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Our prior investigations have established that Inonotus obliquus (Chaga) possesses hypoglycemic effects. Persistent hyperglycemia is known to precipitate renal function abnormalities. The functionality of the kidneys is intricately linked to the levels of cyclic guanosine-3',5'-monophosphate (cGMP), which are influenced by the activities of nitric oxide synthase (NOS) and phosphodiesterase (PDE). Enhanced cGMP levels can be achieved either through the upregulation of NOS activity or the downregulation of PDE activity. The objective of the current study is to elucidate the effects of Chaga on disorders of glucolipid metabolism and renal abnormalities in rats with type 2 diabetes mellitus (T2DM), while concurrently examining the NOS-cGMP-PDE5 signaling pathway. A model of T2DM was developed in rats using a high-fat diet (HFD) combined with streptozotocin (STZ) administration, followed by treatment with Chaga extracts at doses of 50 and 100 mg·kg-1 for eight weeks. The findings revealed that Chaga not only mitigated metabolic dysfunctions, evidenced by improvements in fasting blood glucose, total cholesterol, triglycerides, and insulin resistance, but also ameliorated renal function markers, including serum creatinine, urine creatinine (UCr), blood urea nitrogen, 24-h urinary protein, and estimated creatinine clearance. Additionally, enhancements in glomerular volume, GBM thickness, podocyte foot process width (FPW), and the mRNA and protein expressions of podocyte markers, such as nephrin and wilms tumor-1, were observed. Chaga was found to elevate cGMP levels in both serum and kidney tissues by increasing mRNA and protein expressions of renal endothelial NOS and neural NOS, while simultaneously reducing the expressions of renal inducible NOS and PDE5. In summary, Chaga counteracts HFD/STZ-induced glucolipid metabolism and renal function disturbances by modulating the NOS-cGMP-PDE5 signaling pathway. This research supports the potential application of Chaga in the clinical prevention and treatment of T2DM and diabetic nephropathy (DN), with cGMP serving as a potential therapeutic target.
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GMP Cíclico , Fosfodiesterasas de Nucleótidos Cíclicos Tipo 5 , Dieta Alta en Grasa , Inonotus , Riñón , Óxido Nítrico Sintasa , Transducción de Señal , Animales , GMP Cíclico/metabolismo , Masculino , Transducción de Señal/efectos de los fármacos , Fosfodiesterasas de Nucleótidos Cíclicos Tipo 5/metabolismo , Riñón/efectos de los fármacos , Riñón/metabolismo , Dieta Alta en Grasa/efectos adversos , Ratas , Óxido Nítrico Sintasa/metabolismo , Óxido Nítrico Sintasa/genética , Diabetes Mellitus Tipo 2/metabolismo , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Ratas Sprague-Dawley , Estreptozocina , Humanos , Diabetes Mellitus Experimental/tratamiento farmacológico , Diabetes Mellitus Experimental/metabolismo , Glucemia/metabolismo , Glucemia/efectos de los fármacos , Hipoglucemiantes/farmacologíaRESUMEN
PURPOSE: To evaluate retrospectively the influence of percutaneous cryoablation for small renal tumors on total and affected kidney function and risk factors associated with worsening function of the affected kidney. MATERIALS AND METHODS: Between April 2016 and March 2022, 27 patients who underwent cryoablation for small renal tumors at our institution participated in this study, which investigated time-dependent changes in postoperative renal function. We evaluated estimated glomerular filtration rates (eGFRs) and split renal function revealed by scintigraphy using 99 m technetium-mercaptoacetyltriglycine (99mTc-MAG3) before cryoablation and at 1 week, 1 month, and 6 months after cryoablation. Numerous variables were analyzed to assess risk factors for worsening renal function. RESULTS: Baseline eGFR (mean ± standard deviation) was 56.5 ± 23.7 mL/min/1.73 m2 (mean ± SD; range, 20.5-112.5). Mean eGFRs at 1 week, 1 month, and 6 months after cryoablation were 57.4 ± 24.5 (19.1-114.9), 57.1 ± 25.1 (21.5-114.9), and 53.8 ± 23.9 mL/min/1.73 m2 (20.0-107.5), respectively. Changes were statistically insignificant (p = 1.0000, = 0.6749, and = 0.0761, respectively). Regarding split renal function, mean baseline contribution of the affected kidney determined by 99mTc-MAG3 was 49.7% ± 6.0% (38.8-63.3%); these rates at 1 week, 1 month, and 6 months after cryoablation were 43.7% ± 8.8 (29.1-70.6%), 46.2% ± 7.7% (32.6-70.3%), and 46.0% ± 8.5% (32.5-67.6%), respectively. Differences from baseline were significant for all periods (p < 0001, < 0001, = 0.0001, respectively). Serum C reactive protein and lactate dehydrogenase at 1 day following cryoablation, tumor's nearness to the collecting system or sinus, and volume of ablated normal renal parenchyma were significantly correlated with decreased contributions of the affected kidney by > 10% after cryoablation. CONCLUSION: Unlike total renal function, affected kidney function could worsen after cryoablation.
