Chronic Renal Failure Therapy Research Articles

Intestinal Dialysis Research Progress and the Early Treatment of a NonDiabetic Patient with Symptomatic Uremia and Fatty Liver with Intestinal Dialysis: The Practice of Evidence-Based Medicine

Background: Chronic renal failure results from a variety of pathophysiological mechanisms and etiologies, and is associated with progressive and irreversible damage and loss of the kidneys’ tissue leading to failure of the kidneys to excrete waste products, and also failure to perform some other functions. Many patients with chronic renal failure in a country like Iraq has been reported to be reluctant to accept dialysis therapies because of the wide spread notion of its association with high mortality. The lack of effective, convenient, and affordable therapy for chronic renal failure in many regions of the world should not mean should that the patients with advanced chronic renal failure are left without other suitable, convenient and acceptable care. The aim of this paper is to describe the early treatment of a patient with symptomatic uremia with intestinal dialysis. Patients and Methods: A 60-year non-diabetic male patient was experiencing progressive symptomatic uremia. On the 18th of November, 2023, blood urea was elevated at 217 mg/dL, serum creatine was 5.2 mg/dL, and he had symptomatic uremia with nausea, vomiting, fatigue, pruritus and anemia. The patient was treated with intestinal dialysis (Acacia gum supplementation plus conservative dietary and pharmacological management of chronic renal failure) which was prescribed according to the latest published guidelines. It was necessary during the first week of treatment to eliminate almost all dietary protein, and his diet was consisting mainly of high calorie juices, grapes, and water melon. Results: When the patient was seen on the 2nd of December, 2023, treatment was associated with marked symptomatic and laboratory improvements. Blood urea was 115 mg /dL, serum creatine was 3.6 mg /dL However, and serum calcium was 5.3 mg/dL (Normal ranges: 8-10.5 mg/dL). Therefore, oral alphacalcidol was added in a dose of 1 microgram daily. Conclusion: Intestinal dialysis will continue to be used to improve the management of chronic renal failure and symptomatic uremia as long as there is no convenient and affordable therapy for chronic renal failure in many regions of the world.

Blood purification therapy in chronic renal failure and its impact on renal index, serological index, and inflammatory factors.

This study aimed to explore the clinical effects of blood purification therapy in patients with chronic renal disease, measured by renal function index and inflammation. Data were collected from a tertiary care hospital in Pakistan between June 2022 and September 2023. Eighty-four patients undergoing maintenance hemodialysis for chronic renal failure were retrospectively included in this cohort. Age, sex, BMI, course of disease, primary disease, and educational level were not related to the response to blood purification treatment. Blood purification therapy positively affected renal function, serological indices, and inflammatory factors (P<0.05). Blood purification therapy can improve toxin clearance and renal function and reduce inflammation. Therefore, the authors can conclude that this is an effective therapy for our population.

Caring behaviour and quality of life patients with hemodialysis at Baiturrahim Hospital Jambi

Background: Hemodialysis is one of therapy in chronic renal failure. It’s changed aspects of vitality, physical functional, and psychological and so that affected to quality of life. How caring behaviour were correlated to quality of life was unclear. This reasearch to analyse correlation between caring behaviour to quality of life of patients with chronich renal failure.&#x0D; Method: This research was a quantitative design with Cross Sectional approached. As sums 93 of 122 of subjects has recruited as sampling purpossive. Its conducts on November 2022 to July 2023 at Baiturrahim Hospital, Jambi. Data collected by means Caring Dimension Inventory-25 and KDQOL. Data were analysed and presented as univariate and bivariate with Sperman Rho test at significance level &lt; 0,05.&#x0D; Results: As much of 62,4% subjects reports were good caring bahaviour, and 59,1% subjects were good quality of life. Nurse caring behaviour were correlated with quality of life of patients with hemodialysis. This study implicated that caring behaviour were important attitudes in nusing care for patients undertook hemodialysis.&#x0D; Conclusion: Caring behaviour Nurse were needed to improve the patients quality of life. Nurse who taking care of patients supposed to show how to practice Caring behaviour.&#x0D; &#x0D;

Nursing of a patient undergoing continuous renal replacement therapy for chronic renal failure

Nursing of a patient undergoing continuous renal replacement therapy for chronic renal failure

