Kidney Disease Failure Research Articles

Correlation between Kidney Failure Disease and Parathyroid Gland with Family Genetic History

Family-based and genome-wide studies suggest that genetic differences significantly influence an individual’s lifetime risk for kidney disease. Aimed to: find out if there are relationship between kidney failure disease and family genetic history. Material and Methods: Data were collected using interviewer-administered questionnaires. Data from the biochemical analysis and questionnaire with a Google form survey were recorded in Microsoft Excel. Results: The percentage of Gender for hemodialysis patients males 61(57.6%) more than females 45(42.5%), the correlation between age and other variables is quite weak (R = 0.098, P = 0.315). Gender also shows a weak correlation with other variables (R = 0.049, P = 0.616). There is a significant correlation between having a family member with a parathyroid gland issue and other factors (R = 0.248, P < 0.010). The strongest correlation found is between having a family member who suffers or has suffered from kidney failure and other factors (R = 0.277, P = 0.004). Conclusion: The weak correlations with age and gender indicate that these factors might not be central to the study's main findings. The strongest correlation found is between having a family member who suffers or has suffered from kidney failure and other factors.

Comparing health-related quality of life and utility scores of patients undergoing hemodialysis and continuous ambulatory peritoneal dialysis in Indonesia.

Although both hemodialysis and continuous ambulatory peritoneal dialysis (CAPD) are covered by national healthcare insurance, 98% of kidney failure disease patients are treated with hemodialysis. This study compared the health-related quality of life (HRQoL) and utility scores of patients receiving hemodialysis and CAPD in Indonesia and determined factors associated with HRQoL and utility scores. A cross-sectional study was performed using the Kidney Disease Quality of Life-36 and EQ-5D-5L instruments at six hospitals. Utility scores were presented as SF-6D and EQ-5D scores. Factors associated with the EQ-5D were evaluated using Tobit regressions due to ceiling effects, while the SF-6D and HRQoL were assessed using generalized linear models since the data were not normally distributed. Among the 613 patients, 76% were treated with hemodialysis. After adjusting for sociodemographic characteristics and clinical parameters, CAPD patients reported better HRQoL compared to hemodialysis patients in terms of the SF-6D (p = .038), mental component summary (p = .020), symptoms (p = .005), and effects of kidney disease (p<.001), but no significant differences were reported in EQ-5D (p = .083), physical component summary (p = .323), burden of kidney disease (p = .111), and kidney summary scores (p = .068). Poorer HRQoL and utility scores were likely experienced by older patients who were male, married, with diabetes, treated in Class A hospitals, and with lower education, hemoglobin, and albumin levels. In Indonesia, patients treated with CAPD had better HRQoL and utility scores compared to patients undergoing hemodialysis. Therefore, CAPD should be promoted by healthcare professionals as the first treatment option for patients who are eligible for both hemodialysis and CAPD.

Efektivitas Penerapan Acupressure terhadap Kualitas Hidup Pasien Selama Hemodialisis: Sistematik Review dan Meta-Analisis

Background: quality of life is an individual's perception of his or her position in life in the context of culture, value systems, and its relationship to life goals, expectations, standards, and other related things.Objective: this study aims to determine the effect of Acupressure in improving the quality of life of hemodialysis patients.Methods: The research used in this study was systematic review and meta-analysis using the PICOT method, by searching through Pubmed, Embese, and Proquest databases, so that as many as 6 articles were obtained that discussed the effectiveness of Acupressure in improving the quality of hemodialysis patients.Results: studies showed that most of the studies revealed that there was an effect of acupressure on improving quality of life in patients with hemodialysis. Acupressure actions such as improving sleep quality, reducing the intensity of pain, depression and anxiety. In conclusion, this acupressure therapy can be useful in improving the quality of life experienced by hemodialysis patients.Clinical implications: The results of this study are an indication of the importance of nonpharmacological therapy in nursing intervention by providing acupresuree to improve the quality of life of patients with chronic kidney failure disease while undergoing hemodialysis and patients can independently intervene as an effort to prevent and self-manage at home so that the patient's quality of life is improved during treatment.Keywords: Acupresuree, Hemodialysis, Quality of Life