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Criocirugía , Tasa de Filtración Glomerular , Neoplasias Renales , Humanos , Criocirugía/métodos , Neoplasias Renales/cirugía , Neoplasias Renales/diagnóstico por imagen , Masculino , Femenino , Anciano , Estudios Retrospectivos , Persona de Mediana Edad , Anciano de 80 o más Años , Riñón/diagnóstico por imagen , Riñón/cirugía , Adulto , Radiofármacos , Pruebas de Función Renal , Factores de Riesgo , Resultado del TratamientoRESUMEN
Objective The objective of this study is to measure renal function improvement after endopyelotomy for secondary pelvi-ureteric junction (PUJ) obstruction using technetium-99m diethylene-triamine-pentaacetate (DTPA) renal scintigraphy. Material and methods This descriptive study was carried out at the Department of Urology, Institute of Kidney Diseases, Peshawar, Pakistan from June 1, 2021, to May 31, 2023. The study included 118 secondary PUJ blockage patients who underwent endopyelotomy. Patient demographics, clinical history, and preoperative imaging findings were obtained. DTPA renal scintigraphy assessed renal function improvement postoperatively at intervals to determine the efficacy of endopyelotomy. Results The majority of the patients included in the study were male (n=65, 55.1%). The average age of the patients was 45.2 years, with the majority falling within the age range of 46-60 years (n=42, 35.6%). All patients had ultrasonography and computed tomography imaging done, and preoperative renal functions were obtained. Comorbidities included hypertension in 32 (27.12%) and diabetes in 18 (15.25%). DTPA renal scintigraphy showed improved renal function in 81.35% of patients at three months, 88.13% at six months, and 83.05% at 12 months; 15.3% of patients needed further treatments, and 5.1% had PUJ blockage recurrence. Conclusion This study offers significant insights into the results and complexities of endopyelotomy in patients suffering from PUJ blockage. The findings indicate that the technique efficiently enhances kidney function and alleviates symptoms in most patients. However, the study also emphasizes the need to monitor patients undergoing this procedure.
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Research has demonstrated that hypertension can lead to an exaggeration in the renal functional and histological changes caused by ureteral obstruction. These changes were particularly observed shortly after the release of a relatively brief period of unilateral ureteral obstruction (UUO). However, the long-term impact of hypertension on the recovery of renal functions has not been investigated beyond the immediate period after UUO reversal. In order to investigate this effect, a group of spontaneously hypertensive rats (G-SHR, n = 11) and a group of normotensive Wistar Kyoto rats (G-NTR, n = 11) were subjected to a 48 h reversible left UUO. The impact of UUO was then examined 45 days after the reversal of obstruction. The glomerular filtration rate, renal blood flow, and the fractional excretion of sodium in the post-obstructed left kidney (POK) showed similarities to the non-obstructed right kidney (NOK) in both groups. However, the changes in the albumin creatinine ratio, renal injury markers, pro-apoptotic markers, and histological changes in the G-SHR were much more pronounced compared to the G-NTR. We conclude that hypertension continues to have a significant impact on various aspects of renal injury and function, even several weeks after UUO reversal.
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Hipertensión , Obstrucción Ureteral , Ratas , Animales , Obstrucción Ureteral/complicaciones , Obstrucción Ureteral/patología , Ratas Endogámicas SHR , Riñón/patología , Tasa de Filtración GlomerularRESUMEN
Like most organs, the renal system decreases in function as we age. In the elderly, chronic kidney disease is common. When patients with chronic kidney disease take nephrotoxic medications, they are more likely to suffer adverse drug reactions, be hospitalized, and spend an extended period in the hospital. Calculating the renal clearance of a drug dose based on its glomerular filtration rate, or creatinine clearance, is necessary. Multiple tools are available for identifying renally inappropriate medications (RIMs). RIM prescriptions can be influenced by various factors, which vary according to the study. A higher number of medications means a higher likelihood of using RIMs. Numerous studies have investigated RIMs. The most contraindicated drug in renal insufficiency patients was a non-steroidal anti-inflammatory medication. A variety of interventions have been used to reduce RIM prescriptions to varying degrees of success.
