Prevention Of Kidney Disease Research Articles

Remnant cholesterol, preinflammatory state and chronic kidney disease: association and mediation analyses

Blood lipid management is a key approach in the prevention of chronic kidney disease (CKD). Remnant cholesterol (RC) plays an important role in the development of multiple diseases via chronic inflammation. The aim of our study was to determine the relationship between RC and CKD and explore the role of inflammation in this relationship. The 7696 subjects from the Chinese Health and Nutrition Survey were divided into four subgroups according to the quartile of RC. The estimated glomerular filtration rate was calculated using the CKD Epidemiology Collaboration equation. Fasting RC was calculated as total cholesterol minus low-density lipoprotein cholesterol and high-density lipoprotein cholesterol. Logistic regression analysis was employed to evaluate the relationships between RC and CKD. Mediation analysis was undertaken to identify potential mediators of high-sensitivity C-reactive protein (hs-CRP) and white blood cells (WBCs). Of all participants, the mean age was 51 years, and the male accounted for 47.8%. The multivariable-adjusted odds ratios (95% CIs) for the highest versus lowest quartile of remnant cholesterol were 1.40 (1.10–1.78, p for trend = 0.006) for CKD. RC and preinflammatory markers have combined effect on CKD. The preinflammatory state, presented by increased hs-CRP or WBCs, partially mediated the association between RC and CKD with proportion of 10.14% (p = 0.002) and 11.65% (p = 0.012), respectively. In conclusion, this study suggested a positive relationship between RC and CKD, which was partially mediated by preinflammatory state. These findings highlight the importance of RC and inflammation in renal dysfunction. IMPACT STATEMENT What is already known on this subject?: Dyslipidemia plays an important role in the development of chronic kidney disease (CKD). Remnant cholesterol (RC), as a triglyceride-rich particle, can contribute to target organ damage, primarily through inflammatory pathways. However, the relationship between RC and CKD in the community-dwelling population, particularly the role of inflammation, is not yet fully understood. What do the results of this study add?: This study shows that RC was significantly associated with CKD. RC and preinflammatory status exhibit a combined effect on CKD. Preinflammatory state, presented by increased high-sensitivity C-reactive protein or white blood cells, partially mediated the association between RC and CKD. What are the implications of these findings for clinical practice and/or further research?: The study provides us with a better understanding of the role of RC and inflammation in kidney dysfunction and raises the awareness of RC in the management of CKD.

Development of a predictive model for the risk of microalbuminuria: comparison of 2 machine learning algorithms

PurposeTo identify the independent risk variables that contribute to the emergence of microalbuminuria(MAU) in type 2 diabetes mellitus(T2DM), to develop two different prediction models, and to show the order of importance of the factors in the better prediction model combined with a SHAP(Shapley Additive exPlanations) plot.MethodsRetrospective analysis of data from 981 patients with T2DM from March 2021 to March 2023. This dataset included socio-demographic characteristics, disease attributes, and clinical biochemical indicators. After preprocessing and variable screening, the dataset was randomly divided into training and testing sets at a 7:3 ratio. To address class imbalance, the Synthetic Minority Oversampling Technique (SMOTE) was applied to balance the training set. Subsequently, prediction models for MAU were constructed using two algorithms: Random Forest and BP neural network. The performance of these models was evaluated using k-fold cross-validation (k = 5), and metrics such as the area under the ROC curve (AUC), accuracy, precision, recall, specificity, and F1 score were utilized for assessment.ResultsThe final variables selected through multifactorial logistic regression analysis were age, BMI, stroke, diabetic retinopathy(DR), diabetic peripheral vascular disease (DPVD), 25 hydroxyvitamin D (25(OH)D), LDL cholesterol, neutrophil-to-lymphocyte ratio (NLR), and glycated haemoglobin (HbA1c) were used to construct the risk prediction models of Random Forest and BP neural network, respectively, and the Random Forest model demonstrated superior overall performance (AUC = 0.87, Accuracy = 0.80, Precision = 0.79, Recall = 0.84, Specificity = 0.76, F1 Score = 0.81). The SHAP feature matrix plot revealed that HbA1c, NLR, and 25(OH)D were the three most significant factors in predicting the development of MAU in T2DM, with 25(OH)D acting as an independent protective factor.ConclusionEffective identification of MAU in T2DM, therapeutic strategies for controllable high-risk factors, and prevention or delay of diabetic kidney disease(DKD) can all be achieved with the help of the risk prediction model developed in this study.

