunção renal (DR em pacientes com IC de acordo com o tipo de disfunção ventricular. MÉTODOS: Foram estudados prospectivamente 209 pacientes com IC crônica estável. Pacientes com fração de ejeção BACKGROUND: The presence of anemia and renal dysfunction grants a bad prognosis for patients with heart failure and reduced ejection fraction (HFREF. The impact on patients with heart failure and normal ejection fraction (HFNEF is not widely studied. OBJECTIVES: To study the prevalence and the prognosis of anemia and renal dysfunction (RD in patients with heart failure according to the type of ventricular dysfunction. METHODS: A total of 209 patients with chronic and stable heart failure were prospectively studied. Individuals with ejection fraction <50% were considered as HFREF patients. Anemia was defined, based on WHO criteria, as hemoglobin <13 g/dl for men and <12 g/dl for women. Renal function was calculated by means of the Simplified Modified Diet Renal Disease (sMDRD formula. Hospitalizations, emergency admittances and obit by cardiac causes were considered as cardiac events. RESULTS: Ninety patients had HFREF and 119 had HFNEF. The glomerular filtration rate (GFR was smaller in HFREF group (57.6 ± 66.2 versus 94.8 ± 36.6 ml/min/1.73m²; p=0.01. There was no difference in the prevalence of anemia between groups (23.3% versus 18.5%; p=0.34. Moderate to severe RD prevalence was higher in HFREF group (32.2% versus 16.8%; p=0.01. RD was the only factor associated with anemia that was independently associated with cardiac events (HR 2.52; 95%CI=1.27-5.2; p=0.01. CONCLUSION: RD was less prevalent in HFNEF, while the

  5. Long-term reversibility of renal dysfunction associated to light chain deposition disease with bortezomib and dexamethasone and high dose therapy and autologous stem cell transplantation

    Directory of Open Access Journals (Sweden)

    Tomás J. González-López

    2011-11-01

    Full Text Available A 63-year-old woman presented with progressive renal insufficiency, until a glomerular filtration rate (GFR of 12 mL/min. A renal biopsy demonstrated glomerular deposition of immunoglobulin k light chain. The presence of a small population of monoclonal plasmacytes producing an only light k monoclonal component was demonstrated and Bortezomib and Dexamethasone (BD was provided as initial therapy. After seven courses of therapy, renal function improved without dialysis requirements up to a GFR 31 mL/min. Under hematological complete response (HCR the patient underwent high dose of melphalan (HDM and autologous peripheral blood stem cell transplant. Fifty-four months later the patient remains in HCR and the GFR has progressively improved up to 48 mL/min. This report describes a notably renal function improvement in a patient with Light Chain Deposition Disease after therapy with BD followed by HDM, which can support this treatment as a future option for these patients.

  6. Diagnosis and treatment of renal artery stenosis.

    NARCIS (Netherlands)

    Plouin, P.F.; Bax, L.

    2010-01-01

    A reduction in the diameter of the renal arteries can lead to hypertension, renal dysfunction and/or pulmonary edema. About 90% of patients with renal artery stenosis have atherosclerosis, and 10% have fibromuscular dysplasia. Atherosclerotic renal artery stenosis is a common condition that typicall

  7. Serum levels of N-terminal-pro B-type natriuretic peptide as a diagnostic marker for left ventricular dysfunction in children with end-stage renal disease on hemodialysis

    Directory of Open Access Journals (Sweden)

    Amr Mohamed Zoair

    2016-01-01

    Full Text Available The objective of this study was to determine the diagnostic cutoff value of N-terminal-pro B-type natriuretic peptide (NT-pro BNP as a marker of left ventricular (LV dysfunction in children with end-stage renal disease (ESRD on regular hemodialysis (HD. The study was carried out on thirty children with ESRD on regular HD and thirty healthy controls. Echocardiographic studies were done, including a conventional mode for ejection fraction, fractional shortening, tissue Doppler imaging, and longitudinal global strain by speckle tracking. Serum levels of NT-pro BNP were measured in venous blood samples before and about 30 min after HD by ELISA. Volume status was assessed by calculating interdialytic weight gain %. There were significant higher serum NT-pro BNP levels before HD (mean: 702.3 ± 274.3 ng/L compared to controls (mean: 365.55 ± 76.5 ng/L (P <0.001 and these levels decreased significantly after the HD session (mean: 625.1 ± 117.69 ng/L (P = 0.031. Echocardiographic studies showed a significant impairment of LV function of the patients compared to controls. Patients with LV dysfunction had significant higher serum concentrations of NT-pro BNP compared to patients without dysfunction both before (P = 0.003 and after dialysis (P <0.001. Receiver operating curve demonstrated better prediction of LV dysfunction by NT-pro BNP levels after HD compared to its levels before HD (area under the curve was 0.9 and 0.73, respectively. Using a cutoff value of 630 ng/L, serum NT-pro BNP levels after dialysis were a diagnostic predictor of LV dysfunction with a sensitivity of 86.6%, specificity of 93.3%, positive predictive value of 92.8%, and negative predictive value of 87.5%. Serum NT-pro BNP levels were strongly correlated with the parameters of LV dysfunction in children with ESRD on regular HD. A postdialysis cutoff value of 630 ng/L could serve as a biochemical marker of LV dysfunction in those children regardless of chronic fluid overload.

  8. Drug Transporter Genetic Variants Are Not Associated with TDF-Related Renal Dysfunction in Patients with HIV-1 Infection: A Pharmacogenetic Study.

    Directory of Open Access Journals (Sweden)

    Takeshi Nishijima

    Full Text Available To investigate whether single nucleotide polymorphisms (SNP of drug transporter proteins for TDF is a risk factor for TDF-related renal function decrement.This study investigated the association between 3 SNPs (ABCC2-24, 1249, and ABCB1 2677, which are shown to be associated with TDF-induced tubulopathy, and clinically important renal outcomes (>10ml/min/1.73m2 decrement in eGFR relative to baseline, >25% decrement in eGFR, and eGFR 10ml/min/1.73m2 and those without such decrement (ABCC2: -24, p = 0.53, 1249, p = 0.68; ABCB1: 2677, p = 0.74, nor between those without and with the other two renal outcomes (>25% decrement: ABCC2: -24, p = 0.83, 1249, p = 0.97, ABCB1: 2677, p = 0.40; eGFR <60ml/min/1.73m2: ABCC2: -24, p = 0.51, 1249, p = 0.81, ABCB1: 2677, p = 0.94. Logistic regression analysis showed that the risk genotype of the three SNPs were not associated with any of the three renal outcomes, respectively. Logistic regression model that applied either dominant, recessive, or additive model yielded the same results.SNPs of the drug transporters for TDF are not associated with clinically important renal outcomes in patients who initiated TDF-containing ART.

  9. Disfunção renal e marcadores inflamatórios em hipertensos atendidos em hospital universitário Renal dysfunction and inflammatory markers in hypertensive patients seen in a university hospital

    Directory of Open Access Journals (Sweden)

    Fátima Lúcia Machado Braga

    2013-01-01

    Full Text Available FUNDAMENTO: A doença renal crônica representa hoje um grande desafio para a saúde pública no sentido de se obterem conhecimentos para subsidiar intervenções que possam alterar a velocidade de perda da função renal. OBJETIVO: Avaliar a magnitude do déficit da função renal em hipertensos adultos e sua relação com marcadores inflamatórios: proteína C reativa ultrassensível, velocidade de hemossedimentação e relação neutrófilos/linfócitos. MÉTODOS: Estudo transversal envolvendo 1.273 adultos hipertensos, de ambos os sexos, sendo 1.052 com déficit da função renal e 221 sem déficit, diagnosticados pela equação Modification of Diet in the Renal Disease. A razão de chances (OR e a razão de prevalência (RP foram utilizadas para determinar a probabilidade de ocorrência de atividade inflamatória na doença renal. RESULTADOS: O déficit de função renal foi diagnosticado em 82,6% dos avaliados, sendo que a maioria da amostra (70,8% estava inserida no estágio 2 da doença renal crônica. No modelo de regressão permaneceram independentemente associadas ao déficit da função renal a síndrome metabólica (RPajustada = 1,09 [IC95%: 1,04-1,14], a proteína C reativa ultrassensível (RPajustada = 1,54 [IC95%: 1,40-1,69] e a velocidade de hemossedimentação (RPajustada = 1,20 [IC95%: 1,12-1,28]. No entanto, considerando os indivíduos classificados no estágio 2 do déficit da função renal, a chance de alteração dos marcadores inflamatórios foram de OR = 10,25 (IC95%: 7,00-15,05 para a proteína C reativa ultrassensível, OR = 8,50 (IC95%: 5.70-12.71 para a relação neutrófilos/linfócitos e OR = 7,18 (IC95%: 4,87-10,61 para a velocidade de hemossedimentação. CONCLUSÃO: Os resultados mostram associação da atividade inflamatória e da síndrome metabólica com o déficit da função renal.BACKGROUND: Today, chronic kidney diseases represent a great challenge to public health as regards the acquisition of knowledge

  10. Evaluation of renal allograft dysfunction using {sup 99m}Tc-DTPA dynamic SPECT. Analysis with two compartment model and graph plot

    Energy Technology Data Exchange (ETDEWEB)

    Akahira, Hideaki; Takekawa, Shoichi; Nigawara, Kazuo; Funyu, Tomihisa [Oyokyo Kidney Research Inst., Hirosaki, Aomori (Japan). Hirosaki Hospital

    1996-12-01

    To estimate renal blood flow and glomerular function in transplanted kidneys, we applied the 2 compartment model and the graphic analysis method to {sup 99m}Tc-DTPA dynamic SPECT and calculated some parameters, i.e. K1 (renal influx rate constant), K3 (glomerular filtration rate constant), Vdl (function phase distribution volume), and others. Twenty-three renal transplant recipients were examined and divided into following 3 groups according to their serum creatinine levels (SCr); Group I; less than 1.3 mg/dl (1.1{+-}0.3, n=7), Group II: 1.4-2.5 mg/dl (1.8{+-}0.3, n=7), and Group III more than 2.6 mg/dl (4.8{+-}2.9, n=5). The K3 value became lower in the order of Group I>II>III, and well correlated with blood urea nitrogen (BUN, r=<0.91, P<0.001) and creatinine clearance (Ccr, r=0.87, P<0.001). The K1 value reduced markedly in Group III despite or no difference between Group I and II. Glomerular filtration rate (GFR) derived from K1 and K3 showed a correlation with those by Tauxe`s method. From these results and clinical conditions including histopathological findings, it is suggested that K1, K3 and Vdl are useful paraments of renal central arterial blood flow, renal peripheral arteriolar blood flow and renal {sup 99m}Tc-DTPA uptake function, respectively. (author)

  11. Glomerular Filtration Rate Estimation in Renal and Non-Renal Solid Organ Transplantation

    DEFF Research Database (Denmark)

    Hornum, Mads; Feldt-Rasmussen, Bo

    2017-01-01

    or estimates of renal function in these patients, in order to accurately and safely dose immunosuppressive medication and perform and adjust the treatment and prophylaxis of renal dysfunction. This is a short overview and discussion of relevant studies and possible caveats of estimated glomerular filtration...... rate methods for use in renal and non-renal TX....

  12. Cardiac, renal, and neurological benefits of preoperative levosimendan administration in patients with right ventricular dysfunction and pulmonary hypertension undergoing cardiac surgery: evaluation with two biomarkers neutrophil gelatinase-associated lipocalin and neuronal enolase

    Directory of Open Access Journals (Sweden)

    Guerrero-Orriach JL

    2016-04-01

    Full Text Available José Luis Guerrero-Orriach,1 Daniel Ariza-Villanueva,1 Ana Florez-Vela,1 Lourdes Garrido-Sánchez,2,3 María Isabel Moreno-Cortés,1 Manuel Galán-Ortega,1 Alicia Ramírez-Fernández,1 Juan Alcaide Torres,3 Concepción Santiago Fernandez,3 Isabel Navarro Arce,1 José María Melero-Tejedor,4 Manuel Rubio-Navarro,1 José Cruz-Mañas1 1Department of Cardio-Anaesthesiology, University Hospital Virgen de la Victoria, Málaga, Spain; 2CIBER Fisiología de la Obesidad y Nutrición (CIBEROBN, Instituto de Salud Carlos III, Málaga, Spain; 3Department of Nutrition and Endocrinology, Instituto de Investigaciones Biomédicas de Málaga (IBIMA, University Hospital Virgen de la Victoria, Málaga, Spain; 4Department of Cardiovascular Surgery, University Hospital Virgen de la Victoria, Málaga, Spain Purpose: To evaluate if the preoperative administration of levosimendan in patients with right ventricular (RV dysfunction, pulmonary hypertension, and high perioperative risk would improve cardiac function and would also have a protective effect on renal and neurological functions, assessed using two biomarkers neutrophil gelatinase-associated lipocalin (N-GAL and neuronal enolase. Methods: This is an observational study. Twenty-seven high-risk cardiac patients with RV dysfunction and pulmonary hypertension, scheduled for cardiac valve surgery, were prospectively followed after preoperative administration of levosimendan. Levosimendan was administered preoperatively on the day before surgery. All patients were considered high risk of cardiac and perioperative renal complications. Cardiac function was assessed by echocardiography, renal function by urinary N-GAL levels, and the acute kidney injury scale. Neuronal damage was assessed by neuron-specific enolase levels. Results: After surgery, no significant variations were found in mean and SE levels of N-GAL (14.31 [28.34] ng/mL vs 13.41 [38.24] ng/mL, neuron-specific enolase (5.40 [0.41] ng/mL vs 4.32 [0.61] ng

  13. [Impact of renal dysfunction on clinical course of myocardial infarction complicated by acute heart failure in patients with preserved systolic function].

    Science.gov (United States)

    Parkhomenko, O M; Hur"ieva, O S; Kornatskyĭ, Iu V; Kozhukhov, S M; Sopko, O O

    2013-01-01

    Aiming to assess the relationships between renal function and ST-segment elevation myocardial infarction (MI) clinical course and remote outcomes in patients with preserved systolic left ventricular (LV) function (LV ejection fraction > 40%) estimated glomerular filtration rates (eGFR) were evaluated on 1st and 3rd -10th MI day (n = 491). On 3rd-10th day of MI in patients with acute heart failure (HF) symptoms on admission day (1st group, n = 153) eGFR infarction (Hazzard Ratio (HR) with 95% confidence intervals (95% CI) = 4,08 [1,72 -11,73], P acute HF (2nd group, n = 338) eGFR renal dysfucntion in patients with and without acute HF and preserved LV function.

  14. 肾功能异常的肾活检患者临床及病理特点分析%Clinical and pathological characteristics of renal biopsy in patients with renal dysfunction

    Institute of Scientific and Technical Information of China (English)

    王叙芬

    2015-01-01

    目的:研究和分析肾功能异常的肾活检患者临床及病理特点,为疾病的诊断、治疗及预后提供科学的参考依据。方法选取2012年9月至2015年7月收治的22例肾功能异常患者作为观察组,选取同时期收治的18例肾功能正常患者作为对照组,分析和比较两组患者肾活检结果。结果两组患者标本合格率比较无明显差异(P>0.05),观察组患者并发症发生率较对照组更高(P 0.05), the observation group of patients with complication rates higher than the control group (P < 0.05), 22 patients after renal biopsy to correct diagnosis of 9 cases.Conclusion:Abnormal renal patients for renal biopsy operation, is advantageous to the definite pathological type, provide a reference for the diagnosis, treatment and prognosis of diseases, has important clinical value.

  15. Ultrasound-guided percutaneous renal biopsy-induced accessory renal artery bleeding in an amyloidosis patient

    Directory of Open Access Journals (Sweden)

    Zhang Qing

    2012-12-01

    Full Text Available Abstract Ultrasound-guided percutaneous renal biopsy is an important technique for diagnosis of glomerular diseases, and the biopsy-induced life-threatening bleeding rarely happens. Primary systemic amyloidosis is a rare disease which may lead to organ dysfunction including arterial stiffness. The accessory renal artery is a kind of renal vascular variation which goes into the renal parenchyma directly or via the renal hilum. Here we reported a rare case of percutaneous renal biopsy-induced accessory renal artery life-threatening bleeding in a renal amyloidosis patient, and our experience of successful rescue in this patient. Virtual Slides http://www.diagnosticpathology.diagnomx.eu/vs/1524207344817819

  16. Oxidative stress causes renal dopamine D1 receptor dysfunction and hypertension via mechanisms that involve nuclear factor-kappaB and protein kinase C.

    Science.gov (United States)

    Banday, Anees Ahmad; Fazili, Fatima Rizwan; Lokhandwala, Mustafa F

    2007-05-01

    Renal dopamine, via activation of D1 receptors, plays a role in maintaining sodium homeostasis and BP. There exists a defect in renal D1 receptor function in hypertension, diabetes, and aging, conditions that are associated with oxidative stress. However, the exact underlying mechanism of the oxidative stress-mediated impaired D1 receptor signaling and hypertension is not known. The effect of oxidative stress on renal D1 receptor function was investigated in healthy animals. Male Sprague-Dawley rats received tap water (vehicle) and 30 mM L-buthionine sulfoximine (BSO), an oxidant, with and without 1 mM tempol for 2 wk. Compared with vehicle, BSO treatment caused oxidative stress and increase in BP, which was accompanied by defective D1 receptor G-protein coupling and loss of natriuretic response to SKF38393. BSO treatment also increased NF-kappaB nuclear translocation, protein kinase C (PKC) activity and expression, G-protein-coupled receptor kinase-2 (GRK-2) membranous translocation, and D1 receptor serine phosphorylation. In BSO-treated rats' supplementation of tempol decreased oxidative stress, normalized BP, and restored D1 receptor G-protein coupling and natriuretic response to SKF38393. Tempol also normalized NF-kappaB translocation, PKC activity and expression, GRK-2 sequestration, and D1 receptor serine phosphorylation. In conclusion, these results show that oxidative stress activates NF-kappaB, causing an increase in PKC activity, which leads to GRK-2 translocation and subsequent D1 receptor hyper-serine phosphorylation and uncoupling. The functional consequence of this phenomenon was the inability of SKF38393 to inhibit Na/K-ATPase activity and promote sodium excretion, which may have contributed to increase in BP. Tempol reduced oxidative stress and thereby restored D1 receptor function and normalized BP.

  17. [Renal transplantation and urinary lithiasis].

    Science.gov (United States)

    Lechevallier, E; Saussine, C; Traxer, O

    2008-12-01

    Renal lithiasis in renal donors is rare. A renal stone in a donor, or in a renal transplant, is not a contraindication for harvesting nor transplantation. If possible, the stone must be removed at the time of the transplantation. The risk of lithiasis is increased in the renal transplant recipient, with a frequency of 2-6%. Metabolic abnormalities for lithiasis are frequent and can be induced by the immunosuppressive treatment, anticalcineurins. Lithiasis can have a poor prognosis in the renal recipient with a risk for infection or renal dysfunction. Small (renal transplant can be followed-up. Stones of 0.5-1.5cm need an extracorporeal lithotripsy with a previous safety JJ stent. Stones greater than 1.5cm can be treated by ureteroscopy or percutaneous surgery.

  18. A comparative study of renal dysfunction in patients with inflammatory arthropathies: strong association with cardiovascular diseases and not with anti-rheumatic therapies, inflammatory markers or duration of arthritis.

    LENUS (Irish Health Repository)

    Haroon, Muhammad

    2012-02-01

    AIMS: The aim of this study was to investigate the prevalence of chronic kidney disease (CKD) among comparable patients with rheumatoid arthritis (RA) and seronegative inflammatory arthritis, and to explore any predictive factors for renal impairment. METHODS: Consecutive patients with peripheral joint disease (oligo and polyarthritis) were recruited from our inflammatory arthritis clinics. We divided patients in two groups: RA group and seronegative inflammatory arthritis group. The cohort consisted of 183 patients (RA = 107, seronegative arthritis = 76 [psoriatic arthritis = 69, undifferentiated oligoarthritis = 7]). Estimated glomerular filtration rate (eGFR) was calculated using the established Modification of Diet in Renal Disease equation. Demographic details, disease-specific characteristics, anti-rheumatic drugs and the presence of cardiovascular diseases were recorded. RESULTS: In total, 17.48% (n = 32) of the cohort had CKD. There was no statistically significant variation between the two groups as regards baseline demographics, disease characteristics, use of anti-rheumatic drugs and the presence of individual cardiovascular diseases. We found that eGFR and the presence of CKD were similar among these groups. Among patients with CKD, 72% had undiagnosed CKD. No association of statistical significance was noted between CKD and the use of corticosteroids, disease-modifying antirheumatic drugs and anti-tumor necrosis factor agents. The association of cardiovascular diseases with CKD remained significant after adjusting for confounders (age, gender, duration of arthritis, high C-reactive protein, use of anti-rheumatic drugs). CONCLUSIONS: Patients with inflammatory arthritis are more prone to have CKD. This could have serious implications, as the majority of rheumatology patients use non-steroidal anti-inflammatory drugs and different immunosuppressives, such as methotrexate. No association of kidney dysfunction was noted with inflammatory disease

  19. Diagnostic and prognostic value of brain natriuretic peptide (BNP) concentrations in very elderly heart disease patients: specific geriatric cut-off and impacts of age, gender, renal dysfunction, and nutritional status.

    Science.gov (United States)

    Blondé-Cynober, F; Morineau, G; Estrugo, B; Fillie, E; Aussel, C; Vincent, J-P

    2011-01-01

    Confirming the presence of heart failure (HF) in geriatric patients is made difficult by the overlapping symptoms with other diseases and by limited access to investigative techniques such as echography, and the clinical signs are either non-constant or difficult to interpret. In this context, BNP measurement could prove highly useful. We determined a cut-off value of BNP for diagnosing HF in geriatric patients and gauged its predictive power in terms of cardiovascular events, dependence and death within a 6-month timeframe. This clinical and biological study was performed in patients, 44 women and 20 men, age>65 years with suspected HF hospitalized in the geriatric unit at Emile-Roux hospital. Echography was performed at baseline examination. BNP concentrations were determined at baseline examination and at 2 and 6 months later. Renal function was assessed via the Cockroft-Gault formula. Nutritional status was assessed using the geriatric nutritional risk index (GNRI). Final reference diagnosis was established by both cardiologist and geriatrician. The diagnostic value of BNP was assessed by area under the ROC curve. The average age of the 64 patients was 84.3±7.4 years. The final diagnosis was HF in 26 patients (41%). A BNPvalue of 90% (accuracy 80%) for excluding the diagnosis of HF. BNP values were predictive of cardiovascular events over a 2-month timeframe in patients with HF and over a 6-month timeframe in the global population. BNP values were not predictive of mortality in patients with or without HF. BNP testing should help to differentiate pulmonary from cardiac etiologies of dyspnea, but a specific cut-off point has to be used in geriatric settings, mainly for patients presenting nutritional and renal dysfunctions.

  20. Male Sexual Dysfunction and Chronic Kidney Disease

    Science.gov (United States)

    Edey, Matthew M.

    2017-01-01

    Male sexual dysfunction is common in chronic kidney disease (CKD), particularly in end-stage renal disease. Historically, this cause of considerable morbidity has been under-reported and under-recognized. The ideal approach to diagnosis and management remains unclear due to a paucity of good quality data, but an understanding of the pathophysiology is necessary in order to address the burden of this important complication of CKD. This paper will review the endocrine dysfunction that occurs in renal disease, particularly the hypothalamic–pituitary–gonadal axis, discuss the causes of erectile dysfunction, infertility, and altered body image and libido in these patients and suggest appropriate treatment interventions. PMID:28382300

  1. Renal replacement therapy in ICU

    Directory of Open Access Journals (Sweden)

    C Deepa

    2012-01-01

    Full Text Available Diagnosing and managing critically ill patients with renal dysfunction is a part of the daily routine of an intensivist. Acute kidney insufficiency substantially contributes to the morbidity and mortality of critically ill patients. Renal replacement therapy (RRT not only does play a significant role in the treatment of patients with renal failure, acute as well as chronic, but also has spread its domains to the treatment of many other disease conditions such as myaesthenia gravis, septic shock and acute on chronic liver failure. This article briefly outlines the role of renal replacement therapy in ICU.

  2. Hypothalamic dysfunction

    Science.gov (United States)

    ... common causes of hypothalamic dysfunction are surgery, traumatic brain injury, tumors, and radiation. Other causes include: Anorexia nervosa or bulimia Bleeding Genetic disorders that cause iron ...

  3. Bladder Dysfunction and Vesicoureteral Reflux

    Directory of Open Access Journals (Sweden)

    Ulla Sillén

    2008-01-01

    Full Text Available In this overview the influence of functional bladder disturbances and of its treatment on the resolution of vesicoureteral reflux (VUR in children is discussed. Historically both bladder dysfunction entities, the overactive bladder (OAB and the dysfunctional voiding (DV, have been described in conjunction with VUR. Treatment of the dysfunction was also considered to influence spontaneous resolution in a positive way. During the last decades, however, papers have been published which could not support these results. Regarding the OAB, a prospective study with treatment of the bladder overactivity with anticholinergics, did not influence spontaneous resolution rate in children with a dysfunction including also the voiding phase, DV and DES (dysfunctional elimination syndrome, most studies indicate a negative influence on the resolution rate of VUR in children, both before and after the age for bladder control, both with and without treatment. However, a couple of uncontrolled studies indicate that there is a high short-term resolution rate after treatment with flow biofeedback. It should be emphasized that the voiding phase dysfunctions (DV and DES are more severe than the genuine filling phase dysfunction (OAB, with an increased frequency of UTI and renal damage in the former groups. To be able to answer the question if treatment of bladder dysfunction influence the resolution rate of VUR in children, randomized controlled studies must be performed.

  4. Pregnancy and renal transplantation.

    Science.gov (United States)

    Başaran, O; Emiroğlu, R; Seçme, S; Moray, G; Haberal, M

    2004-01-01

    Ovarian dysfunction, anovulatory vaginal bleeding, amenorrhea, high prolactin levels, and loss of libido are the causes of infertility in women with chronic renal failure. After renal transplantation, endocrine function generally improves after recovery of renal function. In this study we retrospectively evaluated the prepregnancy and postdelivery renal function, outcome of gestation, as well as maternal and fetal complications for eight pregnancies in eight renal transplant recipients between November 1975 and March 2003 of 1095 among 1425. Eight planned pregnancies occurred at a mean of 3.6 years posttransplant. Spontaneous abortion occured in the first trimester in one case. One intrauterine growth retardation was observed with a full-term pregnancy; one intrauterine growth retardation and preterm delivery; one preeclampsia with preterm delivery and urinary tract infection; and one preeclampsia with preterm delivery and oligohydramnios. The mean gestation period was 35.5 +/- 3.0 weeks (31.2 to 38.0). Pregnancy had no negative impact on renal function during a 2-year follow-up. No significant proteinuria or acute rejection episodes were observed. Among the seven deliveries, no congenital anomaly was documented and no postpartum problems for the child and the mother were observed. Our study suggests that successful pregnancy is possible in renal transplant recipients. In cases with good graft function and absence of severe proteinuria or hypertension, pregnancy does not affect graft function or patient survival; however, fetal problems are encountered such as intrauterine growth retardation, low birth weight, and preeclampsia.