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Purpose In this study, we aimed to demonstrate whether retrograde intrarenal stone surgery (RIRS) performed due to renal stones during the childhood period has any detrimental impact on renal functions. Materials and methods We retrospectively analyzed 121 patients aged 2 to 16 years who underwent RIRS for renal stones between March 2018 and February 2023. Data were available for 41 patients. The estimated glomerular filtration rate (eGFR) was computed using the modification of diet in renal disease (MDRD) formula on the day preceding the surgery and the third month after the surgery. We employed the National Kidney Foundation's chronic kidney disease (CKD) classification to categorize the glomerular filtration rate (GFR) into five groups. Preoperative and postoperative eGFR values of pediatric patients were compared by analyzing changes in CKD groups. Results Of the patients included in the study, 21 (51.2%) were male, while 20 (48.8%) were female children. No significant difference was found between the preoperative median eGFR and the postoperative median eGFR values (p=0.958). In the 3rd month after surgery, it was observed that 5 (12.1%) patients showed an improvement in their CKD stage, while deterioration was noted in 1 (2.4%) patient. Although a negative correlation was observed between the median eGFR change and both the operation time and the stone volume in Pearson correlation analysis, it was determined that this change did not create a significant difference (p=0.213 and p=0.295, respectively). Conclusion Stone surgery conducted with RIRS appears to yield positive outcomes on kidney function in the pediatric population. Nevertheless, being particularly attentive to patients with prolonged operation times and larger stone volumes is essential.
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BACKGROUND: The data evaluating contrast-induced-acute kidney injury (AKI) in patients with acute pancreatitis is scarce. This study aimed to compare the frequency of AKI in patients with acute necrotizing pancreatitis undergoing non-contrast computed tomography (NCCT) with those undergoing contrast-enhanced computed tomography (CECT) during hospitalization. METHODS: This prospective randomized controlled trial (CTRI/2019/12/022206) screened consecutive patients with acute pancreatitis for eligibility and randomly allocated patients with acute necrotizing pancreatitis (based on CECT in the first week of illness) and normal renal functions to receive either NCCT or CECT during hospitalization. The incidence of development of new AKI and clinical outcomes was compared between the two groups. Post-hoc analysis was done to adjust for disease severity. RESULTS: As many as 105 patients completed the study as per protocol (NCCT = 45 and CECT = 60). AKI occurred in 36 (34.3%) patients, nine (20%) in the NCCT and 27 (45%) in the CECT group. Contrast induced-AKI occurred in 11 (18.3%) patients, while 25 had AKI secondary to acute pancreatitis. The relative risk (RR) of AKI in the CECT group was 2.25 (95% CI 1.17-4.30, p = .0142). The frequency of intensive care unit (ICU) admission (RR = 2.1, 95% CI 1.34-3.27, p = .0001) and need for drainage of collections (RR = 1.39, 95% CI 1.1-1.7, p = .005) was significantly higher and the length of hospitalization (p = .001) and ICU admission (p = 0.001) were significantly longer in the CECT group. However, when adjusted for the severity of acute pancreatitis, there was no difference in AKI and clinical outcomes between the NCCT and CECT groups. The duration of AKI was significantly longer and the need for dialysis was significantly higher in patients who had AKI secondary to acute pancreatitis compared to those with contrast induced-AKI (p = .003). CONCLUSION: CECT is not significantly associated with AKI in acute necrotizing pancreatitis.
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Lesión Renal Aguda , Pancreatitis Aguda Necrotizante , Humanos , Pancreatitis Aguda Necrotizante/complicaciones , Pancreatitis Aguda Necrotizante/diagnóstico por imagen , Enfermedad Aguda , Estudios Prospectivos , Tomografía Computarizada por Rayos X/métodos , Lesión Renal Aguda/epidemiología , Lesión Renal Aguda/etiología , Estudios Retrospectivos , Medios de Contraste/efectos adversos , Factores de RiesgoRESUMEN
BACKGROUND/AIM: Diabetes is a multifactorial syndrome that affects the functioning of the renin-angiotensin system (RAS). The role of advanced glycation end products (AGEs) in diabetes is well known. In the present study, we hypothesized that the prevention of AGE accumulation or abrogation of AGE synthesis using an AGE inhibitor, aminoguanidine (AG), in streptozotocin (STZ)-induced diabetic animal models would affect the progression of diabetes and its related complications. We determined the effects of aminoguanidine (AG), an AGE inhibitor, in STZ-induced diabetic rats by determining various indices of RAS and renal functions. Additionally, we also investigated the effect of the drug, AG, on various hemodynamic and physiological functions in the body of the animals. METHODS: Male Sprague Dawley rats weighing 200-250 g were assigned to four groups (n = 4-6): Vehicle, Vehicle+AG, STZ-induced, and STZ-induced+AG rats. Type 1 diabetes was induced by a single intraperitoneal (IP) injection of streptozotocin (55 mg/kg) dissolved in sodium citrate buffer. The control groups (Vehicle) were