#1895 Elucidating Asprosin's role as an intracellular metabolism regulator in diabetes and obesity-induced renal damage

Abstract Background and Aims Asprosin, an adipokine with a multifaceted function that encompasses inducing insulin resistance, promoting inflammation, and stimulating appetite, is the focus of our investigation. We seek to establish its pivotal role as a mediator in regulating cellular energy metabolism, particularly in the context of renal damage induced by diabetes and obesity. Method We conducted experiments using type 2 diabetic db/db mice and obesity-induced high-fat diet mice. These animal models were categorized into two groups: one received Asprosin neutralizing antibodies (250 μg/mouse/21 days), targeting the 28-amino acid peptide located proximal to Asprosin's C-terminus (KKKELNQLEDRYDKDYLSGELGDNLKMK), while the other received an AMPK activator (Metformin) associated with the regulation of Asprosin receptors (OLFR734/G proteins-cAMP-PKA). Additionally, we cultured renal constituent cells (mesangial cells, glomerular endothelial cells) in high glucose and palmitic acid conditions and silencing Asprosin expression using siRNA. We assessed the levels of Asprosin, AMPK, and their respective downstream signaling pathways. Results Asprosin was found to be overexpressed in the serum and kidney tissues of both db/db mice and high-fat diet mice, as well as in renal constituent cells cultured under high glucose and palmitic acid conditions. Interfering with Asprosin led to reduced body and liver weight in mice, improved glucose tolerance, and mitigated renal injury in vivo. Asprosin knockdown ameliorated lipid accumulation and inflammatory infiltration, both in vitro and in vivo. Moreover, Asprosin absence activated the AMPK/Sirts/mTOR signaling pathway, while the AMPK activator Metformin reversed the effects of Asprosin on lipid accumulation and inflammatory response, confirming Asprosin's direct role in intracellular lipid metabolism. Conclusion The mechanism of intracellular energy metabolism regulation mediated by Asprosin presents promising potential for targeted organ therapy in the development and prevention of diabetic kidney disease. Inhibiting Asprosin suppressed lipid accumulation and inflammation in diabetic kidney disease through the activation of AMPK-associated signaling pathway.

Ginsenoside Rg1 attenuates chronic inflammation-induced renal fibrosis in mice by inhibiting AIM2 inflammasome in an Nrf2-dependent manner

Chronic kidney disease (CKD) is a growing global public health issue. Ginsenoside Rg1 (Rg1) has favorable nephroprotective effects, but its role and mechanism in CKD need further investigation. Therefore, we observed the effect of Rg1 on the mouse kidneys after 21 days of low-dose lipopolysaccharide (LPS) exposure. Meanwhile, we investigated the protective mechanism of Rg1 in LPS-induced mesangial cells using the Nrf2 inhibitor ML385. We found that chronic exposure to LPS caused fibrosis in mouse kidneys, accompanied by AIM2 activation and oxidative stress imbalance; however, Rg1 restored the anomalies, accompanied by activation of Nrf2/HO-1 signaling. Finally, our in vitro studies revealed that Rg1′s nephroprotective effects could be inhibited by ML385, and Rg1 can bind Nrf2, suggesting that the protective effects of Rg1 may involve Nrf2 activation and then inhibition of the AIM2. Our study has significant implications for the prevention and treatment of kidney diseases, particularly those related to inflammation.