  5. 肾脏相关标志物在评估妊娠高血压综合征肾损伤的研究%Clinica value of markers related kidney in assessing renal dysfunction in pregnancy induced hypertension women

    Institute of Scientific and Technical Information of China (English)

    陈志晓; 谢淑贤; 陈金玲; 陈国卫; 利定建; 吴修宇

    2015-01-01

    目的 评价胱抑素C(Cys C)、同型半胱氨酸(Hcy)、24小时尿蛋白定量(24 h-UPE)、尿素(UREA)、肌酐(Scr)在妊娠高血压综合征(PIH)早期肾损伤及损伤程度应用的价值.方法 检测133例PIH患者的Cys C、Hcy、24 h-UPE、UREA、Scr等指标 ;PIH患者分为轻度、中度重度组并与30例健康妊娠者(健康对照组)作比较.结果 轻度PIH组各项指标均高于健康对照组 ,中度、重度PIH组显著高于健康对照组、轻度PIH组 ,差异有统计学意义(P<0 .05);Cys C和24 h-UPE具有高度的相关性(r=0 .780 ,P<0 .01).结论 联合检测Cys C、Hcy、24 h-UPE、UREA、Scr能更准确和客观地反映PIH患者肾脏损伤程度 ,有利于早期诊断与治疗.%Objective To evaluate the significance of the serum cystatin C (Cys-C) Homocysteine(Hcy) ,24 h urinary protein excretion(24 h-UPE) ,UREA and Scr in assessing renal dysfunction in Pregnancy induced hyperten-sion(PIH) women .Methods Biochemistry was used to evaluate the level of Cys-C ,Hcy ,24 h-UPE ,UREA and Scr in 133 PIH patients (study group) who were divided into 3 groups ,the low group ,medium group and severe group , compared with 30 normal pregnant women(control group) .Results The concentrations of Cys-C ,Hcy ,24 h-UPE , UREA and Scr were significantly higher in the low PIH group than in the control group ,all in the medium PIH group and severe PIH group higher in the control group and low PIH group .Correlation analyses demonstrated significant correlations between Cys-C and 24 h-UPE in all the 133 pregnant women ,r=0 .780(P<0 .01) .Conclusion Cys-C , Hcy ,24 h-UPE ,UREA and Scr can reflect the degree of renal function damage in patients with PIH .

  6. Effect of penile erectile dysfunction on quality of life in male renal transplant recipients%男性肾移植受者阴茎勃起功能障碍对生活质量的影响

    Institute of Scientific and Technical Information of China (English)

    周洪澜; 王伟刚; 王远涛; 王钢; 高嘉林; 郑忠宇; 傅耀文

    2012-01-01

    Objective To explore the effects of penile erectile dysfunction (ED) on the quality of life in male renal transplant recipients.Methods 150 cases of male married recipients undergoing renal transplantation were selected randomly.The recipients were divided into ED group (n =63) and non-ED group (n =87) through the IIEF-5 score.The Short Form-36 Health Status Survey (SF-36)and Hamilton Anxiety Scale were used to compare their living quality and the state of mental health between the two groups,respectively.Results The SF-36 scores in ED group in General Health,Vitality,Social Function,Role Limitation due to Emotional Problems,Mental Health were significantly lower than those in non-ED group (P<0.05).There were 13 cases in ED group with anxiety disorders (20.6%),significantly more than in non-ED group (3.4%),P<0.05.Conclusion ED is an important influencing factor for the quality of life in male kidney transplant recipients.%目的 探讨阴茎勃起功能障碍(ED)对男性肾移植受者生活质量的影响.方法 随机选择接受肾移植的已婚男性受者150)例,进行ED国际问卷-5(IIEF-5)评分,将其分为ED组(63例)和非ED组(87例).应用健康状况调查简表(SF-36)评价2组受者的生活质量,应用汉密顿焦虑量表对比2组受者的心理健康状态.结果 ED组在躯体功能、生理职能、躯体疼痛方面与非ED组的差异无统计学意义(P>0.05);ED组在总体健康、活力、社会功能、情感职能、心理健康方面的SF-36评分明显低于非ED组(P<0.05);ED组有13例受者伴焦虑障碍,占20.6%,明显高于非ED组(占3.4%,P<0.05).结论 ED是影响男性肾移植受者生活质量的一项重要因素.

  7. Effect of proteinuria and renal dysfunction on the prognosis of patients with PIH%蛋白尿与肾功能损伤对妊娠高血压综合征患者预后的影响

    Institute of Scientific and Technical Information of China (English)

    王大伟

    2016-01-01

    Objective To study the effect of proteinuria and renal dysfunction on prognosis of patients with PIH.Methods Randomly selected 180 cases of PIH hospital admutted from March 2013 to March 2014 period and 30 patients with clinically normal pregnancy as research subjects, respectively.The urine protein, serum urea nitrogen, uric acid, creatinine, calcium and blood pressure levels were compared and analyzed.Results PIH and normal pregnant patients compared to their delivery ahead of time, the incidence of preterm children is relatively high, and serum urea nitrogen, uric acid, creatinine, and blood pressure levels were significantly higher in patients with a normal delivery, there were significant differences (P < 0.05), urinary calcium content and protein content was significantly lower than those in patients with normal birth, there were significant differences (P < 0.05).Conclusions Changes in proteinuria and renal function by affecting the prognosis of patients with PIH, has a certain clinical significance.%目的 研究蛋白尿与肾功能损伤对妊娠高血压综合征(妊高征)患者预后的影响.方法 随机选取2013年3月至2014年3月接收的180例妊高征患者和30例正常妊娠临床患者作为研究对象,分别检测其尿蛋白定量、血清尿素氮、尿酸、肌酐、钙以及血压水平,并进行比较和分析.结果 妊高征患者和正常妊娠患者相比较,其分娩时间提前,早产儿的发生率比较高,而且血清尿素氮、尿酸、肌酐以及血压水平明显高于正常分娩患者,差异有统计学意义(P<0.05),钙含量和尿蛋白含量明显低于正常分娩患者,差异有统计学意义(P<0.05).结论 蛋白尿和肾功能的变化受到妊高征患者预后的影响,在临床上有着一定的指导意义.

  8. RENAL FUNCTION DERANGEMENT IN HELLP SYNDROME

    Directory of Open Access Journals (Sweden)

    Anusha Harihara Gopalan

    2017-04-01

    Full Text Available BACKGROUND HELLP is the acronym for haemolysis, elevated liver enzymes and low platelet count. HELLP syndrome is a form of severe preeclampsia with an incidence of 0.2-0.6% of all pregnancies. The aim of our study is to evaluate the trend of renal dysfunction in HELLP syndrome patients. MATERIALS AND METHODS This is a cross-sectional observational study conducted in Department of Obstetrics and Gynaecology, Institute of Maternal and Child Health, Government Medical College, Kozhikode, during the period of 12 months from January 2013 to December 2013. All patients with HELLP syndrome were included in the study and their renal function tests monitored. RESULTS Results were renal dysfunction prevalence in HELLP syndrome patients is 77%. The renal impairment recovered by 6 days on an average. All had normal renal function tests at the time of discharge. Patients with renal function derangement had a mean duration of hospital stay and transfusion requirements more than the patients without renal function derangement, which was statistically significant (p value 0.036. Haemodialysis required for one out of 60 patients. One maternal mortality due to acute renal failure. CONCLUSION As the prevalence of renal dysfunction is high, some amount of renal impairment maybe a part of the HELLP syndrome disease spectrum itself. Though the incidence of progression to acute renal failure and dialysis is less, this is the important cause of morbidity and mortality in HELLP syndrome patients.

  9. Trauma renal Renal trauma

    Directory of Open Access Journals (Sweden)

    Gerson Alves Pereira Júnior

    1999-02-01

    Full Text Available Apresentamos uma revisão sobre trauma renal, com ênfase na avaliação radiológica, particularmente com o uso da tomografia computadorizada, que tem se tornado o exame de eleição, ao invés da urografia excretora e arteriografia. O sucesso no tratamento conservador dos pacientes com trauma renal depende de um acurado estadiamento da extensão da lesão, classificado de acordo com a Organ Injury Scaling do Colégio Americano de Cirurgiões. O tratamento conservador não-operatório é seguro e consiste de observação contínua, repouso no leito, hidratação endovenosa adequada e antibioti- coterapia profilática, evitando-se uma exploração cirúrgica desnecessária e possível perda renal. As indicações para exploração cirúrgica imediata são abdome agudo, rápida queda do hematócrito ou lesões associadas determinadas na avaliação radiológica. Quando indicada, a exploração renal após controle vascular prévio é segura, permitindo cuidadosa inspeção do rim e sua reconstrução com sucesso, reduzindo a probabilidade de nefrectomia.We present a revision of the renal trauma with emphasis in the radiographic evaluation, particularly CT scan that it has largely replaced the excretory urogram and arteriogram in the diagnostic worh-up and management of the patient with renal trauma. The successful management of renal injuries depends upon the accurate assessment of their extent in agreement with Organ Injury Scaling classification. The conservative therapy managed by careful continuous observation, bed rest, appropriate fluid ressuscitation and prophylactic antibiotic coverage after radiographic staging for severely injured kidneys can yield favorable results and save patients from unnecessary exploration and possible renal loss. The indications for immediate exploratory laparotomy were acute abdomen, rapidly dropping hematocrit or associated injuries as determinated from radiologic evaluation. When indicated, renal exploration

  10. Renal arteriography

    Science.gov (United States)

    ... Read More Acute arterial occlusion - kidney Acute kidney failure Aneurysm Atheroembolic renal disease Blood clots Renal cell carcinoma Renal venogram X-ray Review Date 1/5/2016 Updated by: Jason Levy, ...

  11. Effects of nutritional supplementation on fatigue, and autonomic and immune dysfunction in patients with end-stage renal disease: a randomized, double-blind, placebo-controlled, multicenter trial.

    Directory of Open Access Journals (Sweden)

    Sanae Fukuda

    Full Text Available Fatigue is a predictor of cardiovascular events in patients with end-stage renal disease (ESRD undergoing hemodialysis treatment. We hypothesized that multinutritional support would improve quality of life, fatigue symptoms, and potential quantitative measures including endocrine, immune and autonomic functions in patients with ESRD undergoing hemodialysis.Two hundred and two hemodialysis patients were randomly assigned to receive active treatment (containing vitamin B1, vitamin B2, niacin, vitamin B6, vitamin B12, folic acid, vitamin C, carnitine, coenzyme Q10, naïve galacto-oligosaccharide, and zinc or placebo after each dialysis session for 12 weeks. The patients and attending physicians were blinded to the treatment, and 172 patients (86 in each group completed the study. Fatigue was evaluated via fatigue questionnaire at 0, 4, and 12 weeks. To assess human herpes virus (HHV 6 and 7 reactivation, numbers of viral DNA copies were determined in saliva by polymerase chain reaction at weeks 0 and 12. Autonomic function was determined via measurement of beat-to-beat variation by using acceleration plethysmography.Clinical characteristics, changes in fatigue, quality of life score, endocrine functions, and laboratory data did not differ significantly between the two groups. Several parameters of heart rate variability significantly increased after nutritional treatment compared to placebo. Nutritional drink for 12 weeks significantly suppressed HHV7 DNA copy numbers. Similarly, HHV6 DNA copy numbers tended to be decreased by treatment but without reaching statistical significance.Nutritional supplementation may modulate immune and autonomic dysfunction in ESRD patients undergoing hemodialysis.

  12. The impact of admission renal dysfunction on in-hospital and long-term outcome of patients with ST-elevation myocardial infarction in Beijing%入院时肾功能不全对急性ST段抬高型心肌梗死患者长期预后的影响

    Institute of Scientific and Technical Information of China (English)

    李超; 胡大一; 马长生; 杨进刚; 宋莉; 史旭波

    2015-01-01

    Objective To investigate impact of admission renal dysfunction on in-hospital and longterm outcome of patients with ST-elevation myocardial infarction (STEMI).Methods This was a multicentre,observational,prospective-cohort study.Totally 718 consecutive patients were admitted to 19 hospitals in Beijing within 24 hours of onset of STEMI.Estimation of glomerular filtration rate (eGFR) was calculated according to the abbreviated MDRD equation.The patients were categorized into two groups as renal preservation group(eGFR ≥60 ml · min-1 · 1.73 m-2) and renal dysfunction group(eGFR < 60 ml ·min-1 · 1.73 m-2).The association between admission renal dysfunction and in-hospital and six-year outcome was evaluated.Results A total of 718 patients with STEMI were evaluated.There were 551 men and 167 women with age of (61.0 ± 13.0) years.One hundred and thirty-three patients(18.5%) had renal dysfunction.Patients with renal dysfunction were more often female and older,more patients had hypertension,diabetes and heart failure,and more patients had ≥ Killip Ⅱ classes on admission.These patients were less likely to present with chest pain.The in-hospital mortality(16.5% vs 2.6%,P<0.001),major adverse cardiac events(MACE) (60.9% vs 24.4%,P <0.001),six-year all-cause mortality(35.3%vs 11.4%,P < 0.001),six-year cardiac mortality (15.9% vs 5.7%,P =0.001) and six-year MACE (52.4% vs 28.0%,P < 0.001)were markedly increased in renal dysfunction group than in renal preservation group.After adjusting for other confounding factors,renal dysfunction was an independent predictor of in-hospital MACE (OR 2.120,95% CI 1.563-2.878,P =0.003),six-year all-cause mortality (RR 2.122,95% CI 1.127-3.996,P =0.020) and six-year MACE(RR 1.586,95% CI 1.003-2.530,P =0.047).Conclusions The mortality and MACE in STEMI patients with renal dysfunction were higher than in those with preserved renal function.Renal dysfunction evaluated by eGFR on admission is an

  13. On renal pathophysiology in preeclampsia

    OpenAIRE

    2014-01-01

    Preeclampsia is a complication of pregnancy which can suddenly change from a relatively mild phenotype into a life-threatening situation. One of the organs that is always involved during preeclampsia is the kidney. The placenta plays an important role in the renal pathophysiology of preeclampsia. The placenta produces excessive amounts of anti-angiogenic factors which are associated with systemic endothelial dysfunction. Although the underlying mechanisms of renal injury during preeclampsia r...

  14. [Intensity of lipid peroxidation in the kidneys in nephrotoxic acute renal failure (experimental study)].

    Science.gov (United States)

    Makarenko, V S; Zhiznevskaia, N G; Koltygina, T I; Gapanovich, V M; Makarenko, E V

    2000-01-01

    Mercury chloride was injected cubcutaneously in rats to induce nephrotoxic acute renal failure (ARF). Renal dysfunction in ARF occurs under intensification of lipid peroxidation in the kidneys. Pretreatment with antioxidant ionol diminishes lipid peroxidation intensity in the kidneys in ARF and restricts the severity of renal dysfunction.

  15. Pregnancy in women with renal disease. Part II: specific underlying renal conditions.

    Science.gov (United States)

    Vidaeff, Alex C; Yeomans, Edward R; Ramin, Susan M

    2008-08-01

    The obstetric outcome in women with kidney disease has improved in recent years due to continuous progress in obstetrics and neonatology, as well as better medical management of hypertension and renal disease. However, every pregnancy in these women remains a high-risk pregnancy. When considering the interaction between renal disease and pregnancy, maternal outcomes are related to the initial level of renal dysfunction more than to the specific underlying disease. With regards to fetal outcomes, though, a distinction may exist between renal dysfunction resulting from primary renal disease and that in which renal involvement is part of a systemic disease. In part II of this review, some specific causes of renal failure affecting pregnancy are considered.

  16. The renal transcriptome in experimental hypertension

    NARCIS (Netherlands)

    Wesseling, S.

    2007-01-01

    The renal transcriptome in experimental hypertension The kidneys importantly determine blood pressure. Kidney dysfunction can result in hypertension, which in turn leads to renal damage. In primary hypertension the cause is unknown. The condition is polygenic, however, which genetic defects cause el

  17. Renal failure in patients with multiple myeloma.

    Science.gov (United States)

    Almueilo, Samir H

    2015-01-01

    Renal dysfunction is encountered in 20-25% of patients with multiple myeloma (MM) at the time of diagnosis. There is often a precipitating event. Several biochemical and clinical correlations with renal failure in MM have been reported. Renal failure in MM is associated with worse outcome of the disease. We retrospectively analyzed the medical records of 64 patients with MM admitted to our institution during the period January 1992 to December 2012. Abnormal renal function was observed in 24 (37.5%) patients and 17 (26.6%) of them had renal failure; 14 of the 17 (82.4%) of patients with renal failure had Stage III MM. Urine Bence- Jones protein was positive in ten (58.8%) patients with renal failure versus ten (21.3%) patients without renal failure (P = 0.004). Potential precipitating factors of renal failure were determined in nine patients. Renal function normalized in 11 patients with simple measures, while six patients required hemodialysis; one remained dialysis dependent till time of death. Early mortality occurred in five (29.4%) patients with renal failure as compared with two (4.3%) patients in the group without renal failure (P = 0.005). In conclusion, renal failure is associated with a higher tumor burden and Bence-Jones proteinuria in patients with MM. It is reversible in the majority of patients; however, early mortality tends to be higher in patients with persistent renal failure.

  18. Erectile dysfunction.

    Science.gov (United States)

    Wylie, Kevan

    2008-01-01

    Erectile dysfunction is a common problem affecting sexual function in men. Approximately one in 10 men over the age of 40 is affected by this condition and the incidence is age related. Erectile dysfunction is a sentinel marker for several reversible conditions including peripheral and coronary vascular disease, hypertension and diabetes mellitus. Endothelial dysfunction is a common factor between the disease states. Concurrent conditions such as depression, late-onset hypogonadism, Peyronie's disease and lower urinary tract symptoms may significantly worsen erectile function, other sexual and relationship issues and penis dysmorphophobia. A focused physical examination and baseline laboratory investigations are mandatory. Management consists of initiating modifiable lifestyle changes, psychological and psychosexual/couples interventions and pharmacological and other interventions. In combination and with treatment of concurrent comorbid states, these interventions will often bring about successful resolution of symptoms and avoid the need for surgical interventions.

  19. Hypertension in Renal Allograft Recipients

    Directory of Open Access Journals (Sweden)

    Waiser Johannes

    1999-01-01

    Full Text Available Hypertension is a frequent complication after renal transplantation. It contributes to the considerable cardiovascular morbidity and mortality in renal allograft recipients. Additionally, it has a major impact on long-term allograft survival. The pathogenesis of post transplant hypertension is multifactorial. Besides common risk factors, renal allograft recipients accumulate specific risk factors related to the original renal disease, renal transplantation per se and the immunosuppressive regimen. Chronic allograft dysfunction is the main cause of post transplant hypertension. The introduction of calcineurin inhibitors, such as cyclosporine, has increased the prevalence of hypertension. At present, the growing manual of diagnostic and therapeutic tools enables us to adapt better antihypertensive therapy. Tight monitoring, individualization of the immunosuppressive protocol, inclusion of non-pharmacological measures and aggressive antihypertensive treatment should help to minimize the negative implications of post transplant hypertension. Probably, this goal can only be reached by "normalization" of systolic and diastolic blood pressure to below 135/85 mmHg.

  20. Relation between renal dysfunction and the prognosis of patients withacute myocardial infarction%肾功能不全与急性心肌梗死患者预后的关系

    Institute of Scientific and Technical Information of China (English)

    徐琼; 刘进军; 宣玲

    2015-01-01

    目的 探讨肾功能不全(renal dysfunction)与急性心肌梗死(acute myocardial infarction,AMI)患者预后的关系.方法 搜集蚌埠医学院第一附属医院108例因急性心肌梗死入院患者的资料,将入院首次测得血肌酐值代入改良的MDRD方程计算出肾小球滤过率(c-aGFR),据其值将患者分为4组,GFR≥90 ml/(min·1.73 m2)为A组,60 ml/(min· 1.73 m2)≤GFR≤89 ml/(min· 1.73 m2)为B组,30 ml/(min· 1.73 m2)≤GFR≤59 ml/(min·1.73 m2)为C组,GFR≤29 ml/(min·1.73 m2)为D组,随访期为住院期间及出院后1年内,观察各组患者随访期内心绞痛、心力衰竭、再次心肌梗死、心源性死亡的发生情况,即主要心血管不良事件.结果 在随访期内发生主要心血管不良事件的患者为45例,包括15例心绞痛、15例心力衰竭、8例再次心肌梗死、7例心源性死亡,发生主要心血管不良事件患者中肾功能不全组较肾功能正常组明显增多,差异有统计学意义.结论 GFR值对评估AMI患者预后有一定价值,GFR是衡量肾功能的指标,肾功能不全患者其住院期间及出院1年内预后较差.

  1. N-acetil-β-D-glicosaminidase como biomarcador precoce de disfunção renal para a exposição ocupacional ao chumbo inorgânico N-acetyl-β-D-glucosaminidase as an early biomarker of renal dysfunction due to occupational exposure to inorganic lead

    Directory of Open Access Journals (Sweden)

    Leandro Nishikawa Gonçales

    2008-08-01

    Full Text Available OBJETIVO: Este estudo teve como objetivo averiguar a atividade enzimática da N-acetil-β-D-glicosaminidase (NAG como possível biomarcador precoce de disfunção renal para a exposição ocupacional ao chumbo inorgânico. MATERIAIS E MÉTODOS: Foi selecionado um grupo de 30 pessoas do sexo masculino expostas ao chumbo inorgânico em uma fábrica de baterias localizada no estado do Paraná. Fizeram parte do grupo os funcionários que mostraram valores de chumbo sanguíneo inferiores a 40 mg/dl. O grupo controle foi representado por 15 adultos saudáveis com similaridade em relação à idade e ao gênero do grupo exposto. Foram determinados os níveis de plumbemia, do ácido d-aminolevulínico urinário e a atividade da NAG urinária. RESULTADOS E DISCUSSÃO: Foi evidenciado que a atividade urinária da NAG foi significativamente maior (p OBJECTIVE: This study aimed to verify the enzymatic activity of N-acetyl-β-D-glucosaminidase (NAG as a possible early biomarker of renal dysfunction due to occupational exposure to inorganic lead. MATERIALS AND METHODS: We selected a group of 30 males that had been exposed to inorganic lead in a battery factory in the state of Paraná. This group comprised those employees whose blood lead levels were below 40 mg/dl. The control group consisted of 15 healthy adults of similar age and gender compared with the exposed group. Blood lead concentrations, d-aminolevulinic acid levels and urinary NAG activity were measured. RESULTS AND DISCUSSION: It was shown that urinary NAG activity was significantly higher (p < 0.05, U test of Mann-Whitney in the exposed group in comparison to the control group, and there was a significant negative correlation (p < 0.05, Spearman Rank Order correlation between the biological indicator of lead exposure and urinary NAG activity. CONCLUSION: The results showed that the increase of urinary NAG activity may be used as an early biomarker of the exposure to inorganic lead.

  2. Erectile dysfunction

    African Journals Online (AJOL)

    that increase blood flow to the penis. The blood ... The pressure of the blood in the chambers makes the ... What are the risk factors for erectile dysfunction? The most .... losing excessive weight and increasing physical activity, may improve the ...

  3. Renal Osteodystrophy

    Directory of Open Access Journals (Sweden)

    Aynur Metin Terzibaşoğlu

    2004-12-01

    Full Text Available Chronic renal insufficiency is a functional definition which is characterized by irreversible and progressive decreasing in renal functions. This impairment is in collaboration with glomeruler filtration rate and serum creatinine levels. Besides this, different grades of bone metabolism disorders develop in chronic renal insufficiency. Pathologic changes in bone tissue due to loss of renal paranchyme is interrelated with calcium, phosphorus vitamine-D and parathyroid hormone. Clinically we can see high turnover bone disease, low turnover bone disease, osteomalacia, osteosclerosis and osteoporosis in renal osteodystropy. In this article we aimed to review pathology of bone metabolism disorders due to chronic renal insufficiency, clinic aspects and treatment approaches briefly.

  4. OBSTETRIC RENAL FAILURE

    Directory of Open Access Journals (Sweden)

    Rajeshwari

    2015-11-01

    Full Text Available Renal failure in obstetrics is rare but important complication, associated with significant mortality and long term morbidity.1,2 It includes acute renal failure due to obstetrical complications or due to deterioration of existing renal disease. AIMS AND OBJECTIVES: To evaluate the etiology and outcome of renal failure in obstetric patients. METHODS: We prospectively analyzed 30 pregnant and puerperal women with acute renal failure or pre-existing renal disease developing renal failure during pregnancy between November 2007 to sep-2009. Patients who presented/developed ARF during the hospital stay were included in this study. RESULTS: Among 30 patients, mean age was 23 years and 33 years age group. 12 cases (40% patients were primigravidae and 9(30% patients were multigravidae and 9 cases (30% presented in post-partum period. Eighteen cases (60% with ARF were seen in third trimester, followed by in postpartum period 9 cases (30%. Most common contributing factors to ARF were Pre-eclampsia, eclampsia and HELLP syndrome 60%, sepsis 56.6%, post abortal ARF 10%. DIC 40%. Haemorrhage as the aetiology for ARF was present 46%, APH in 20% and PPH in 26.6%. The type of ARF was renal in (63% and prerenal (36%; Oliguric seen in 10 patients (33% and high mortality (30%. Among the 20 pregnant patients with ARF, The average period of gestation was 33±2 weeks (30 -36 weeks, 5 cases (25% presented with intrauterine fetal demise and 18 cases (66% had preterm vaginal delivery and 2 cases (10% had induced abortion. And the average birth weight was 2±0.5 kg (1.5 kg. Eight cases (26% required dialysis. 80% of patients recovered completely of renal functions. 63% patients recovered without renal replacement therapy whereas 17% required dialysis. the maternal mortality was 20%, the main reason for mortality was septic shock and multi organ dysfunction (66%. CONCLUSION: ARF related pregnancy was seen commonly in the primigravidae and in the third trimester, the most

  5. The expression of monocyte chemoattractant protein 1 and RANTES and their significance in the pathogenesis of chronic renal allograft dysfunction%MCP-1、RANTES在慢性移植肾失功肾组织中的表达及意义

    Institute of Scientific and Technical Information of China (English)

    李晏强; 罗皓; 邹和群; 眭维国; 王保瑶; 邹贵勉

    2012-01-01

    目的 探讨单核细胞趋化蛋白-1(MCP-1)和RANTES在慢性移植肾失功(CRAD)患者移植肾组织中的表达及意义.方法 用免疫组织化学技术和计算机真彩色图像分析系统半定量检测32例慢性移植肾失功患者移植肾组织中MCP-1和RANTES的表达,分析与移植肾间质纤维化/小管萎缩程度及炎性细胞浸润程度之间的关系.结果 慢性移植肾失功患者的移植肾组织中MCP-1和RANTES的表达较正常肾组织中明显增加,并随着间质纤维化/小管萎缩及炎症细胞浸润程度而递增.结论 移植肾组织中MCP-1和RANTES的表达升高与慢性移植肾失功的进展有关.%Objective To in vestige the expression of monocyte chemoattractant protein 1 (MCP-l) and RANTES and their significance in the pathogenesis of chronic renal allograft dy sfunction.Method Immunohistochemical assay and computer-assisted genuine colored image analysis system were used to detect the expression of MCP-l and RANTES in the renal allografts of patients with CARD. The relationship between expression level of mcp-land Rantes and either the grade of inflammatory cell infiltration or interstitial fibrosis/tubular atrophy in renal allograft was analyzed.Six specimens of healthy renal tissue were used as controls. Results The expressions levels of MCP-l and RANTES were significantly higher in the renal tissues of the patients, compared to normal renal tissues, and the expressions tended to increase with the pathological grades of either inflammatory cell infiltration or interstitial fibrosis/tubular atrophy in renal allograft tissue.Conclusion The up-regulated expression of MCP-l and Rantes in transplant kidney tissue may have the relationship win the progressive of the chronic renal allograft dysfunction

  6. Structural and functional MRI in children with renal disease: first experience

    DEFF Research Database (Denmark)

    Jørgensen, Bettina; Karstoft, Kristian; Jørgensen, Troels Munch;

    2010-01-01

    This MRI study demonstrates our first clinical experiences with structural and functional evaluation in children with renal dysfunction, and communicates our experience with quantitative measurements of renal function compared to reference values found employing radionucleotides....