injected with buffer. The blood glucose levels were measured after 48 hours, and animals with blood glucose levels > 300 mg/dL were included in the study. Blood glucose levels in the vehicle rats were also determined to ensure non-diabetic conditions. After confirmation, AG was administrated at a dose of 1 g/L in drinking water for two weeks. Urine was collected to measure the glomerular filtration rate (GFR), and the immune reactivity for AT1 and AT2 proteins was analyzed by immunoblotting. Data were expressed as mean ± standard error of the mean (SEM), and a p-value < 0.05 was considered statistically significant. RESULTS: Diabetic rats had a significant drop in body weight, accompanied by increased food and water consumption. The diabetic rats exhibited significantly increased urine flow and GFR. These phenotypes were significantly or considerately reversed by AG treatment in the STZ+AG-treated diabetic rats. Aminoguanidine prevented the increase in blood sugar levels compared to STZ-induced diabetic rats alone (295.9 ± 50.69 versus 462.3 ± 18.6 mg/dL (p < 0.05)). However, it did not affect the glomerular filtration rate (GFR) and glomerular damage, as assessed by the renal histopathological studies. The STZ-induced diabetic rats had an increased sodium excretion (3.24 ± 0.40 mmol) and significantly increased expression of the AT2 receptor and that of the AT1 receptor, which was slightly reversed by the treatment with AG. Treatment with AG decreased sodium excretion (2.12 ± 0.63, as compared to the diabetic rats). These rats also had modestly decreased expression of the AT2 receptor (0.99 ± 0.07 versus 1.12 ± 0.08, as compared to the STZ-induced diabetic rats), while the AT1 receptors showed a slight increase in the STZ+AG-treated rats compared to the STZ-induced diabetic rats (1.1 ± 0.19 versus 1.08 ± 0.12). CONCLUSION: This study highlights the action of the drug AG in not exacerbating any damage in diabetic rats. Employing AG as a pharmacological intervention to prevent an increase in blood sugar adds a new dimension to controlling increased blood sugar and preventing diabetic complications. The employability and pharmacological intervention of the drug AG, in diabetes, therefore, need a renewed and further investigation.
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A newly synthesized nanoplatform of hyaluronic acid and chitosan nanoparticles (HA/CNPs) was applied to improve the therapeutic efficacy and protection of bone marrow mesenchymal stem cells (BM-MSCs) against cisplatin (CDDP)-induced nephrotoxicity in rats. CDDP administration causes significant increases in levels of serum creatinine (SCr), urea, and KIM-1 coupled with significant albumin level falls, as indicative of acute renal dysfunction. Moreover, the level of the antioxidant enzyme (GSH) was significantly decreased, while the levels of lipid peroxidation (MDA) and inflammatory (IL-6) and apoptotic (caspase-3) markers were significantly increased, indicating a decline in the kidney's antioxidant defense and increased inflammation. In contrast, when rats were pre-treated with either MSCs or MSCs-HA/CNPs before receiving CDDP, the levels of SCr, urea, KIM-1, MDA, IL-6, and caspase-3 were significantly decreased with simultaneous significant rises in GSH and albumin, impelling a great improvement in the antioxidant and anti-inflammatory defenses of the kidney as well as its functions. Intriguingly, MSCs-HA/CNPs were more effective against caspase-3 than MSCs alone, revealing the high anti-apoptotic capability of HA/CNPs. This finding suggests that HA/CNPs could effectively protect MSCs from oxidative stress and apoptosis and thus increase their stability and longevity.
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Quitosano , Células Madre Mesenquimatosas , Ratas , Animales , Cisplatino/toxicidad , Cisplatino/metabolismo , Ácido Hialurónico/farmacología , Caspasa 3/metabolismo , Quitosano/farmacología , Antioxidantes/farmacología , Antioxidantes/metabolismo , Interleucina-6/metabolismo , Riñón , Adyuvantes Inmunológicos/farmacología , Estrés Oxidativo , Urea/metabolismo , ApoptosisRESUMEN
Both ureteral obstruction (UO) and hypertension are common conditions that affect kidney functions. Hypertension and chronic kidney disease are closely associated with an overlapping and intermingled cause-and-effect relationship. The effect of hypertension on the renal dysfunction following reversible UO has not been studied previously. To study this effect, spontaneously hypertensive (G-HT, n = 10) and normotensive Wistar (G-NT, n = 10) rats underwent 48-h reversible left unilateral UO (UUO), and the effect of UUO was studied 96 h following UUO reversal. The glomerular filtration rate, renal blood flow, and renal tubular functions such as the fractional excretion of sodium in the post-obstructed left kidney (POK) in both groups were significantly altered compared with the non-obstructed right kidney (NOK). However, the alterations in the G-HT were significantly more exaggerated when compared with the G-NT. Similar findings were observed with the histological features, gene expression of kidney injury markers, pro-inflammatory, pro-fibrotic and pro-apoptotic cytokines, and pro-collagen, as well as tissue levels of apoptotic markers. We conclude that hypertension has significantly exaggerated the alterations in renal functions and other parameters of renal injury associated with UUO.