Ambient Air Pollution and Chronic kidney disease risk in Deltan communities: A Policy Brief, 2023

Chronic kidney disease (CKD) is a persistent, devastating, yet neglected, non-communicable disease in developing and emerging countries. National, regional, and international agencies’ communications and reports on non-communicable diseases intentionally or non-intentionally do not feature CKD. The traditional risk factors for CKD, such as hypertension and diabetes, which have received relatively ample attention, do not sufficiently explain the high burden of CKD in these countries. Ambient air pollution is an emerging significant environmental risk factor for CKD; however, epidemiological data and evidence are lacking for susceptible populations in developing countries. The Niger Delta region of Nigeria is a petrochemical hub known for environmental degradation, including air pollution, and thus, serves as a good case study for investigating the association between air pollution and CKD. This brief is based on the results of a mixed-methods study conducted in four communities situated near an oil and gas refinery in Warri, Nigeria. Air pollutant concentrations measured in partnership with citizen scientists showed that all except one air pollutant (ozone) exceeded the WHO acceptable limits in all four communities. The overall prevalence of CKD was high (12.3%) but even higher (18%) in a socially deprived semi-urban community closest to the oil refinery. Hypertension, diabetes, other behavioral risk factors, and exposures associated with CKD were prevalent among the inhabitants of the four communities. However, public environmental health information and education are lacking. A multifaceted approach is required to mitigate air pollution and the associated health risks in the state. Public inclusion is strongly recommended for the planning and implementation of future interventions. Kidney disease prevention and treatment should be emphasized in health policies and insurance schemes.

Development and Characterization of a Novel FVB-PrkdcR2140C Mouse Model for Adriamycin-Induced Nephropathy.

The Adriamycin (ADR) nephropathy model, which induces podocyte injury, is limited to certain mouse strains due to genetic susceptibilities, such as the PrkdcR2140C polymorphism. The FVB/N strain without the R2140C mutation resists ADR nephropathy. Meanwhile, a detailed analysis of the progression of ADR nephropathy in the FVB/N strain has yet to be conducted. Our research aimed to create a novel mouse model, the FVB-PrkdcR2140C, by introducing PrkdcR2140C into the FVB/NJcl (FVB) strain. Our study showed that FVB-PrkdcR2140C mice developed severe renal damage when exposed to ADR, as evidenced by significant albuminuria and tubular injury, exceeding the levels observed in C57BL/6J (B6)-PrkdcR2140C. This indicates that the FVB/N genetic background, in combination with the R2140C mutation, strongly predisposes mice to ADR nephropathy, highlighting the influence of genetic background on disease susceptibility. Using RNA sequencing and subsequent analysis, we identified several genes whose expression is altered in response to ADR nephropathy. In particular, Mmp7, Mmp10, and Mmp12 were highlighted for their differential expression between strains and their potential role in influencing the severity of kidney damage. Further genetic analysis should lead to identifying ADR nephropathy modifier gene(s), aiding in early diagnosis and providing novel approaches to kidney disease treatment and prevention.

Chronic kidney disease and the global public health agenda: an international consensus.

Early detection is a key strategy to prevent kidney disease, its progression and related complications, but numerous studies show that awareness of kidney disease at the population level is low. Therefore, increasing knowledge and implementing sustainable solutions for early detection of kidney disease are public health priorities. Economic and epidemiological data underscore why kidney disease should be placed on the global public health agenda - kidney disease prevalence is increasing globally and it is now the seventh leading risk factor for mortality worldwide. Moreover, demographic trends, the obesity epidemic and the sequelae of climate change are all likely to increase kidney disease prevalence further, with serious implications for survival, qualityoflife and health care spending worldwide. Importantly, the burden of kidney disease is highest among historically disadvantaged populations that often have limited access to optimal kidney disease therapies, which greatly contributes to current socioeconomic disparities in health outcomes. This joint statement from the International Society of Nephrology, European Renal Association and American Society of Nephrology, supported by three other regional nephrology societies, advocates for the inclusion of kidney disease in the current WHO statement on major non-communicable disease drivers of premature mortality.