Effect of Salvia miltiorrhiza Combined with Aromatic Amino Acids on the Impaired Renal Function in Rats with Chronic Renal Failure

Background and Aim: At present, the main therapy for chronic renal failure (CRF) is dialysis and renal transplantation, but neither obtains satisfactory results. Salvia miltiorrhiza (SM) is a very popular medicinal plant that has been extensively applied to treat various diseases. It also has been reported that lowering the aromatic aminoacids (AAA) in the protein diet can improve renal function in rodents with CRF. This study seeks to employ the use of SM combined with low aromatic amino acid diet (LA-AAD) for treatment of CRF in rats. Methods: Animals were assigned into 3 groups: Control, CRF and Experiment. CRF models were induced by 2.5% adenine administered by gavage for 8 weeks. Control and CRF group received normal protein diet (18.8% proteins, AAA 0.024%), and Experiment group was divided into 3 subgroups, being treated with SM (1.0g/kg/d) and LA-AAD (18% proteins, AAA 0.009%) differently. Proteinuria, blood urine nitrogen (BUN), serum and urine creatinine (Scr, Ucr) were measured and creatinine clearance rate (CCR) was calculated accordingly. Results: Proteinuria, BUN, Scr analyses showed amelioration of functional parameters and increased the CCR significantly in LA-AAD + SM group. Conclusion: These results showed that the combination of SM and LA-AAD could be beneficial to the improvement of renal function in CRF rats and this method can be a novel strategy for CRF treatment.

Haematological Indicators of Response to Erythropoietin Therapy in Chronic Renal Failure Patients on Haemodialysis: Impact of Angiotensin-Converting Enzyme rs4343 Gene Polymorphism.

PurposeThis is the first cross-sectional study studying the changes in haematological indicators of the response to recombinant human erythropoietin (rHuEPO) therapy in chronic renal failure (CRF) patients on haemodialysis (HD) stratified according to ACE G2350A (rs4343) gene polymorphism.DesignAn observational cross-sectional study.SettingNephrology department and Biochemistry and molecular biology department, faculty of medicine, Cairo University.PatientsA total of 256 CRF patients on HD for at least six months (162 male and 103 female) and 160 healthy subjects (122 male and 38 female) were recruited in the current study after signing a consent form. ACE G2350A (rs4343) Insertion/Deletion (I/D) was tested, the association between ACE G2350A (RS4343) gene polymorphisms and patients response to rHuEpo was evaluated.ResultsACE G2350A (rs4343) I/D was the most prevalent genotype, while I/I genotype was the lowest prevalent among patient or control subjects included in the study. D allele is the most prevalent allele, either among patients or the control group. Hemoglobin (Hb) level in patients with I/I and Deletion/Deletion (D/D) genotype was significantly higher compared to those with I/D genotype (P = 0.012 and P = 0.005, respectively). Serum iron in the I/D genotype was significantly higher than those with either I/I or D/D genotype (P = 0.045 and P = 0.018, respectively). Angiotensin-converting enzyme (ACE) content, total leukocytic count (TLC), and soluble erythropoietin receptor (sEpoR) were independent predictors of Hb level. The ACE gene, TLC, and serum iron were the independent factors that may affect the Haematocrit (Hct) level. ACE G2350A (rs4343) gene polymorphisms may affect the HD patient’s responses to rHuEPOs.ConclusionIn HD patients, screening for ACE G2350A (rs4343) gene polymorphisms before rHuEpo administration may help predict patient response.