  7. Oral Dysfunction

    OpenAIRE

    鈴木, 規子; スズキ, ノリコ; Noriko, SUZUKI

    2004-01-01

    The major oral functions can be categorized as mastication, swallowing, speech and respiratory functions. Dysfunction of these results in dysphagia, speech disorders and abnormal respiration (such as Sleep Apnea). These functions relate to dentistry in the occurrence of : (1) oral preparatory and oral phases, (2) articulation disorders and velopharyngeal incompetence (VPI), and (3) mouth breathing, respiratory and blowing disorders. These disorders are related to oral and maxillofacial diseas...

  8. 血清视黄醇结合蛋白4在危重患者急性肾功能障碍监测中的应用%Application of serum retinol binding protein 4 in the monitoring critically ill patients with acute renal dysfunction

    Institute of Scientific and Technical Information of China (English)

    喻红波; 刘阳; 张强; 李刚

    2011-01-01

    [Objective] To investigate the clinical value of serum retinol binding protein 4 in the monitoring acute renal dysfunction critically ill patients. [Methods] Serum retinol binding protein 4, creatinine and renal creatinine clearance level were determined in 72 critically ill patients, and their difference was analyzed. [Results] The levels of serum retinol binding protein 4 and creatinine clearance rate was negatively correlated, and serum retinol binding protein-4 correlated better with GFR than creatinine. The detection rate of acute renal dysfunction by serum retinol binding protein 4 (28/38) was higher than that of serum creatinine (8/38), the difference was statistically significant. [Conclusion] Retinol binding protein 4 is an accurate marker of subtle changes in GFR, and may be superior to creatinine when assessing this parameter in clinical practice in critically ill patients. The analysis of serum retinol binding protein 4 in critically ill patients may be helpful for the monitoring of acute renal dysfunction.%[目的]探讨视黄醇结合蛋白4在危重患者急性肾功能障碍监测中的应用.[方法]测定72例危重患者视黄醇结合蛋白4,肌酐及肾脏内生肌酐清除率水平,并分析其差异.[结果]危重患者视黄醇结合蛋白4水平与肾脏内生肌酐清除率水平明显负相关,且高于血清肌酐.在急性肾功能障碍检出率上,视黄醇结合蛋白4(28/38)高于血清肌酐(8/38),差异有统计学意义.[结论]视黄醇结合蛋白4是较精准的肾小球滤过率监测指标,可用于危重患者急性肾功能障碍的监测.

  9. Renal perfusion scintiscan

    Science.gov (United States)

    Renal perfusion scintigraphy; Radionuclide renal perfusion scan; Perfusion scintiscan - renal; Scintiscan - renal perfusion ... supply the kidneys. This is a condition called renal artery stenosis. Significant renal artery stenosis may be ...

  10. Estresse oxidativo e disfunção endotelial na doença renal crônica Estrés oxidativo y disfunción endotelial en la enfermedad renal crónica Oxidative stress and endothelial dysfunction in chronic kidney disease

    Directory of Open Access Journals (Sweden)

    Valeria Costa-Hong

    2009-05-01

    Full Text Available FUNDAMENTO: A doença renal crônica (DRC caracteriza-se pela alta prevalência de aterosclerose. Uma vez que o estresse oxidativo e a disfunção endotelial são promotores da aterosclerose, é interessante verificar se as duas condições estão associadas em pacientes com DRC, ainda sem doença cardiovascular (DCV clínica. OBJETIVO: Avaliar as relações entre o estresse oxidativo e a função endotelial em pacientes com DRC estágio 5, sem DCV. MÉTODOS: Foram estudados 22 pacientes com DRC, não-diabéticos, não-fumantes, sem DCV e tratados por hemodiálise; além de 22 indivíduos normais. Em todos os indivíduos foram avaliados a reatividade vascular, dependente e independente de endotélio (ultra-som de alta resolução da artéria braquial, e o estresse oxidativo (níveis plasmáticos de substâncias reativas ao ácido tiobarbitúrico - TBARS. RESULTADOS: A reatividade vascular dependente de endotélio (6,0 ± 4,25% vs. 11,3 ± 4,46%, p FUNDAMENTO: La enfermedad renal crónica (ERC se caracteriza por la alta prevalencia de aterosclerosis Siendo el estrés oxidativo y la disfunción endotelial promotores de la aterosclerosis, es interesante verificar si las dos condiciones están asociadas en pacientes con ERC, aun sin enfermedad cardiovascular (ECV clínica. OBJETIVO: Evaluar las relaciones entre el estrés oxidativo y la función endotelial en pacientes con ERC estado 5, sin ECV. MÉTODOS: Se estudiaron 22 pacientes con ERC, no diabéticos, no fumadores, sin ECV y tratados por hemodiálisis; además de 22 individuos normales. En todos los individuos se evaluaron la reactividad vascular, dependiente e independiente de endotelio (ecografía de alta resolución de la arteria braquial, y el estrés oxidativo (niveles plasmáticos de sustancias reactivas al ácido tiobarbitúrico - TBARS. RESULTADOS: La reactividad vascular dependiente de endotelio (6,0 ± 4,25% vs. 11,3 ± 4,46%, p BACKGROUND: Chronic kidney disease (CKD is characterized

  11. Markers of renal function tests

    Directory of Open Access Journals (Sweden)

    Shivaraj Gowda

    2010-04-01

    Full Text Available Background: The markers of renal function test assess the normal functioning of kidneys. These markers may be radioactive and non radioactive. They indicate the glomerular filtration rate, concentrating and diluting capacity of kidneys (tubular function. If there is an increase or decrease in the valves of these markers it indicates dysfunction of kidney. Aim: The aim of this review is to compare and analyze the present and newer markers of renal function tests which help in diagnosis of clinical disorders. Material & Methods: An extensive literature survey was done aiming to compare and compile renal function tests makers required in diagnosis of diseases. Results: Creatinine, urea, uric acid and electrolytes are makers for routine analysis whereas several studies have confirmed and consolidated the usefulness of markers such as cystatin C and β-Trace Protein. Conclusion: We conclude that further investigation is necessary to define these biomarkers in terms of usefulness in assessing renal function.

  12. 莫西沙星对老年肾功能不全社区获得性肺炎的治疗效果及安全性评价%Efficiency and safety of moxifloxacin in treatment of elderly community acquired pneumonia with renal dysfunction

    Institute of Scientific and Technical Information of China (English)

    杭晨晨; 王烁

    2014-01-01

    Objective To evaluate the effectiveness and safety of moxifloxacinin treatment of community acquired pneumonia in elderly patients with renal dysfunction , so as to provide safe and effective antibiotics for the treatment of community acquired pneumonia for patients . elderly renal dysfunction .Methods A total of 128 elderly patients with community acquired pneumonia , who enrolled the emergency department of the hospital from Jan 2011 to Dec 2013 , were divided into two groups according to the renal function .The normal group ( n =63 ) and the renal dysfunction group without hemodialysis ( n =65 ) were both treated with moxifloxacin .The clinical efficacies and the adverse reactions were observed .Results There was no statistically difference in the clinical effective rates (81.0% vs.87.7%, P=0.294), the pathogensclearance rate (80.56% vs.88.37%, P=0.335) and the incidence of the adverse reactions (7.93% vs.9.23%, P=0.794) between the two groups.There was no significant difference of moxifloxacin plasma concentration between the two groups at each time point.The plasma concentration was stable in the whole protocol .Conclusion Moxifloxacincan achieve good clinic effect in the treatment of community acquired pneumonia with renal dysfunction in elderly patients with less adverse reaction .%目的:评估莫西沙星在老年肾功能不全社区获得性肺炎( community acquired pneumonia, CAP)中的治疗效果及安全性,为临床治疗老年肾功能不全CAP选择安全、高效的抗菌药物。方法选取2011-01~2013-12在急诊科住院的128例老年CAP患者,根据肾功能状况分为肾功能正常组(n=63)和肾功能不全但未透析组(n=65),均给予莫西沙星治疗,观察临床疗效及不良反应。结果肾功能正常组与肾功能不全组比较,治疗有效率(81.0%vs.87.7%,P=0.294),细菌清除率(80.56%vs.88.37%,P=0.335),不良反应发生率(7.93%vs.9

  13. Melamine Impairs Renal and Vascular Function in Rats.

    Science.gov (United States)

    Tian, Xiao Yu; Wong, Wing Tak; Lau, Chi Wai; Wang, Yi-Xiang; Cheang, Wai San; Liu, Jian; Lu, Ye; Huang, Huihui; Xia, Yin; Chen, Zhen Yu; Mok, Chuen-Shing; Lau, Chau-Ming; Huang, Yu

    2016-06-21

    Melamine incident, linked to nephrotoxicity and kidney stone in infants previously exposed to melamine-contaminated milk products, was unprecedentedly grave in China in 2008 as little was known about the mechanistic process leading to renal dysfunction in affected children. This study investigates whether neonatal ingestion of melamine leads to renal and vascular dysfunction in adulthood; and whether ingestion of melamine in pregnant rats leads to renal dysfunction in their offspring. A combination of approaches employed includes functional studies in rat renal arteries, renal blood flow measurement by functional magnetic resonance imaging, assay for pro-inflammatory and fibrotic biomarkers, immunohistochemistry, and detection of plasma and renal melamine. We provide mechanistic evidence showing for the first time that melamine reduces renal blood flow and impairs renal and vascular function associated with overexpression of inflammatory markers, transforming growth factor-β1, bone morphogenic protein 4 and cyclooxygenase-2 in kidney and renal vasculature. Melamine also induces renal inflammation and fibrosis. More importantly, melamine causes nephropathies in offsprings from pregnant rat exposed to melamine during pregnancy, as well as in neonatal rat exposed to melamine afterbirth, thus supporting the clinical observations of kidney stone and acute renal failure in infants consuming melamine-contaminated milk products.

  14. Hepatocyte Growth Factor Prevents Acute Renal Failure of Accelerates Renal Regeneration in mice

    Science.gov (United States)

    Kawaida, Kouichi; Matsumoto, Kunio; Shimazu, Hisaaki; Nakamura, Toshikazu

    1994-05-01

    Although acute renal failure is encountered with administration of nephrotoxic drugs, ischemia, or unilateral nephrectomy, there has been no effective drug which can be used in case of acute renal failure. Hepatocyte growth factor (HGF) is a potent hepatotropic factor for liver regeneration and is known to have mitogenic, motogenic, and morphogenic activities for various epithelial cells, including renal tubular cells. Intravenous injection of recombinant human HGF into mice remarkably suppressed increases in blood urea nitrogen and serum creatinine caused by administration of cisplatin, a widely used antitumor drug, or HgCl_2, thereby indicating that HGF strongly prevented the onset of acute renal dysfunction. Moreover, exogenous HGF stimulated DNA synthesis of renal tubular cells after renal injuries caused by HgCl_2 administration and unilateral nephrectomy and induced reconstruction of the normal renal tissue structure in vivo. Taken together with our previous finding that expression of HGF was rapidly induced after renal injuries, these results allow us to conclude that HGF may be the long-sought renotropic factor for renal regeneration and may prove to be effective treatment for patients with renal dysfunction, especially that caused by cisplatin.

  15. RENAL CRYOABLATION

    Directory of Open Access Journals (Sweden)

    A. V. Govorov

    2012-01-01

    Full Text Available Renal cryoablation is an alternative minimally-invasive method of treatment for localized renal cell carcinoma. The main advantages of this methodology include visualization of the tumor and the forming of "ice ball" in real time, fewer complications compared with other methods of treatment of renal cell carcinoma, as well as the possibility of conducting cryotherapy in patients with concomitant pathology. Compared with other ablative technologies cryoablation has a low rate of repeat sessions and good intermediate oncological results. The studies of long-term oncological and functional results of renal cryoablation are presently under way.

  16. Renal angiomyolipoma

    DEFF Research Database (Denmark)

    Holm-Nielsen, P; Sørensen, Flemming Brandt

    1988-01-01

    lesion. Three cases of renal angiomyolipoma, 2 of which underwent perfusion-fixation, were studied by electron microscopy to clarify the cellular composition of this lesion. In the smooth muscle cells abundant accumulation of glycogen was found, whereas the lipocytes disclosed normal ultrastructural......-specific vesicular structures. These findings suggest a secondary vascular damage, i.e. the thickened vessels may not be a primary, integral part of renal angiomyolipoma. Evidence of a common precursor cell of renal angiomyolipoma was not disclosed. It is concluded that renal angiomyolipoma is a hamartoma composed...

  17. Determinants and consequences of renal function variations with aldosterone blocker therapy in heart failure patients after myocardial infarction

    DEFF Research Database (Denmark)

    Rossignol, Patrick; Cleland, John G F; Bhandari, Sunil;

    2012-01-01

    We evaluated the effect of the selective mineralocorticoid receptor antagonist eplerenone on renal function and the interaction between changes in renal function and subsequent cardiovascular outcomes in patients with heart failure and left ventricular systolic dysfunction after an acute myocardi...

  18. Metabolic syndrome is associated with impaired long-term renal allograft function; not all component criteria contribute equally

    NARCIS (Netherlands)

    de Vries, APJ; Bakker, SJL; van Son, WJ; van der Heide, JJH; Ploeg, RJ; The, HT; de Jong, PE; Gans, ROB

    2004-01-01

    Chronic renal transplant dysfunction (CRTD) remains a leading cause of renal allograft loss. Evidence suggests that immunological and ischemic insults are mainly associated with CRTD occurring within the first year after transplantation, whereas nonimmunological insults are predominantly associated

  19. Dietary Acid Load and Metabolic Acidosis in Renal Transplant Recipients

    NARCIS (Netherlands)

    Berg, van den Else; Engberink, M.F.; Brink, E.J.; Baak, van M.A.; Joosten, M.M.; Gans, R.O.B.; Navis, G.; Bakker, S.J.L.

    2012-01-01

    Background and objectives Acidosis is prevalent among renal transplant recipients (RTRs) and adversely affects cardiometabolic processes. Factors contributing to acidosis are graft dysfunction and immunosuppressive drugs. Little is known about the potential influence of diet on acidosis in RTRs. Thi

  20. Dietary Acid Load and Metabolic Acidosis in Renal Transplant Recipients

    NARCIS (Netherlands)

    Berg, van den Else; Engberink, M.F.; Brink, E.J.; Baak, van M.A.; Joosten, M.M.; Gans, R.O.B.; Navis, G.; Bakker, S.J.L.

    2012-01-01

    Background and objectives Acidosis is prevalent among renal transplant recipients (RTRs) and adversely affects cardiometabolic processes. Factors contributing to acidosis are graft dysfunction and immunosuppressive drugs. Little is known about the potential influence of diet on acidosis in RTRs.

  1. 老年肾功能不全患者应用利奈唑胺的疗效及其对血小板的影响%Clinical efficacy of linezolid used by the elderly with renal dysfunction and its effect on platelets

    Institute of Scientific and Technical Information of China (English)

    王斌; 葛庆岗; 郑亚安; 朱熹

    2013-01-01

    OBJECTIVE To evaluate the clinical efficacy of linezolid in the treatment of the gram-positive cocci infections in the elderly patients with renal dysfunction and analyze its effect on the platelets. METHODS A retrospective analysis of the clinical data was conducted for 27 elderly patients with the renal dysfunction who were treated with linezolid in emergency intensive care unit ( EICU) and surgery intensive care unit (SICU) from Aug 2009 to Oct 2011. RESULTS Totally 27 elderly patients were given the linezolid with a course of 3 - 16 days and the average time of (9. 75±3. 54 ) days,the clinical effective rate was 77. 8%,the eradication rate of the gram-positive cocci was 93. 5%. The incidence of thrombocytopenia was 70. 4%, the patients with the platelets decreased by between 25. 0% and 50. 0% accounted for 22. 2%, the patients with the platelets decreased more than 50. 0% accounted for 48. 2%, the patients with the minimal platelet count < 50 × 109/L accounted for 18. 5%. Linezolid may cause thrombocytopenia, especially the patients with more than 80 years of age. The lower the baseline of platelet counts and more severe the renal dysfunction, the earlier the thrombocytopenia may occur. CONCLUSION Linezolid is effective and safe in treatment of the gram-positive cocci infections in the patients with renal dysfunction,however, it is necessary to remain highly vigilant to the incidence of thrombocytopenia.%目的 探讨老年肾功能不全患者应用利奈唑胺抗革兰阳性球菌感染的疗效及其对血小板的影响.方法 对2009年8月-2011年10月急诊重症监护病房(EICU)和危重医学科、应用利奈唑胺治疗革兰阳性球菌感染的老年肾功能不全患者进行回顾性分析.结果 27例患者使用利奈唑胺的疗程为3~16 d,平均(9.75±3.54)d,临床有效率为77.8%,革兰阳性球菌清除率为93.5%;血小板减少发生率为70.4%,其中血小板减少25.0%~50.0%的占22.2%,减少>50.0%的占48.2

  2. Renal cancer

    NARCIS (Netherlands)

    Corgna, Enrichetta; Betti, Maura; Gatta, Gemma; Roila, Fausto; De Mulder, Pieter H. M.

    2007-01-01

    In Europe, renal cancer (that is neoplasia of the kidney, renal pelvis or ureter (ICD-9 189 and ICD-10 C64-C66)) ranks as the seventh most common malignancy in men amongst whom there are 29,600 new cases each year (3.5% of all cancers). Tobacco, obesity and a diet poor in vegetables are all acknowle

  3. Renal fallure

    Institute of Scientific and Technical Information of China (English)

    1992-01-01

    920705 Endothelin and acute renal failure:study on their relationship and possiblemechanisms. LIN Shanyan(林善锬), et al.Renal Res Lab, Huashan Hosp, Shanghai MedUniv, Shanghai, 200040. Natl Med J China 1992;72(4): 201-205. In order to investigate the role of endothelin

  4. Renal cancer.

    NARCIS (Netherlands)

    Corgna, E.; Betti, M.; Gatta, G.; Roila, F.; Mulder, P.H.M. de

    2007-01-01

    In Europe, renal cancer (that is neoplasia of the kidney, renal pelvis or ureter (ICD-9 189 and ICD-10 C64-C66)) ranks as the seventh most common malignancy in men amongst whom there are 29,600 new cases each year (3.5% of all cancers). Tobacco, obesity and a diet poor in vegetables are all

  5. Renal cancer

    NARCIS (Netherlands)

    Corgna, Enrichetta; Betti, Maura; Gatta, Gemma; Roila, Fausto; De Mulder, Pieter H. M.

    2007-01-01

    In Europe, renal cancer (that is neoplasia of the kidney, renal pelvis or ureter (ICD-9 189 and ICD-10 C64-C66)) ranks as the seventh most common malignancy in men amongst whom there are 29,600 new cases each year (3.5% of all cancers). Tobacco, obesity and a diet poor in vegetables are all

  6. Renal fructose-metabolizing enzymes: significance in hereditary fructose intolerance.

    Science.gov (United States)

    Kranhold, J F; Loh, D; Morris, R C

    1969-07-25

    In patients with hereditary fructose intolerance, which is characterized by deficient aldolase activity toward fructose-1-phosphate, fructose induces a renal tubular dysfunction that implicates only the proximal convoluted tubule. Because normal metabolism of fructose by way of fructose-1-phosphate requires fructokinase, aldolase "B," and triokinase, the exclusively cortical location of these enzymes indicates that the medulla is not involved in the metabolic abnormality presumably causal of the renal dysfunction.

  7. Renal Aspects of Peptic Ulcer Pharmacology

    Directory of Open Access Journals (Sweden)

    Daniel Muruve

    1992-01-01

    Full Text Available Medications to treat peptic ulcer disease are used widely and may have adverse effects on renal function. Similarly, renal dysfunction may alter the pharmacokinetics of this diverse group of medications resulting in dosage adjustments. The older agents, antacids and sucralfate, allow absorption of cations (calcium, magnesium and aluminum which may result in toxicity. Newer medications (H2 blockers and omeprazole appear to have fewer side effects and be better tolerated with appropriate dosage adjustments.

  8. HBV Vaccination in Chronic Renal Failure Patients

    OpenAIRE

    Mir-davood Omrani; Mohammad Hassan Khadem Ansari

    2006-01-01

    HBV infection in chronic renal failure (CRF) becomes chronic in 30 to 60% compared with less than 10% in nonuremic patients. Immunological dysfunction in patients on hemodialysis may be related to imbalanced cytokine systems, such as tumor necrosis factor (TNF-|α|) and interleukin (IL) 6,1 by retention of renal metabolite in uremia and chronic inflammation and have a poor immunological reaction to T-cell-dependent antigens, like hepatitis B vaccination. Immunocompromised patients who are unre...

  9. Adefovir nephrotoxicity in a renal allograft recipient

    Directory of Open Access Journals (Sweden)

    N George

    2015-01-01

    Full Text Available Adefovir dipivoxil, an oral prodrug of adefovir, is used in the treatment of lamivudine-resistant hepatitis B virus (HBV infection. Nephrotoxicity manifesting as proximal renal tubular dysfunction and acute tubular necrosis (ATN were commonly reported in the past, when higher doses were used for the treatment of human immunodeficiency virus infection. However, nephrotoxicity is rare at lower doses that are currently recommended for the treatment of HBV infection. A 31-year-old female was detected to be hepatitis B surface antigen positive months after a kidney transplant. The patient was initiated on lamivudine, but developed resistance after 1 year of treatment, at which time low-dose adefovir was added. The patient developed renal allograft dysfunction after 10 months of starting adefovir. Serum creatinine increased from 1.1 mg/dl to 1.9 mg/dl, along with progressively increasing sub-nephrotic proteinuria. Renal allograft biopsy revealed features of ATN. After discontinuation of adefovir, proteinuria resolved and renal dysfunction improved slowly over the next 2 years. Adefovir-induced nephrotoxicity, although uncommon at lower doses, needs to be considered in the differential diagnosis of renal dysfunction and sub-nephrotic proteinuria occurring in patients receiving adefovir for prolonged periods.

  10. Radiocontrast-induced renal failure

    Energy Technology Data Exchange (ETDEWEB)

    Misson, R.T.; Cutler, R.E.

    1985-05-01

    Review of the literature concerning contrast-induced renal dysfunction shows that the currently used agents are remarkably safe with careful patient selection. Clinically apparent kidney failure after their use is essentially nonexistent in those without preexistent renal insufficiency. The incidence rises rapidly in those with azotemia from any cause, however, and diabetic persons with nephropathy are perhaps at special risk. Vigorous volume expansion is possibly effective as a preventive measure and may attenuate adverse effects in those in whom postcontrast dysfunction occurs. New agents are becoming available. It is not yet known if these will prove safer or cost-effective. They have some experimentally demonstrated and theoretical advantages over the presently used agents. 58 references, 1 figure, 2 tables.

  11. 慢性肾功能不全对ST段抬高型心肌梗死患者经皮冠状动脉介入治疗预后的影响%Influence of chronic renal dysfunction on prognosis of patients with ST-segment elevated myocardial infarction undergoing primary percutaneous coronary intervention

    Institute of Scientific and Technical Information of China (English)

    丁超; 胡晓华; 陈方; 张晓玲; 高阅春; 吴长燕

    2012-01-01

    Objective To evaluate the influence of chronic renal dysfunction on prognosis of patients with ST-segment elevated myocardial infarction( STEMI) undergoing primary percutaneous coronary intervention ( PCI). Methods Data of 743 STEMI patients undergoing primary PCI in Beijing Anzhen hospital were retrospectively collected. Patients were divided into the renal dysfunction group and control group according to estimated glomeruar filtration rate(eGFR) 60 mL·min-1· 1.73 m-2. Clinical characteristics,lesion characteristics and prognostic outcomes were compared between the two groups. Results Compared with control group, patients in renal dysfunction group were elder and less male patients, there were more patients with heart failure, hypertension, diabetus mellilus, previous myocardial infarction history .multiple vascular disease and cardiac inadequacy( Killip's grade≥2)in renal dysfunction group(P <0. 05). Major adverse cardiovascular event(MACE) rate and death rate were higher in renal dysfunction group than control group during the period of hospital stay and after following up for 2 years(P <0. 05). The results of Logistic mullifactor regression analysis showed that,eGFR<60 mL·min-1· 1.73 m-2 ,age≥70 years,Killip's grade≥2,diabetus mellitus,previous myocardial infarction history and multiple vascular disease were independent predictors of 2-year death ( P < 0. 05), and the corrected relative risk of eGFR < 60 mL·min-1· 1.73 m-2 was 1.93(95%CI = 1. 24 -4. 56,P = 0. 01). Conclusion Prognosis of STEMI patient undergoing primary PCI combined with chronic renal dysfunction is bad. Estimated GFR <60 mL·min-1·1.73 m-2 is the strongest risk factor for unfavourable prognosis of the STEMI patients who undergo primary PCI.%目的 评价慢性肾功能不全对ST段抬高型心肌梗死(STEMI)患者经皮冠状动脉介入治疗(PCI)预后的影响.方法 回顾性收集因STEMI在北京安贞医院接受急诊PCI的患者743例.将肾小球滤过率(eGFR)<60 m

  12. Focus on renal congestion in heart failure.

    Science.gov (United States)

    Afsar, Baris; Ortiz, Alberto; Covic, Adrian; Solak, Yalcin; Goldsmith, David; Kanbay, Mehmet

    2016-02-01

    Hospitalizations due to heart failure are increasing steadily despite advances in medicine. Patients hospitalized for worsening heart failure have high mortality in hospital and within the months following discharge. Kidney dysfunction is associated with adverse outcomes in heart failure patients. Recent evidence suggests that both deterioration in kidney function and renal congestion are important prognostic factors in heart failure. Kidney congestion in heart failure results from low cardiac output (forward failure), tubuloglomerular feedback, increased intra-abdominal pressure or increased venous pressure. Regardless of the cause, renal congestion is associated with increased morbidity and mortality in heart failure. The impact on outcomes of renal decongestion strategies that do not compromise renal function should be explored in heart failure. These studies require novel diagnostic markers that identify early renal damage and renal congestion and allow monitoring of treatment responses in order to avoid severe worsening of renal function. In addition, there is an unmet need regarding evidence-based therapeutic management of renal congestion and worsening renal function. In the present review, we summarize the mechanisms, diagnosis, outcomes, prognostic markers and treatment options of renal congestion in heart failure.