Diabetes mellitus is a risk factor for incident chronic kidney disease: A nationwide cohort study

ObjectiveDiabetes mellitus and chronic kidney disease are multifactorial conditions with multiple etiologies that share similar pathophysiologies. This nationwide cohort study examined the impact of diabetes mellitus on the follow-up development of chronic kidney disease. MethodsBy retrieving the Longitudinal Health Insurance Database 2005, 5121 patients with diabetes mellitus were included in this study and 5121 patients without diabetes mellitus, who were matched according to sex, age, and Charlson comorbidity index made up the control group. The adjusted hazard ratios for chronic kidney disease were calculated using Cox proportional hazards regression analysis. Kaplan–Meier analysis was used to estimate the cumulative incidence of chronic kidney disease rate in the diabetes mellitus and control groups. ResultsAfter adjusting for sex, age, and Charlson comorbidity index score, the diabetes mellitus group had a 1.380 times higher (95% CI: 1.277–1.492) risk of developing chronic kidney disease than the control group. Further stratified analysis showed that patients with diabetes mellitus had a significantly higher risk of developing chronic kidney disease regardless of their sex, age, and Charlson comorbidity index score, compared to those without diabetes mellitus. ConclusionsThere is a possibility that diabetes mellitus serves as an independent risk factor for chronic kidney disease development. Early screening and monitoring of diabetes mellitus appear to be of great importance in the prevention of chronic kidney disease.

The potential for improved outcomes in the prevention and therapy of diabetic kidney disease through 'stacking' of drugs from different classes.

Aggressive therapy of diabetic kidney disease (DKD) can not only slow the progression of DKD to renal failure but, if utilized at an early enough stage of DKD, can also stabilize and/or reverse the decline in renal function. The currently recognized standard of therapy for DKD is blockade of the renin-angiotensin system with angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs). However, unless utilized at a very early stage, monotherapy with these drugs in DKD will only prevent or slow the progression of DKD and will neither stabilize nor reverse the progression of DKD to renal decompensation. Recently, the addition of a sodium-glucose cotransporter-2 inhibitor and/or a mineralocorticoid receptor blocker to ACE inhibitors or ARBs has been clearly shown to further decelerate the decline in renal function. The use of glucagon-like peptide-1 (GLP-1) agonists shown promise in decelerating the progression of DKD. Other drugs that may aid in the deceleration the progression of DKD are dipeptidyl peptidase-4 inhibitors, pentoxifylline, statins, and vasodilating beta blockers. Therefore, aggressive therapy with combinations of these drugs (stacking) should improve the preservation of renal function in DKD.

Abstract 52: Associations of Ideal Cardiovascular Health and Its Change With Cardiovascular-Kidney Outcomes in Young Adults

Introduction: The AHA recently highlighted the linkage of cardiovascular (CVD) and chronic kidney disease (CKD) and the importance of promoting cardiovascular health (CVH) to prevent them. We hypothesized that attaining ideal CVH score or improving it in young adulthood is associated with low risk of cardiovascular-kidney events, but data are scarce. Methods: We studied 3,836,283 participants of the Korean national health screening in 2009-2010 (baseline age 20-39 y) without prior CVD or CKD. Participants were categorized by the number of ideal CVH components met (range 0-6; diet data unavailable). A subgroup of 2,768,705 participants who underwent follow-up health exam in 2011-2014 (median 4.2 y from baseline) were stratified by combination of baseline and follow-up CVH scores. The primary outcome was a composite of CVD events, incident CKD, and death from kidney disease or CVD, until 31 Dec 2021 (Fig, footnote). Results: At baseline, participants had median age 31 y, and 38.2% were female. During a median follow-up of 12.1 y, 172,217 cardiovascular-kidney events occurred. The multivariable-adjusted risk of cardiovascular-kidney event decreased gradually (HR 0.81 per 1 p higher CVH score) with higher CVH scores (Fig, A). A CVH score of 6 was associated with a 65% lower risk of cardiovascular-kidney event than a CVH score of 0. An increase in CVH score from the baseline to follow-up exam was associated with a lower risk of cardiovascular-kidney event (HR 0.87 per +1 p CVH score change). The risk was lowest in participants with high CVH at both baseline and follow-up; having high CVH at baseline, and improving from low to high CVH, were also associated with lower risk than those who maintained low CVH (Fig, B). Findings were similar for CKD and other individual endpoints. Conclusions: Achieving, maintaining, or improving ideal CVH during young adulthood was associated with lower risk of cardiovascular-kidney events, highlighting the importance of promoting early-life CVH for combined prevention of cardiovascular and kidney disease.

