Electrolyte Balance Research Articles

Effect of a Compound Unani Formulation in Constipation (Qabḍ): A Case Report

Background and Prevalence: Constipation is a significant public health issue in India, with prevalence ranging from 16% to 37%. Herbal medicines are traditionally used in India for various ailments, including constipation. Herbal Medicine Usage: The WHO estimates that 80% of people globally rely on herbal medicines for primary health care due to their perceived safety, efficacy, and fewer side effects compared to conventional medications. Unani Medicine Perspective: Unani medicine, a traditional system in South Asia, includes various formulations for treating constipation as mentioned in classical Unani literature. Case Description: A 29-year-old female patient with no underlying health conditions presented with constipation at the General Medicine OPD of RRIUM Srinagar. Investigations: Thorough investigations including CBC, LFT, KFT, RBS, HbA1c, thyroid profile, electrolyte balance, lipid profile, and cortisol level were normal, confirming unexplained constipation. Treatment: The Unani formulation, Safuf-i-anardana, was administered at 9 g in the morning and 7 g at bedtime with plain water for one week. Outcome: The patient experienced relief from constipation after treatment, with the formulation enhancing intestinal motility and promoting bulk formation of stools due to its laxative and purgative properties. Keywords: Constipation, Qabḍ, Turbud, Safuf-i-anardana, unani medicine, mushil

Sex differences in the adrenal circadian clock: a role for BMAL1 in the regulation of urinary aldosterone excretion and renal electrolyte balance in mice.

Brain and muscle ARNT-Like 1 (BMAL1) is a circadian clock transcription factor that regulates physiological functions. Male adrenal-specific Bmal1 (ASCre/+::Bmal1) KO mice displayed blunted serum corticosterone rhythms, altered blood pressure rhythm, and altered timing of eating, but there is a lack of knowledge in females. This study investigates the role of adrenal BMAL1 in renal electrolyte handling and urinary aldosterone levels in response to low salt in male and female mice. Mice were placed in metabolic cages to measure 12-h urinary aldosterone after a standard diet and 7 days low-salt diet, as well as daily body weight, 12-h food and water intake, and renal sodium and potassium balance. Adrenal glands and kidneys were collected at ZT0 or ZT12 to measure the expression of aldosterone synthesis genes and clock genes. Compared with littermate controls, ASCre/+::Bmal1 KO male and female mice displayed increased urinary aldosterone in response to a low-salt diet, although mRNA expression of aldosterone synthesis genes was decreased. Timing of food intake was altered in ASCre/+::Bmal1 KO male and female mice, with a blunted night/day ratio. ASCre/+::Bmal1 KO female mice displayed decreases in renal sodium excretion in response to low salt, but both male and female KO mice had changes in sodium balance that were time-of-day-dependent. In addition, sex differences were found in adrenal and kidney clock gene expression. Notably, this study highlights sex differences in clock gene expression that could contribute to sex differences in physiological functions.NEW & NOTEWORTHY Our findings highlight the importance of sex as well as time-of-day in understanding the role of the circadian clock in the regulation of homeostasis. Time-of-day is a key biological variable that is often ignored in research, particularly in preclinical rodent studies. Our findings demonstrate important differences in several measures at 6 AM compared with 6 PM. Consideration of time-of-day is critical for the translation of findings in nocturnal rodent physiology to diurnal human physiology.

Balanced Electrolyte Solutions Versus 0.9% Saline for Kidney Transplantation: An Updated Systematic Review and Meta-analysis.

Perioperative intravenous fluids are administered to kidney transplant recipients to maintain hemodynamic stability and graft perfusion; however, the ideal fluid remains uncertain. Although 0.9% saline (saline) is commonly used, its high chloride content causes hyperchloremic metabolic acidosis and may increase the risks of delayed graft function (DGF) and hyperkalemia. Balanced electrolyte solutions (BES) have a more physiological chloride concentration and may reduce these risks. Previous meta-analyses found insufficient evidence to compare BES with saline for these outcomes; however, new studies have recently been published. In this updated review, we compared the effects of BES with saline on the risk of DGF and hyperkalemia in kidney transplantation. MEDLINE, Embase, and CENTRAL were searched for randomized controlled trials comparing BES with saline in kidney transplantation. The primary outcomes were DGF and hyperkalemia. Eligible studies were assessed for risk of bias and data were pooled for analysis. The Grading of Recommendations Assessment, Development, and Evaluation framework was used to assess the quality of evidence. Ten studies involving 1532 participants were included. The quality of evidence was high for deceased donor transplantation and very low for living donor transplantation. The relative risk (RR) of DGF associated with BES compared with saline was 0.83 (95% confidence interval [CI], 0.71-0.96; P = 0.01) in deceased donor transplantation. There was no difference in DGF in living donor transplantation (RR 0.79; 95% CI, 0.26-2.41; P = 0.68). There was no difference in hyperkalemia between groups (RR 0.87; 95% CI, 0.59-1.27; P = 0.46). Compared with saline, BES reduces the risk of DGF in deceased donor kidney transplantation without increasing hyperkalemia.