  13. The association between renal impairment and cardiac structure and function in patients with acute myocardial infarction

    DEFF Research Database (Denmark)

    Ersbøll, Mads; Valeur, Nana; Hassager, Christian

    2014-01-01

    BACKGROUND: Renal dysfunction in patients with acute myocardial infarction (MI) is an important predictor of short- and long-term outcome. Cardiac abnormalities dominated by left ventricular (LV) hypertrophy are common in patients with chronic renal dysfunction. However, limited data exists...... on the association between LV systolic- and diastolic function assessed by comprehensive echocardiography and renal dysfunction in contemporary unselected patients with acute MI. METHODS: We prospectively included 1054 patients with acute MI (mean age 63 years, 73% male) and performed echocardiographic assessment...... fraction or GLS attenuated its importance considerably. CONCLUSION: Renal dysfunction in patients with acute MI is independently associated with echocardiographic evidence of increased LV filling pressure. However, the prognostic importance of renal dysfunction is attenuated to a greater degree by LV...

  14. Renal teratogens.

    Science.gov (United States)

    Morgan, Thomas M; Jones, Deborah P; Cooper, William O

    2014-09-01

    In utero exposure to certain drugs early in pregnancy may adversely affect nephrogenesis. Exposure to drugs later in pregnancy may affect the renin-angiotensin system, which could have an impact on fetal or neonatal renal function. Reduction in nephron number and renal function could have adverse consequences for the child several years later. Data are limited on the information needed to guide decisions for patients and providers regarding the use of certain drugs in pregnancy. The study of drug nephroteratogenicity has not been systematized, a large, standardized, global approach is needed to evaluate the renal risks of in utero drug exposures.

  15. Causes of frequency and nocturia after renal transplantation.

    NARCIS (Netherlands)

    Weide, M.J.A. van der; Achterberg, T. van; Smits, J.P.J.M.; Heesakkers, J.P.F.A.; Bemelmans, B.L.H.; Hilbrands, L.B.

    2008-01-01

    OBJECTIVE: To explore the role of bladder capacity, bladder pain, dysfunctional voiding, urgency, urinary tract infections (UTIs), and urinary output as potential causes of frequency and nocturia after renal transplantation. PATIENTS AND METHODS: Data were gathered from 52 adult renal transplant

  16. Causes of frequency and nocturia after renal transplantation

    NARCIS (Netherlands)

    Weide, M.J.A. van der; Achterberg, T. van; Smits, J.P.J.M.; Heesakkers, J.P.F.A.; Bemelmans, B.L.H.; Hilbrands, L.B.

    2008-01-01

    OBJECTIVE: To explore the role of bladder capacity, bladder pain, dysfunctional voiding, urgency, urinary tract infections (UTIs), and urinary output as potential causes of frequency and nocturia after renal transplantation. PATIENTS AND METHODS: Data were gathered from 52 adult renal transplant

  17. Causes of frequency and nocturia after renal transplantation.

    NARCIS (Netherlands)

    Weide, M.J.A. van der; Achterberg, T. van; Smits, J.P.J.M.; Heesakkers, J.P.F.A.; Bemelmans, B.L.H.; Hilbrands, L.B.

    2008-01-01

    OBJECTIVE: To explore the role of bladder capacity, bladder pain, dysfunctional voiding, urgency, urinary tract infections (UTIs), and urinary output as potential causes of frequency and nocturia after renal transplantation. PATIENTS AND METHODS: Data were gathered from 52 adult renal transplant pat

  18. Causes of frequency and nocturia after renal transplantation

    NARCIS (Netherlands)

    Weide, M.J.A. van der; Achterberg, T. van; Smits, J.P.J.M.; Heesakkers, J.P.F.A.; Bemelmans, B.L.H.; Hilbrands, L.B.

    2008-01-01

    OBJECTIVE: To explore the role of bladder capacity, bladder pain, dysfunctional voiding, urgency, urinary tract infections (UTIs), and urinary output as potential causes of frequency and nocturia after renal transplantation. PATIENTS AND METHODS: Data were gathered from 52 adult renal transplant pat

  19. Pregnancy in women with renal disease. Yes or no?

    OpenAIRE

    Edipidis, K

    2011-01-01

    Women with renal disease who conceive and continue pregnancy, are at significant risk for adverse maternal and fetal outcomes. Although advances in antenatal and neonatal care continue to improve these outcomes, the risks remain proportionate to the degree of underlying renal dysfunction.

  20. Urinary Soluble CD163 in Active Renal Vasculitis

    NARCIS (Netherlands)

    O'Reilly, Vincent P.; Wong, Limy; Kennedy, Claire; Elliott, Louise A.; O'Meachair, Shane; Coughlan, Alice Marie; O'Brien, Eoin C.; Ryan, Michelle M.; Sandoval, Diego; Connolly, Emma; Dekkema, Gerjan J.; Lau, Jiaying; Abdulahad, Wayel H.; Heeringa, Peter; Buckley, Colm; O'Brien, Cathal; Finn, Stephen; Cohen, Clemens D.; Lindemeyer, Maja T.; Hickey, Fionnuala B.; O'Hara, Paul V.; Feighery, Conleth; Moran, Sarah M.; Mellotte, George; Clarkson, Michael R.; Dorman, Anthony J.; Murray, Patrick T.; Little, Mark A.; Sanders, Johannes

    2016-01-01

    A specific biomarker that can separate active renal vasculitis from other causes of renal dysfunction is lacking, with a kidney biopsy often being required. Soluble CD163 (sCD163), shed by monocytes and macrophages, has been reported as a potential biomarker in diseases associated with excessive mac

  1. Urinary Soluble CD163 in Active Renal Vasculitis

    NARCIS (Netherlands)

    O'Reilly, Vincent P.; Wong, Limy; Kennedy, Claire; Elliott, Louise A.; O'Meachair, Shane; Coughlan, Alice Marie; O'Brien, Eoin C.; Ryan, Michelle M.; Sandoval, Diego; Connolly, Emma; Dekkema, Gerjan J.; Lau, Jiaying; Abdulahad, Wayel H.; Heeringa, Peter; Buckley, Colm; O'Brien, Cathal; Finn, Stephen; Cohen, Clemens D.; Lindemeyer, Maja T.; Hickey, Fionnuala B.; O'Hara, Paul V.; Feighery, Conleth; Moran, Sarah M.; Mellotte, George; Clarkson, Michael R.; Dorman, Anthony J.; Murray, Patrick T.; Little, Mark A.; Sanders, Johannes

    2016-01-01

    A specific biomarker that can separate active renal vasculitis from other causes of renal dysfunction is lacking, with a kidney biopsy often being required. Soluble CD163 (sCD163), shed by monocytes and macrophages, has been reported as a potential biomarker in diseases associated with excessive mac

  2. Currently available useful immunohistochemical markers of renal pathology for the diagnosis of renal allograft rejection.

    Science.gov (United States)

    Kanzaki, Go; Shimizu, Akira

    2015-07-01

    Renal allograft dysfunction may be induced by various causes, including alloimmune rejection, viral infection, urinary tract obstruction, calcineurin inhibitor nephrotoxicity and/or recurrent renal disease. In order to determine the underlying cause, a renal biopsy is performed and the renal transplant pathology is diagnosed using the internationally consensus Banff classification. Although a progressive understanding of allograft rejection has provided numerous immunohistochemical markers, only the C4d is regarded to be a sufficiently useful marker for antibody-mediated allograft rejection according to the Banff classification. This review summarizes currently available useful immunohistochemical markers of renal transplant pathology, including C4d, with diagnostic implications for human renal allograft rejection. In particular, we discuss immunohistochemical markers in the following three categories: immunohistochemical markers of renal pathology used to (i) analyze the mechanisms of alloimmune rejection, (ii) monitor cell injury and/or inflammation associated with rejection and (iii) identify renal components in order to improve the diagnosis of rejection. In addition, recent progress in the field of renal transplant pathology includes the development of a new method for assessing molecular pathology using OMICS analyses. As the recent findings of various studies in patients undergoing renal transplantation are very encouraging, novel immunohistochemical markers must be also developed and combined with new technologies for the diagnosis of human renal allograft rejection.

  3. Clinical features of renal artery stenosis in elderly patients

    Institute of Scientific and Technical Information of China (English)

    TANG Ri-ning; LIU Bi-cheng; REN li-qun; WANG Yan-li; MA Gen-shan

    2007-01-01

    @@ Together with an increasingly aging world population there is also an increasing prevalence of atherosclerosis. Renal artery stenosis (RAS) is one of the systemic manifestations of atherosclerosis. Its incidence is about 15%-35%.1 RAS accounts for 5%-27% of all patients with end-stage renal disease (ESRD).2 Patients with renal dysfunction resulting from RAS are at risk of death from cardiovascular disease and ESRD.3

  4. Novel approaches to assessing renal function in cirrhotic liver disease.

    Science.gov (United States)

    Portal, Andrew J; Austin, Mark; Heneghan, Michael A

    2007-09-01

    Renal dysfunction is common in patients with end-stage liver disease. Etiological factors include conditions as diverse as acute tubular necrosis, immunoglobulin A nephropathy and hepatorenal syndrome. Current standard tests of renal function, such as measurement of serum urea and creatinine levels, are inaccurate as the synthesis of these markers is affected by the native liver pathology. This article reviews novel markers of renal function and their potential use in patients with liver disease.

  5. Light-chain nephropathy in patient with renal carcinoma.

    OpenAIRE

    Enia, G.; Maringhini, S; L'Abbate, A; Zoccali, C.; Maggiore, Q

    1981-01-01

    Paraneoplastic syndromes are often associated with renal parenchymal tumours. This report describes a case of renal-cell carcinoma with kappa-chain nephropathy. The patient, a 60-year-old man, had renal tubular dysfunction, shown by low serum concentrations of urate and phosphate. Kappa-chains were found in both serum and urine, but no lambda-chains were found. Investigations showed a clear-cell carcinoma, and the patient underwent a radical nephrectomy. Two years after operation serum phosph...

  6. Sarcoidose renal

    Directory of Open Access Journals (Sweden)

    AQUINO MARIA ENEDINA CLAUDINO DE

    2001-01-01

    Full Text Available Em uma mulher de 62 anos, branca, em avaliação pré-operatória de facectomia, foram detectadas alterações urinárias, tendo sido firmados os diagnósticos de calculose renal esquerda e exclusão renal homolateral. No pré-operatório da nefrectomia foram evidenciados processo pulmonar intersticial bilateral e adenopatia torácica, cuja investigação foi adiada para após a cirurgia. No rim retirado foram detectados granulomas epitelióides não necrotizantes, o mesmo ocorrendo posteriormente em biópsia transbrônquica. A paciente foi tratada com metilprednisolona, com discreta melhora pulmonar, o que não ocorreu com a função renal. O diagnóstico final foi de sarcoidose com envolvimento pulmonar, ganglionar torácico e renal.

  7. Renal failure

    Institute of Scientific and Technical Information of China (English)

    1993-01-01

    930150 Epidermal growth factor and its recep-tor in the renal tissue of patients with acute re-nal failure and normal persons.LIU Zhihong(刘志红),et al.Jinling Hosp,Nanjing,210002.Natl Med J China 1992;72(10):593-595.Epidermal growth factor(EGF)and its receptor(EGF-R)were identified by immunohis-tochemical method(4 layer PAP)in the renaltissue specimens obtained from 11 normal kid-neys and 17 cases of acute renal failure(ARF).The quantitative EGF and EGF-R in the tissuewere expressed as positive tubules per mm~2.The amount of EGF and EGF-R in renal tissue

  8. Aortic Valve Replacement for Infective Endocarditis in a Renal Transplant Recipient

    Directory of Open Access Journals (Sweden)

    Masmoudi Sayda

    2000-01-01

    Full Text Available Renal transplant recipients are more prone to developing infections. We report a 37-year old renal transplant recipient who developed infective endocarditis of the aortic valve, heart failure and renal allograft dysfunction. He underwent aortic valve replacement which was followed by improvement in cardiac as well as allograft function.

  9. Renal failure

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    2005234 Association between serum fetuin-A and clinical outcome in end-stage renal disease patients. WANG Kai(王开), Dept Renal Dis, Renji Hosp Shanghai, 2nd Med Univ, Shanghai 200001. Chin J Nephrol, 2005;21(2):72-75. Objective: To investigate the change of serum fetuin-A level before and after dialysis, and the association of serum fetuin-A level with clinical parameters

  10. Renal failure

    Institute of Scientific and Technical Information of China (English)

    1995-01-01

    950351 Serum erythropoietin levels in chronic renalinsufficiency.ZHAI Depei(翟德佩),et al.DeptNephrol.General Hosp,Tianjin Med Univ,Tianjin,300000.Tianjin Med J 1995;23(1):19-21.Patients with chronic renal insufficiency(CRI) areoften associated with anemia.The deficiency of EPOproduction in the kidney is thought to be a key factorin the pathogenesis of renal anemia.Serum erythropoi-

  11. Renal Hemangiopericytoma

    Directory of Open Access Journals (Sweden)

    İbrahim Halil Bozkurt

    2015-03-01

    Full Text Available Hemangiopericytoma is an uncommon perivascular tumor originating from pericytes in the pelvis, head and tneck, and the meninges; extremely rarely in the urinary system. We report a case of incidentally detected renal mass in which radiologic evaluation was suggestive of renal cell carcinoma. First, we performed partial nephrectomy, and then, radical nephrectomy because of positive surgical margins and the pathological examination of the surgical specimen that revealed a hemangiopericytoma. No additional treatment was administered.

  12. Severe antenatally diagnosed renal disorders: background, prognosis and practical approach.

    Science.gov (United States)

    Aulbert, Wiebke; Kemper, Markus J

    2016-04-01

    Nowadays most renal disorders, especially urinary tract malformations and renal cystic disease, are diagnosed antenatally. In cases of severe bilateral disease, intrauterine renal dysfunction may lead to renal oligohydramnios (ROH), resulting in pulmonary hypoplasia which affects perinatal mortality and morbidity as well as the long-term outcome. However, some infants may only have mild pulmonary and renal disease, and advances in postnatal and dialysis treatment have resulted in improved short- and long-term outcome even in those infants with severe ROH. Here, we review the current state of knowledge and clinical experience of patients presenting antenatally with severe bilateral renal disorders and ROH. By addressing underlying mechanisms, intrauterine tools of diagnosis and treatment as well as published outcome data, we hope to improve antenatal counselling and postnatal care. KEY SUMMARY POINTS: 1. Nowadays most renal disorders are diagnosed antenatally, especially urinary tract malformations and renal cystic disease. 2. Severe kidney dysfunction may lead to renal oligohydramnios, which can cause pulmonary hypoplasia and is a risk factor of perinatal mortality and postnatal renal outcome. However, as considerable clinical heterogeneity is present, outcome predictions need to be treated with caution. 3. Advances in postnatal and dialysis treatment have resulted in improved short- and long-term outcomes even in infants with severe renal oligohydramnios. 4. A multidisciplinary approach with specialist input is required when counselling a family with an ROH-affected fetus as the decision-making process is very challenging.

  13. 急性HBV感染合并肾功能衰竭及多器官损害1例%Acute hepatitis B combined with renal failure and multiple organ dysfunction: one case report

    Institute of Scientific and Technical Information of China (English)

    陈晓红; 单蕾; 付成涛; 刘佳; 刘成林

    2011-01-01

    急性乙型肝炎并发肾功能衰竭十分少见,其肝外表现通常为血清病样表现,包括发热、皮疹和多动脉炎.我们报道1位男性34岁患者,诊断为急性HBV感染,临床表现为肝脏和肝外多器官的损害,以肾功能衰竭为突出的表现,推测是由循环免疫复合物沉积在肾小球血管壁,导致膜性肾小球肾炎而引起的.患者接受了血液透析和持续性血液滤过治疗、常规的护肝和对症治疗及恩替卡韦抗病毒治疗,最后痊愈.%Acute hepatitis B is often accompanied by serum-sickness-like syndrome, including fever, rash and polyarteritis. Acute renal failure in acute hepatitis B is extremely rare. A 34-year-old male presented to our hospital, with initial laboratory values showing acute hepatitis B virus infection. The clinical feature indicated hepatitis and extrahepatic impairments of kidney, myocardium and platelet, and renal failure was the prominent manifestation which appeared early in the day 3 of onsetting, including 19 days of oliguria and 6 days of anuria. Kidney impairment was presumed owing to deposition of immune complex which resulted in membranous glomerulonephritis. The patient accepted hemodialysis and continuous renal replacement therapy, and entecavir was applied to depress HBV DNA copying and may have shortened the course of the disease. At 2-month follow up, the patient healed completely.

  14. Immune Dysfunction in Uremia—An Update

    OpenAIRE

    Gerald Cohen; Hörl, Walter H.

    2012-01-01

    Kidney dysfunction leads to disturbed renal metabolic activities and to impaired glomerular filtration, resulting in the retention of toxic solutes affecting all organs of the body. Cardiovascular disease (CVD) and infections are the main causes for the increased occurrence of morbidity and mortality among patients with chronic kidney disease (CKD). Both complications are directly or indirectly linked to a compromised immune defense. The specific coordinated roles of polymorphonuclear leukocy...

  15. Alterations in blood pressure, antioxidant status and caspase 8 expression in cobalt chloride-induced cardio-renal dysfunction are reversed by Ocimum gratissimum and gallic acid in Wistar rats.

    Science.gov (United States)

    Akinrinde, A S; Oyagbemi, A A; Omobowale, T O; Asenuga, E R; Ajibade, T O

    2016-07-01

    The protective abilities of the chloroform extract of Ocimum gratissimum (COG) and gallic acid against cobalt chloride (CoCl2) - induced cardiac and renal toxicity were evaluated. Rats were exposed to CoCl2 (350ppm) for 7 days, either alone, or in combination with COG (100 and 200mg/kg) or gallic acid (120mg/kg). CoCl2 given alone, caused significant increases (pgallic acid treatment significantly reduced (pgallic acid by modulation of CoCl2-induced alterations in blood pressure, antioxidant status and pro-apoptotic caspase 8 in Wistar rats.

  16. Lipoprotein lipase gene deficiency accelerates early renal dysfunctions in type 1 diabetic mice%脂蛋白脂酶基因缺陷加重小鼠1型糖尿病肾病的早期进展

    Institute of Scientific and Technical Information of China (English)

    周晓琳; 王兆红; 王宇辉; 沈蔷; 张玲; 管又飞; 刘国庆; 黄薇

    2012-01-01

    目的 探讨脂蛋白脂酶(LPL)基因缺陷对小鼠1型糖尿病(T1DM)肾病早期病变的影响.方法 雄性LPL基因缺陷杂合子(LK)和野生型(WT)小鼠腹腔注射链脲佐菌素(STZ),造成T1DM模型后4个月检测相应指标的改变.结果 糖尿病组血糖、血浆TG及TC、肾重/体重比、肌酐清除率(Ccr)、24 h尿白蛋白(UAlb)含量、肾小球表面积均高于非糖尿病组.糖尿病LK组(DLK)与糖尿病WT组(DWT)相比,血浆TG水平、UAlb及血压均增高(P<0.05).与TG合成相关的核转录因子固醇调节元件结合蛋白-1c(SREBP-1c)基因在DLK组比DWT组表达明显增加(P<0.05),但肾TG含量无改变.结论 LPL基因缺陷促进T1DM小鼠UAlb含量及血压升高,加重T1 DM早期的进展.%Objective To investigate the effect of lipoprotein lipase (LPL) gene deficiency on early stage of type 1 diabetic nephropathy (DN) in mice Methods At 4 months after induction of diabetes by STZ, plasma and renal parameters were examined in heterozygous LPL knock out (LKO) and wide-type (WT) mice. Results (l)Compared with control groups, diabetic groups showed the increased levels of creatinine clearance rate, 24-hour urinary albumin excretion (UAE) and glomerular surface area, which suggested it was at the incipient stage of DN. (2 ) Plasma triglyceride ( P< 0. 05), UAE (P< 0. 01) and blood pressure (P<0. 05)increased in diabetic LKO (DLKO) mice than in diabetic WT (DWT) mice. (3) Real time PCR analysis showed that renal LPL mRNA expression was decreased in LPL deficiency group and diabetes group. Expression of sterol regulatory element binding protein-lc was up-regulated in DLKO mice compared with DWT mice (P<0. 05), but renal lipid deposition didn't differ between 2 groups. Conclusions LPL gene deficiency increases albuminuria and blood pressure in type 1 diabetic mice, suggesting LPL gene deficiency may enhance development of early stage of DN in mice.Objective To investigate the effect of lipoprotein lipase (LPL) gene

  17. HYPERTENSION IN RENAL ALLOGRAFT RECIPIENTS

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    Objective To further evaluate the effect of hypertension on renal graft function, and the relationship between hypertension, hyperlipoidemia and ischemic heart disease. Methods 102 renal transplant recipients with a functioning renal graft for more than 1 year were enrolled in this study. Renal function was followed for the further 24 months. Results The overall prevalence of hypertension was 89.2%(91/102) and 36.2%(33/91) hypertensive patients had uncontrolled blood pressure. After 24 months those with high blood pressure had significantly higher Scr levels than normotensive patients (P<0.05). The number of different antihypertensive classes required was related to Scr (P<0.05). Plasma cholesterol levels in hypertension patients especially in blood pressure uncontrolled group were significantly elevated (P<0.01). Ischemic heart disease was more common in hypertensive patients (P<0.05). Cyclosporine A was associated with hypertension more frequently than azathioprine and FK506, whereas low-dose prednisolone did not appear to influence blood pressure. Conclusion The data further confirmed that hypertension was associated with hyperlipidemia and ischemic heart disease, and emerged as a predictor of renal graft dysfunction. Whether cyclosporine A should be converted to new immunosuppressive agents and which class of antihypertensive medication is more effective in this population remain open questions.

  18. [Renal toxicity of antiviral drugs].

    Science.gov (United States)

    Frasca', Giovanni M; Balestra, Emilio; Tavio, Marcello; Morroni, Manrico; Manarini, Gloria; Brigante, Fabiana

    2012-01-01

    Highly effective and powerful antiviral drugs have been introduced into clinical practice in recent years which are associated with an increased incidence of nephrotoxicity. The need of combining several drugs, the fragility of the patients treated, and the high susceptibility of the kidney are all factors contributing to renal injury. Many pathogenetic mechanisms are involved in the nephrotoxicity of antiviral drugs, including drug interaction with transport proteins in the tubular cell; direct cytotoxicity due to a high intracellular drug concentration; mitochondrial injury; and intrarenal obstruction or stone formation due to the low solubility of drugs at a normal urinary pH. As a result, various clinical pictures may be observed in patients treated with antiviral drugs, ranging from tubular dysfunction (Fanconi syndrome, renal tubular acidosis, nephrogenic diabetes insipidus) to acute renal failure (induced by tubular necrosis or crystal nephropathy) and kidney stones. Careful attention should be paid to prevent renal toxicity by evaluating the glomerular filtration rate before therapy and adjusting the drug dosage accordingly, avoiding the combination with other nephrotoxic drugs, and monitoring renal parameters on a regular basis while treating patients.

  19. 血清尿酸与急性心肌梗死合并慢性肾功能不全患者预后的关系%Association between serum uric acid level and prognosis of patients with acute myocardial infarction andchronic renal dysfunction

    Institute of Scientific and Technical Information of China (English)

    赵宇飞; 程自平; 王麟

    2016-01-01

    Objective To determine the association between serum uric acid level and prognosis of patients withacute myocardial infarc-tion and chronic renal dysfunction.Methods Totally 512 acute myocardial infarction patients with chronic renal dysfunction were en-rolled in this study.These patients were assigned into two groups:high uric acid group(n =200)and low uric acid group(n =312). Basic clinical characters were analyzed and major adverse cardiovascular events(MACEs)were observed during 48-month follow-up. Results The results showed that during 48-month follow-up,death of any cause occurred in 1.0% patients(2 of 200)in low uric acid group,as compared with 5.3% in the high uric acid group (17 of 312)(hazard ratio,5.379;95% confidence interval,1.204 to 24.035;P =0.028).The incidences of stroke,heart failure and revascularization weresignificantly higher in high uric acidgroup.Con-clusions High serum uric acid level increases the incidences of death,revascularization,stroke and heart failure in acute myocardial infarction patients with chronic renal dysfunction.%目的:探讨血清尿酸水平对合并有慢性肾功能不全的急性心肌梗死患者远期预后的影响。方法选取512例合并有慢性肾功能不全的急性心肌梗死患者,按血清尿酸水平分为低尿酸组(n =200)和高尿酸组(n =312),分析各组病变血管、临床生化指标、合并症以及治疗情况,并对所有患者进行48个月随访,观察各组远期严重心血管不良事件。结果低尿酸组中共有2例患者死亡,高尿酸组中17例患者死亡(风险比:5.379;95%置信区间,1.204~24.035;P =0.028)。高尿酸组卒中、心衰和血运重建发生率均高于低尿酸组,且差异有统计学意义。结论合并有慢性肾功能不全的急性心肌梗死患者血清尿酸水平升高会导致患者远期死亡率、卒中发生率、心衰发生率和血运重建发生率增加。

  20. Pregnancy in women with renal disease. Yes or no?

    Science.gov (United States)

    Edipidis, K

    2011-01-01

    Women with renal disease who conceive and continue pregnancy, are at significant risk for adverse maternal and fetal outcomes. Although advances in antenatal and neonatal care continue to improve these outcomes, the risks remain proportionate to the degree of underlying renal dysfunction.The aim of this article, is to examine the impact of varying degrees of renal insufficiency on pregnancy outcome, in women with chronic renal disease and to provide if possible, useful conclusions whether and when, a woman with Chronic Kidney Disease (CKD), should decide to get pregnant.This article, reviews briefly the normal physiological changes of renal function during pregnancy, and make an attempt to clarify the nature and severity of the risks, in the settings of chronic renal insufficiency and end stage renal disease, including dialysis patients and transplant recipients.

  1. Glomerular Filtration Rate Estimation in Renal and Non-Renal Solid Organ Transplantation

    DEFF Research Database (Denmark)

    Hornum, Mads; Feldt-Rasmussen, Bo

    2017-01-01

    Following transplantation (TX) of both renal and non-renal organs, a large proportion of patients have renal dysfunction. There are multiple causes for this. Chronic nephrotoxicity and high doses of calcineurin inhibitors are important factors. Preoperative and perioperative factors like...... hypertension, hypotension, drugs and infections may play a causative role as well. Organ-specific causes include hepatorenal syndrome, cirrhosis, low cardiac function, low respiratory function and diabetes developed both before and after TX. It is important to be able to perform precise and valid measurements...