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Hipertensión , Enfermedades Renales , Obstrucción Ureteral , Ratas , Animales , Obstrucción Ureteral/complicaciones , Obstrucción Ureteral/patología , Ratas Wistar , Riñón/patología , Enfermedades Renales/patologíaRESUMEN
Background: Assessment of kidney function in emergency settings is essential across all medical subspecialties. Daily assessment of patient creatinine results from emergency medical services showed that some deviated from expected values, implying drug-related interference. Methods: Real-time clinical evaluation of an enzyme method (Roche CREP2) in comparison with the Jaffé gen. 2 method (Roche CREJ2) was performed. During the period of December 2022 and January 2023, we analyzed 8,498 patient samples, where 5,524 were heavily medicated STAT patient specimens, 500 were pediatric specimens, and 2,474 were from a distant general population in a different region using the same methods. Results: In 109 out of 5,524 hospital specimens (1.97%, p < 0.001), the CREP2 value was apparently (25% or more) lower than CREJ2. Suspect interfering medication was found in a sample of 43 out of 46 reviewed patients where medication data were available. This phenomenon was not observed in the general population. Conclusion: In a polymedicated urgent care hospital population, a creatinine enzyme method produces unreliable results, apparently due to multiple drug-related interferences.
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Background: Activated carbon (AC) is a carbonaceous material derived from carbonization and activation of carbon-containing compounds at high temperature and has a large surface area, providing it with excellent adsorption properties. Human exposure to ACs via ingestion is increasing and, unfortunately, there is little to no evidence related to its level of toxicity. Materials and methods: Activated carbon of powdered date kernels from Al-Baha city in Saudi Arabia were used to treat rats and cell lines (HepG2 and HCT-116). Toxicity, microbiological tests and biochemical analyses were carried out to investigate biological activity of both commercially available AC (CAC), pharmaceutical AC (PAC) and AC from date palm kernels (AAC). Results: None of the ACs showed activity on Staphylococcus aureus, Bacillus subtilis, Protius mirabilis and Escherichia coli. AAC showed the most cytotoxic effect on both HCT-116 and HepG2 cell lines after 24 h, with IC50 of 48.7 ± 17.2 µg/ml and 51 ± 6.24 µg/ml respectively. Rats treated with AAC for 48 h showed no impairment of hepatic and renal functions, unlike those exposed to CAC and PAC. Similarly, AAC-exposed rats did not show oxidative stress in both the liver and kidneys while CAC and PAC exposure resulted in depletion of CAT, GPx, SOD and GSH in both organs. L-arginase and α-fucosidase expression were also induced by both PAC and CAC while α-fucosidase levels were unaffected in AAC-exposed rats. Conclusion: AAC appears to be biologically safe compared with PAC and CAC due to its antioxidant activities and non-effect on both hepatic and renal functions.
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Nanomaterials are now considered in an extensive range of applications in various fields such as biotechnology and biomedicine. The present study aimed to investigate the protective role of Salvia officinalis Silver Nanoparticles (SOSNPs) as an anti-oxidant on nephrotic damage induced by methotrexate (MTX) in adult rabbits. Green silver nanoparticles were synthesized using alcoholic extract of Salvia officinalis (S. Officinalis) leaves and were characterized by UV-spectrophotometry and scanning electron microscope. The mixing of the plant extract of S. Officinalis with silver nitrate solution leads to the change of the reaction mixture color to yellowish within 1 h and dark brown after 8 h. For studying the protective role of SOSNPs, a total of 28 adult Wistar albino rabbits were divided into four groups and treated intramuscularly (twice per week) for 45 days as follows: T1: S. Officinalis (150 mg/kg B.W), T2: SOSNPs (150 mg/kg B.W); T3: MTX (0.25 mg/kg B.W) and SOSNPs (150 mg/kg B.W); T4: MTX (0.25 mg/kg B.W). Blood was collected at 0, 15, 30, and 45 days using retro-orbital sinus and cardiac puncture technique, and the serum factors including malondialdehyde (MDA), glutathione (GSH) in serum, creatinine, as well as blood urea nitrogen and uric acid concentrations were measured at the next step. The results indicated that MTX (T4) caused a case of oxidative stress by a significant decrease in GSH and MDA as well as an increase in serum creatinine, urea, and uric acid concentrations. On the other hand, the protective roles of S. Officinalis and SOSNPs given concurrently with MTX were clarified in T2 and T3 groups, where there was the alleviation of renal damage through the correction of the previously mentioned parameters as well as the correction of anti-oxidant status. Finally, the present study documented the anti-oxidant activity and renal protective effects of SOSNPs against the damaging effects of MTX in rabbits.