Effectiveness of Balanced Electrolyte Solution vs Normal Saline in the Resuscitation of Adult Patients with Diabetic Ketoacidosis: An Updated Systematic Review and Meta-analysis.

Fluid resuscitation is the first-line treatment for patients with diabetic ketoacidosis (DKA). However, the optimal choice of resuscitative fluid remains controversial. This study aims to evaluate the impact of balanced electrolyte solution (BES) compared to 0.9% sodium chloride (NS) on various physiological and clinical outcomes in adult DKA patients. An extensive search of electronic databases, including Embase, PubMed, Cochrane Library, Web of Science, and Google Scholar, was conducted to select studies that directly compared BES and NS in adult DKA patients. This systematic review and meta-analysis included nine studies, comprising both randomized controlled trials and retrospective studies. Combined estimates were expressed as mean differences (MDs) with 95% confidence intervals (CIs). The primary outcomes were time to resolution of DKA and length of hospital stay. The secondary outcomes were post-resuscitation chloride and bicarbonate levels and adverse events. No significant difference was observed between BES and NS in the time to DKA resolution (MD: -1.63; 95% CI: -7.66-4.41; p = 0.60) or length of hospital stay (MD: -0.07; 95% CI: -0.44-0.31; p = 0.73). However, BES resulted in significantly higher post-resuscitation bicarbonate levels (MD: 1.63; 95% CI: 0.86-2.39; p < 0.001) and lower post-resuscitation chloride levels (MD: -2.37; 95% CI: -3.56 to -1.19; p < 0.001). The use of BES is associated with improved post-resuscitation electrolyte balance and preventing hyperchloremic metabolic acidosis in DKA patients. While BES may offer some biochemical advantages, both BES and NS are safe for treating DKA. Gupta P, Nasa P, Shahabdeen SM. Effectiveness of Balanced Electrolyte Solution vs Normal Saline in the Resuscitation of Adult Patients with Diabetic Ketoacidosis: An Updated Systematic Review and Meta-analysis. Indian J Crit Care Med 2025;29(1):65-74.

Difficulties in the differential diagnosis of comorbid fluid and electrolyte balance disorders: description of a clinical case

Difficulties in the differential diagnosis of comorbid fluid and electrolyte balance disorders: description of a clinical case

Coenzyme Q10 Attenuates Kidney Injury Induced by Titanium Dioxide Nanoparticles and Cadmium Co-exposure in Rats.

This study examined the possible defensive role of coenzyme Q10 (CQ10) against the impact of cadmium (Cd) and titanium dioxide nanoparticle (TNP) exposure on rat kidneys. Distilled water (1mL/rat), corn oil (1mL/rat), 10mg CQ10/kg b.wt, 50mg TNP/kg b.wt, 5mg Cd/kg b.wt, TNP + Cd, or TNP + Cd + CQ10 was administered orally to seven groups of 70 male Sprague Dawley rats for 60days. The findings demonstrated that TNP and/or Cd exposure considerably raised serum levels of several renal damage products, disturbed electrolyte balance including sodium, potassium, and calcium, decreased antioxidant enzyme concentration in the kidneys, and elevated malondialdehyde. In addition, rats exposed to TNP and/or Cd had significantly higher levels of renal titanium and Cd. In addition, rats exposed to TNP and/or Cd showed significant histopathological lesions and collagen deposition as revealed by H and E and Masson trichrome staining, respectively. The kidneys were severely damaged by the combined effects of TNP and Cd, although CQ10 greatly mitigated these effects. According to the study, exposure to TNP and Cd can damage the kidneys' function and structure, especially when combined. However, CQ10 can protect against TNP and Cd's nephrotoxic effects.