Current State And Trends In The Incidence Of Chronic Kidney Disease Among Adult Population And Opportunities For Its Prevention And Treatment In Moscow Healthcare Organizations

Introduction. Currently, the incidence of kidney diseases among adult population is growing. It is expected to become the fifth leading cause of death by 2040. Showing no symptoms at early stages, chronic kidney disease (CKD) is closely related to diabetes mellitus, hypertension, obesity and kidney dysfunction in older age, which requires long-term and expensive treatment. Organization structure and the strategy of medical care provided by Moscow nephrology service is aimed at implementing measures for risk prevention and active early detection of kidney disease, as well as informing general population and medical community about existing diagnostic methods, modern treatment options and schemes.
 The purpose of the study was to identify trends in CKD prevalence and incidence among able-bodied population in the context of Moscow nephrology service improvement. 
 Materials and Methods. An analysis of disease prevalence and incidence among able-bodied population based on official statistics data of the Russian Research Institute of Health (RIH) of the Ministry of Health of the Russian Federation and the Centre of Medical Statistics of Moscow Healthcare Department was carried out; indicators of time series and average growth/decrease rates were calculated. In order to identify a long-term trend, least squares method was used. Incidence rates were expressed per 100,000 able-bodied population.
 Results. In 2022, the overall disease prevalence in Moscow was lower than for the country as a whole (31.3 and 74.2 cases per 100,000 population, respectively), while incidence of the able-bodied population in Moscow was lower than countrywide (2.9 and 11.5 cases per 100,000 population, respectively). The long-term dynamics of CRD prevalence and incidence was generally characterized by an upward trend. Thus, the average annual incidence in Moscow was 9.8% and 6.1%, while in the Russian Federation 7.2% and 5.4%, respectively. On average, 91.3% of able-bodied patients with CKD in Moscow are under follow-up monitoring for a year. The number of dispensary patients with CKD increased by 2.5 times in 2022 in comparison to 2013, from 11.7 to 29.5 per 100,000 population, respectively. Since 2016, patients with newly diagnosed CKD have been provided with 100% coverage of follow-up monitoring.

Transcriptome analysis provides insights into high fat diet-induced kidney injury and moderate intensity continuous training-mediated protective effects

Although physics exercise has been utilized to prevent and treat a variety of metabolic diseases, its role in obesity-related kidney diseases remains poorly understood. In this study, we assessed the protective potential of moderate intensity continuous training (MICT) against high fat diet (HFD)-induced kidney injury and found that MICT could significantly reduce obesity indexes (body weight, serum glucose, total cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol) and kidney injury indexes (serum creatinine and the expression of Kim-1 mRNA) in HFD-fed mice. PAS staining and Masson staining displayed that MICT maintained the morphological structure of kidney subunits and reduced kidney fibrosis in HFD-fed mice. By kidney RNA-seq, we identified several genes and pathways (Cd9, Foxq1, Mier3, TGF-β signaling pathway etc.) that might underlie HFD-induced kidney injury and MICT-mediated protective effects. In conclusion, this study revealed the protective role of MICT in HFD-induced kidney injury and suggested potential targets for the prevention and treatment of obesity-related kidney diseases.

Young-onset chronic kidney disease in Mexico: Secondary analysis of global burden of disease study, 1990–2019

ObjectiveTo report the burden of young-onset chronic kidney disease (CKD) in Mexico from 1990 to 2019, and to assess the association between young-onset CKD burden with the Socio-Demographic Index (SDI), and the Healthcare Access and Quality Index (HAQ). MethodsSecondary analysis of data using the Global Burden of Disease, Injuries, and Risk Factors Study (GBD) by sex, age groups, states, and subcauses. Mortality, years of life lost (YLL), years lived with disability (YLD), and disability-adjusted life years (DALY), were obtained. ResultsBetween 1990 and 2019, the young-onset CKD mortality rate increased by 87.3% (126.3% for men and 48.1% for women). In 2019, this rate was highest in Tlaxcala, Estado de México, Puebla, Veracruz, Jalisco, and Guanajuato (all above 8 deaths per 100,000 inhabitants); Sinaloa and Quintana Roo had the lowest mortality rates (under 3.5 deaths per 100,000 inhabitants). While men had a higher rate of YLL, women were more likely to present YLD due to CKD. In 1990 there was a negative and statistically significant correlation between the HAQ Index and the young-onset CKD DALY rate. ConclusionsIn the last 30 years, the burden of early-onset chronic CKD has had an unprecedented increase among the Mexican population, compromising the fulfillment of the Sustainable Development Goals. This will be unattainable if actions to promote healthy lifestyles and prevent kidney disease are not immediately established and articulated, starting with the youngest age groups.