Assessment of creatinine and blood urea in kidney failure patient within Kerkuk city, Iraq

The assessment of creatinine, a waste product produced by muscle metabolism that is filtered out of the body by the kidneys and the levels of blood urea are important tools for monitoring kidney's function. A total of 191 patients (105 male and 86 female) encountered in this study, with kidney failure compared with 21 control healthy individuals (11 male and 10 female). A significant increase (p≤0.0012) in creatinine was detected in kidney failure patients (9.3±3.2) in comparison with control (0.62±0.1) as well as between the genders. In female the creatinine level was significantly higher (p≤0.05) than that of male. The general levels of urea have also elevated in kidney failure disease (KFD) from (112±42) in comparison with control (25±10) but with a slight significant difference (p≤0.05) between the genders. The percentages of Hb% showed a significant decrease (p≤0.007) in kidney failure patients in comparison with control of all cases. Similarly, the packed cell volume (PCV) had significantly dropped down (p≤0.01) in total patients as well as in between genders in comparison with their counter control. Increased urea 4-5 folds in kidney patients confirms, to certain extend, the occurrence of dysfunction of kidneys and failure to re-absorb the nitrogen components leading to elevation of its amount in patients. Regular monitoring of creatinine and blood urea levels, along with other factors deems essential for improving patient health and quality of life.

The Antioxidant Status of Kidney Failure Patients

Foundation: Kidney disappointment is an ailment in which the kidneys no longer function. (1) It is isolated into intense kidney disappointment (cases that proliferate) and persistent kidney disappointment (those that are long haul). Indications might incorporate leg expansion, feeling tired, heaving, loss of craving, or disarray. Complexities of intense infection might incorporate uremia, high blood potassium, or volume over-burden. Difficulties of ongoing illness might incorporate coronary illness, hypertension, or sickliness. Creatinine is a breakdown result of creatine phosphate in muscle and is generally delivered at a genuinely consistent rate by the body (contingent upon bulk). Point: This study expects to research the connection between catalase compound, creatinine, and urea level with the advancement of kidney disappointment. Techniques: Plasma of Catalase, creatinine, and Urea were not entirely settled in 46 patients with kidney disappointment and 21 solid subjects as control bunch utilizing the colorimetric technique. All outcomes were genuinely examined. Results: A profoundly huge increment was found in the serum level of creatinine and urea in patients with Kidney disappointment contrasted with control (P &lt; 0.05). Compared with the control, serum levels of catalase compound were diminished in the patient gathering (P &lt; 0.05). End: The consequences of the current review give proof that the family background of kidney infection, diabetes mellitus, hypertension, coronary illness, and long-haul uncontrolled hypertension has an unmistakable connection with kidney disappointment hazard. Undeniable degrees of creatinine and urea were introduced in patients with Kidney disappointment. Keywords: Catalase enzyme, Creatinine, Urea, Kidney failure Diseases.

Monitoring of Opportunistic Fungal Infections in Cases with PJP Symptoms Enduring Kidney Failure Diseases

Monitoring of Opportunistic Fungal Infections in Cases with PJP Symptoms Enduring Kidney Failure Diseases