La dieta mediterránea como dietoterapia de la insuficiencia renal crónica

espanolObjetivo: dar a conocer la evidencia cientifica acerca del uso de la dieta mediterranea como dietoterapia de la insuficiencia renal cronica con el fin de reducir el riesgo de complicaciones asociadas a la enfermedad. Metodos: se llevo a cabo una revision narrativa entre mayo de 2019 y abril de 2020. Se realizaron busquedas bibliograficas en PubMed, LILACS, MEDES, SCIELO, Cochrane Library, Health System Evidence, Guia Salud, National Institute for Health and Care Excellence (NICE), y la Biblioteca virtual del Servicio Andaluz de Salud (SAS). Se usaron distintos meta-buscadores: SUMSearch, Epistemonikos, Turning Research Into Practice (Trip) y National Health Service (NHS). Criterios de inclusion: revisiones sistematicas, estudios originales y guias de practica clinica, que abordaran el tema de la dieta mediterranea como dietoterapia en la insuficiencia renal cronica en adultos. Publicadas en los ultimos cinco anos, sin limite de idioma. Resultados: se localizaron 544 documentos, se seleccionaron 26, se incluyeron en la revision siete (tras cribado en funcion de los criterios de inclusion y la calidad de la evidencia). La dieta mediterranea tiene propiedades capaces de reducir la presion arterial, aumentar el filtrado glomerular y mejorar el perfil lipidico, asi como controlar la glucosa en sangre de los pacientes con insuficiencia renal cronica. Discusion: la evidencia sobre el tema es escasa. La dieta mediterranea es capaz de reducir las comorbilidades asociadas a la insuficiencia renal cronica. Sin embargo, es necesario seguir investigando en este campo. EnglishObjective: to make public the scientific evidence about the use of the Mediterranean Diet as diet therapy for Chronic Renal Failure, with the aim to reduce the risk of disease-related complications. Methods: a narrative review was conducted between May, 2019 and April, 2020. Bibliographic searches were conducted in PubMed, LILACS, MEDES, SCIELO, Cochrane Library, Health System Evidence, Guia Salud, National Institute for Health and Care Excellence (NICE), and the Virtual Library of the Andalusian Health Service (SAS). Different metasearch engines were used: SUMSearch, Epistemonikos, Turning Research Into Practice (Trip) and National Health Service (NHS). Inclusion criteria: systematic reviews, original studies, and clinical practice guidelines, addressing the subject of Mediterranean Diet as diet therapy for Chronic Renal Failure in adult patients, published during the last five years, no language limitations. Results: in total, 544 documents were retrieved, 26 were selected, and seven were included in the review (after screening based on the inclusion criteria and the quality of evidence). The Mediterranean Diet has properties able to reduce blood pressure, increase glomerular filtration, and improve the lipid profile, as well as to control the blood glucose in patients with Chronic Renal Failure. Discussion: there is limited evidence about this subject. The Mediterranean Diet is able to reduce the comorbidities associated with Chronic Renal Failure; however, further research is required in this area.

Adsorptivity of cationic cellulose nanocrystals for phosphate and its application in hyperphosphatemia therapy

Nanocellulose has gained much attention because of its excellent properties. Cationic cellulose nanocrystals (cCNC) shows good adsorptivity toward negative ions and molecules. Phosphate binders are most used to treat hyperphosphatemia and it is significant to develop its alternatives with high specific and low cost in the clinic. Herein, we prepared cCNC and characterized it by FTIR, TEM, dynamic light scattering, and viscosity method. We simulated the binding process of cationic cellulose for phosphate and used it as phosphate binder for hyperphosphatemia therapy to study the phosphate binding effect and evaluate the oral toxicity. Cationic cellulose improved the conditions of mice models and efficiently decreased the level of phosphate in the serum. cCNC had a better binding effect than cationic microcrystalline cellulose both in vitro and in vivo. cCNC could be used as alternatives to phosphate binder for therapy of chronic renal failure and hyperphosphatemia.

Regenerated nephrons in kidney cortices ameliorate exacerbated serum creatinine levels in rats with adriamycin nephropathy

Kidney regeneration could be classified into 2 groups: kidney generation and kidney repair. We have attempted in vivo nephron generation for kidney repair, as a therapy for chronic renal failure (CRF), by exploiting cellular interactions via conditioned media. In the previous report, we demonstrated the generation of rich nephrons in rat intact kidney cortices through percapsular injection of mesenchymal stem cell (MSC)-differentiated tubular epithelial cells (TECs) after pretreatment of 3-dimensional culture using a small amount of gel complex and condensed medium. In this study, to verify the amelioration of serum creatinine (sCr) levels by regenerated nephrons in rats with CRF, we first created damaged kidneys through systemic administration of adriamycin, and implanted the pretreated MSC-differentiated TECs into unilateral kidney cortices 2 weeks after adriamycin administration (A-2W, that is I–0W). After recovery of acute kidney injury, the control rats without cell implantation showed re-exacerbation of sCr levels, resulting in death within A-12W. Alternatively, the cell-implanted rats had a formation of mature nephrons in I–3W, and showed significant amelioration of sCr levels in I–7W. As a result, these rats could live until euthanization in I–12W or I–16W, indicating the utility of cell injection therapy into a kidney (K-CIT) for CRF. We expect that our K-CIT or the refined methods will be applied to patients with CRF.