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Antioxidantes , Nanopartículas del Metal , Salvia officinalis , Animales , Nanopartículas del Metal/toxicidad , Metotrexato/toxicidad , Ratas , Ratas Wistar , Plata/toxicidad , Ácido ÚricoRESUMEN
Lung transplantation (LT) is a viable therapeutic option in the treatment of advanced lung disease. With improvements in post-transplant survival, complications involving different organ systems after LT are increasingly seen. While non-infectious, extrapulmonary complications after LT are not frequently responsible for early post-transplant mortality, they significantly impact the quality of life and long-term survival. These complications are, therefore, becoming increasingly relevant as patients with LT are living longer. These complications encompass almost all organ systems and are driven by a combination of the preexisting comorbidities, events, and complications around the operative procedure and recovery, and perhaps most importantly, medication side effects of the post-LT regimen. We will discuss the wide array of non-infectious extrapulmonary complications after LT in a two-part series of review articles. While we intend to discuss the relevant literature around these complications, there is little in terms of consensus documents to guide the management approach of these complications. We will, therefore, share our experience and learnings that have shaped the management protocols we have in place in an effort to prevent and treat such complications. The goal of the first part of this two-part review is to provide an overview of the most pertinent non-infectious extrapulmonary complications pertaining to cardiovascular, renal, neuropsychiatric and ophthalmologic organ systems.
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The response of the kidney and its recovery following unilateral ureteral obstruction (UUO) depend on several factors including the duration of obstruction, the species involved and the age of the individual. In neonates, there is compelling evidence to indicate that even short periods of reversible UUO might lead to long-term renal impairment. In adults, the glomerular filtration rate returns to baseline values soon after the release of short periods of UUO. Despite this return to normal, experimental data have demonstrated that short periods of reversible UUO could lead to long-term renal functional alterations including tubular atrophy, interstitial fibrosis and urinary albumin leakage in addition to alterations in pro-inflammatory and pro-fibrotic cytokines. The concentrating ability of the kidney and its response to stimuli such as renal nerve stimulation and physiological doses of angiotensin-II were also shown to be affected at least in the intermediate-term following UUO reversal. In humans, epidemiological studies have also demonstrated a clear association between long-term renal impairment and ureteral obstruction. However, in clinical studies, it is usually difficult to precisely determine the degree and the time of onset of ureteral obstruction and more studies are required in this field. In conclusion, the available experimental and clinical data indicate that even short periods of UUO can cause long-term renal dysfunction. These findings might have clinical implications related to the early intervention following acute onset of UUO and to the need for long-term monitoring of renal functions particularly in patients with underlying chronic renal disease.
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INTRODUCTION: In this study, it was aimed to compare scintigraphic split renal function (SRF) and computed tomographic (CT) kidney volumes by semiautomatic segmentation method in predicting graft functions after kidney transplantation. METHODS: One hundred and twelve patients (77 males, 35 females) who had a living-donor kidney transplant between 2015 and 2017 in our centre were included in the study. While SRF was calculated with technetium-99m-diethylenetriaminepentaacetic acid (99m Tc-DTPA) scintigraphy, CT angiography was used for volumetric calculations. RESULTS: CT-volumetric measurements, especially renal cortical volume (RCV: 103.8 ± 20 ml) and ratio to body mass index (RCV/BMI: 4.45 ± 1.3) were found to be more significant than 99m Tc-DTPA-SRF in predicting graft functions. The correlations between SRF and RCV with 6th-month estimated glomerular filtration rate (eGFR) (rSRF: 0.052, rRCV: 0.317, p = 0.041) and 1st-year eGFR (rSRF: 0.104, rRCV: 0.374, p = 0.033) were found to be more significant in favour of RCV. The correlation between SRF/BMI and RCV/BMI with 1st-, 6th- and 12th-month eGFR (respectively, p = 0.02/0.048/0.024) were found to be more significant in favour of RCV/BMI. Although univariate analysis showed a significant relationship between most volumetric measurements and 1st-year graft functions, in multivariate analysis only RCV [odds ratio (OR): 1.04 (1.01-1.07), p = 0.023] and RCV/BMI [OR: 2.5 (1.27-5.39), p = 0.013] showed a significant relationship between graft functions. CONCLUSION: In our study, it was shown that CT-based renal volumetric measurements, especially RCV and RCV/BMI, predicted graft functions more strongly than scintigraphic 99m Tc-DTPA-SRF.