  2. A comparison of toxicities in acute myeloid leukemia patients with and without renal impairment treated with decitabine.

    Science.gov (United States)

    Levine, Lauren B; Roddy, Julianna Vf; Kim, Miryoung; Li, Junan; Phillips, Gary; Walker, Alison R

    2017-01-01

    Purpose There are limited data regarding the clinical use of decitabine for the treatment of acute myeloid leukemia in patients with a serum creatinine of 2 mg/dL or greater. Methods We retrospectively evaluated 111 patients with acute myeloid leukemia who had been treated with decitabine and compared the development of toxicities during cycle 1 in those with normal renal function (creatinine clearance greater than or equal to 60 mL/min) to those with renal dysfunction (creatinine clearance less than 60 mL/min). Results Notable differences in the incidence of grade ≥3 cardiotoxicity (33% of renal dysfunction patients vs. 16% of normal renal function patients, p = 0.042) and respiratory toxicity (40% of renal dysfunction patients vs. 14% of normal renal function patients, p = 0.0037) were observed. The majority of heart failure, myocardial infarction, and atrial fibrillation cases occurred in the renal dysfunction group. The odds of developing grade ≥3 cardiotoxicity did not differ significantly between patients with and without baseline cardiac comorbidities (OR 1.43, p = 0.43). Conclusions This study noted a higher incidence of grade ≥3 cardiac and respiratory toxicities in decitabine-treated acute myeloid leukemia patients with renal dysfunction compared to normal renal function. This may prompt closer monitoring, regardless of baseline cardiac comorbidities. Further evaluation of decitabine in patients with renal dysfunction is needed.

  3. Posterior Tibial Tendon Dysfunction

    Science.gov (United States)

    .org Posterior Tibial Tendon Dysfunction Page ( 1 ) Posterior tibial tendon dysfunction is one of the most common problems of the foot and ankle. It occurs when the posterior tibial tendon becomes inflamed or torn. As a result, the ...

  4. Female Sexual Dysfunction

    Science.gov (United States)

    ... Endocrinologist Search Featured Resource Menopause Map™ View Female Sexual Dysfunction February 2012 Download PDFs English Espanol Editors ... Resources Mayo Clinic Cleveland Clinic What is female sexual dysfunction (FSD)? Many women have a low sex ...

  5. Ameliorative effect of vitamin E on potassium dichromate-induced hepatotoxicity in rats

    Directory of Open Access Journals (Sweden)

    Ali A. Shati

    2014-07-01

    There was a significant accumulation of Cr in the livers of the Cr group compared with the control group. In addition, exposure to K2Cr2O7 induced significant increases in the level of thiobarbituric-reactive substances (TBARS and significant decreases in glutathione (GSH content and superoxide dismutase (SOD activity in the Cr group compared with the control group. Moreover, livers of the Cr group showed major histological alterations, such as severe necrosis, increased lymphocytic infiltration, and a significant decrease in the DNA content. Oral vitamin E administration concomitant with K2Cr2O7 ameliorated all these changes and resulted in normal hepatic histological and cellular contents. In conclusion, oral vitamin E administration has a hepatoprotective role against K2Cr2O7-induced hepatotoxicity in rats.

  6. Renal Cysts

    Science.gov (United States)

    ... as “simple” cysts, meaning they have a thin wall and contain water-like fluid. Renal cysts are fairly common in ... simple kidney cysts, meaning they have a thin wall and only water-like fluid inside. They are fairly common in ...

  7. Renal failure

    Institute of Scientific and Technical Information of China (English)

    1997-01-01

    970363 Effect on serum PTH and 1, 25(OH)2 D3levels of rapid correction of metabolic acidosis in CRFpatients with secondary hyperparathyroidism. YUANQunsheng(袁群生), et al. Renal Div, PUMC Hosp,Beijing, 100730. Chin J Nephrol 1996; 12(6): 328-331.

  8. Drug-induced renal injury

    African Journals Online (AJOL)

    Drugs can cause acute renal failure by causing pre-renal, intrinsic or post-renal toxicity. Pre-renal ... incidence of drug dose adjustment in renal impairment in the SAMJ. ... Fever, haemolytic anaemia, thrombocytopenia, renal impairment and.

  9. Therapeutic Effect Analysis of Continuous Renal Replacement Therapy in 90 Cases of Multiple Organ Dysfunction Syndrome%连续性肾脏替代疗法治疗多脏器功能障碍综合征90例疗效分析

    Institute of Scientific and Technical Information of China (English)

    王少清; 汪力; 秦花; 黄艾晶

    2012-01-01

    Objective To study the clinical therapeutic effects of continuous renal replacement therapy ( CRRT) in multipal organ dysfunction syndrom( MODS ). Methods 90 MODS patients accepted therapy of CRRT in our hospital from Jan. 2009 to Jun 2010. Their APACHE Ⅱ , vital signs, such as blood pressure, heart rate,arterial blood gas analysis,and renal function,blood electrolyte were observed during course of CRRT. Results After CRRT treatment, vital signs of all patients were stable. The APACHE Ⅱ of patients were obviously declined. The laboratory test results, such as BLN , SCr, blood electrolyte and pll were significantly improved. Compared with the situation before treatment, there was significant difference( All P <0. 05 ). Conclusion Application of CRRT in patients with MODS can be effective in improving renal function, regulating acid-base imbalance, electrolyte disorders and prognosis of patients.%目的 探讨连续性肾脏替代疗法(CRRT)治疗多脏器功能障碍综合征(MODS)的临床疗效.方法 选取2009年1月至2010年6月接受CRRT治疗的MODS患者90例,观察治疗前后患者急性生理学和慢性健康评估(APACHEⅡ)评分、生命体征(血压、心率、血氧饱和度)以及电解质、肾功能情况.结果 与治疗前比较,全部患者治疗后APACHEⅡ明显下降,差异有统计学意义(P<0.05).治疗后患者生命体征稳定,各个指标与治疗前比较差异有统计学意义(P<0.05).与治疗前比较,所有患者治疗后血肌酐、尿素氮、电解质、pH值均得到较好控制,差异有统计学意义(P<0.05).结论 应用CRRT治疗MODS患者可有效改善肾功能,调节酸碱失衡、电解质紊乱,有利于改善患者的预后.

  10. Proximal tubular dysfunction as an indicator of chronic graft dysfunction

    Directory of Open Access Journals (Sweden)

    N.O.S. Câmara

    2009-03-01

    Full Text Available New strategies are being devised to limit the impact of renal sclerosis on graft function. Individualization of immunosuppression, specifically the interruption of calcineurin-inhibitors has been tried in order to promote better graft survival once chronic graft dysfunction has been established. However, the long-term impact of these approaches is still not totally clear. Nevertheless, patients at higher risk for tubular atrophy and interstitial fibrosis (TA/IF development should be carefully monitored for tubular function as well as glomerular performance. Since tubular-interstitial impairment is an early event in TA/IF pathogenesis and associated with graft function, it seems reasonable that strategies directed at assessing tubular structural integrity and function would yield important functional and prognostic data. The measurement of small proteins in urine such as α-1-microglobulin, N-acetyl-beta-D-glucosaminidase, alpha/pi S-glutathione transferases, β-2 microglobulin, and retinol binding protein is associated with proximal tubular cell dysfunction. Therefore, its straightforward assessment could provide a powerful tool in patient monitoring and ongoing clinical assessment of graft function, ultimately helping to facilitate longer patient and graft survival associated with good graft function.

  11. The doripenem serum concentrations in intensive care patients suffering from acute kidney injury, sepsis, and multi organ dysfunction syndrome undergoing continuous renal replacement therapy slow low-efficiency dialysis

    Directory of Open Access Journals (Sweden)

    Wieczorek A

    2014-10-01

    Full Text Available Andrzej Wieczorek, Andrzej Tokarz, Wojciech Gaszynski, Tomasz Gaszynski Department of Anesthesiology and Intensive Therapy, Medical University of Lodz, Lodz, Poland Abstract: Doripenem is a novel wide-spectrum antibiotic, and a derivate of carbapenems. It is an ideal antibiotic for treatment of serious nosocomial infections and severe sepsis for its exceptionally high efficiency and broad antibacterial spectrum of action. Doripenem is eliminated mainly by the kidneys. In cases of acute kidney injury, dosing of doripenem depends on creatinine clearance and requires adjustments. Doripenem is eliminated during hemodialysis because its molecular weight is 300–400 Da. The aim of this study was to establish the impact of continuous renal replacement therapy (CRRT slow low-efficiency dialysis (SLED on doripenem serum concentrations in a population of intensive-therapy patients with life-threatening infections and severe sepsis. Ten patients were enrolled in this observational study. Twelve blood samples were collected during the first administration of doripenem in a 1-hour continuous infusion while CRRT SLED was provided. Fluid chromatography was used for measurement of the concentration of doripenem in serum. In all collected samples, concentration of doripenem was above the minimum inhibition concentration of this antibiotic. Based on these results, we can draw the conclusion that doripenem concentration is above the minimum inhibition ­concentration throughout all of CRRT. The dosing pattern proposed by the manufacturer can be used in patients receiving CRRT SLED without necessary modifications. Keywords: AKI, antibiotic, antimicrobial therapy, carbapenem, CRRT, infection, MODS, SLED

  12. The doripenem serum concentrations in intensive care patients suffering from acute kidney injury, sepsis, and multi organ dysfunction syndrome undergoing continuous renal replacement therapy slow low-efficiency dialysis.

    Science.gov (United States)

    Wieczorek, Andrzej; Tokarz, Andrzej; Gaszynski, Wojciech; Gaszynski, Tomasz

    2014-01-01

    Doripenem is a novel wide-spectrum antibiotic, and a derivate of carbapenems. It is an ideal antibiotic for treatment of serious nosocomial infections and severe sepsis for its exceptionally high efficiency and broad antibacterial spectrum of action. Doripenem is eliminated mainly by the kidneys. In cases of acute kidney injury, dosing of doripenem depends on creatinine clearance and requires adjustments. Doripenem is eliminated during hemodialysis because its molecular weight is 300-400 Da. The aim of this study was to establish the impact of continuous renal replacement therapy (CRRT) slow low-efficiency dialysis (SLED) on doripenem serum concentrations in a population of intensive-therapy patients with life-threatening infections and severe sepsis. Ten patients were enrolled in this observational study. Twelve blood samples were collected during the first administration of doripenem in a 1-hour continuous infusion while CRRT SLED was provided. Fluid chromatography was used for measurement of the concentration of doripenem in serum. In all collected samples, concentration of doripenem was above the minimum inhibition concentration of this antibiotic. Based on these results, we can draw the conclusion that doripenem concentration is above the minimum inhibition concentration throughout all of CRRT. The dosing pattern proposed by the manufacturer can be used in patients receiving CRRT SLED without necessary modifications.

  13. Renal failure (chronic)

    OpenAIRE

    Clase, Catherine

    2011-01-01

    Chronic renal failure is characterised by a gradual and sustained decline in renal clearance or glomerular filtration rate (GFR). Continued progression of renal failure will lead to renal function too low to sustain healthy life. In developed countries, such people will be offered renal replacement therapy in the form of dialysis or renal transplantation. Requirement for dialysis or transplantation is termed end-stage renal disease (ESRD).Diabetes, glomerulonephritis, hypertension, pyelone...

  14. Thrombosis in end-stage renal disease.

    Science.gov (United States)

    Casserly, Liam F; Dember, Laura M

    2003-01-01

    Although renal failure has classically been associated with a bleeding tendency, thrombotic events are common among patients with end-stage renal disease (ESRD). A variety of thrombosis-favoring hematologic alterations have been demonstrated in these patients. In addition, "nontraditional" risk factors for thrombosis, such as hyperhomocysteinemia, endothelial dysfunction, inflammation, and malnutrition, are present in a significant proportion of chronic dialysis patients. Hemodialysis (HD) vascular access thrombosis, ischemic heart disease, and renal allograft thrombosis are well-recognized complications in these patients. Deep venous thrombosis and pulmonary embolism are viewed as rare in chronic dialysis patients, but recent studies suggest that this perception should be reconsidered. Several ESRD treatment factors such as recombinant erythropoietin (EPO) administration, dialyzer bioincompatibility, and calcineurin inhibitor administration may have prothrombotic effects. In this article we review the pathogenesis and clinical manifestations of thrombosis in ESRD and evaluate the evidence that chronic renal failure or its management predisposes to thrombotic events.

  15. Castleman-Kojima disease (TAFRO syndrome) : a novel systemic inflammatory disease characterized by a constellation of symptoms, namely, thrombocytopenia, ascites (anasarca), microcytic anemia, myelofibrosis, renal dysfunction, and organomegaly : a status report and summary of Fukushima (6 June, 2012) and Nagoya meetings (22 September, 2012).

    Science.gov (United States)

    Kawabata, Hiroshi; Takai, Kazue; Kojima, Masaru; Nakamura, Naoya; Aoki, Sadao; Nakamura, Shigeo; Kinoshita, Tomohiro; Masaki, Yasufumi

    2013-01-01

    Recently, a unique clinicopathologic variant of multicentric Castleman's disease (MCD) has been identified in Japan. This disease is characterized by a constellation of symptoms, as listed in the title, and multiple lymphadenopathy of mild degree with a pathologic diagnosis of atypical CD, often posing diagnostic and therapeutic problems for pathologists and hematologists, respectively. These findings suggest that this disease represents a novel clinical entity belonging to systemic inflammatory disorders with a background of immunological abnormality beyond the ordinal spectrum of MCD. To define this disorder more clearly, Japanese participants presented clinicopathologic data at the Fukushima and Nagoya meetings. Many of the patients presented by the participants were significantly accompanied by a combination of thrombocytopenia, ascites (anasarca), pleural effusions, microcytic anemia, fever, myelofibrosis, renal dysfunction, and organomegaly (TAFRO). Multiple lymphadenopathies were generally of mild degree, less than 1.5 cm in diameter, and consistently featured the histopathology of mixed- or less hyaline vascular-type CD. Autoantibodies were often detected. However, this disease did not fulfill the diagnostic criteria for well-known autoimmune diseases including systemic lupus erythematosus. Castleman-Kojima disease and TAFRO syndrome (the favored clinical term) were proposed for this disease. The patients were sensitive to steroid and anti-interleukin-6 receptor antibody (tocilizumab), but some exhibited a deteriorated clinical course despite the treatment. The participants proposed a future nationwide survey and a Japanese consortium to facilitate further clinical and therapeutic studies of this novel disease. [J Clin Exp Hematop 53(1): 57-61, 2013].

  16. Ⅱ型单纯疱疹病毒/人类免疫缺陷病毒-1共感染者肾功能损伤危险因素的分析%Risk factors of renal dysfunction in patients with herpes simplex virus 2/human immunodeficiency virus-1 co-infection

    Institute of Scientific and Technical Information of China (English)

    李英; 卢斯汉; 胡荣欣; 杜健群; 李水凤

    2015-01-01

    Objective To explore the effects of herpes simplex virus 2 (HSV‐2) co‐infection on the renal function in human immunodeficiency virus‐1 (HIV‐1) infected patients ,and to screen the risk factors of renal dysfunction .Methods A total of 302 HIV‐1‐infected patients were included at The Eighth People′s Hospital of Guangzhou from October 2011 to February 2014 ,which were divided into two groups:HIV(+ )HSV(+ ) group and HIV (+ )HSV (-) group .At the same time ,143 patients with HIV (-) HSV (+ ) were included as controls . The measurements of renal function were tested and compared among groups .Pearson correlation analysis was used to explore the relationship between HSV‐2 DNA level and the severity of renal dysfunction .Multivariate Logistic regression analysis was used to determine the risk factors of renal dysfunction .Results There were 128 cases in HIV‐1(+ )HSV‐2(+ ) group ,174 in HIV‐1(+ )HSV‐2(-) group and 143 in HIV‐1(-)HSV‐2(+ ) .Compared to HIV(-) HSV(+ ) group ,the level of serum creatinine (F=14 .37 , P<0 .01) ,BUN (F=12 .54 , P< 0 .01) , 24 h urine protein (F=16 .58 ,P<0 .01) and urine protein/creatinine ratio (F=6 .37 ,P=0 .018) in both HIV(+ )HSV (+ ) group and HIV (+ )HSV (-) group were significantly increased ,while estimated glomerular filtration rate (eGFR) in these two groups were significantly decreased (F= 11 .96 , P<0 .01) .Meanwhile ,compared to HIV(+ )HSV(-) group ,HIV‐1 RNA level (t=5 .876 ,P<0 .01) , serum creatinine (t=2 .315 ,P=0 .012) ,24 h urine protein (t=3 .648 ,P=0 .004) ,and urine protein/creatinine ratio (t=2 .312 ,P=0 .012) in HIV(+ )HSV(+ ) group were significantly increased ,while CD4+ T lymphocyte counts (t=4 .903 , P<0 .01) and eGFR (t=2 .275 , P=0 .016) were significantly decreased .Pearson correlation analysis indicated that HSV‐2 DNA level was positively correlated with HIV‐1 RNA level (r= 0 .626 , P= 0 .002) ,serum creatinine level(r= 0 .798 , P< 0 .01) ,24 h urine protein level (r=0 .702 , P

  17. The puzzle of kidney dysfunction in heart failure : an introduction

    NARCIS (Netherlands)

    Metra, Marco; Voors, Adriaan A.

    Heart failure and kidney disease often coexist, and each of the two conditions may lead to progression of the other. Kidney dysfunction is an independent prognostic factor in patients with either acute or chronic heart failure. Worsening renal function may be related with poorer outcomes as well.

  18. The puzzle of kidney dysfunction in heart failure : an introduction

    NARCIS (Netherlands)

    Metra, Marco; Voors, Adriaan A.

    2012-01-01

    Heart failure and kidney disease often coexist, and each of the two conditions may lead to progression of the other. Kidney dysfunction is an independent prognostic factor in patients with either acute or chronic heart failure. Worsening renal function may be related with poorer outcomes as well. Mu

  19. The puzzle of kidney dysfunction in heart failure : an introduction

    NARCIS (Netherlands)

    Metra, Marco; Voors, Adriaan A.

    2012-01-01

    Heart failure and kidney disease often coexist, and each of the two conditions may lead to progression of the other. Kidney dysfunction is an independent prognostic factor in patients with either acute or chronic heart failure. Worsening renal function may be related with poorer outcomes as well. Mu

  20. Myoglobinuria masquerading as acute rejection in a renal allograft recipient with recurrent post transplant diabetic nephropathy.

    Science.gov (United States)

    Gupta, Pallav; Sharma, Amit; Khullar, Dinesh

    2014-08-01

    Rhabdomyolysis contributes to 7-10% of total AKI cases. Myoglobinuria as a cause of acute renal allograft dysfunction is extremely uncommon. Renal allograft recipient on cyclosporine or tacrolimus can develop myoglobinuria in presence of other precipitating factors. Present case describes an interesting report of myoglobinuria in a patient with post transplant diabetic nephropathy mimicking acute graft rejection. Clinically myoglobinuria presenting as renal allograft dysfunction is diagnosis of exclusion and renal biopsy is extremely important in making a correct diagnosis and planning optimal management in such cases.

  1. Renale Osteopathie

    OpenAIRE

    Horn S

    2001-01-01

    Die renale Osteopathie umfaßt Erkrankungen des Knochens, die bei Patienten mit chronischen Nierenerkrankungen auftreten, wie den sekundären bzw. tertiären Hyperparathyreoidismus, die adynamische Knochenerkrankung und die Osteopathie nach Nierentransplantation. Durch die Identifikation des Kalzium-Sensing-Rezeptors bzw. des Vitamin D-Rezeptors hat sich unser Verständnis der Zusammenhänge in den letzten Jahren erheblich verbessert. Neue Medikamente versprechen effizientere Prophylaxe- und Thera...

  2. Renale Knochenerkrankungen

    Directory of Open Access Journals (Sweden)

    Mayer G

    2008-01-01

    Full Text Available Störungen des Mineral- und Knochenstoffwechsels sind bei fast allen Patienten mit chronischen Nierenerkrankungen anzutreffen. Pathogenetisch spielt eine Neigung zur Phosphatretention bei einer Reduktion der glomerulären Filtrationsrate die zentrale Rolle. Neben typischen, aber sehr variablen Veränderungen der Knochenstruktur (renale Osteopathie besteht auch eine sehr enge Assoziation zwischen diesen Störungen und dem massiv erhöhten kardiovaskulären Risiko der Patienten.

  3. Obesity and renal hemodynamics

    NARCIS (Netherlands)

    Bosma, R. J.; Krikken, J. A.; van der Heide, J. J. Homan; de Jong, P. E.; Navis, G. J.

    2006-01-01

    Obesity is a risk factor for renal damage in native kidney disease and in renal transplant recipients. Obesity is associated with several renal risk factors such as hypertension and diabetes that may convey renal risk, but obesity is also associated with an unfavorable renal hemodynamic profile

  4. Obesity and renal hemodynamics

    NARCIS (Netherlands)

    Bosma, R. J.; Krikken, J. A.; van der Heide, J. J. Homan; de Jong, P. E.; Navis, G. J.

    2006-01-01

    Obesity is a risk factor for renal damage in native kidney disease and in renal transplant recipients. Obesity is associated with several renal risk factors such as hypertension and diabetes that may convey renal risk, but obesity is also associated with an unfavorable renal hemodynamic profile inde

  5. Long-term renal toxicity in children following fractionated total-body irradiation (TBI) before allogeneic stem cell transplantation (SCT)

    Energy Technology Data Exchange (ETDEWEB)

    Gerstein, Johanna; Meyer, Andreas; Fruehauf, Joerg; Karstens, Johann H.; Bremer, Michael [Dept. of Radiation Oncology, Medical School Hannover (Germany); Sykora, Karl-Walter [Dept. of Pediatric Hematology and Oncology, Medical School Hannover (Germany)

    2009-11-15

    Purpose: to retrospectively assess the incidence and time course of renal dysfunction in children ({<=} 16 years) following total-body irradiation (TBI) before allogeneic stem cell transplantation (SCT). Patients and methods: between 1986 and 2003, 92 children (median age, 11 years; range, 3-16 years) underwent TBI before allogeneic SCT. 43 of them had a minimum follow-up of 12 months (median, 51 months; range, 12-186 months) and were included into this analysis. Conditioning regimen included chemotherapy and fractionated TBI with 12 Gy (n = 26) or 11.1 Gy (n = 17). In one patient, renal dose was limited to 10 Gy by customized renal shielding due to known nephropathy prior to SCt. Renal dysfunction was defined as an increase of serum creatinine > 1.25 times the upper limit of age-dependent normal. Results: twelve children (28%) experienced an episode of renal dysfunction after a median of 2 months (range, 1-10 months) following SCT. In all but one patient renal dysfunction was transient and resolved after a median of 8 months (range, 3-16 months). One single patient developed persistent renal dysfunction with onset at 10 months after SCT. None of these patients required dialysis. The actuarial 3-year freedom from persistent renal toxicity for children surviving > 12 months after SCt was 97.3%. Conclusion: the incidence of persistent renal dysfunction after fractionated TBI with total doses {<=} 12 Gy was very low in this analysis. (orig.)

  6. Perirenal effusion in dogs and cats with acute renal failure.

    Science.gov (United States)

    Holloway, Andrew; O'Brien, Robert

    2007-01-01

    Perirenal fluid accumulation has been described as an ultrasonographic feature of urine leakage, hemorrhage, abscessation, or neoplasia. The purpose of this retrospective study was to report perirenal effusion as an additional ultrasonographic finding in canine and feline patients with acute renal failure. The causes of acute renal failure in 18 patients included nephrotoxicity (4), leptospirosis (3), ureteral obstruction (2), renal lymphoma (2), ureteronephrolithiasis (2), prostatic urethral obstruction (1) and interstitial nephritis and ureteritis (1). An underlying cause was not identified in three patients. The sonographic finding of perirenal fluid was bilateral in 15 patients. Unilateral perirenal fluid was identified ipsilateral to the site of ureteric obstruction in two patients. Large effusions extended into the caudal retroperitoneal space. Additional sonographic findings suggestive of renal parenchymal disease included mild (5), moderate (5) or severe (2) pyelectasia, increased renal echogenicity (11), increased (9) or decreased renal size (2) and ureteral and/or renal calculi (3). There did not appear to be an association between the volume of perirenal fluid and the severity of renal dysfunction. All patients with large effusions underwent euthanasia. Perirenal fluid developing in acute renal failure is thought to be an ultrafiltrate associated with tubular back-leak into the renal interstitium that overwhelms lymphatic drainage within the perirenal and retroperitoneal connective tissues although obstruction to urine flow may also play a role. Localized perirenal retroperitoneal free fluid may be a useful ultrasonographic feature to assist with the characterization of, and determination of prognosis in, patients with suspected renal disease.

  7. Renal Function Recovery after Nephrectomy or Nephron-Sparing Surgery in Children with Unilateral Renal Tumor.

    Science.gov (United States)

    Cozzi, Denis A; Ceccanti, Silvia; Cozzi, Francesco

    2017-02-01

    Introduction Children with unilateral renal tumor (URT) and preoperative renal dysfunction (PRD) may benefit from nephron-sparing surgery (NSS). To test this hypothesis, we studied the outcome of baseline renal function after nephrectomy or NSS among children with URT. Materials and Methods Retrospective records review of children with URT who underwent nephrectomy (25 children) or NSS (11 children) at our institution. We analyzed the estimated glomerular filtration rate (eGFR) changes over time among patients, stratified by both preoperative renal function (with or without PRD) and surgical extent (NSS vs. nephrectomy). The primary end point was evaluation of compensatory recovery of preoperative eGFR after surgery. Only children older than 2 years at surgery were included in the study. Renal dysfunction was defined as an eGFR  100 mL/min/1.73 m(2), respectively, achieved or maintained two-kidney eGFR values (T-KEV) (p = 0.01). After NSS, four adolescent patients with PRD and seven without PRD achieved or maintained T-KEV. Conclusion The majority of children with URT and low baseline eGFR present with an impaired renal function recovery after nephrectomy and may benefit from NSS. Collaborative studies are needed to support present findings. Georg Thieme Verlag KG Stuttgart · New York.

  8. Bilateral Renal Mass-Renal Disorder: Tuberculosis

    Directory of Open Access Journals (Sweden)

    Ozlem Tiryaki

    2013-01-01

    Full Text Available A 30-year-old woman has presented complaining of weakness and fatigue to her primary care physician. The renal sonography is a routine step in the evaluation of new onset renal failure. When the renal masses have been discovered by sonography in this setting, the functional imaging may be critical. We reported a case about bilateral renal masses in a young female patient with tuberculosis and renal insufficiency. Magnetic resonance (MR has revealed the bilateral renal masses in patient, and this patient has been referred to our hospital for further management. The patient’s past medical and surgical history was unremarkable.