Gambaran Kadar Asam Urat Pada Pasien Gagal Ginjal

Uric acid or urine acid is a product of purine nucleic acid catabolism. Uric acid is produced from within the body (genetic) and from outside (food consumed). Uric acid is measured to assess purine metabolism abnormalities, to confirm the diagnosis and monitoring of treatment, and to detect abnormalities in kidney function. In this situation, the results of purine metabolism (uric acid) that should be excreted out of the body through the kidneys do not occur, so that uric acid in the blood will increase over time. Kidney failure disease kidney organ function has decreased so that eventually unable to work as a filter, dispose of body electrolytes, and maintain fluid and chemical balance in the blood or urine production. This study aims to determine uric acid levels and the percentage of uric acid levels that are outside the normal range and the relationship between hemodialysis time and uric acid levels in patients with kidney failure. The research method used is the descriptive method and the examination method uses the uricase enzymatic method. For data analysis using the SPSS Bivariate test program with Spearmen's Rank test with a sig value of 0.608 which was carried out on 32 samples of serum from hemodialysis patients at random. The results of this study showed that the average uric acid level was 7.1 mg/dL, while normal uric acid levels were 2.7 mg/dL, and the highest was 10.2 mg/dL. Uric acid levels that showed normal results were 12 respondents or 37.5% and increased results were 20 respondents or 62.5%. There is no relationship between the length of hemodialysis time and uric acid levels in patients with kidney failure.

SOCIAL VARIABLES AFFECTING FUTURE ANXIETY IN PATIENTS WITH RENAL FAILURE : ANTHROPOLOGY RESEARCH AT THE DIALYSIS SCREENING CENTER IN BAGHDAD

Anthropology is concerned with the study of diseases to which a person is exposed and their psychological and social effects on his immediate and future life. Chronic and dangerous diseases threatening human life have become a problem in various societies, both developed and backward. Perhaps the scientific progress in the medical and health fields that most peoples and societies have enjoyed has become a double-edged sword as it has become a path for the spread of chronic organic diseases and psychological diseases that pose a clear threat to human life. And among the most important of these chronic diseases, kidney failure disease, which is considered one of the serious diseases that accompanies a person for a long period of his life, which affects the patient's physical and psychological condition, since this disease has negative dimensions on the psychological structure of the human being, as it intersects with many organic diseases And the dangerous psychological, that patients with chronic renal failure associated with and restricted to treatment and dialysis, generates in the patients “organic” physiological problems and various psychological problems, as this disease affects the family bonding of the patients' families. Inferiority and lack of respect and self-esteem, and consequently psychological disorders such as anxiety, depression, impotence and loneliness have been proven. Studies show that patients with kidney failure suffer from anxiety to a degree that does not allow them to fulfill their future life requirements as required, and their hope in life diminishes.

The Role of HMGB1and KIM-1 Repair Genes in the Progression of Kidney Failure Disease

Renal Failure(RF) is a leading clinical characteristic of patients in nephrology , it represents significantconcern and the main challenge for healthcare systems. The incidence rate of RF is rising globally , mainlyas a result of increased aging population. The current study , was performed to identify the effect ofHMGB1and KIM-1gene expression in renal failure disease focusing on it is role on the repair processes.This study comprises 100 patients diagnosed clinicaly and seriologicaly with renal failure )52 males and 48females ) their age vary from (17 to 80 years) and 30 healthy individuals as a control group( 18 males and12 females ). RNA extracted from blood samples and converted to cDNA which subjected to real-time PCRfor detection gene expression .HMGB1 and KIM-1 have significantly overexpression (3.51 folds and 5.37folds ) respectively in RF patients compared with healthy control subjects ( p &lt;0.05). However , HMGB1and KIM-1 gene folding elevated gradually with advance the severity of the RF disease.