Evaluation of hematological, electrolyte and lipid profiles of potash samples obtained from Anambra State, Nigeria: A comparative sub-acute study on the effects of low-dose trona and natron on Wistar rats.

Trona and natron are natural-occurring salts geologically referred to as evaporites and commonly known as potash. Both types of potash are most common among Nigerian users, especially as food softeners/additives and medicinal remedies. The sub-acute toxicological effects of the two primary varieties consumed in Anambra State, Nigeria, on hematological, electrolyte, kidney function, and lipid profiles at low doses remain unexplored. A 28-day sub-acute study used 120-140 g Wistar rats. Three groups of six (n=6) rats were assembled. Group A (control) received feed and water, group B received 500 mg/kg of reddish potash (natron) while group C received 500 mg/kg of greyish potash (trona). Standard methods were used in analyzing parameters. Data was analyzed with SPSS, version 27. Results were shown as mean ± SD. One-way ANOVA was performed to compare mean values. Hematological results in groups A and B reveal a significant (p&lt;0.05) decrease in red blood cells and platelets and an increase in white blood cells (p&lt;0.05) compared to the control. The electrolytes results recorded significant increase(p&lt;0.05) in Na+ in group B while group C recorded a significant increase in K+ and CL- when compared to the control. Group B had a significantly higher creatinine and urea than group C and the control. The study revealed a significant increase (p&lt;0.05) in total cholesterol and high density lipoprotein in group B, but not in triglycerides or low density lipoprotein. The study concludes that on chronic consumption, low dosages (10 % of LD50) of natron or trona can alter hematological parameters, electrolyte balance, renal function (particularly in natron), and lipid profile.

"Electrolyte Imbalance in Chronic Kidney Disease: Management Strategies and Approaches to Enhance Quality Of Life

Chronic Kidney Disease (CKD) is a progressive condition characterized by a gradual loss of kidney function, significantly impairing the body's ability to maintain electrolyte and fluid balance. Electrolytes, including sodium, potassium, calcium, phosphorus, and magnesium, play a crucial role in homeostasis, influencing nerve signaling, muscle function, and acid-base equilibrium. In CKD, the diminished renal function disrupts this delicate balance, leading to prevalent and clinically significant electrolyte imbalances. These imbalances contribute to a range of complications, such as cardiovascular disorders, bone disease, and neuromuscular dysfunction, severely impacting patients' overall quality of life (QoL). Management strategies for electrolyte disturbances in CKD include dietary modifications, pharmacological interventions, and advanced therapies like dialysis and kidney transplantation. These approaches aim to stabilize electrolyte levels, prevent complications, and enhance patients' QoL. This review explores the pathophysiology, clinical manifestations, and diagnostic approaches to electrolyte imbalances in CKD, emphasizing evidence-based management strategies and emerging innovations. Addressing these challenges holistically is crucial for improving clinical outcomes and supporting the well-being of individuals living with CKD.

Use of parenteral nutrition in the management of enterocutaneous fistula.

Nutrition plays an integral role in the management of patients with enterocutaneous fistula (ECF), but practice guidelines are often vague because of limited evidence. As a result, clinicians must rely on expert consensus and sound nutrition principles to guide practice. The initial phase of ECF management involves recognition (eg, fistula location and quantifying output) and stabilization (eg, source control and fluid and electrolyte balance). All patients with ECF should be considered at risk of malnutrition because of malabsorption, high gastrointestinal fluid and nutrient losses, and chronic inflammation. Strict bowel rest in conjunction with parenteral nutrition (PN) is typically warranted on initial presentation, but patients can often transition to oral diet or enteral nutrition if ECF output is low (<500 ml/day) and there is good control of ECF drainage at the skin level. Patients with high-output ECF (>500 ml/day) may require PN to meet fluid, electrolyte, and nutrient requirements to support spontaneous or surgical closure of the ECF. Because the healing process can take months, transfer from the inpatient to home setting should be considered when a patient is medically stable. Preparing for discharge home requires stabilization of fluid and electrolyte balance, achievement of glycemic control, containment of ECF output, and patient and/or caregiver training. A long-term PN treatment plan should be developed that incorporates outpatient monitoring, determination of target weight, and desired PN end point. The purpose of this article is to review the optimal use of PN in adult patients with ECF.

Saline versus balanced crystalloids for hydration post-kidney biopsy.