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Trasplante de Riñón , Donadores Vivos , Femenino , Tasa de Filtración Glomerular , Humanos , Riñón/diagnóstico por imagen , Riñón/fisiología , Trasplante de Riñón/efectos adversos , Trasplante de Riñón/métodos , Masculino , Cintigrafía , Radiofármacos , Estudios Retrospectivos , Pentetato de Tecnecio Tc 99mRESUMEN
At present, hundreds of millions of Chinese people face increasingly serious health risks, and health checks have undoubtedly played a significant role in finding health risks. However, the current health check in China mainly judges the quality of physical functions by a single index value without dynamic analysis of the changing trends of the index, which may lead to unreasonable diagnostic conclusions. In this paper, the data characteristics of physical indicators are systematically analyzed, and grey system models dedicated to data with the characteristics are applied to simulate and predict the changing trends of body indicators. On this basis, possible pathological changes in body organs were identified. Specifically, this paper analyses the state of human kidney functions by grey prediction models. The results showed that even when the renal function index (serum creatinine) is within the normal range, the human renal function might be abnormal. The grey model analysis of the change trends of serum creatinine can predict the potential health hazards of renal functions.
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Overproduction of free radicals is controlled by antioxidant defense mechanisms. These defense mechanisms are achieved by antioxidant enzymes such as catalase (CAT). The current study aimed to assess the changes in steroid hormones, oxidant/antioxidants biomarkers, lipid profiles/liver functions indices, renal function biomarkers and minerals metabolism in non-pregnant, lactating or pregnant one-humped she-camels (Camelus dromedarius) pre-synchronized with controlled internal drug releasing. The study also focused on the correlational relationships between steroid hormones and the oxidant/antioxidant biomarkers, lipid profiles and liver functions indices, renal functions and mineral metabolism in these she-camels. The study was conducted on apparently healthy dromedary she-camels (n = 60) during breeding season. A sexually active camel-bull was introduced to she-camels pre-synchronized with CIDR. Fifty to sixty days after natural mating, she-camels were examined for pregnancy. She-camels were divided into three main groups according to both pregnancy and lactation as following: pregnant (PREG, n = 38) which was kept as control one, non-pregnant and lactating (LACT, n = 8), and non-pregnant and non-lactating she-camels (NPREG, n= 14). Steroid hormones, i.e., progesterone (P4), estradiol (E2) and cortisol, oxidant indictors, i.e., malondialdehyde (MDA), antioxidant biomarkers, i.e., superoxide dismutase (SOD), total antioxidant capacity (TAC), CAT and reduced glutathione (GSH), lipid profiles indices, renal functions and related minerals were assessed. The present study confirmed the efficacy of using CIDR for synchronization in she-camels. Significant elevations in serum steroids hormones in PREG compare with LACT and NPREG. The highest concentrations of MDA as lipid peroxidation and oxidative stress indictors and lowest levels of antioxidant biomarkers except for SOD, i.e., TAC, CAT and GSH, were reported in PREG compared with LACT and NPREG. PREG showed the highest liver enzymes activities and lowest total protein values. Remarkable increases in serum concentrations of renal function parameters and phosphorous (P) were observed in PREG when compared with the other two groups. The investigated she-camels revealed significant correlation between steroid hormones and the oxidant biomarkers, antioxidant biomarkers, liver functions, renal functions and minerals metabolism parameters. P4 showed positive correlations with antioxidant biomarkers, i.e., TAC, CAT and GSH, and serum aspartate aminotransferase (AST) activities, whereas negative correlations were reported between P4 and renal functions biomarkers, i.e., blood urea nitrogen (BUN), creatinine (Cr) and creatinine kinase (CK), and minerals metabolism parameters, i.e., P and magnesium (Mg), in CIDR pre-synchronized she-camels. In contrast, E2 and cortisol showed negative correlations with antioxidant biomarkers, i.e., TAC, CAT and GSH, lipid profiles/liver functions indices, i.e., AST, alkaline phosphatase (ALP) and γ-glutamyl transferase (GGT), CK and Mg, however, positive correlations were demonstrated between E2 and cortisol, and MDA, Cr and P in investigated she-camels. In conclusion, the present study confirmed the efficacy of using CIDR for synchronization in she-camels. The highest MDA levels as indictors for oxidative stress and the lowest antioxidant levels, i.e., TAC, CAT and GSH, except for SOD in pregnant she-camels, were attributable to physiological oxidative stress as excellent compensatory responses observed in the PREG group to face such a physiologic stage. Moreover, lower P levels in non-pregnant she-camels would be contributed to failure of conception or early embryonic death. The investigated she-camels revealed significant correlations between steroid hormones and the oxidant indicators, antioxidant biomarkers, lipid profile indices and renal functions biomarkers that provided better understanding for physiological stress during pregnancy in camels.