PENGARUH MUSIK INSTRUMENTAL TERHADAP KUALITAS HIDUP PADA PASIEN GAGAL GINJAL KRONIK YANG MENJALANI HEMODIALISA

Chronic renal failure or late-stage renal disease is a progressive and irreversible disorder of renal function (the body fails in maintaining metabolism and balance of fluids and electrolytes), thereby causing uremia (retention of urea and other nitrogen waste in the blood). Treatment of kidney failure disease can be done by pharmacological and non-pharmacological means. Non-pharmacological treatment can be in the form of the provision of instrumental music. This study aims to find out the influence of instrumental music on quality of life in chronic kidney failure patients undergoing hemodialysis at the Royal Prima Hospital Medan. This type of research is pre-experimental research with a one-group pre-post-test design with the provision of instrumental music for 20 minutes. The population is 66 people and sampled as many as 20 people with accidental sampling techniques. The analysis used in using Wilcoxon test. Based on the calculation of the Wilcoxon signed-rank test, obtained Z= - 3,938 with (p=0.000) &lt; 0.05, so it can be concluded that there is an instrumental music influence on the quality of life in chronic renal failure patients undergoing hemodialysis at Royal Prima Medan Hospital in 2018. It is recommended that instrumental music can be applied as an alternative therapy to improve the quality of life.

Long-term outcomes during 37 years of pediatric kidney transplantation: a cohort study comparing ethnic groups.

This study aimed to evaluate short- and long-term outcomes of kidney transplantation over 37 years in a national referral center and compare outcomes between Israeli Jewish and Arab children. Data on 599 pediatric transplantations performed in 545 children during 1981-2017, including demographic parameters, kidney failure disease profile, and pre-transplant dialysis duration, were retrieved from our computerized database and patient files. Patient and graft survival were estimated using the Kaplan-Meier method. Twenty-year patient survival was 91.4% for live donor (LD) and 80.2% for deceased donor (DD) kidney recipients. Respective 10-year and 20-year graft survival rates for first kidney-only transplants were 75.2% and 47.0% for LD and 60.7% and 38.4% for DD grafts. Long-term graft survival improved significantly (p < 0.001) over the study period for recipients of both LD and DD allografts and reached 7-year graft survival of 92.0% and 71.3%, respectively. The proportion of DD transplantations was higher in the Arab subpopulation: 73.8% vs. 48.4% (p < 0.001). Graft survival was not associated with age at transplantation and did not differ between the Arab (N = 202) and Jewish children (N = 343). Median (IQR) waiting time on dialysis did not differ significantly between the Arab and Jewish children: 18 (10-30) and 15 (9-30) months, respectively (p Mann-Whitney = 0.312). Good and progressively improving long-term results were obtained in pediatric kidney transplantation at our national referral center, apparently due to expertise gained over time and advances in immunosuppression. Equal access to DD kidney transplant and similar graft survival were found between ethnic groups.

Phylogenetic Analysis of TTV (TorqueTeno Virus) in Iraqi Woman Suffering of Failure Kidney Disease

There are still very few studies of the Torque Tenovirus infection rate between hemodialysis patients inIraq. Thus, the aim of this study was to assess the frequency of TTV viremia in hemodialysis Iraqi patients.This study has carried out in Baghdad city from October 2019 to February 2020 and included 150 patientswith kidney failure disease undergoing hemodialysis and 50 control subjects .Blood samples have beenobtained for serological TTV detection. The result shows PCR has been used to detect TTV, isolates havebeen identified through N22 region sequencing and phylogenetic analysis has also been performed. Of the150 patients, 2 (1 male and 1 female) were TTV positive.The results shows in ( isolate 14) substitutionfour Transversion A>C, C>G,A>T, and T>A three Transition T>C,A>G, and T>C of Specific region withinTTV(N-22) and showed 94% identified with a standard in Gene Bank while having 99% identified witha standard in Gene Bank with (isolate 17) substitution fiveTransversion A>T,A>C,T>A, A>Tand C>GthreeTransition A>G,A>G and T>C . The phylogenetic analysis showed that identical among themselvesand the world with 100% compatibility values.