  9. Rapid improvement in renal function in patients with multiple myeloma and renal failure treated with bortezomib

    Directory of Open Access Journals (Sweden)

    Qayum Abdul

    2010-01-01

    Full Text Available Multiple Myeloma (MM frequently presents with renal dysfunction apart from other manifestations. Development of renal failure in patients with MM carries a poor prognosis. Bortezo-mib is a new addition to drugs used in MM and has shown good efficacy and safety profiles. Previous trials have shown its efficacy in relapsed and refractory MM as well. Studies have also shown that bortezomib is also effective in patients with MM who present with renal failure. We report here six cases of renal failure secondary to MM treated with bortezomib. All patients had poor performance status of 3-4 on ECOG scale. Five out of six patients showed satisfactory anti-myeloma response to bortezomib. Reversal of renal failure was observed in all six patients. Adverse effects to bortezomib were mild and manageable. Reversal of renal failure persisted despite incomplete response to MM in two cases, and progression of disease in one patient. It appears that bortezomib may have an effect on the kidneys in reversal of renal failure, other than its anti-myeloma effect. In conclusion, borte-zomib appears to be an effective treatment for patients with advanced MM and renal failure irres-pective of performance status and age.

  10. Distal renal tubular acidosis

    Science.gov (United States)

    Renal tubular acidosis - distal; Renal tubular acidosis type I; Type I RTA; RTA - distal; Classical RTA ... excreting it into the urine. Distal renal tubular acidosis (Type I RTA) is caused by a defect ...

  11. Proximal renal tubular acidosis

    Science.gov (United States)

    Renal tubular acidosis - proximal; Type II RTA; RTA - proximal; Renal tubular acidosis type II ... by alkaline substances, mainly bicarbonate. Proximal renal tubular acidosis (Type II RTA) occurs when bicarbonate is not ...

  12. Emergency intervention therapy for renal vascular injury

    Institute of Scientific and Technical Information of China (English)

    LIU Feng-yong; WANG Mao-qiang; FAN Qing-sheng; WANG Zhi-jun; DUAN Feng; SONG Peng

    2009-01-01

    Objective: To evaluate the efficacy and safety of the interventional techniques in the treatment of renal vascular injury.Methods: A total of 16 patients with renal vascular injuries were treated by superselective arterial embolization.The renal injuries resulted from renal biopsy in 7 patients,endovascular intervention in 2.percutaneous puncture and pyelostomy in 2.local resection of renal tumor in 1 and trauma in 4.With regards to clinical manifestations,there was hemorrhagic shock in 8 patients,severe flank pain in 14,and hematuria in 14.CT and ultrasonography confmued that 15 Patients had perirenal hematoma.The embolization was performed with microcoils in 13 and standard stainless steel coils in 3 patients,associated with polyvinyl alcohol particles (PVA) in 9,and gelfoam particles in 6 cases.Results: Renal angiogram revealed arteriovenous fistula in renal parenchyma in 9 cases,pseudoaneurysm in 3 and extravasation of contrast media in 4.The arterial embolization was successful in all 16 cases in a single session.The angiography at the end of therapy showed that abnormal vessels had disappeared without other major intrarenal arterial branch occlusion.In 13 patients with hemodynamical compromise,blood loss-related symptoms were immediately relieved after blood transfusion.In 14 patients with severe flank pain,the pain was progressively relieved.Hematuda ceased in 14 patients 2-14 days after the embolization procedures.The renal function was impaired after the procedure in 6 cases,in which preoperative renal insufficiency was exacerbated in 3 and developed new renal dysfunction in 3.2 of whom received hemodialysis.The ultrasonography showed that perirenal hematoma was gradually absorbed within 2.6 mortths after the procedure.A11 patients were followed up in 6-78 months (mean,48 months).Six patients died of primary diseases (5 cases of renal failure and multiple organ failure and 1 case of malignant tumor).Ten patients survived without bleeding and further

  13. Renal tuberculosis

    Directory of Open Access Journals (Sweden)

    Džamić Zoran

    2016-01-01

    Full Text Available Tuberculosis is still a significant health problem in the world, mostly in developing countries. The special significance lies in immunocompromised patients, particularly those suffering from the HIV. Urogenital tuberculosis is one of the most common forms of extrapulmonary tuberculosis, while the most commonly involved organ is the kidney. Renal tuberculosis occurs by hematogenous dissemination of mycobacterium tuberculosis from a primary tuberculosis foci in the body. Tuberculosis is characterized by the formation of pathognomonic lesions in the tissues - granulomata. These granulomata may heal spontaneously or remain stable for years. In certain circumstances in the body associated with immunosuppression, the disease may be activated. Central caseous necrosis occurs within tuberculoma, leading to formation of cavities that destroy renal parenchyma. The process may gain access to the collecting system, forming the caverns. In this way, infection can be spread distally to renal pelvis, ureter and bladder. Scaring of tissue by tuberculosis process may lead to development of strictures of the urinary tract. The clinical manifestations are presented by nonspecific symptoms and signs, so tuberculosis can often be overlooked. Sterile pyuria is characteristic for urinary tuberculosis. Dysuric complaints, flank pain or hematuria may be presented in patients. Constitutional symptoms of fever, weight loss and night sweats are presented in some severe cases. Diagnosis is made by isolation of mycobacterium tuberculosis in urine samples, by cultures carried out on standard solid media optimized for mycobacterial growth. Different imaging studies are used in diagnostics - IVU, CT and NMR are the most important. Medical therapy is the main modality of tuberculosis treatment. The first line anti-tuberculosis drugs include isoniazid, rifampicin, pyrazinamide and ethambutol. Surgical treatment is required in some cases, to remove severely damaged kidney, if

  14. Renal function in tyrosinaemia type I after liver transplantation : A long-term follow-up

    NARCIS (Netherlands)

    Pierik, LJWM; van Spronsen, FJ; Bijleveld, CMA; van Dael, CML

    2005-01-01

    Hereditary tyrosinaemia type I is an autosomal recessive inborn error of tyrosine catabolism caused by a deficiency of the enzyme fumarylacetoacetase that results in liver failure, hepatocellular carcinoma, renal tubular dysfunction and acute intermittent porphyria. When treated with liver transplan

  15. Reduced cyclooxygenase involvement in vascular endothelial function in rat renal transplantation

    NARCIS (Netherlands)

    Smit-Van Oosten, Annemieke; Boonstra, Arnold H.; Navis, Gerjan; Van Goor, Harry; Buikema, Hendrik

    2005-01-01

    Background: Cardiovascular disease is a major cause of death following renal transplantation. Mechanisms leading to vascular dysfunction outside the transplanted organ involve common risk factors such as hypertension, hypercholesterolemia, proteinuria, but immune-mediated factors may also be involve

  16. Reduced cyclooxygenase involvement in vascular endothelial function in rat renal transplantation

    NARCIS (Netherlands)

    Smit-Van Oosten, Annemieke; Boonstra, Arnold H.; Navis, Gerjan; Van Goor, Harry; Buikema, Hendrik

    2005-01-01

    Background: Cardiovascular disease is a major cause of death following renal transplantation. Mechanisms leading to vascular dysfunction outside the transplanted organ involve common risk factors such as hypertension, hypercholesterolemia, proteinuria, but immune-mediated factors may also be involve

  17. Renale Osteopathie

    Directory of Open Access Journals (Sweden)

    Horn S

    2001-01-01

    Full Text Available Die renale Osteopathie umfaßt Erkrankungen des Knochens, die bei Patienten mit chronischen Nierenerkrankungen auftreten, wie den sekundären bzw. tertiären Hyperparathyreoidismus, die adynamische Knochenerkrankung und die Osteopathie nach Nierentransplantation. Durch die Identifikation des Kalzium-Sensing-Rezeptors bzw. des Vitamin D-Rezeptors hat sich unser Verständnis der Zusammenhänge in den letzten Jahren erheblich verbessert. Neue Medikamente versprechen effizientere Prophylaxe- und Therapiemöglichkeiten. Wir beeinflussen dadurch nicht nur die Morbidität und Lebensqualität, sondern auch die Mortalität unserer Patienten.

  18. Estresse oxidativo e disfunção endotelial na doença renal crônica Estrés oxidativo y disfunción endotelial en la enfermedad renal crónica Oxidative stress and endothelial dysfunction in chronic kidney disease

    OpenAIRE

    Valeria Costa-Hong; Luiz Aparecido Bortolotto; Vanda Jorgetti; Fernanda Consolim-Colombo; Krieger, Eduardo M.; Jose Jayme Galvão De Lima

    2009-01-01

    FUNDAMENTO: A doença renal crônica (DRC) caracteriza-se pela alta prevalência de aterosclerose. Uma vez que o estresse oxidativo e a disfunção endotelial são promotores da aterosclerose, é interessante verificar se as duas condições estão associadas em pacientes com DRC, ainda sem doença cardiovascular (DCV) clínica. OBJETIVO: Avaliar as relações entre o estresse oxidativo e a função endotelial em pacientes com DRC estágio 5, sem DCV. MÉTODOS: Foram estudados 22 pacientes com DRC, não-diabéti...

  19. What physicians need to know about renal function in outpatients with heart failure.

    Science.gov (United States)

    Waldum-Grevbo, Bård

    2015-01-01

    The majority of outpatients with heart failure (HF) have chronic kidney disease (CKD) as an important comorbidity. Both glomerular filtration rate and abnormal urinary albumin excretion are major predictors of outcome in HF patients. Despite this, patients with renal dysfunction have been systematically excluded from the large randomized HF trials. There is lack of evidence for optimal treatment in these cardiorenal patients and treatment nihilism may account in part for their bad prognosis. Identifying and monitoring the progression of renal disease and making an effort to preserve renal function should be an important task in the management of all patients with HF. In this review, the current understanding of the pathophysiology of renal dysfunction in outpatients with HF will be summarized. Furthermore, important principles of the identification and management of cardiorenal patients will be described in order to make the physician more capable of managing outpatients with HF and renal dysfunction.

  20. Renal calculus

    CERN Document Server

    Pyrah, Leslie N

    1979-01-01

    Stone in the urinary tract has fascinated the medical profession from the earliest times and has played an important part in the development of surgery. The earliest major planned operations were for the removal of vesical calculus; renal and ureteric calculi provided the first stimulus for the radiological investigation of the viscera, and the biochemical investigation of the causes of calculus formation has been the training ground for surgeons interested in metabolic disorders. It is therefore no surprise that stone has been the subject of a number of monographs by eminent urologists, but the rapid development of knowledge has made it possible for each one of these authors to produce something new. There is still a technical challenge to the surgeon in the removal of renal calculi, and on this topic we are always glad to have the advice of a master craftsman; but inevitably much of the interest centres on the elucidation of the causes of stone formation and its prevention. Professor Pyrah has had a long an...

  1. Subclinical renal abnormalities in young thalassemia major and intermedia patients and its relation to chelation therapy

    OpenAIRE

    Adly, Amira A.M.; Dalia N. Toaima; Noha Refaat Mohamed; Karim Mahmoud Abu El Seoud

    2014-01-01

    Background: Limited data are available about renal involvement in thalassemia patients. Renal dysfunction in these patients seems to be multifactorial attributed mainly to long standing anemia, chronic hypoxia, iron overload and toxicity of iron chelators. Objective: To assess the frequency of subclinical glomerular and tubular dysfunctions in children and adolescents with β-thalassemia major and intermedia, and to correlate these findings with the degree of iron overload and type of chela...

  2. Continuous Renal Replacement Therapy for Severe Obstetric Sepsis

    Directory of Open Access Journals (Sweden)

    D. L. Shukevich

    2010-01-01

    Full Text Available Objective: to improve the results of treatment for severe obstetric sepsis by pathogenetically founded continuous renal replacement therapies as extracorporeal homeostatic correction. Subjects and methods. Forty-two women with severe abdominal sepsis were divided into 3 groups: 1 14 women with severe extragenital abdominal sepsis who received standard intensive care (a control group; 2 12 women with severe obstetric sepsis who had standard intensive care (a study group; 3 16 with severe obstetric sepsis who had the standard intensive care supplemented with continuous renal replacement therapy (an intervention group. Results. In Group 2, endogenous intoxication and multiple organ dysfunction were controlled later than in Group 1, mortality rates being 41.7 and 7.1%, respectively. Clinical laboratory differences were due to gestosis recorded in 100% of the patients with severe obstetric sepsis. When continuous renal replacement therapy was incorporated into the complex therapy of severe obstetric sepsis, there was a prompter regression of endogenous intoxication and multiple organ dysfunction, mortality was decreased by an average of 35% as compared with that during standard therapy. Conclusion. The inclusion of continuous renal replacement therapy into the complex treatment program for severe obstetric sepsis made it possible to reduce control time _ for endogenous intoxication and multiple organ dysfunction and to decrease mortality by an average of 35% as compared with that during standard intensive care. Key words: obstetric sepsis, abdominal sepsis, gestosis, endogenous intoxication, multiple organ dysfunction, renal replacement therapy.

  3. Impact of Renal Dysfunction on the Incidence of Obstructive Apnea and Hypopnea Syndrome:a Retrospective Analysis%肾功能异常对阻塞性睡眠呼吸暂停低通气综合征疾病发生的影响

    Institute of Scientific and Technical Information of China (English)

    罗洋; 龚勇; 甘红兵; 耿培宏

    2014-01-01

    目的:评价肾功能异常对阻塞性睡眠呼吸暂停低通气综合征( OSAHS)疾病进展的作用。方法:对2011年8月~2013年8月在首都医科大学附属北京天坛医院睡眠检测中心行睡眠呼吸监测的成人患者临床资料进行回顾性分析。结果:116例患者中。 OSAHS及非OSAHS分别为74例及42例。两组年龄、性别、糖尿病、高脂血症、高血压病及肾小球滤过率(eGFR)差异均存在统计学意义(P28)(OR:6.9,95%CI:3.1~28.1)及高三酰甘油血症(OR:1.7,95%CI:1.4~22.5)为 OSAHS 发生独立相关风险因素(P 28(OR:6. 9,95%CI:3. 1~28. 1),hypertriglyceridemia (OR:1. 7,95%CI:1. 4~22. 5) were significantly associated with the occurrence of OSAHS (P<0. 05). Conclusion:Renal dysfunction,together with age,diabetes,obesi-ty,hypertriglyceridemia are independent risk factors of the incidence of OSAHS.

  4. Focus on renal congestion in heart failure

    OpenAIRE

    Afsar, Baris; Ortiz, Alberto; Covic, Adrian; Solak, Yalcin; Goldsmith, David; Kanbay, Mehmet

    2015-01-01

    Hospitalizations due to heart failure are increasing steadily despite advances in medicine. Patients hospitalized for worsening heart failure have high mortality in hospital and within the months following discharge. Kidney dysfunction is associated with adverse outcomes in heart failure patients. Recent evidence suggests that both deterioration in kidney function and renal congestion are important prognostic factors in heart failure. Kidney congestion in heart failure results from low cardia...

  5. Saethre-Chotzen syndrome presenting with incomplete renal Fanconi syndrome.

    Science.gov (United States)

    Oktenli, Cagatay; Saglam, Mutlu; Zafer, Emre; Gül, Davut

    2002-10-01

    Here we report on a patient with findings of acrocephaly, craniosynostosis, low frontal hairline, ptosis of eyelids, deviated nasal septum, broad great toes, moderate hallux valgus, bilateral symmetrical complete soft tissue syndactyly of toes 2 and 3, and partial soft tissue syndactyly of toes 4 and 5 consistent with the diagnosis of Saethre-Chotzen syndrome. Additionally, the patient had some unusual findings as part of generalized dysfunction of the renal tubules including hypophosphatemia with renal phosphate wasting, normocalcemic hypercalciuria, hypomagnesemia with renal magnesium wasting, low-molecular-weight proteinuria, decreased serum PTH levels, osteopenia, and nephrolithiasis. In the light of these findings, the diagnosis of incomplete renal Fanconi syndrome was made. In conclusion, on the basis of the present findings, it is difficult to say whether renal tubular dysfunction are somehow connected to the Saethre-Chotzen syndrome or not. Therefore, we consider that this is probably just a coincident. However, further studies may show the connection between renal tubular dysfunction and Saethre-Chotzen syndrome.

  6. Renal actinomycosis with concomitant renal vein thrombosis.

    Science.gov (United States)

    Chang, Dong-Suk; Jang, Won Ik; Jung, Ji Yoon; Chung, Sarah; Choi, Dae Eun; Na, Ki-Ryang; Lee, Kang Wook; Shin, Yong-Tai

    2012-02-01

    Renal actinomycosis is a rare infection caused by fungi of the genus Actinomyces. A 74-year-old male was admitted to our hospital because of gross hematuria with urinary symptoms and intermittent chills. Computed tomography of the abdomen showed thrombosis in the left renal vein and diffuse, heterogeneous enlargement of the left kidney. After nephrectomy, sulfur granules with chronic suppurative inflammation were seen microscopically, and the histopathological diagnosis was renal actinomycosis. Our case is the first report of renal actinomycosis with renal vein thrombosis.

  7. TRANSPLANTE RENAL

    Directory of Open Access Journals (Sweden)

    Soraia Geraldo Rozza Lopes

    2014-01-01

    Full Text Available El objetivo del estudio fue comprender el significado de espera del trasplante renal para las mujeres en hemodiálisis. Se trata de un estudio cualitativo-interpretativo, realizado con 12 mujeres en hemodiálisis en Florianópolis. Los datos fueron recolectados a través de entrevistas en profundidad en el domicilio. Fue utilizado el software Etnografh 6.0 para la pre-codificación y posterior al análisis interpretativo emergieron dos categorías: “las sombras del momento actual”, que mostró que las dificultades iniciales de la enfermedad están presentes, pero las mujeres pueden hacer frente mejor a la enfermedad y el tratamiento. La segunda categoría, “la luz del trasplante renal”, muestra la esperanza impulsada por la entrada en la lista de espera para un trasplante.

  8. Renal failure

    Institute of Scientific and Technical Information of China (English)

    1993-01-01

    930564 Dwell times affect the local host de-fence mechanism of peritoneal dialysis patients.WANG Tao(汪涛),et al.Renal Instit,SunYatsen Med Univ,Guangzhou,510080.Chin JNephrol 1993;9(2):75—77.The effect of different intraperitoneal awelltimes on the local host defence in 6 peritonealdialysis patients was studied.A significant de-crease in the number of peritoneal cells,IgG con-centration and the phagoeytosis and bactericidalactivity of macrophages was determined when thedwell time decreased from 12 to 4 hs or form 4 to0.5hs,but the peroxidase activity in macrophagesincreased significantly.All variables,except theperoxidase activity in macrophages,showed nosignificant difference between patients of high or

  9. Traumatismo renal

    OpenAIRE

    Rocha, Sofia Rosa Moura Gomes da

    2009-01-01

    Introdução: A realização deste trabalho visa a elaboração de uma revisão sistematizada subordinada à temática da traumatologia renal. Objectivos: Os principais objectivos deste trabalho são: apurar a etiologia, definir a classificação, analisar o diagnóstico e expôr o tratamento e as complicações. Desenvolvimento: Os traumatismos são a principal causa de morte antes dos 40 anos. O rim é o órgão do aparelho génito-urinário mais frequentemente atingido. Os traumatismos renais são mais fre...

  10. Renal Artery Stenosis in a Young Female without Fibromuscular Dysplasia with Literature Review.

    Science.gov (United States)

    Peralta, Paloma; Cholankeril, Matthew; Goldberg, Daniel; Koneru, Jayanth; Shamoon, Fayez

    2016-01-01

    Renal artery stenosis (RAS) is rare in young patients without fibromuscular dysplasia (FMD). RAS is primarily classified as having two major etiologies, namely, atherosclerosis and FMD, with 90% and 10%, respectively. We report a case of a female in her mid 20s who developed hypertension due to RAS with no evidence of FMD or underlying renal dysfunction and underwent successful angioplasty and stenting.

  11. Tubulointerstitial Nephritis Complicated by Fanconi Syndrome and Renal Tubular Acidosis Associated with three autoimmune diseases

    OpenAIRE

    Io, Kumiko; Obata, Yoko; Nishino, Tomoya; Hirose, Misaki; Yamashita, Hiroshi; Uramatsu, Tadashi; Ichikawa, Tatsuki; Hayashi, Tomayoshi; Kawakami, Atsushi; Taguchi, Takashi; Kohno, Shigeru

    2013-01-01

    A 45-year-old woman experiencing back pain showed signs of metabolic acidosis and electrolyte imbalances. The results of blood and urine tests indicated Fanconi syndrome and renal tubular acidosis. An x-ray showed vertebral fractures, which were thought to responsible for the back pain. In addition, the patient had proteinuria and renal dysfunction; therefore, renal biopsy was performed, and tubulointerstitial nephritis (TIN) was diagnosed. While investigating TIN, primary biliary cirrhosis a...

  12. [Extracorporeal renal replacement therapies in acute renal failure].

    Science.gov (United States)

    Schaefer, R M; Barenbrock, M; Teschner, M; Bahner, U

    2000-05-15

    The most serious forms of acute renal failure (ARF) are nowadays encountered in the intensive care unit (ICU), where up to 25% of new patients are reported to develop ARF. Lethality rates may reach 50 to 90% when the ARF is part of a multiple organ dysfunction syndrome. A multitude of extracorporeal procedures have been introduced into intensive care medicine. Applied with adequate skills and experience, most of these techniques will suffice to replace excretory renal function. However, because of low efficacy arterio-venous procedures (CAVH and CAVHD) have been abandoned for the veno-venous, pump-driven techniques (CVVH and CVVHD). Up to now, there is no consensus whether continuous or intermittent renal replacement therapy is more advantageous. In many cases, oliguric patients with circulatory instability will be treated by CVVH, even though there is no prospective study to show that in terms of outcome continuous treatment is superior to intermittent hemodialysis. It is equally conceivable to treat such patients with daily, prolonged (intermittent) hemodialysis. Apparently, the dose of replacement therapy, be it continuous filtration (36 to 48 l/24 h) or intermittent hemodialysis (daily 3 to 4 h) with a target BUN of less than 50 mg/dl, is more important than the modality of treatment. Moreover, there is good evidence that the use of biocompatible membranes (no complement- or leukocyte activation) is preferable and that with high-volume hemofiltration bicarbonate-containing replacement fluids should be used. However, despite all the technical advances, we firmly believe that the skills and the experience of those physicians and nurses who actually perform renal replacement therapy in the ICU are more important than the modality of treatment applied.

  13. ADQI 7 : the clinical management of the Cardio-Renal syndromes: work group statements from the 7th ADQI consensus conference

    NARCIS (Netherlands)

    Davenport, A.; Anker, S. D.; Mebazaa, A.; Palazzuoli, A.; Vescovo, G.; Bellomo, R.; Ponikowski, P.; Anand, I.; Aspromonte, N.; Bagshaw, S.; Berl, T.; Bobek, I.; Cruz, D. N.; Daliento, L.; Haapio, M.; Hillege, H.; House, A.; Katz, N.; Maisel, A.; Mankad, S.; McCullough, P.; Ronco, F.; Shaw, A.; Sheinfeld, G.; Soni, S.; Zamperetti, N.; Zanco, P.; Ronco, C.

    2010-01-01

    Many patients with heart failure have underlying renal dysfunction, and similarly, patients with kidney failure are prone to cardiac failure. This has led to the concept of cardio-renal syndromes, which can be an acute or chronic cardio-renal syndrome, when cardiac failure causes deterioration in re

  14. Tenofovir-related nephrotoxicity in human immunodeficiency virus-infected patients: three cases of renal failure, Fanconi syndrome, and nephrogenic diabetes insipidus.

    Science.gov (United States)

    Karras, Alexandre; Lafaurie, Matthieu; Furco, André; Bourgarit, Anne; Droz, Dominique; Sereni, Daniel; Legendre, Christophe; Martinez, Frank; Molina, Jean-Michel

    2003-04-15

    We report 3 cases of renal toxicity associated with use of the antiviral agent tenofovir. Renal failure, proximal tubular dysfunction, and nephrogenic diabetes insipidus were observed, and, in 2 cases, renal biopsy revealed severe tubular necrosis with characteristic nuclear changes. Patients receiving tenofovir must be monitored closely for early signs of tubulopathy (glycosuria, acidosis, mild increase in the plasma creatinine level, and proteinuria).

  15. Prevalence and association of post-renal transplant anemia

    Directory of Open Access Journals (Sweden)

    Hesham Elsayed

    2012-01-01

    Full Text Available In some renal allograft recipients, anemia persists or develops following transplantation. Anemia is associated with pre-operative blood loss and allograft dysfunction, including delayed graft function, acute rejection and chronic allograft dysfunction. To study the prevalence and association of post-renal transplant anemia, we studied 200 renal transplant recipients; 131 (65.5% patients were males and 69 (34.5% patients were females, and age ranged from 17 to 67 years, with a mean of 37.7 ± 10.8 years. All patients were receiving cyclosporine, prednisolone and mycophenolate mofetil (MMF. Complete blood count was done at two times: three and six months post-renal transplant. There were 74% anemic patients three months after renal transplantation and 45% anemic patients six months after renal transplantation. High creatinine value, female gender, delayed graft function, episodes of acute rejection, perioperative blood loss and infections were the only significant independent risk factors for prevalence of anemia post-renal transplant. In our study, we did not find an association between MMF and cyclosporine nor angiotensin-converting enzyme inhibitors (ACEIs or angiotensin receptors blocker (ARBs with anemia. This study demonstrates that anemia is a common complication during the first six months after kidney transplantation, with several risk factors precipitating this complication.

  16. Rhabdomyolysis and unilateral renal infarction after a motor vehicle crash.

    Science.gov (United States)

    Sanai, Toru; Yokoyama, Masaaki; Murata, Akinari; Ukon, Kei; Fuchigami, Kazumi

    2007-01-01

    A 46-year-old man with no previous history of abnormal urinalysis findings or renal dysfunction was admitted to a local hospital because of a motor vehicle crash. An open laparotomy was performed to treat a perforation of the small intestine. After operation, oliguria and renal dysfunction developed, and he was admitted to our hospital because of acute renal failure after trauma. Acute renal failure was assumed to be due to rhabdomyolysis with elevated serum creatinine, blood urea nitrogen, and creatine kinase levels and myoglobinemia. Left flank pain occurred several days after admission, and the serum alkaline phosphatase level increased between days 5 and 12 following admission. Although hemodialysis was performed 9 times and the urine output was satisfactory, the creatinine clearance levels increased only to about 50 mL/min/1.73 m2 (0.84 mL/s/m2) at 6 weeks following admission. As a result, a diagnosis of renal infarction due to acute renal artery occlusion was considered. The left kidney was atrophic on an abdominal computed tomographic scan and was nonfunctioning on a renogram. This case shows the importance of not overlooking the possibility of a renal infarction associated with rhabdomyolysis after a motor vehicle crash. In particular, the changes in the serum alkaline phosphatase levels were important in making a correct diagnosis in this case.