Isotonic fluids are becoming the standard for hydration and maintenance fluid therapy, but there is no consensus on the optional choice among the different types of isotonic solution. This study is a single-center, non-randomized controlled trial at Kobe University Hospital, Japan, between April 2021 and March 2023. The study included pediatric patients aged 1-19years who underwent kidney biopsies. From April 2021 to March 2022, 0.9% sodium chloride (saline) was administered, and from April 2022 to March 2023, balanced crystalloids were used. The primary outcome was the occurrence of hyponatremia (< 137mEq/L) after a kidney biopsy. Secondary outcomes included other electrolyte balances, blood gas parameters, creatinine-based estimated glomerular filtration rate (Cr-eGFR), and arginine vasopressin concentrations (UMIN Clinical Trial Registry: UMIN 000044330). Of 61 patients enrolled, 2 were excluded, leaving 34 in the saline group and 25 in the balanced crystalloid group. No hyponatremia occurred, and serum sodium concentrations were similar between both groups (138.7 vs. 138.9mEq/L, P = 0.08). The saline group showed a greater increase in serum chloride (+ 1.7 vs. + 0.2, P < 0.01) and a greater decrease in HCO3- concentrations (- 0.6 vs. + 0.9, P < 0.01). There were minimal changes in pH (- 0.01 vs. - 0.01, P = 0.99) and Cr-eGFR (- 1.5 vs. + 1.1mL/min/1.73 m2, P = 0.96) in both groups. During pediatric kidney biopsy, both saline and balanced crystalloids were effective in preventing hyponatremia. Although saline infusion results in higher serum chloride concentrations and lower blood HCO3- concentrations than balanced crystalloids infusion, the clinical significance was minimal.

(Keynote) From Electrode Development to Process Optimization: A Journey of Scaling-up CO2 Electrolysis

Electrochemical reduction of CO2 is a promising method for converting a greenhouse gas into value-added products, utilizing renewable energy. Novel catalysts, electrode assemblies, and cell configurations are all necessary to achieve economically appealing performance. In this talk, I am going to present a zero gap electrolyzer cell, which converts gas phase CO2 to products without the need for any liquid catholyte. I will demonstrate how multiple cells are connected into a stack, thus scaling up the electrolysis process. I will show how proper cell components and operational conditions result in industrially relevant performance. I will demonstrate the role of each component of the membrane electrode assembly, such as the catalysts, the porous transport layers, the membrane, and the ionomers.In the second part of my talk, I will show that while precipitate formation in the cathode gas diffusion electrode is detrimental for the long-term stability, the presence of alkali metal cations at the cathode improves performance. To overcome this contradiction, I will present different approaches which help to extend the lifetime of the electrolyzer cell. I will also present a detailed electrolyte and water balance of the operational cell, to better understand the contributing factors to these phenomena. As an outlook, I will present a complex machine learning based approach, through which we aim to find the optimal operating conditions of such CO2 electrolyzer cells.Finally, I will share the most recent insights on our containerized prototype CO2 electrolyzer system, capable of processing 100 t CO2/year.

High-Sensitivity Electrical Admittance Sensor with Regression Analysis for Measuring Mixed Electrolyte Concentrations.

Electrolyte balance is essential for the proper functioning of the body, and imbalances can lead to various health issues, some of which may be life-threatening. Therefore, measuring electrolyte concentrations is becoming increasingly important, particularly for athletes engaged in high-intensity and prolonged physical activity. In this project, we developed a highly sensitive sensing device capable of accurately and rapidly measuring electrolyte concentrations in mixed solutions, providing precise analysis of trace electrolyte levels. The sensor device requires no complex operational procedures and can quickly complete measurements, making it well-suited for point-of-care applications. Integration of regression models further enhances the device's ability to estimate concentrations in mixed electrolyte solutions. The test results demonstrate that the device can detect subtle concentration variations, with a precision as low as 0.5 mM. This proposed sensing device offers a cost-effective and efficient solution for real-time monitoring of electrolyte levels in healthcare.