Changes in Life Quality of Chronic Kidney Disease Patients with Hemodialysis Who Are Given Vitamin B1, B6, and B12 Parenterally

Background: Chronic kidney disease (CKD) is a disease that causes a progressive decrease in kidney function, which can end in kidney failure disease and will have an impact on decreasing quality of life. Previous research has shown that by giving vitamins B1, B6, and B12 can improve quality of life.&#x0D; Aim: To measure changes in quality of life in patients with chronic kidney disease who were given vitamins B1, B6, and B12 parenterally.&#x0D; Material and Methods: This study used quasi experimental (one group pre and post test) in 117 patients who were selected in Bethesda Hospital and Panti Rapih Hospital Yogyakarta hemodialysis unit. Patients were given vitamins B Combination injections twice a week in each hemodialysis for 4 weeks. Quality of life was measured by SF-8 questionnaire on the first day of hemodialysis before given vitamins (pre-test) and on the 30th day, after eight injection of vitamins B1, B6, and B12 (post test).&#x0D; Results: The mean age of observed patients were 51.58 ± 12.51 years. From 117 patients, 73 patients (62,4%) were male and 44 patients (37.6%) were female. The improvement in overall quality of life in patients was not significant (p= 0.055). Quality of life improvement was only significant in the male group (p = 0.016).&#x0D; Conclusion: There was no significant difference after 4-weeks-injections of vitamins B Combination to the overall quality of life in chronic kidney disease patients undergoing hemodialysis. But there was found a significant improvement in quality of life in the male patients with chronic kidney disease who had hemodialysis.&#x0D; Keywords : chronic kidney disease, quality of life, vitamins B1, B6, and B12, SF-8 questionnaire.

Abstract P119: Hypertension and Renal Dysfunction Are Mitigated by Surgical Renal Denervation in an Adult Rat Model of Polycystic Kidney Disease

Polycystic kidney disease (PKD) is the most common form of inherited chronic kidney disease failure. PKD is also associated with hypertension (HTN) and increased peripheral sympathetic activity (SNA). Recent studies have shown ablation of renal nerves may be effective treatment for varying forms of HTN and renal disease; however, the role and mechanism for renal nerves in PKD-associated renal dysfunction and HTN are unclear. Therefore, this study was conducted to test the hypothesis that renal denervation (RDN) would reduce AP, lower peripheral SNA, and improve renal function in the adult PKD rat. To test this hypothesis, 6-month-old male and female PKD rats underwent bilateral surgical RDN or sham surgery (Total n=18; 9/group; 3M/6F). Cardiovascular parameters were monitored by implanted radiotelemeter. Peripheral sympathetic tone was estimated by depressor response to acute ganglionic blockade (GB). Renal function was assessed by measuring glomerular filtration rate (GFR) by FITC-sinistrin clearance. Two weeks following treatment, rats were euthanized and tissues were collected for further analysis. Data was analyzed by a two-way ANOVA, across sex and treatment groups (α=0.05). Data presented as mean+SEM. At baseline, no differences in mean AP (132±2 vs. 129±3 mmHg), GB response (39±3vs. 42±4 ΔmmHg), nor GFR (0.93±0.06 vs. 0.91±0.04 mL/min/100g) were detected between RDN vs. sham. Two weeks following treatment, AP was lower in RDN (120±2mmHg) vs. sham (128±3mmHg). Similarly, GB was halved in RDN (-16±2 ΔmmHg) compared to sham (-32±3 ΔmmHg). GFR was increased in RDN rats vs. sham (1.18±0.06 vs. 0.84±0.08 mL/min/100g). Lastly, no difference in renal cystic area was detected between RDN and sham (8.27±1.39 vs. 8.74±0.90 %). No effect of sex was detected in any of the reported measurements. Altogether, these data support our initial hypothesis, where RDN effectively lowered AP and peripheral sympathetic tone in the PKD rat. Interestingly, we also observed a substantial increase in GFR in these animals, indicating an improvement in renal function despite no observable effect on cystic area. Of note, RDN was effective in both males and female rats. Further studies using repeated measurements are required to elucidate the order in which these effects occur.

Spectroelectrochemical Nanosensor for the Determination of Cystatin C in Human Blood.