New Dietary Therapy for Chronic Renal Failure: Intestinal Dialysis Technology

New Dietary Therapy for Chronic Renal Failure: Intestinal Dialysis Technology

ANALISIS KEBIASAAN MEROKOK DAN KONSUMSI OBAT ANALGETIK SEBAGAI FAKTOR RESIKO PENYAKIT GAGAL GINJAL KRONIS

Background: Chronic Renal Failure (CRF) is a chronic degenerative disease that requires great attention. This is not only because of the ever-increasing incidence, but also because of the maintenance process that takes time and enormous expenses. Globally, nationally and regionally, chronic renal failure tends to increase. The most effective therapy for chronic renal failure is the prevention of risk factors. Objectives: Identify of smokingand analgetic drug consumption as a risk factor for chronic renal failure. Methode: This research is a correlation research with case control design. The sample were 75 case study groups and 75 control groups. Data obtained through interviews and analyzed using multiple logistic regression with SPSS series 18. Result: Smoking habit (p = 0.625) and analgetik consumption (p = 0.069 had no effect on the incidence of chronic renal failure. Conclusion: Research conclusions are smoking and analgetik consumption had no effect on the incidence of chronic renal failure Keywords: Analgetik consumption, Chronic Renal Failure, smoking

Biochemical Study in Iraqian Patients with Chronic Renal Failure Therapy by Regular Hemodialysis

Biochemical Study in Iraqian Patients with Chronic Renal Failure Therapy by Regular Hemodialysis

Dialisi peritoneale 2013: si può fare

La dialisi peritoneale manifesta un decremento nella sua diffusione; vengono prese in considerazione le possibili vie per invertire questo trend, nel rispetto delle competenze dei vari attori implicati nella terapia sostitutiva della funzione renale (nefrologo, infermiere, istituzione, paziente).

ANALISIS GAYA HIDUP (LIFESTYLE) SEBAGAI FAKTOR RESIKO PENYAKIT GAGAL GINJAL KRONIS

Background : globally, nationally, and regionally, chronic renal failure tends to increase.The most effective therapy for chronic renal failure is the prevention of risk factors.Objectives : identify lifestyles in the form of high-fat diet habits and consumption ofenergy supplements as a risk factor for chronic renal failure.Methods : this research is a correlation research with case control design. The samplewere 75 case study groups and 75 control groups. Data obtained through interviews andanalyzed using multiple logistic regression with SPSS series 18.Results : lifestyle that affect the incidence of chronic renal failure is high fat dietary habits(p = 0.001; OR = 0.256; CI = 0.116 - 0.562), consumption of energy supplements (P =0.001; OR = 0.229; CI = 0.094 - 0.560).Conclution : research conclusions are high-fat dietary habits and consuming energysupplement drinks is a lifestyle that affects the increased risk of chronic renal failure.Keyword : Chronic Kidney Desease, Lifestyle, Risk Factors.

Icariin combined with human umbilical cord mesenchymal stem cells significantly improve the impaired kidney function in chronic renal failure.

At present, the main therapy for chronic renal failure (CRF) is dialysis and renal transplantation, but neither obtains satisfactory results. Human umbilical cord mesenchymal stem cells (huMSCs) are isolated from the fetal umbilical cord which has a high self-renewal and multi-directional differentiation potential. Icariin (ICA), a kidney-tonifying Chinese Medicine can enhance the multipotency of huMSCs. Therefore, this work seeks to employ the use of ICA-treated huMSCs for the treatment of chronic renal failure. Blood urea nitrogen and creatinine (Cr) analyses showed amelioration of functional parameters in ICA-treated huMSCs for the treatment of CRF rats at 3, 7, and 14 days after transplantation. ICA-treated huMSCs can obviously increase the number of cells in injured renal tissues at 3, 7, and 14 days after transplantation by optical molecular imaging system. Hematoxylin-eosin staining demonstrated that ICA-treated huMSCs reduced the levels of fibrosis in CRF rats at 14 days after transplantation. Superoxide dismutase and Malondialdehyde analyses showed that ICA-treated huMSCs reduced the oxidative damage in CRF rats. Moreover, transplantation with ICA-treated huMSCs decreased inflammatory responses, promoted the expression of growth factors, and protected injured renal tissues. Taken together, our findings suggest that ICA-treated huMSCs could improve the kidney function in CRF rats.