Examination of fecal electrolyte on pediatric patient with intestinal stoma

Intestinal stomas are increasingly performed in pediatric patients to manage various gastrointestinal conditions, such as congenital malformation of intestinal, necrotizing enterocolitis and intestinal obstruction, which are frequently occured in developing countries with Low-Middle Income Country (LMIC). However, the presence of a stoma has possibility of morbidity such as can significantly affect the body’s fluid and electrolyte balance, particularly in infant and under five years old children. This risk is increased due to the immature renal system in pediatric patients, increased loss of fluids and electrolytes through stoma output, especially small intestinal stoma. In addition to being a challenge in the management of infants and children with stomas and intestinal resections, electrolyte imbalances are one of the factors contributing to morbidity and mortality in these group. Early detection of abnormalities can guide timely interventions such as fluid replacement therapy and dietary modifications, prevent complications like dehydration, metabolic acidosis or electrolyte disturbances. Measuring fecal electrolyte provide valuable insights into the patient’s hydration status and potential electrolyte imbalances. Since the fecal sample measuring is the simplest, harmless and noninvasive than the other electrolyte tests, so it can be considered for pediatric patients.

In-silico study and in-vitro validations for an affinity of mangiferin with aldose reductase: Investigating potential in tackling diabetic retinopathy

Type II Diabetes mellitus (T2DM) and associated complications primarily diabetic retinopathy cases are rising with an alarming rate. Prolong hyperglycemia along with the aldose reductase (AR) activity play a pivotal role in the development of oxidative stress in the aqueous humor and diabetic retinopathy. AR catalyzes conversion of glucose into sorbitol and or fructose get diffuse into lens leading to impaired electrolyte balance and cataract formation. Here in the study, affinity of mangiferin was evaluated first using in silico approaches (Docking studies) and then validated via isothermal titration calorimetry. Here in the present study aim was to check the does mangiferin do have affinity with AR, does mangiferin inhibit the AR and polyol pathway as key pathway involve in the diabetic retinopathy. Both in silico and laboratory investigations were carried out to explore the affinity of mangiferin with the aldose reductase. Swiss target prediction study showed that the AR is prime target of mangiferin in the human proteome. The molecular docking study and affinity searches were performed to seek the bonding pattern and forces involved. Docking (affinity 34.37 kcal/mol) for AR pose 1 was reported superior over the AR pose 2 (affinity −35.46 kcal/mol) against mangiferin. Mangiferin showed significant AR inhibition where IC50 reported 67.711 µg/ml and highest inhibition was reported at 300 µg/ml i.e. 86.44 %. On the contrary, Quercetin showed much higher inhibition of aldose reductase at similar concentration i.e. 94.47 % at 300 µg/ml with IC50 59.6014 µg/ml. Here, AR pose 1 showed higher affinity with the mangiferin and confirmed via Isothermal Titration Calorimetry clearly showed higher binding affinity parameters. Binding affinity of AR pose 1 with the mangiferin was higher as showed with affinity parameter determined via ITC i.e. floating association constant (Ka) reported 6.47×106, binding enthalpy (ΔH) −46.11 kJ/mol and higher binding sites (n) i.e. 1.84. Findings demonstrates that the mangiferin is promising AR inhibitor with the ADME prediction (CLR 1.119 ml/min and t1/2 1.162 h).

Abstract 4138745: Blockade of Mineralocorticoid Receptor by Esaxerenone Improves Insulin Sensitivity in Obese Mice

Background: Aldosterone regulates blood pressure and electrolyte balance. However, overactivation of the mineralocorticoid receptor (MR) and elevated aldosterone levels are implicated in the pathogenesis of cardiometabolic disorders, though the underlying mechanisms are not fully understood. In this study, we investigated whether a novel, non-steroidal selective MR blocker, esaxerenone, ameliorates the development of metabolic disorders in obese mice models and examined the underlying mechanism. Methods: Esaxerenone (3 mg/kg/day) was orally administered to high-fat diet (HFD)-fed C57BL/6J or normal chow-fed db/db mice. Metabolic parameters, tissue morphology, and effects of esaxerenone on insulin sensitivity were assessed. Gene expression and insulin signaling, determined by Akt phosphorylation, were examined using quantitative RT-PCR and western blotting, respectively. In in-vitro experiments, insulin targets cell lines such as 3T3-L1 adipocytes, HepG2 cells, and C2C12 myotubes were used. Insulin-responsive cells were treated with 10 nM or 100 nM esaxerenone or eplerenone for 30 minutes before 4-hour 1000 nM aldosterone stimulation. Insulin signaling was assessed 15 minutes after stimulation with 17 nM insulin. Results: Esaxerenone improved insulin sensitivity (P&lt;0.05) without altering metabolic parameters in HFD-induced obese and db/db mice. Esaxerenone suppressed fat accumulation, adipocyte size, and liver lipid droplets compared with the vehicle-treated group (P&lt;0.01). In adipose tissue, esaxerenone reduced macrophage infiltration (P&lt;0.01) and the expression of inflammatory molecules (P&lt;0.05). In in-vitro experiments, aldosterone significantly decreased the expression levels of PPARγ and adiponectin in 3T3-L1 adipocytes. Moreover, aldosterone attenuated insulin-induced Akt phosphorylation in 3T3-L1 adipocytes, HepG2 cells, and C2C12 myotubes in a dose-dependent manner (P&lt;0.01). Pretreatment with esaxerenone reversed the effect of aldosterone, whereas eplerenone, an MR antagonist, did not show a similar effect at the same dose. Conclusion: Inhibition of MR by esaxerenone improved insulin sensitivity in HFD-induced obese and genetically diabetic mice. The reduction of inflammation and fat accumulation and enhancement of insulin signaling were suggested to be underlying mechanisms. Esaxerenone might be a beneficial therapeutic approach for managing metabolic disorders.