The detection of protein biomarkers for the clinical diagnosis of diseases requires selective and sensitive methodologies and biosensors that can be easily used at pathology laboratories and points of care. An ideal methodology would be able to conduct multimode screening of low and high concentrations of proteins in biological fluids using recyclable platforms. In this work, we demonstrate a novel nanosensing methodology for the dual detection of cystatin C (CST-C), as a protein biomarker model, in blood plasma by surface-enhanced Raman spectroscopy and electrochemistry. The new methodology utilizes the thiol chemistry of biomolecules to develop a target-specific and recyclable extractor chip for the rapid isolation of protein biomarkers from blood plasma. This is followed by the rapid reduction of the disulfide bonds within the isolated protein to influence its oriented immobilization onto a conductive gold coated silicon nanopillar substrate via stable gold-sulfur (Au-S) bonds. The oriented immobilization led to reproducible surface-enhanced Raman spectroscopy (SERS) measurements of the reduced protein (RSD = 3.8%) and allowed for its direct electrochemical determination. After the SERS measurement, differential pulse voltammetry (DPV) was used to desorb the analyte from the substrate and generate a reduction current that is proportional to its concentration. CST-C was determined down to 1 pM and 62.5 nM by SERS and DPV, respectively, which satisfies the requirements for monitoring Alzheimer's and kidney failure diseases. The new dual nanosensing methodology has strong potential for miniaturization in a lab-on-a-chip platform for the screening of many protein biomarkers that have a disulfide bond structure.

Performance of Data Mining Techniques to Predict in Healthcare Case Study : Chronic Kidney Failure Disease

With the promises of predictive analytics in big data, and the use of machine learning algorithms, predicting future is no longer a difficult task, especially for health sector, that has witnessed a great evolution following the development of new computer technologies that gave birth to multiple fields of research. Many efforts are done to cope with medical data explosion on one hand, and to obtain useful knowledge from it, predict diseases and anticipate the cure on the other hand. This prompted researchers to apply all the technical innovations like big data analytics, predictive analytics, machine learning and learning algorithms in order to extract useful knowledge and help in making decisions. In this paper, we will present an overview on the evolution of big data in healthcare system, and we will apply three learning algorithms on a set of medical data. The objective of this research work is to predict kidney disease by using multiple machine learning algorithms that are Support Vector Machine (SVM), Decision Tree (C4.5), and Bayesian Network (BN), and chose the most efficient one.

The Effectiveness of Cognitive-Existential Group Therapy on Increasing Hope and Decreasing Depression in Women-Treated With Haemodialysis.

Introduction:Hopefulness is one of the most significant predictors of adaptation in hemodialysis patients, and plays a vital role in the recovery process. In contrast to hopefulness, depression is a frequent psychological reaction of the hemodialysis treatment with many negative consequences. The current research was designed to examine the effect of cognitive-existential treatment on the level of hopefulness and depression in hemodialysis patients.Materials & Methods:This quasi-experimental research included 22 female patients suffering from chronic kidney failure disease undergoing hemodialysis treatment for at least 3 months. The patients were randomly assigned into two groups of experimental and control conditions. The experimental group received a combination of treatment including some elements of “existentialism” philosophy and a “cognitive” approach designed for the Iranian population. The treatment protocol lasted for 12 sessions of 90 minutes twice per week prior to the entry of the patient to the dialysis session. Miller’s hope scale and BDI-II-21 were employed to collect the data. Statistical analysis was performed on the data using analysis of covariance by SPSS: 16 software.Results:The result of the analysis indicated that there was a significant improvement in hopefulness level and decrease in depression of the patients in the experiment condition (P<0.01).Conclusion:The result of analysis showed that cognitive-existential treatment resulted in the increase of hopefulness and decrease level of depression in the hemodialysis patients suffering from chronic kidney failure.