Validation of the Kidney Failure Risk Equation in the Colombian Population.

Chronic kidney disease prevention programs must identify patients at risk of early progression to provide better treatment and prolong kidney replacement therapy-free survival. Risk equations have been developed and validated in cohorts outside of Colombia, so this study aims to evaluate the discrimination and calibration of the four-variable kidney failure risk equation in a Colombian population where it has yet to be validated. External validation study of a kidney failure risk equation using a historical cohort of patients with CKD stages 3, 4, and 5, adults without a history of dialysis or kidney transplantation with a two-year follow-up, belonging to the Baxter Renal Care Services Colombia network. The discriminatory capacity of the model was evaluated by the concordance index using Harrell's C statistic, and the time-dependent area under the receiver operating characteristic (ROC) curve was estimated using the nearest neighbor method, as well as the optimal cut-off point for sensitivity and specificity. Calibration was determined by the degree of agreement between the observed outcome and the probabilities predicted by the model using the Hosmer-Lemeshow statistic. A total of 5,477 patients were included, with a mean age of 72 years, 36.4% diabetic, and a mean baseline eGFR of 36 ml/min/1.73 m2. The rate of dialysis initiation was three events per 100 patient-years, 95% CI (2.9-3.6). The optimal cutoff for sensitivity was 0.94, for specificity, 0.76, and the area under the ROC curve was 0.92. Harrell's C-statistic was 0.88 for the total population, 0.88 for diabetic patients, and 0.93 for those 65 years or older. The validation of the model showed good calibration. In this Colombian cohort, the four-variable KFRE with a two-year prediction horizon has excellent calibration and discrimination, and its use in the care of CKD Colombian patients is recommended.

“Possibilities of early prevention of chronic kidney disease in patients with type 2 diabetes mellitus based on clinical and anamnestic data”

to study the possibilities of early prevention of CKD in patients with type 2 diabetes based on clinical and anamnestic data.

Fructokinase Inhibition to Prevent Kidney Disease.

Fructokinase Inhibition to Prevent Kidney Disease.

ALGORITHM OF SECONDARY PREVENTION OF KIDNEY DISEASES AND URINARY TRACT IN OUTPATIENT CLINICS

Aim effectiveness evaluation of the medical staff actions algorithm an outpatient polyclinic institution during the secondary prevention of kidney and urinary tract diseases.
 Material and methods. This article presents an assessment of the effectiveness of the algorithm developed on the basis of a previously conducted medical and social study, which consists in conducting secondary prevention of exacerbations of the urinary system by prescribing drinking mineral water, diet, physical activity and a protective regimen under the remote control of medical workers with the determination of indicators of the quality of life of patients (on the Wisconsin Questionnaire). The developed algorithm represents the sequence of actions of medical personnel during remote monitoring of patients with pyelonephritis, urolithiasis, urethritis and cystitis. To assess the effectiveness of the proposed algorithm, a survey was conducted among outpatient clinic doctors with more than 10 years of experience using a specially developed questionnaire (score from 1 to 10). To assess the consistency of doctors' opinions, the concordance coefficient was calculated; a high degree of agreement between doctors' opinions in assessing the main indicators was considered at the value of the Kendal W coefficient 0.7. To assess the significance of the obtained concordance coefficient, the 2 criterion was calculated at a significance level of 0.05.
 Results. An analysis of the answers of doctors showed that this algorithm can be used as an alternative to sanatorium treatment for the prevention of exacerbations of diseases of the urinary system.
 Conclusions. The study of the possibility of using medical and organizational measures for the secondary prevention of exacerbations of diseases of the kidneys and urinary tract, presented in the algorithm, makes it possible to achieve an improvement in general well-being in patients under dispensary observation. Algorithm received a positive assessment from doctors of outpatient clinics.