Les nouveaux greffons rénaux

Chronic kidney failure and patients that require haemodialysis is increasing, mainly because of the increasing prevalence of diabetic nephropathy. Kidney transplantation is an alternative therapy for chronic renal failure in its terminal stage. Currently, in France and in the world, there is a shortage of kidney transplants. The evolution of the French legislation allows the organ donation from living donor, including awaiting cardiac arrest.

Peritoneal dialysis 2013: we can do it

The use of peritoneal dialysis is showing a decrease in Italy. We here take into account the possible ways to reverse this trend, respecting the responsibilities of the different figures implicated in the management of the therapy of chronic renal failure (nephrologist, nurse, institution, patient).

Effects of sodium citrate on salt sensitivity and kidney injury in chronic renal failure.

Metabolic acidosis, which is observed in salt-sensitive hypertension, is also associated with kidney injury. Alkali therapy in chronic renal failure (CRF) may ameliorate the progression of kidney disease; however, few studies have examined the effects of alkali therapy on salt sensitivity and kidney injury in CRF. We randomly administered standard diet (SD), sodium chloride with 20% casein diet (NACL), or sodium citrate with 20% casein diet (NACT) to Sprague-Dawley rats after a CRF or a sham operation. Four weeks after 5/6 nephrectomy, serum bicarbonate levels were higher in the NACT-treated group. On the pressure-natriuresis curve, NACT-treated CRF rats were more salt-resistant than NACL-treated CRF rats. Additionally, the NACT-treated CRF group showed less tubulointerstitial damage than the NACL-treated CRF group. The expression and immunoreactivity of NHE3 in the kidney in the NACT-treated CRF group were lower than those in the NACL-treated CRF group. We observed that dietary NACT as alkali therapy in CRF might improve the altered salt-sensitivity and ameliorate the progression of kidney injury compared to the NACL diet, which may be related to reduced renal NHE3 expression.

A Rare Cause of Intestinal Perforation in a Patient on Continuous Ambulatory Peritoneal Dialysis Therapy: Abdominal Cocoon Syndrome

Abdominal Cocoon Syndrome (ACS) or sclerosing encapsulating peritonitis is characterized by intestinal obstruction and ileus as a result of encasement of small intestines totally or partially by a thick fibrous sac. We herein present a patient undergoing Continuous Ambulatory Peritoneal Dialysis (CAPD) therapy for chronic renal failure for 3 years who developed intestinal obstruction and perforation and was subsequently diagnosed with abdominal cocoon syndrome. Abdominal cocoon should be remembered in patients on CAPD therapy. One should also be aware that clinical signs of peritonitis may not become evident in the case of intestinal perforation in patients with ACS. In such cases, computed tomography has an important role in making the diagnosis.

Acute transient freezing of gait in a patient with posterior reversible encephalopathy syndrome

BackgroundPosterior reversible encephalopathy syndrome (PRES) is a transient clinical and neuroradiologic syndrome caused by cerebral vasogenic edema. Various reversible neurologic symptoms were shown in patients with PRES. Freezing of gait (FOG) is mainly observed in neurodegenerative diseases.Case presentationWe report a 43-year-old man, with undergoing hemodialysis therapy for chronic renal failure, had mild elevation of blood pressure. His consciousness level suddenly deteriorated, and brain MRI demonstrated hyperintense lesions in the bilateral basal ganglia on fluid-attenuated inversion recovery images, diffusion-weighted images, and apparent diffusion coefficient maps. After improvement of disturbance of consciousness, he showed FOG accompanied by bradykinesia and postural instability. His FOG spontaneously improved concurrently with alleviation of basal ganglionic lesions on follow-up MRI.ConclusionsIt is suggested that vasogenic edema on bilateral basal ganglia associated with PRES can cause acute transient FOG.