Risk profiles of progression in primary focal segmental glomerulosclerosis

Focal segmental glomerulosclerosis (FSGS) is a component of childhood nephrotic syndrome occurring in 10%-20% of all cases. Over time, 25%-50% of children with FSGS develop kidney failure disease. We followed a cohort of children with FSGS in order to delineate the risk profile of progression to kidney failure (KF). We evaluated patient data collected from 1977 to 2002 at a regional mid-Atlantic nephrology center in the United States. KF was defined primarily for those patients whose serum creatinine (SCr) value doubled compared with the SCr value from a previous visit. Patients who received dialysis or a kidney transplant were also defined as having KF. We analyzed patient data for those who had at least two visits with SCr values recorded. Various baseline characteristics of patients who had developed KF and those with no kidney failure (NKF) were compared. Hazard ratios and correlation were used to further investigate potential risk factors of the kidney failure. We also compared the inverse SCr trend for KF and NKF patients using weighted linear regression. Thirty-four of 43 FSGS patients had adequate follow-up data. About 60% of the patients developed KF over the study period. The average age of the KF patients at diagnosis of FSGS was 9 years, and that of NKF patients 12 years (P=0.05). FSGS patients with KF had a significantly higher mean diastolic blood pressure (DBP) at baseline, compared to those with NKF (P<0.0001). Other baseline characteristics including race, body mass index (BMI), systolic blood pressure, total cholesterol, urinary protein/creatinine ratio and calculated glomerular filtration rate (cGFR) were not significantly different. Baseline DBP was a significant risk factor in progression to KF (HR: 1.03; 95%CI: 1.01-1.06). Inverse SCr values were significantly decreased over time in KF patients (P=0.01). The data of this study indicate that children diagnosed with FSGS who are younger than 10 years and have elevated baseline DBP are more likely to develop kidney failure. The non-significant hazard ratios for other baseline characteristics including gender, race, and BMI are not instrumental risk factors. These results may help understand what may affect progression towards kidney failure in children with FSGS.

Posttraumatic growth in chronic kidney failure disease

Summary It was aimed to determine the posttraumatic growth level of the patients with hemodialysis and to examine the supposed effect of socio-demographic variables, variables associated with disease, perceived social support and ways of coping. Research data were collected by 491 patients in private dialysis centers. It was found that the ones who are aware of disease and are primary, secondary or high school graduate and who well level of income and received initial medication before hemodialysis had showed better Posttraumatic Growth. It was seen that total point of Posttraumatic Growth Scale and the sub-scales of “Changes in Relation With Other People”, “Change in Life Philosophy”, and “Self-Personal Change” have effect on the sub-scales of Coping, Perceived Social Support and Searching for social support/optimism, searching help, friend support, fatalistic coping, family support, and problem solving.

The renal cortical fibroblast in renal tubulointerstitial fibrosis

Renal cortical fibroblasts have key roles in mediating intercellular communication with neighboring/infiltrating cells and extracellular matrix (ECM) and maintenance of renal tissue architecture. They express a variety of cytokines, chemokines, growth factors and cell adhesion molecules, playing an active role in paracrine and autocrine interactions and regulating both fibrogenesis and the interstitial inflammatory response. They additionally have an endocrine function in the production of epoetin. Tubulointerstitial fibrosis, the common pathological consequence of renal injury, is characterized by the accumulation of extracellular matrix largely due to excessive production in parallel with reduced degradation, and activated fibroblasts characterized by a myofibroblastic phenotype. Fibroblasts in the kidney may derive from resident fibroblasts, from the circulating fibroblast population or from haemopoetic progenitor or stromal cells derived from the bone marrow. Cells exhibiting a myofibroblastic phenotype may derive from these sources and from tubular cells undergoing epithelial to mesenchymal transformation in response to renal injury. The number of interstitial myofibroblasts correlates closely with tubulointerstitial fibrosis and progressive renal failure. Hence inhibiting myofibroblast formation may be an effective strategy in attenuating the development of renal failure in kidney disease of diverse etiology.