Sodium Chloride Cotransporter in Hypertension.

The sodium chloride cotransporter (NCC) is essential for electrolyte balance, blood pressure regulation, and pathophysiology of hypertension as it mediates the reabsorption of ultrafiltered sodium in the renal distal convoluted tubule. Given its pivotal role in the maintenance of extracellular fluid volume, the NCC is regulated by a complex network of cellular pathways, which eventually results in either its phosphorylation, enhancing sodium and chloride ion absorption from urines, or dephosphorylation and ubiquitination, which conversely decrease NCC activity. Several factors could influence NCC function, including genetic alterations, hormonal stimuli, and pharmacological treatments. The NCC's central role is also highlighted by several abnormalities resulting from genetic mutations in its gene and consequently in its structure, leading to dysregulation of blood pressure control. In the last decade, among other improvements, the acquisition of knowledge on the NCC and other renal ion channels has been favored by studies on extracellular vesicles (EVs). Dietary sodium and potassium intake are also implicated in the tuning of NCC activity. In this narrative review, we present the main cornerstones and recent evidence related to NCC control, focusing on the context of blood pressure pathophysiology, and promising new therapeutical approaches.

Diabetic Ketoacidosis in Children

The incidence of diabetic ketoacidosis (DKA) in children with type 1 diabetes mellitus reaches 1–12 per 100 patients each year. The case is a boy aged 13 years 10 months with chief complaints of weakness and drowsiness. Blood sugar levels 532 mg/dL, blood ketone levels 6.6, blood pH 7.13, HbA1c 19.2%. The principles of DKA management include fluid therapy, insulin, electrolyte balance, treat the underlying disease, and monitor complications.

ВЛИЯНИЕ ЭКСТРАКОРПОРАЛЬНОЙ АУТОГЕМОМАГНИТОТЕРАПИИ В ИНТРАОПЕРАЦИОННОМ ПЕРИОДЕ ПРИ ПРОВЕДЕНИИ РЕВАСКУЛЯРИЗАЦИИ МИОКАРДА В УСЛОВИЯХ ИСКУССТВЕННОГО КРОВООБРАЩЕНИЯ НА КИСЛОТНО-ЩЕЛОЧНОЕ СОСТОЯНИЕ АРТЕРИАЛЬНОЙ КРОВИ