  17. Prognostic value of endothelial dysfunction in type 1 diabetes mellitus

    Institute of Scientific and Technical Information of China (English)

    Ana; Marice; Ladeia; Raphael; Ribeiro; Sampaio; Maiara; CostaHita; Luis; F; Adan

    2014-01-01

    Patients with diabetes mellitus are at high risk of developing atherosclerosis, associated with higher rates of micro and macro vascular involvement such as coronary artery disease and renal disease. The role of hyperglycemia to induce synthesis of reactive oxygen species by the oxidation of glucose, leading to an increased production of advanced glycosylation end products, as well as inflammation and oxidative stress has been proposed as a possible mechanism in the pathogenesis of endothelial dysfunction(ED). The interaction between C-peptide- the connecting segment of pro-insulin-and nitric oxide in vasodilation is also discussed. Therefore, endothelial dysfunction has been identified as an early marker of vascular disorder in type 1 and type 2 diabetes mellitus. In some other diseases, ED has been considered an independent predictor of vascular disease, regardless of the method used. Studies have demonstrated the importance of endothelial dysfunction as an useful tool for identifying the risk of vascular complications in patients with type 1 diabetes mellitus, particularly as regards to renal impairment. The aim of this review is to clarify the prognostic value of endothelial dysfunction as a marker of vascular disease in these subjects.

  18. Implications of Renal Denervation Therapy in Patients with Sleep Apnea

    Directory of Open Access Journals (Sweden)

    Fernando Jaén-Águila

    2015-01-01

    Full Text Available Obstructive sleep apnea (OSA syndrome is a prevalent condition characterized by repeated episodes of obstruction of the upper airway, leading to intermittent hypoxemia and important endothelial and anatomical dysfunctions that cause cardiovascular and cerebrovascular disease. The finding of the relationship between OSA and hypertension, especially resistant hypertension (RHT, has increased the interest in therapeutic strategies that affect renal sympathetic activity in these patients. The observational studies published until now demonstrated that renal denervation therapy can reduce the severity of OSA syndrome. Renal sympathetic denervation (RDN could be a future therapeutic possibility for conditions other than RHT, such as atrial fibrillation, heart failure, obesity, and OSA syndrome, where renal sympathetic system plays an important physiological role. The aim of this review was to elucidate the implications of renal sympathetic activity in OSA syndrome.

  19. [Percutaneous Nephrolithotripsy for Renal Transplant Lithiasis: A Case Report].

    Science.gov (United States)

    Oida, Takeshi; Kanemitsu, Toshiyuki; Hayashi, Tetsuya; Fujimoto, Nobumasa; Koide, Takuo

    2016-02-01

    A 54-year-old man was introduced to our hospital for follow-up examinations after renal transplantation. At the initial visit, a 25 mm renal transplant stone was noted, which had enlarged to 32 mm at an examination 1 year later. We first attempted transurethral lithotripsy (TUL), but failed due to ureteral stricture. However, we could completely remove the stone in 2 sessions of percutaneous nephrolithotripsy (PNL). The incidence of urinary lithiasis after renal transplantation ranges from 0.17-1.8%, for which PNL and TUL are frequently used. Although considered to be accompanied with risks of bleeding, bowel injury, and renal dysfunction, PNL is effective for urinary lithiasis after renal transplantation. TUL is less invasive, but access may be difficult when the ureter has an unusual course or ureteral stricture exists, as in our patient.

  20. Chronic pelvic floor dysfunction.

    Science.gov (United States)

    Hartmann, Dee; Sarton, Julie

    2014-10-01

    The successful treatment of women with vestibulodynia and its associated chronic pelvic floor dysfunctions requires interventions that address a broad field of possible pain contributors. Pelvic floor muscle hypertonicity was implicated in the mid-1990s as a trigger of major chronic vulvar pain. Painful bladder syndrome, irritable bowel syndrome, fibromyalgia, and temporomandibular jaw disorder are known common comorbidities that can cause a host of associated muscular, visceral, bony, and fascial dysfunctions. It appears that normalizing all of those disorders plays a pivotal role in reducing complaints of chronic vulvar pain and sexual dysfunction. Though the studies have yet to prove a specific protocol, physical therapists trained in pelvic dysfunction are reporting success with restoring tissue normalcy and reducing vulvar and sexual pain. A review of pelvic anatomy and common findings are presented along with suggested physical therapy management.

  1. Female Sexual Dysfunction

    Science.gov (United States)

    ... to be comfortable with your sexuality, improve your self-esteem and accept your body. Try practicing these healthy ... mayoclinic.org/diseases-conditions/female-sexual-dysfunction/basics/definition/CON-20027721 . Mayo Clinic Footer Legal Conditions and ...

  2. Spinal Cord Dysfunction (SCD)

    Data.gov (United States)

    Department of Veterans Affairs — The Spinal Cord Dysfunction (SCD) module supports the maintenance of local and national registries for the tracking of patients with spinal cord injury and disease...

  3. Basal ganglia dysfunction

    Science.gov (United States)

    ... ganglia dysfunction. They include: Dystonia (muscle tone problems) Huntington disease (disorder in which nerve cells in certain parts ... ed. Philadelphia, PA: Elsevier Mosby; 2013:chap 20. Review Date 5/30/2016 Updated by: Amit M. ...

  4. Sexual Dysfunction in Women

    OpenAIRE

    Brown, Pamela

    1989-01-01

    Sexual dysfunction takes place in the context of women's lives and affects their sexuality and self-esteem. Awareness of these influences are vital to the management of the dysfunction and the promotion of positive sexuality. The family physician's contribution to both the prevention and management of sexual concerns includes an awareness of societal influences and facilitation of a woman's sense of her own power and control over her life.

  5. Erectile dysfunction in hemodialysis patients

    Directory of Open Access Journals (Sweden)

    Imen Gorsane

    2016-01-01

    Full Text Available Erectile dysfunction (ED is a common problem seen among patients on hemodialysis (HD, but it is still a taboo subject in our country. The attention given to this sexual problem remained low, and the prevalence of ED among these patients has not been well characterized. We carried out this study in order to determine the prevalence and severity of ED in HD patients. We conducted a descriptive cross-sectional study in our HD unit in March 2013. ED was evaluated using the International Index Erection Function. Thirty patients with a mean age of 49.1 years were eligible for this study. The main causes of chronic kidney disease were hypertension (62.5% and diabetes (41.6%. The prevalence of ED was 80%, including 33.3% severe ED. Plasma levels of gonadotropins: luteinizing hormone (LH, follicule-stimulating hormone were in the standards except for one patient who had an elevated level of LH. Prolactin was elevated in four cases. ED was present in 8.4% of patients before the discovery of renal failure and in 91.6% of patients at the beginning of dialysis. For 19 patients (79.1%, the ED had increased during the dialysis sessions. A significant number of our HD patients presented with ED of varying degrees. Nephrologists should pay attention to the problem of ED in order to improve the quality of their life.

  6. Risk factors for transient dysfunction of gas exchange after cardiac surgery

    Directory of Open Access Journals (Sweden)

    Cristiane Delgado Alves Rodrigues

    2015-02-01

    Full Text Available Objective: A retrospective cohort study was preformed aiming to verify the presence of transient dysfunction of gas exchange in the postoperative period of cardiac surgery and determine if this disorder is linked to cardiorespiratory events. Methods: We included 942 consecutive patients undergoing cardiac surgery and cardiac procedures who were referred to the Intensive Care Unit between June 2007 and November 2011. Results: Fifteen patients had acute respiratory distress syndrome (2%, 199 (27.75% had mild transient dysfunction of gas exchange, 402 (56.1% had moderate transient dysfunction of gas exchange, and 39 (5.4% had severe transient dysfunction of gas exchange. Hypertension and cardiogenic shock were associated with the emergence of moderate transient dysfunction of gas exchange postoperatively (P=0.02 and P=0.019, respectively and were risk factors for this dysfunction (P=0.0023 and P=0.0017, respectively. Diabetes mellitus was also a risk factor for transient dysfunction of gas exchange (P=0.03. Pneumonia was present in 8.9% of cases and correlated with the presence of moderate transient dysfunction of gas exchange (P=0.001. Severe transient dysfunction of gas exchange was associated with patients who had renal replacement therapy (P=0.0005, hemotherapy (P=0.0001, enteral nutrition (P=0.0012, or cardiac arrhythmia (P=0.0451. Conclusion: Preoperative hypertension and cardiogenic shock were associated with the occurrence of postoperative transient dysfunction of gas exchange. The preoperative risk factors included hypertension, cardiogenic shock, and diabetes. Postoperatively, pneumonia, ventilator-associated pneumonia, renal replacement therapy, hemotherapy, and cardiac arrhythmia were associated with the appearance of some degree of transient dysfunction of gas exchange, which was a risk factor for reintubation, pneumonia, ventilator-associated pneumonia, and renal replacement therapy in the postoperative period of cardiac surgery and

  7. Incidence and Predictors of End-Stage Renal Disease in Outpatients With Systolic Heart Failure

    DEFF Research Database (Denmark)

    Bosselmann, Helle Skovmand; Gislason, Gunnar; Gustafsson, Finn

    2013-01-01

    Background- Renal dysfunction is an important prognostic factor in heart failure (HF), but whether this dysfunction progresses to end-stage renal disease (ESRD) is unknown. Therefore, we examined incidence and predictors of ESRD in outpatients with HF. Methods and Results- Patients with systolic HF...... were identified in The Danish Heart Failure database and new-onset ESRD from the Danish Registry on Dialysis. Renal function was estimated by The Chronic Kidney Disease Epidemiology Collaboration equation and patients grouped by estimated glomerular filtration rate (eGFR)-group I: ≥60 mL/min per 1.73 m...

  8. [Renal markers and predictors, and renal and cardiovascular risk factors].

    Science.gov (United States)

    Fernández-Andrade, C

    2002-01-01

    prediction. And also, its possible association nexuses, its injuring mechanisms, and the characterization of the new "emergent" renal and cardiovascular risk's markers and factors. 4. The impact on the possibility to treat the end stage renal disease with effective and prolonged procedures, by hemodialisis or kidney transplantation, has been occurred. The affected population's survival with the adequacy renal-sustitution treatment, and the possibility of indefinite duration of its treatment, has also impacted on the public health, and its resources, in an evident way. Simultaneously to increase of the incidence in the population, the electivity for the treatment has been enlarged and extended increasing it exponentially. These facts are documented here, and are defined the characteristics of the factors and markers of risk, of renal and cardiovascular diseases. The defined factors are valued to mark, so far as with the well-known evidence is possible, the prediction and the progression of the renal and cardiovascular functional deterioration: The hypertension, cardiovascular remodeling, the arterial stiffness, the heart rate, the sympathetic activation, the modification of the physiological response of the target organ to the overcharge, the metabolic syndrome, the obesity, the insulin resistance, the altered lipid profile, and metabolism of the fatty acids, the salt-sensibility, the decrease of the renal functional reserve, the glomerular hyperfiltration, the absence of the arterial pressure nocturnal descent, the abnormal excretion of proteins for the urine, the phenomenon induced by dysfunctions of the clotting, superoxide production, growth factors, the production of chronic inflammation and its markers, the factors of the glomerulosclerosis progression, the hyperuricemic status, the endothelial dysfunction and others, are evaluated. As well as their association among them and with other factors of risk not changeable like the age, and in turn, with other acquired

  9. Renal Differentiation of Mesenchymal Stem Cells Seeded on Nanofibrous Scaffolds Improved by Human Renal Tubular Cell Lines-Conditioned Medium.

    Science.gov (United States)

    Ardeshirylajimi, Abdolreza; Vakilian, Saeid; Salehi, Mohammad; Mossahebi-Mohammadi, Majid

    Kidney injuries and renal dysfunctions are one of the most important clinical problems, and tissue engineering could be a valuable method for solving it. The objective of this study was to investigate the synergistic effect of renal cell line-conditioned medium and Polycaprolactone (PCL) nanofibers on renal differentiation of human mesenchymal stem cells (MSCs). In the current study, after stem cells isolation and characterization, PCL nanofibrous scaffold was fabricated using electrospinning methods and characterized morphologically, mechanically, and for biocompatibility. The renal differentiation of seeded MSCs on the surface of PCL nanofibers with and without human renal tubular cell lines-conditioned medium was investigated by evaluation of eight important renal-related genes expression by real-time reverse transcription polymerase chain reaction (RT-PCR) and immunocytochemistry. Fabricated nanofibrous scaffolds were good in all characterized items. Almost highest expression of all genes was detected in stem cells seeded on PCL under conditioned media in comparison with the stem cells seeded on PCL, tissue culture polystyrene (TCPS) under renal induction medium, and TCPS under conditioned medium. According to the results, PCL nanofibers in contribution with conditioned medium can provide the optimal conditions for renal differentiation of MSCs and could be a promising candidate for renal tissue engineering application.

  10. Acute mixed cellular and humoral rejection of renal allograft with leucopenia.

    Science.gov (United States)

    Agarwal, D K; Hota, J K; Malhotra, V

    2011-08-01

    Diagnosis and management of acute renal allograft dysfunction often pose challenge to nephrologists during practice. Acute rejection is a major cause of acute graft dysfunction but is rare in patients with leucopenia. Acute rejection can have either humoral or cellular components or sometimes mixed components. Mixed acute cellular and humoral rejection often present as steroid resistant rejection. Here we report a patient with live related renal transplant recipient with acute graft dysfunction with leucopenia who was found to have mixed acute cellular and humoral rejection.

  11. Plasma bilirubin and late graft failure in renal transplant recipients

    NARCIS (Netherlands)

    Deetman, Petronella E.; Zelle, Dorien M.; van der Heide, Jaap J. Homan; Navis, Gerjan J.; Gans, Reinold O. B.; Bakker, Stephan J. L.

    2012-01-01

    Exogenous bilirubin has been shown to protect against oxidative stress in ischemia-reperfusion injury. Oxidative stress has been implicated in the pathophysiology of chronic transplant dysfunction leading to late graft failure after renal transplantation. We prospectively investigated whether high e

  12. Renal dysfunction in the setting of HIV/AIDS.

    Science.gov (United States)

    Miro, Jose M; Cofan, Federico; Trullas, Joan C; Manzardo, Christian; Cervera, Carlos; Tuset, Montserrat; Oppenheimer, Federico; Brunet, Mercedes; Moreno, Asuncion; Campistol, Josep M; Gatell, Jose M

    2012-09-01

    Antiretroviral therapy has been immensely successful in reducing the incidence of opportunistic infections and death after HIV infection. This has resulted in heightened interest in noninfectious comorbidities including kidney disease. Although HIV-associated nephropathy, the most ominous kidney disease related to the direct effects of HIV, may be prevented and treated with antiretrovirals, kidney disease remains an important issue in this population. In addition to the common risk factors for kidney disease of diabetes mellitus and hypertension, HIV-infected individuals have a high prevalence of other risk factors, including hepatitis C and exposure to antiretrovirals and other medications. Therefore, the differential diagnosis is vast. Early identification (through efficient screening) and prompt treatment of kidney disease in HIV-infected individuals are critical to lead to better outcomes. This review focuses on clinical and epidemiological issues, treatment strategies (including dialysis and kidney transplantation), and recent advances among kidney disease in the HIV population.

  13. Systemic arterial and venous determinants of renal hemodynamics in congestive heart failure.

    Science.gov (United States)

    Braam, Branko; Cupples, William A; Joles, Jaap A; Gaillard, Carlo

    2012-03-01

    Heart and kidney interactions are fascinating, in the sense that failure of the one organ strongly affects the function of the other. In this review paper, we analyze how principal driving forces for glomerular filtration and renal blood flow are changed in heart failure. Moreover, renal autoregulation and modulation of neurohumoral factors, which can both have repercussions on renal function, are analyzed. Two paradigms seem to apply. One is that the renin-angiotensin system (RAS), the sympathetic nervous system (SNS), and extracellular volume control are the three main determinants of renal function in heart failure. The other is that the classical paradigm to analyze renal dysfunction that is widely applied in nephrology also applies to the pathophysiology of heart failure: pre-renal, intra-renal, and post-renal alterations together determine glomerular filtration. At variance with the classical paradigm is that the most important post-renal factor in heart failure seems renal venous hypertension that, by increasing renal tubular pressure, decreases GFR. When different pharmacological strategies to inhibit the RAS and SNS and to assist renal volume control are considered, there is a painful lack in knowledge about how widely applied drugs affect primary driving forces for ultrafiltration, renal autoregulation, and neurohumoral control. We call for more clinical physiological studies.

  14. The role of the renal afferent and efferent nerve fibers in heart failure.

    Science.gov (United States)

    Booth, Lindsea C; May, Clive N; Yao, Song T

    2015-01-01

    Renal nerves contain afferent, sensory and efferent, sympathetic nerve fibers. In heart failure (HF) there is an increase in renal sympathetic nerve activity (RSNA), which can lead to renal vasoconstriction, increased renin release and sodium retention. These changes are thought to contribute to renal dysfunction, which is predictive of poor outcome in patients with HF. In contrast, the role of the renal afferent nerves remains largely unexplored in HF. This is somewhat surprising as there are multiple triggers in HF that have the potential to increase afferent nerve activity, including increased venous pressure and reduced kidney perfusion. Some of the few studies investigating renal afferents in HF have suggested that at least the sympatho-inhibitory reno-renal reflex is blunted. In experimentally induced HF, renal denervation, both surgical and catheter-based, has been associated with some improvements in renal and cardiac function. It remains unknown whether the effects are due to removal of the efferent renal nerve fibers or afferent renal nerve fibers, or a combination of both. Here, we review the effects of HF on renal efferent and afferent nerve function and critically assess the latest evidence supporting renal denervation as a potential treatment in HF.

  15. Xanthogranulomatous Pyelonephritis Associated with Hepatic Dysfunction in Pregnancy

    OpenAIRE

    Ferreira, L.; Oliveira, C.; CRUZ, C; A. Pacheco

    2015-01-01

    Xanthogranulomatous pyelonephritis is a rare disease characterised by the replacement of normal renal parenchyma by foamy macrophages. The only treatment for this type of pyelonephritis is of a surgical nature with partial or total nephrectomy. The occurrence of xanthogranulomatous pyelonephritis during pregnancy is a rare event (with only 6 cases described in the literature). We report a case of xanthogranulomatous pyelonephritis in a 32-week pregnant woman associated with hepatic dysfunction.

  16. Congestive renal failure: the pathophysiology and treatment of renal venous hypertension.

    Science.gov (United States)

    Ross, Edward A

    2012-12-01

    Longstanding experimental evidence supports the role of renal venous hypertension in causing kidney dysfunction and "congestive renal failure." A focus has been heart failure, in which the cardiorenal syndrome may partly be due to high venous pressure, rather than traditional mechanisms involving low cardiac output. Analogous diseases are intra-abdominal hypertension and renal vein thrombosis. Proposed pathophysiologic mechanisms include reduced transglomerular pressure, elevated renal interstitial pressure, myogenic and neural reflexes, baroreceptor stimulation, activation of sympathetic nervous and renin angiotensin aldosterone systems, and enhanced proinflammatory pathways. Most clinical trials have addressed the underlying condition rather than venous hypertension per se. Interpreting the effects of therapeutic interventions on renal venous congestion are therefore problematic because of such confounders as changes in left ventricular function, cardiac output, and blood pressure. Nevertheless, there is preliminary evidence from small studies of intense medical therapy or extracorporeal ultrafiltration for heart failure that there can be changes to central venous pressure that correlate inversely with renal function, independently from the cardiac index. Larger more rigorous trials are needed to definitively establish under what circumstances conventional pharmacologic or ultrafiltration goals might best be directed toward central venous pressures rather than left ventricular or cardiac output parameters. Copyright © 2012 Elsevier Inc. All rights reserved.

  17. Voiding dysfunction - A review

    Directory of Open Access Journals (Sweden)

    Sripathi V

    2005-01-01

    Full Text Available In a child who is toilet trained the sudden onset of daytime wetting with frequency or urgency is alarming to the parents. Initially this subject was subdivided into a number of descriptive clinical conditions which led to a lot of confusion in recognition and management. Subsequently, the term elimination dysfunction was coined by Stephen Koff to emphasise the association between recurrent urinary infection, wetting, constipation and bladder overactivity. From a urodynamic point of view, in voiding dysfunction, there is either detrusor overactivity during bladder filling or dyssynergic action between the detrusor and the external sphincter during voiding. Identifying a given condition as a ′filling phase dysfunction′ or ′voiding phase dysfunction′ helps to provide appropriate therapy. Objective clinical criteria should be used to define voiding dysfunction. These include bladder wall thickening, large capacity bladder and infrequent voiding, bladder trabeculation and spinning top deformity of the urethra and a clinically demonstrated Vincent′s curtsy. The recognition and treatment of constipation is central to the adequate treatment of voiding dysfunction. Transcutaneous electric nerve stimuation for the treatment of detrusor overactivity, biofeedback with uroflow EMG to correct dyssynergic voiding, and behavioral therapy all serve to correct voiding dysfunction in its early stages. In established neurogenic bladder disease the use of Botulinum Toxin A injections into the detrusor or the external sphincter may help in restoring continence especially in those refractory to drug therapy. However in those children in whom the upper tracts are threatened, augmentation of the bladder may still be needed.

  18. Structural renal changes in obesity and diabetes.

    Science.gov (United States)

    Amann, Kerstin; Benz, Kerstin

    2013-01-01

    Overweight, obesity, and associated diseases represent an emerging problem, not only in Western countries but also in the developing world. They are now characterized as epidemic diseases. Obesity is particularly serious because its incidence in children and adolescents increased dramatically: it is estimated that in the United States every eighth adolescent suffers from obesity, which in the long run may reduce life expectancy in the population. Apart from cardiovascular disease (ie, blood pressure, stroke, and coronary heart disease), kidney diseases also have been shown to be associated with obesity. Epidemiologic studies have indicated that obesity can be a risk factor of chronic kidney disease irrespective of the presence or absence of diabetes, arterial hypertension, and other comorbidities. More evidence is accumulated on the link between chronic kidney disease in obesity and abnormalities in adipokine secretion (hyperleptinemia, lack of adiponectin), activation of the renin-angiotensin system, chronic inflammation, endothelial dysfunction, lipid accumulation, impaired renal hemodynamics, and diminished nephron number related to body mass. In general, obesity is known to aggravate the course of many primary renal diseases such as glomerulonephritides, but also impairs renal function after kidney transplantation. Microalbuminuria, proteinuria, hyperfiltration, and impaired renal function are associated with obesity. Histologically, secondary focal segmental sclerosis has been shown to be caused particularly by obesity. Of practical purpose for clinical nephrology, loss of body weight either by lifestyle modification or bariatric surgery improves albuminuria and hyperfiltration in obese patients, making renal disease in obesity accessible for prevention programs. This review specifically addresses the pathogenesis and morphology of renal functional and particularly structural changes in obesity and associated renal disease such as diabetic nephropathy.

  19. Kidney (Renal) Failure

    Science.gov (United States)

    ... How is kidney failure treated? What is kidney (renal) failure? The kidneys are designed to maintain proper fluid ... marrow and strengthen the bones. The term kidney (renal) failure describes a situation in which the kidneys have ...

  20. Renal arteries (image)

    Science.gov (United States)

    A renal angiogram is a test used to examine the blood vessels of the kidneys. The test is performed ... main vessel of the pelvis, up to the renal artery that leads into the kidney. Contrast medium ...

  1. Neurogenic voiding dysfunction.

    Science.gov (United States)

    Georgopoulos, Petros; Apostolidis, Apostolos

    2017-05-01

    This review aims to analyze and discuss all recently published articles associated with neurogenic voiding discussion providing readers with the most updated knowledge and trigger for further research. They include the proposal of a novel classification system for the pathophysiology of neurogenic lower urinary tract dysfunction (NLUTD) which combines neurological defect in a distinct anatomic location, and data on bowel dysfunction, autonomic dysreflexia and urine biomarkers; review of patient-reported outcome measures in NLUTD; review of the criteria for the diagnosis of clinically significant urinary infections; novel research findings on the pathophysiology of NLUTD; and review of data on minimally and more invasive treatments. Despite the extended evidence base on NLUTD, there is a paucity of high-quality new research concerning voiding dysfunction as opposed to storage problems. The update aims to inform clinicians about new developments in clinical practice, as well as ignite discussion for further clinical and basic research in the aforementioned areas of NLUTD.

  2. Biology of Sexual Dysfunction

    Directory of Open Access Journals (Sweden)

    Anil Kumar Mysore Nagaraj

    2009-05-01

    Full Text Available Sexual activity is a multifaceted activity, involving complex interactions between the nervous system, the endocrine system, the vascular system and a variety of structures that are instrumental in sexual excitement, intercourse and satisfaction. Sexual function has three components i.e., desire, arousal and orgasm. Many sexual dysfunctions can be categorized according to the phase of sexual response that is affected. In actual clinical practice however, sexual desire, arousal and orgasmic difficulties more often than not coexist, suggesting an integration of phases. Sexual dysfunction can result from a wide variety of psychological and physiological causes including derangements in the levels of sex hormones and neurotrensmitters. This review deals with the biology of different phases of sexual function as well as implications of hormones and neurotransmitters in sexual dysfunction

  3. Insulin-like growth factor I preserves renal function postoperatively.

    Science.gov (United States)

    Franklin, S C; Moulton, M; Sicard, G A; Hammerman, M R; Miller, S B

    1997-02-01

    Deterioration of renal function, which can lead to postoperative renal failure, is a complication of surgery involving the suprarenal aorta and surgery involving the renal arteries. Fifty-four patients who were at risk for developing this complication were enrolled in a double-blind, randomized, placebo-controlled trial of insulin-like growth factor (IGF-I) as a therapeutic agent to prevent the decline in renal function. The primary end point was the incidence of renal dysfunction, defined as a reduction of the glomerular filtration rate (creatinine clearance) at each of three measurements over 72 h. IGF-I (100 microg/kg subcutaneously every 12 h for 6 doses) or placebo was administered on admission to the intensive care unit immediately postoperatively. IGF-I- and placebo-treated groups were well matched for sex, age, type of surgery, renal ischemic time during surgery (ischemic index), baseline creatinine clearance, and baseline serum creatinine. No patient in the study developed acute renal failure postoperatively. IGF-I was well tolerated. A smaller proportion of patients in the IGF-I group had a postoperative decline in renal function (22%) than in the placebo-treated group (33%). There were no significant differences in levels of serum creatinine at time of discharge, length of hospital stay, length of intensive care unit stay, length of intubation, or incidence of dialysis or death. Our findings establish the feasibility and potential utility for the use of IGF-I to reduce the incidence of postoperative renal dysfunction in high-risk patients.