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Abstract Introduction: Ankle-brachial pressure index is an objective, noninvasive test for predicting subclinical atherosclerotic diseases. We investigated the role of ankle-brachial pressure index measured with automated sphygmomanometer devices in the prediction of the development of acute kidney injury in patients undergoing major cardiac surgery. Methods: This single-centered, cross-sectional, and observational study was performed on 80 (66 males and 14 females, 58 ± 10 years) patients undergone cardiac surgery. Complete anamnesis, laboratory tests, intravenous fluids, medications, blood products, and all perioperative procedures were recorded in all patients before the surgery. Two automated sphygmomanometer devices giving equivalent results were used for measuring Ankle-brachial pressure index. The data in the first two days after the surgery were used for analysis. The criteria of AKIN were used in the diagnosis of acute kidney injury. Results: Twenty-one (23%) patients developed acute kidney injury in the postoperative period. None of the patients needed renal replacement therapy or died. There was no significant difference between mean ankle-brachial pressure index levels of patients with and without acute kidney injury (1.04 ± 0.17 and 1.06 ± 0.19, respectively, p=0.554). The mean ankle-brachial pressure index was significantly lower in patients with perioperative complications that cause hemodynamic instability (1.07 ± 0.14, 0.96 ± 0.13, p=0.016). On the multivariate analysis model, only perioperative hemodynamic complication development was found to be related to postoperative acute kidney injury. Conclusion: Ankle-brachial pressure index may have a role in predicting perioperative hemodynamic complications, which may cause acute kidney injury in patients undergoing major surgery. Simple automatic blood pressure devices can be used in daily practice for ankle-brachial pressure index measurement instead of complex and expensive doppler devices.
Resumen Introducción: El índice tobillo-brazo (ITB) es una prueba objetiva y no invasiva para diagnosticar la aterosclerosis asintomática. Investigamos el papel del índice tobillo-brazo medido a través de esfigmomanómetros automáticos para pronosticar el desarrollo de insuficiencia renal aguda en pacientes que se sometieron a una cirugía cardíaca mayor. Material y métodos: En este estudio observacional, transversal y unicéntrico, se incluyó a 80 pacientes (66 hombres y 14 mujeres de 58 ± 10 años) que se sometieron a una cirugía cardíaca. Se registraron los siguientes datos de todos los pacientes antes de la cirugía: anamnesis completa, análisis clínicos, líquidos intravenosos, medicamentos, productos hemoderivados e intervenciones perioperatorias. Para medir el ITB, se utilizaron dos esfigmomanómetros automáticos que arrojaron resultados similares. Se analizaron los datos recogidos los primeros dos días luego de la cirugía. Se siguieron los criterios de la AKIN para diagnosticar la insuficiencia renal aguda. Resultados: Veintiún pacientes (23 %) sufrieron insuficiencia renal aguda en el postoperatorio. Ninguno de los pacientes necesitó tratamiento renal sustitutivo ni falleció. No hubo diferencias significativas entre los valores medios del índice tobillo-brazo en pacientes con insuficiencia renal aguda y sin ella (1,04 ± 0,17 y 1,06 ± 0,19, respectivamente; p=0,554). El valor medio del ITB fue significativamente menor en pacientes con complicaciones perioperatorias que causan inestabilidad hemodinámica (1,07 ± 0,14; 0,96 ± 0,13; p=0,016). En el modelo de análisis multivariado, solo se encontró que la aparición de complicaciones hemodinámicas perioperatorias estaba relacionada con la insuficiencia renal aguda luego de la operación quirúrgica. Conclusión: Es posible que el ITB desempeñe un papel en la predicción de complicaciones hemodinámicas perioperatorias, que pueden causar insuficiencia renal aguda en pacientes sometidos a cirugía mayor. En la práctica diaria, pueden utilizarse dispositivos automáticos simples que calculan la tensión arterial para medir el índice tobillo-brazo, en lugar de dispositivos Doppler complejos y costosos.
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The current investigation assessed the impacts of sub-lethal concentrations of silicon dioxide nanoparticles (SiO2NPs) on hepato-renal functions, histopathological characteristics, and gene transcription in gills and liver of Nile tilapia juveniles. Fish were exposed to 20, 40, and 100 mg/L of SiO2NPs for 3 weeks. Pairwise comparisons with the control group showed a significant dose-dependent elevation in serum ALP, ALT, and AST enzyme activities as well as blood urea and creatinine levels in SiO2NP-intoxicated groups. Exposure to 100 mg/L SiO2NPs significantly upregulated expression of HSP70, TNF-α, IL-1ß, and IL-8 genes in the gills as compared to the control group. Moreover, exposure to 100 mg/L SiO2NPs significantly upregulated the expression SOD, HSP70, IL-1ß, IL-8, and TNF-α genes in the hepatic tissues as compared to the control group. Exposure of fish to 20 mg SiO2NPs/L significantly increased the mRNA expression levels of IL-12 in both the gills and liver tissues. Notably, all tested SiO2NP concentrations significantly upregulated the transcription of CASP3 gene in gills and liver of Nile tilapia as compared to the control group. Interestingly, varying histopathological alterations in renal, hepatopancreatic, and branchial tissues were observed to be correlated to the tested SiO2NP concentrations. In conclusion, our results provide additional information on the toxic impacts of SiO2NPs in Nile tilapia at the hematological, tissue, and molecular levels.