Background. To evaluate changes in acid-base balance in patients with coronary heart disease in the intraoperative period during coronary artery bypass grafting under artificial circulation using extracorporeal autohemomagnetotherapy (EAHMT). To consider the presence of a negative effect of this technique on acid-base balance. To study the possible relationship between the polymorphism of the angiotensin-1 receptor gene (AGTR1 A1166C), endothelin-1 (EDN1 Lys 198 Asn), endothelial nitric oxide synthase (NOS3 C786T) and changes in the studied parameters of acid-base balance. Material and methods. Group 1 included standard anesthesia for coronary artery bypass grafting under cardiopulmonary bypass without the use of EAHMT (60 patients). Group 2 included standard anesthesia for coronary artery bypass grafting under cardiopulmonary bypass with the use of EAHMT (63 patients). The following parameters of the acid-base balance of arterial blood were assessed: hydrogen index (pH), lactate (Lac), base deficit (SBE), potassium (K), sodium (Na), hemoglobin (Hb), hematocrit (Hct). All patients of both groups underwent intraoperative venous blood sampling from the central venous catheter. Then, the polymerase chain reaction method was used to study the genotypes of the angiotensin-1 receptor gene polymorphism (AGTR1 A1166C), endothelin-1 (EDN1 Lys 198 Asn), endothelial nitric oxide synthase (NOS3 C786T). Results. At the second stage of the study, a decrease in the hydrogen index of arterial blood, hemoglobin, hematocrit, and base deficit was revealed in both groups. A statistically significant increase in lactate and potassium was obtained in both study groups. No associations were found between the polymorphism of the angiotensin-1 receptor gene (AGTR1 A1166C), endothelin-1 (EDN1 Lys 198 Asn), endothelial nitric oxide synthase (NOS3 C786T) and the arterial blood acid-base balance. Conclusion. The use of EAHMT does not have negative impact on the electrolyte balance and acid-base composition of the blood. The presence of polymorphism of the AGTR1 gene A1166C (rs 5186), EDN1 gene Lys 198 Asn (rs5370), NOS3 gene C786T (rs 2070744) does not affect the acid-base balance of arterial blood.

A new era in the treatment of kidney diseases: NLRP3 inflammasome and cytokine-targeted therapies.

The kidneys are crucial for filtering blood, managing overall body water, electrolyte, and acid-base balance, and regulating blood pressure. They remove metabolic waste products, toxins, and drugs. In addition, they limit inflammation by clearing cytokines and reduce immune cell activation by removing bacterial components. Dendritic cells (DCs) in the kidney maintain peripheral tolerance. About 85% of filtered water is reabsorbed by the proximal tubule, exposing distal nephron cells to high concentrations of low molecular weight antigens. These antigens are captured by DCs, helping to inactivate potentially autoreactive T cells and maintain tolerance to circulating antigens. In kidney failure, immune function is severely compromised due to the retention of toxins and cytokines, which activate immune cells and increase systemic inflammation. The kidneys are also vulnerable to immune-mediated diseases. Loss of immune homeostasis, characterized by over- or under-activity of the immune response, can adversely affect kidney function. With advances in immunology and cellular biology, biologic therapies targeting various pathways involved in the pathophysiology of kidney diseases are being developed. In this review, the immunologic aspects of kidney diseases and focus on cytokine-based therapies that may hold promise for the treatment of kidney diseases in the future will be presented.

The therapeutic potential of Ribes orientale in hypertension: Improving electrolyte balance, enhancing antioxidant activity, and modulating the muscarinic pathway

Cardiovascular diseases like hypertension require diuretics, but their effectiveness and side effects limit their use. Alternatives like Ribes orientale extract are being investigated for potential diuretic. In acute diuretic action, the extract and fractions of Ribes orientale were investigated in saline-loaded rats at doses of 12.5, 25, and 50mg/kg, p.o., while prolonged diuretic activity was also performed by administration of the most potent and significant dose of Ribes orientale butanol fraction (ROBF) for 7days. ROBF diuretic action was confirmed through parameters like urine volume, electrolyte concentration, pH and conductivity. The study found that 50mg/kg of ROBF had the most potent and significant diuretic activity, like furosemide (10mg/kg). It also produced significant natriuresis and insignificant kaliuresis in electrolyte excretion. ROBF increased diuretic activity significantly from the first and 7th days. In the mechanistic study, it has been evaluated that nitric oxide and prostaglandins pathways are not involved in the diuretic effect of ROBF, while cholinergic pathway might be responsible for the diuretic effect of ROBF. Hematological, renal function tests and histopathological studies confirmed the safety of Ribes orientale at 50mg/kg. Results showed slight changes in blood count parameters and no significant changes in creatinine and blood urea nitrogen levels compared to the negative control. Furthermore, downregulation of aldosterone by ROBF prolonged activity enhances the local bradykinin availability that results in marked diuretic and natriuretic activity. It is evident from the decreased level of malondialdehyde (MDA) that Ribes orientale reduces the oxidative stress while increased level of superoxide dismutase (SOD) depicts improving level of antioxidant activity. We conclude that the butanol fraction of Ribes orientale roots possesses a considerable diuretic effect. Therefore, more study is needed to identify the exact mechanism of action and the real efficacy of Ribes orientale as diuretic.