  4. The puzzle of kidney dysfunction in heart failure: an introduction.

    Science.gov (United States)

    Metra, Marco; Voors, Adriaan A

    2012-03-01

    Heart failure and kidney disease often coexist, and each of the two conditions may lead to progression of the other. Kidney dysfunction is an independent prognostic factor in patients with either acute or chronic heart failure. Worsening renal function may be related with poorer outcomes as well. Multiple mechanisms are involved in the cardio-renal interaction, including hemodynamic abnormalities, neurohormonal and inflammatory activation, oxidative stress, anemia, and abnormalities in mineral and vitamin D metabolism. Serum creatinine has limitations for the assessment of kidney function in patients with heart failure as its short-term changes are dependent on hemodynamic changes and fluid status. New biomarkers of glomerular and tubular function might allow an earlier and more accurate detection of worsening renal function.

  5. 肾功能不全对急性心肌梗死患者长期预后影响的性别差异%Gender difference in the prognostic value of renal dysfunction in patients with ST-segment elevation myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    李超; 胡大一; 李莉; 杨进刚; 宋莉; 马长生

    2015-01-01

    Objective To evaluate the gender difference in the prognostic value of admission renal dysfunction (RD) for patients with acute ST-segment elevation (STEMI).Methods This was a multicenter,prospective cohort study.Four hundred and fifty STEMI patients within 24 h of onset and discharged successfully from 19 hospitals in Beijing were included in the study.All the patients were followed up six years later.According to gender,patients were categorized into two groups.Clinical characteristics,reperfusion therapy conditions and outcomes were analyzed.Multivariate Cox regression analysis was used to evaluate the possible gender difference in the prognostic value of RD.Results Among all the subjects,342 were men and 108 were women with age of (61.3 ± 12.5) years.Compared to man patients,women were older (P < 0.001),and more subjects were with hypertension (67.6% vs 49.7 %,P =0.005),stroke (15.7% vs 8.8%,P =0.039) and RD (17.9% vs 6.7%,P =0.001).After adjustment of age,past medical history,and acute reperfusion therapy.Cox regression analysis showed that RD was associated with the risk of all-cause mortality (HR 3.771,95% CI 1.382-10.294,P =0.010) and major adverse cardiovascular events (MACE,HR 2.292,95% CI:1.091-4.817,P =0.029) in male patients.However,the associations between RD and all-cause mortality(HR 0.889,95% CI 0.241-3.281,P =0.859),and MACE(HR 1.508,95% CI 0.616-3.693,P =0.368)were disappeared in women.The interaction test showed that there existed significant interactions between gender and RD in all-cause mortality(HR 2.709,95%CI 1.150-6.384,P =0.023)and MACE(HR 1.977,95% CI 1.009-3.876,P =0.023).Conclusions There is a considerable gender difference in the prognostic value of RD for the outcomes in patients with STEMI.RD seemed to be an important prognostic maker in male patients.%目的 评价入院时肾功能不全(renal dysfunction,RD)对急性ST段抬高型心肌梗死(ST-segment elevation myocardial infarction,STEMI)患者长

  6. Therapeutic effects of tacrolimus substituting for cyclosporin in renal transplant recipients with hepatic dysfunction%肾移植术后肝功能异常患者用他克莫司替换环孢素A疗效的初步观察

    Institute of Scientific and Technical Information of China (English)

    郭宏波; 张玉海

    2000-01-01

    目的 观察他克莫司(FK506) 替换环孢素A(CsA)并联合应用霉酚酸酯(MMF)及泼尼松(Pred)防治肾移植术后肝功能异常患者的有效性及安全性.方法 肾移植术后8例肝功能异常患者(男性5例,女性3例,平均38.23岁),用FK506替换CsA治疗,停用CsA24h后,开始给予FK506.FK506初始剂量根据患者体重、肝功能损害程度及术后时间确定,服药1周后,根据全血FKS06谷值浓度调整剂量,使其谷值浓度维持于5~15μg/L.结果 用FK506替换CsA,1个月后患者血中直接胆红素从替换前的(22.66±17.19)μmnol/L下降至(7.05±2.32)/μmol/L,P<0.05;间接胆红素从替换前的(42.15±34.15)μmol/L下降至(14.54±2.59)μmol/L,P<0.05;血清丙氨酸转氨酶从替换前的(83.00±93.14)IU/L下降至1个月后的(29.50±15.41)IU/L,P>0.05;血清肌酐从(177.91±86.41)μmol/L下降至(135.92±34.05)μmol/L,P>0.05.3例腹水的患者均于药物替换 1个月后完全消失.仅有1例患者出现便秘、食欲下降伴上肢颤抖.结论 用FK506 替换 CsA 并联合应用MMF及Pred 对防治肾移植术后肝功能异常是安全和有效的措施.%Objective To evaluate the efficacy and safety of CsA substituted by tacrolimus(FK506) combined with MMF and prednisone in prevention of rejection in renal transplant recipents with hepatic dysfunction. Methods Eight patients with hepatic dysfunction received the treatment of FK506 substituting for CsA. FK506 was administeted at least 24 h after the last dose of cyclosporine.The initial dose of FK506 was based on body weight,the degree of hepatic dysfunetion and the period after operation of the patients.After administration of one week.the dose of FK506 was subsequently adjusted to maintain its whole blood trough levels between 5~15μg/L. Results Substitute of tacrolimus for cycbsporin resulted in a markedly reduced blood index,direct-bilirubin from(22.66±17.19)μmol/L to(7.05±2.32)μmol/L(P<0.05), indirect-bilirubin from(42.15±34.15)

  7. [Renal leiomyoma. Case report].

    Science.gov (United States)

    Joual, A; Guessous, H; Rabii, R; Benjelloun, M; Benlemlih, A; Skali, K; el Mrini, M; Benjelloun, S

    1999-01-01

    The authors report a case of renal leiomyoma observed in a 56-year-old man. This cyst presented in the from of loin pain. Computed tomography revealed a homogeneous renal tumor. Treatment consisted of radical nephrectomy. Histological examination of the specimen showed benign renal leiomyoma.

  8. Renal inflammatory myofibroblastic tumor

    DEFF Research Database (Denmark)

    Heerwagen, S T; Jensen, C; Bagi, P

    2007-01-01

    Renal inflammatory myofibroblastic tumor (IMT) is a rare soft-tissue tumor of controversial etiology with a potential for local recurrence after incomplete surgical resection. The radiological findings in renal IMT are not well described. We report two cases in adults with a renal mass treated...

  9. 多发性骨髓瘤的肾脏损害%Renal impairment in multiple myelomas

    Institute of Scientific and Technical Information of China (English)

    Cheng Yang; Tianbiao Lan; Yi Cheng

    2011-01-01

    Objective: The aim of the study was to investigate the clinic manifestation, diagnosis and treatment on multiple myeloma (MM) with the onset of renal impairment. Methods: The 27 cases of multiple myeloma with the onset of renal impairment were collected in Department of Nephrology, Wuhan General Hospital of Guangzhou Command, China, from January 2007 to January 2011. All cases were divided into the groups with renal dysfunction (n = 16) and normal renal function (n =11). The clinic manifestations, treatments and prognosis of all patients were analyzed. Results: Of all the patients in normal renal function group, 5 suffered nephrotic syndrome, 4 had abnormal results of routine urinalysis (hematuria or proteinuria)which were not caused by nephrotic syndrome, and 1 suffered urinary tract infection. Five pathological specimens of renal biopsy revealed that light chain protein, immunoglobulin and complement C3 were deposited mainly in the glomerular basement membrane and mesangia, tubular basement membrane and arteriolar walls. Two pathological specimens were proved to be renal amyloidosis. Patients with renal dysfunction had poorer prognosis, severer anemia, higher values of serum lactate dehydrogenase (LDH) and β2-microglobulin (β2-MG), worse responses to chemotherapy. Of 16 patients with renal dysfunction, 14 (87.5%) were stage III, which were significantly higher than that in the group of normal renal function [63.6% (7/11)]. Of 16 cases with renal dysfunction, 9 were treated with blood purification, and 5 of 9 cases were treated with plasma exchange.Conclusion: Multiple myeloma with the onset of renal impairment was easily misdiagnosed. Hemodialysis concomitant with chemotherapy could contribute to recovery of renal function.

  10. Moxonidine prevents ischemia/reperfusion-induced renal injury in rats.

    Science.gov (United States)

    Tsutsui, Hidenobu; Sugiura, Takahiro; Hayashi, Kentaro; Ohkita, Mamoru; Takaoka, Masanori; Yukimura, Tokihito; Matsumura, Yasuo

    2009-01-28

    Enhancement of renal sympathetic nerve activity during renal ischemia and its consequent effect on norepinephrine overflow from nerve endings after reperfusion play important roles in the development of ischemic acute kidney injury. In the present study, we evaluated whether moxonidine, an alpha(2)-adrenaline/I(1)-imidazoline receptor agonist which is known to elicit sympathoinhibitory action, would prevent the post-ischemic renal injury. Ischemic acute kidney injury was induced by clamping the left renal artery and vein for 45 min followed by reperfusion, 2 weeks after contralateral nephrectomy. Intravenous (i.v.) injection of moxonidine at a dose of 360 nmol/kg to ischemic acute kidney injury rats suppressed the enhanced renal sympathetic nerve activity during the ischemic period, to a degree similar to findings with intracerebroventricular (i.c.v.) injection of moxonidine at a dose of 36 nmol/kg. On the other hand, suppressive effects of the i.v. treatment on renal venous norepinephrine overflow, renal dysfunction and tissue injury in the post-ischemic kidney were significantly greater than those elicited by the i.c.v. treatment. These results suggest that renoprotective effects of moxonidine on ischemic acute kidney injury probably result from its suppressive action on the ischemia-enhanced renal sympathetic nerve activity followed by norepinephrine spillover from the nerve endings of the post-ischemic kidney.

  11. [Podocyte dysfunction and proteinuria

    NARCIS (Netherlands)

    Vogtländer, N.P.J.; Rietjens, S.J.; Vlag, J. van der; Berden, J.H.M.

    2004-01-01

    Podocytes play a central role in the pathogenesis of several glomerular diseases. In recent years, this has been revealed by molecular analysis of a number of rare hereditary renal diseases. Podocytes contain three domains: the domain bound to the glomerular basement membrane (GBM), the domain of th

  12. Peritoneal dialysis treatment for severe lupus nephritis patients complicated with essential organ dysfunction

    OpenAIRE

    Zhou, Yan; Yu, Yusheng; Tang, Zheng; Li, Shijun; Hu, Weixin; LUO, CHUNLEI; Liu,Zhihong

    2015-01-01

    The aim of the present study was to evaluate the clinical efficacy of peritoneal dialysis (PD) in patients with severe lupus nephritis (LN) complicated with organ dysfunction. In total, 13 severe LN patients complicated with multiple-organ dysfunction, who underwent PD treatment between November 2003 and September 2010, were enrolled in the study. Six patients received methylprednisolone pulse therapy due to lupus activity and progressive renal failure. These patients were complicated with se...

  13. Progressive renal failure due to renal infiltration by BK polyomavirus and leukaemic cells: which is the culprit?

    Science.gov (United States)

    Sangala, Nicholas; Dewdney, Alex; Marley, Nicholas; Cranfield, Tanya; Venkat-Raman, Gopalakrishnan

    2011-02-01

    Renal infiltration with leukaemic cells is a common finding in patients suffering with chronic lymphocytic leukaemia (CLL) but rarely does it lead to significant renal dysfunction. Similarly, BK nephropathy is a recognized cause of graft failure in renal transplant recipients but rarely causes significant disease in native kidneys. In the few reports where leukaemic infiltration of the kidney has led to significant renal impairment, the pathological process causing renal dysfunction is not identified on biopsy. In these cases, it is unclear whether BK polyomavirus (BKV) nephropathy has been excluded. We describe a case of dual pathologies in a patient with Binet stage C CLL and deteriorating renal function where renal biopsy reveals leukaemic infiltration of the kidney occurring alongside BKV nephropathy. The relative importance of each pathology in relation to the rapid decline to end-stage renal failure remains unclear, but the presence of both pathologies appears to impart a poor prognosis. Additionally, we describe the novel histological finding of loss of tubular integrity resulting in tubular infiltration and occlusion by leukaemic cells. It is possible that the patient with advanced CLL is at particular risk of BK activation, and the presence of BK nephropathy may compromise tubular integrity allowing leukaemic cell infiltration and obstruction of tubules. This case bares remarkable resemblance to the first and only other report of its kind in the literature. It is not clear how available immunocytochemistry for polyoma infection is outside transplant centres, and it is possible that BK nephropathy is being under-diagnosed in patients with CLL in the context of declining renal function. At present, the combination of BKV nephropathy and leukaemic infiltration represents a management conundrum and the prognosis is poor. Further research is required in order to better understand the pathological process and therefore develop management strategies.

  14. Cystinosis (ctns) zebrafish mutant shows pronephric glomerular and tubular dysfunction

    Science.gov (United States)

    Elmonem, Mohamed A.; Khalil, Ramzi; Khodaparast, Ladan; Khodaparast, Laleh; Arcolino, Fanny O.; Morgan, Joseph; Pastore, Anna; Tylzanowski, Przemko; Ny, Annelii; Lowe, Martin; de Witte, Peter A.; Baelde, Hans J.; van den Heuvel, Lambertus P.; Levtchenko, Elena

    2017-01-01

    The human ubiquitous protein cystinosin is responsible for transporting the disulphide amino acid cystine from the lysosomal compartment into the cytosol. In humans, Pathogenic mutations of CTNS lead to defective cystinosin function, intralysosomal cystine accumulation and the development of cystinosis. Kidneys are initially affected with generalized proximal tubular dysfunction (renal Fanconi syndrome), then the disease rapidly affects glomeruli and progresses towards end stage renal failure and multiple organ dysfunction. Animal models of cystinosis are limited, with only a Ctns knockout mouse reported, showing cystine accumulation and late signs of tubular dysfunction but lacking the glomerular phenotype. We established and characterized a mutant zebrafish model with a homozygous nonsense mutation (c.706 C > T; p.Q236X) in exon 8 of ctns. Cystinotic mutant larvae showed cystine accumulation, delayed development, and signs of pronephric glomerular and tubular dysfunction mimicking the early phenotype of human cystinotic patients. Furthermore, cystinotic larvae showed a significantly increased rate of apoptosis that could be ameliorated with cysteamine, the human cystine depleting therapy. Our data demonstrate that, ctns gene is essential for zebrafish pronephric podocyte and proximal tubular function and that the ctns-mutant can be used for studying the disease pathogenic mechanisms and for testing novel therapies for cystinosis. PMID:28198397

  15. Effect of U-74500A, a 21-aminosteroid on renal ischemia-reperfusion injury in rats.

    Science.gov (United States)

    Kaur, Hitchintan; Satyanarayana, Padi S V; Chopra, Kanwaljit

    2003-03-01

    Renal ischemia-reperfusion injury constitutes the most common pathogenic factor for acute renal failure and is the main contributor to renal dysfunction in allograft recipients and revascularization surgeries. Many studies have demonstrated that reactive oxygen species play an important role in ischemic acute renal failure. The aim of the present study was to investigate the effects of the synthetic antioxidant U-74500A, a 21-aminosteroid in a rat model of renal ischemia-reperfusion injury. Renal ischemia-reperfusion was induced by clamping unilateral renal artery for 45 min followed by 24 h of reperfusion. Two doses of U-74500A (4.0 mg/kg, i.v.) were administered 45 min prior to renal artery occlusion and then 15 min prior to reperfusion. Tissue lipid peroxidation was measured as thiobarbituric acid reacting substances (TBARS) in kidney homogenates. Renal function was assessed by estimating serum creatinine, blood urea nitrogen (BUN), creatinine and urea clearance. Renal morphological alterations were assessed by histopathological examination of hematoxylin-eosin stained sections of the kidneys. Ischemia-reperfusion produced elevated levels of TBARS and deteriorated the renal function as assessed by increased serum creatinine, BUN and decreased creatinine and urea clearance as compared to sham operated rats. The ischemic kidneys of rats showed severe hyaline casts, epithelial swelling, proteinaceous debris, tubular necrosis, medullary congestion and hemorrhage. U-74500A markedly attenuated elevated levels of TBARS as well as morphological changes, but did not improve renal dysfunction in rats subjected to renal ischemia-reperfusion. These results clearly demonstrate the in vivo antioxidant effect of U-74500A, a 21-aminosteroid in attenuating renal ischemia-reperfusion injury.

  16. Clinical outcomes in the use of mycophenolate mofeil in liver transplant patients with chronic renal dysfunction%霉酚酸酯用于肝移植术后慢性肾功能损害患者的疗效分析

    Institute of Scientific and Technical Information of China (English)

    安玉玲; 蔡常洁; 张婷婷; 李敏如; 易慧敏; 陈规划

    2011-01-01

    Objective To evaluate the effect of mycophenolate mofeil (MMF) combined with dose-decreased calcineurin inhibitors (CNIs) in patients who received liver transplanation with chronic kidney malfunction.Methods 28 liver transplant patients with chronic kidney malfunction were prospectively included in this study.MMF was initiated and the dose of the original immunosuppressive drug CNIs decreased.The change in renal function and adverse events were evaluated.Results One patient was discontinued with MMF treatment because of serious myelosuppression.The other 27 patients were treated with MMF with a median of 30.8 months.The basal creatinine values and the basal creatinine clearance were ( 134.26 ± 27.25) μmol/1 and (57.70 ± 16.93) ml/min,respectively.The basal glomerular filtration rate was (53.91±11.63) ml/min.The creatinine values at 1,3,6,12,24 and 36 months were 124.30±28.27 (P=0.006),130.19±29.29 (P=0.174),125.49±38.18 (P=0.194),119.71±31.36 (P=0.010),137.43±42.55 (P=0.804),and (139.04±39.80) μmol/L (P=0.916).And the creatinine clearance values at 1,3,6,12,24 and 36 months were 62.57±19.29 (P=0.008),61.18± 19.70 (P=0.086),64.27±22.82 (P=0.018),67.48±22.59 (P=0.002),57.18±19.55 (P=0.405),and (54.56±23.48) ml/minute (P=0.708),respectively.The glomerular filtration rate at 1,3,6,12,24 and 36 months were 59.20 ± 14.05 (P=0.006),56.61±14.01 (P=0.04),60.47±17.33 (P=0.016),63.59±17.66 (P=0.002),53.75±13.60 (P=0.369),and (51.70±16.07) ml/min (P=0.703).One patient (3.7%) had mild acute rejection.5 patients (18.5 % ) had mild abdominal distention or diarrhea.2 patients (7.4%) had ischemic cholangitis.No patient had cytomegalo virus infection or tumor recurrence.Conclusion In liver transplant recipients with chronic renal dysfunction,MMF allowed CNIs dose reduction or discontinuation,improved or stabilized renal function in most patients and it had only mild adverse events.%目的 探讨肝移植术后慢性肾功能损害患者在减

  17. Postpartum renal vein thrombosis.

    Science.gov (United States)

    Rubens, D; Sterns, R H; Segal, A J

    1985-01-01

    Renal vein thrombosis in adults is usually a complication of the nephrotic syndrome. Rarely, it has been reported in nonnephrotic women postpartum. The thrombosis may be a complication of the hypercoagulable state associated with both the nephrotic syndrome and pregnancy. Two postpartum patients with renal vein thrombosis and no prior history of renal disease are reported here. Neither patient had heavy proteinuria. In both cases, pyelonephritis was suspected clinically and the diagnosis of renal vein thrombosis was first suggested and confirmed by radiologic examination. Renal vein thrombosis should be considered in women presenting postpartum with flank pain.

  18. Renal infarction resulting from traumatic renal artery dissection.

    Science.gov (United States)

    Kang, Kyung Pyo; Lee, Sik; Kim, Won; Jin, Gong Yong; Na, Ki Ryang; Yun, Il Yong; Park, Sung Kwang

    2008-06-01

    Renal artery dissection may be caused by iatrogenic injury, trauma, underlying arterial diseases such as fibromuscular disease, atherosclerotic disease, or connective tissue disease. Radiological imaging may be helpful in detecting renal artery pathology, such as renal artery dissection. For patients with acute, isolated renal artery dissection, surgical treatment, endovascular management, or medical treatment have been considered effective measures to preserve renal function. We report a case of renal infarction that came about as a consequence of renal artery dissection.

  19. Early recurrence of proliferative glomerulonephritis with monoclonal immunoglobulin deposits in a renal allograft

    Directory of Open Access Journals (Sweden)

    Rohit Tewari

    2016-01-01

    Full Text Available Proliferative glomerulonephritis with monoclonal immunoglobulin deposits (PGNMIDs is a clinico-pathologic entity, the recurrence of which in the renal allograft has only recently been described. A 55-year-old male presented with rapid deterioration of renal function. Light microscopy showed membranoproliferative glomerulonephritis with kappa light chain restriction and only one sub-class of IgG. He subsequently underwent renal transplant. Two months later, he developed acute graft dysfunction. Renal biopsy showed a recurrence of the disease. Work up for multiple myeloma was positive. Membranoproliferative pattern of injury in the posttransplant setting has a wide range of differential diagnosis, PGNMID being one of them.

  20. Relationships between oxidative stress markers and red blood cell characteristics in renal azotemic dogs.

    Science.gov (United States)

    Buranakarl, C; Trisiriroj, M; Pondeenana, S; Tungjitpeanpong, T; Jarutakanon, P; Penchome, R

    2009-04-01

    Oxidative stress parameters and erythrocyte characteristics were studied in 15 normal healthy dogs and 33 renal azotaemic dogs from Small Animal Hospital, Faculty of Veterinary Science, Chulalongkorn University. Dogs with renal azotaemia had reduced mean corpuscular volume (MCV) (PDogs with severe renal azotaemia had higher intraerythrocytic sodium contents (RBC-Na) (Pred blood cell catalase activity and glutathione and plasma malondialdehyde were unaltered while urinary malondialdehyde-creatinine ratio (U-MDA/Cr) increased significantly (Pdogs. Moreover, the U-MDA/Cr is a sensitive biochemical parameter which increased along with degree of renal dysfunction.

  1. Diastolic dysfunction in cirrhosis

    DEFF Research Database (Denmark)

    Møller, Søren; Wiese, Signe Skovgaard; Halgreen, Hanne

    2016-01-01

    Development of esophageal varices, ascites, and hepatic nephropathy is among the major complications of cirrhosis. The presence of cirrhotic cardiomyopathy, which includes a left ventricular diastolic dysfunction (DD), seems to deteriorate the course of the disease and the prognosis. Increased st...

  2. Female sexual dysfunction

    DEFF Research Database (Denmark)

    Giraldi, Annamaria; Wåhlin-Jacobsen, Sarah

    2016-01-01

    Female sexual dysfunction (FSD) is a controversial condition, which has prompted much debate regarding its aetiology, components, and even its existence. Our inability to work together as clinicians, psychologists, patients, and advocates hinders our understanding of FSD, and we will only improve...

  3. Mitochondrial Dysfunction in Cancer

    Directory of Open Access Journals (Sweden)

    Michelle L Boland

    2013-12-01

    Full Text Available A mechanistic understanding of how mitochondrial dysfunction contributes to cell growth and tumorigenesis is emerging beyond Warburg as an area of research that is under-explored in terms of its significance for clinical management of cancer. Work discussed in this review focuses less on the Warburg effect and more on mitochondria and how dysfunctional mitochondria modulate cell cycle, gene expression, metabolism, cell viability and other more conventional aspects of cell growth and stress responses. There is increasing evidence that key oncogenes and tumor suppressors modulate mitochondrial dynamics through important signaling pathways and that mitochondrial mass and function vary between tumors and individuals but the sigificance of these events for cancer are not fully appreciated. We explore the interplay between key molecules involved in mitochondrial fission and fusion and in apoptosis, as well as in mitophagy, biogenesis and spatial dynamics and consider how these distinct mechanisms are coordinated in response to physiological stresses such as hypoxia and nutrient deprivation. Importantly, we examine how deregulation of these processes in cancer has knockon effects for cell proliferation and growth. Scientifically, there is also scope for defining what mitochondria dysfunction is and here we address the extent to which the functional consequences of such dysfunction can be determined and exploited for cancer diagnosis and treatment.

  4. Shared Parenting Dysfunction.

    Science.gov (United States)

    Turkat, Ira Daniel

    2002-01-01

    Joint custody of children is the most prevalent court ordered arrangement for families of divorce. A growing body of literature indicates that many parents engage in behaviors that are incompatible with shared parenting. This article provides specific criteria for a definition of the Shared Parenting Dysfunction. Clinical aspects of the phenomenon…

  5. Effects of ulinastatin on renal ischemia-reperfusion injury in rats

    Institute of Scientific and Technical Information of China (English)

    Cong-cong CHEN; Zi-ming LIU; Hui-hua WANG; Wei HE; Yi WANG; Wei-dong WU

    2004-01-01

    AIM: To investigate the effect and possible mechanism of ulinastatin on renal ischemia-reperfusion injury in rats.METHODS: Male Sprague-Dawley rats were subjected to 45-min bilateral renal ischemia, treated with intravenously 12 500 U ulinastatin at 30 min prior to ischemia and at the beginning of reperfusion, compared with a nontreated group without ulinastatin and a sham-operation group without bilateral renal ischemia. After 0 h, 2 h, 6 h, 12 h, and 24 h of reperfusion, serum creatinine and blood urea nitrogen were measured for the assessment of renal function, renal sections were used for histologic grading of renal injury, for immunohistochemical localization of Bcl-2 and heat shock protein 70. Renal ultrastructure was observed through a transmission electron microscope.RESULTS: Ulinastatin significantly reduced the increase in blood urea nitrogen and creatinine produced by renal ischemia-reperfusion, suggesting an improvement in renal function. Ulinastatin reduced the histologic evidence of renal damage associated with ischemia-reperfusion and accompanied with an up-regulation in the expression of Bcl-2 protein, but it had no significent effect on the expression of HSP 70. Ulinastatin also significantly reduced kidney ultrastructure damage caused by renal ischemia-reperfusion. CONCLUSION: The protease inhibitor, ulinastatin,reduced the renal dysfunction and injury associated with ischemia-reperfusion of the kidney. The protective effect of ulinastatin might be associated with the up-regulation of Bcl-2 expression and the effect on membrane fragility.

  6. Nontraditional cardiovascular risk factors in end-stage renal disease : studies on inflammatory markers and thyroid hormones

    NARCIS (Netherlands)

    Meuwese, Christiaan Lucas

    2014-01-01

    Patients with end-stage renal disease have an approximate eight fold increased mortality rate due to cardiovascular causes as compared with individuals of equal age and sex without renal dysfunction. Whereas traditional cardiovascular risk factors (such as smoking, hypertension and obesity) fail to

  7. Renal function dependent association of AGTR1 polymorphism (A1166C) and Electrocardiographic left-ventricular hypertrophy

    NARCIS (Netherlands)

    Smilde, Tom D. J.; Zuurman, Mike W.; Hillege, Hans L.; van Veldhuisen, Dirk J.; van Gilst, Wiek H.; van der Steege, Gerrit; Voors, Adriaan A.; Kors, Jan A.; de Jong, Paul E.; Navis, Gerjan

    2007-01-01

    Background: The association of renin-angiotensin system (RAS) polymorphisms and left-ventricular hypertrophy (LVH) may depend on the presence of risk factors for LVH, such as