Artesunate-Nanoliposome-TPP, a Novel Drug Delivery System That Targets the Mitochondria, Attenuates Cisplatin-Induced Acute Kidney Injury by Suppressing Oxidative Stress and Inflammatory Effects.

Acute kidney injury (AKI) is a syndrome, posing a substantial healthcare burden. The pathological basis of AKI is associated with inflammation and oxidative stress which cause additional damage to mitochondria. Artesunate (ATS) is a derivative of artemisinin isolated from Artemisia annua L. that is an effective treatment for malaria and favored for the prevention and treatment of kidney diseases. However, there are still challenges related to its efficacy, including poor water solubility, limited oral bioavailability and short half-life. Liposome-based nanoparticles are used for drug delivery due to their ideal biocompatibility and their ability to improve the bioavailability of specific drugs and enhance drug efficacy. In this study, a novel TPP-based natural ATS-nanoliposome, namely T-A-Ls, was applied for the treatment of AKI. ATS was encapsulated with or without triphenylphosphonium (TPP)-modified nanoliposomes. AKI was induced by cisplatin in C57BL/6J mice and a cisplatin-induced injury model was generated in HK-2 cells in vitro. Blood urea nitrogen (BUN), serum creatinine (Scr) measurements and section staining were utilized to assess renal protective effect of T-A-Ls. Inflammatory-related factors and proteins were quantified via Elisa, Immunofluorescence and Western Blot (WB). The anti-mitochondrial oxidative stress effect of T-A-Ls was determined by ROS, JC-1 and oxygen consumption rate (OCR) kits. Immunohistochemistry and WB were conducted to measure associated protein expressions. In vivo biodistribution and the concentration of T-A-Ls in kidney were also explored. T-A-Ls exhibited good oxidative resistance, preferential renal uptake, mitochondrial targeting, and it ameliorated kidney injury in cisplatin-induced AKI mice. Mitochondrial dysfunction, ATP production and respiratory capacity were improved in damaged HK-2 cells; ROS content decreased while mitochondrial membrane potential recovered. T-A-Ls exerted renal protection by inhibiting inflammation and reducing oxidative stress; these effects were mediated by a downregulation in the expression of RAGE and iNOS and an upregulation in both Nrf2 and HO-1. T-A-Ls could improve the delivery of ATS to the kidney, offering a promising avenue to treat AKI.

World Kidney Day; previous experience influences future directions

World Kidney Day is an annual, global awareness campaign that aims to raise awareness of the importance of kidney health and hopes to alleviate the global burden of kidney diseases. It is observed annually on the second Thursday of March. The campaign focuses on elucidating various aspects of kidney health, including prevention, early detection, and management of kidney diseases. It highlights the risk factors contributing to kidney disease, such as diabetes, hypertension, dyslipidemia, metabolic syndrome, and obesity. By raising awareness about these risk factors, World Kidney Day encourages individuals to make lifestyle modifications and promptly seek medical intervention to reduce their risk factors.

Resveratrol improves diabetic kidney disease by modulating the gut microbiota-short chain fatty acids axis in db/db mice

Diabetic kidney disease is associated with the dysbiosis of the gut microbiota and its metabolites. db/db mice were fed chow diet with or without 0.4% resveratrol for 12 weeks, after which the gut microbiota, faecal short-chain fatty acids (SCFAs), and renal fibrosis were analysed. Resveratrol ameliorated the progression of diabetic kidney disease and alleviated tubulointerstitial fibrosis. Further studies showed that gut microbiota dysbiosis was modulated by resveratrol, characterised by the expansion of SCFAs-producing bacteria Faecalibaculum and Lactobacillus, which increased the concentrations of SCFAs (especially acetic acid) in the faeces. Moreover, microbiota transplantation experiments found that alteration of the gut microbiota contributed to the prevention of diabetic kidney disease. Acetate treatment ameliorated proteinuria, glomerulosclerosis and tubulointerstitial fibrosis in db/db mice. Overall, resveratrol improved the progression of diabetic kidney disease by suppressing tubulointerstitial fibrosis, which may be involved, at least in part, in the regulation of the gut microbiota-SCFAs axis.