Treatment Of Chronic Renal Insufficiency Research Articles

The Early Diagnosis and Treatment of Chronic Renal Insufficiency.

Chronic renal insufficiency (CRI) is becoming more common and has an increasing impact on public health. In Germany, approximately one in ten adults has CRI. Its most serious consequence is generally not the development of end-stage renal failure, but rather the markedly increased cardiovascular risk as kidney function declines. This review is based on the findings of a selective search in PubMed for literature about the treatment options for CRI, and on our overview of the existing guideline recommendations on diagnostic testing. . Patients with diabetes mellitus and arterial hypertension are at especially high risk of developing CRI. For these patients, some of the guidelines recommend regular testing for albuminuria and measurement of the glomerular filtration rate (GFR), though sometimes only when specific risk constellations are present. The treatment of CRI has evolved in recent years. At first, aside from general measures, only RAS inhibitors were available as a specific therapy for CRI. With the extension of the approval of SGLT-2 inhibitors to non-diabetic CRI patients, the options for treatment have become wider. Two randomized controlled trials have revealed the benefit of SGLT-2 inhibitors with respect to their primary combined endpoints: time to a specified eGFR reduction and renal/cardiovascular death (HR 0.61 [0.51; 0.72] and 0.72 [0.64; 0.82]). The potential side effects and contraindications of SGLT-2 inhibitors must be taken into account. A further treatment option for diabetics with CRI has become available with the approval of the non-steroidal mineralocorticoid receptor antagonist finerenone. In patients with risk factors, renal function should be regularly tested.

Clinical Study on the Treatment of Chronic Renal Insufficiency in Decompensated Stage of Spleen- kidney Yang Deficiency with Quxie Fushen Decoction

Clinical Study on the Treatment of Chronic Renal Insufficiency in Decompensated Stage of Spleen- kidney Yang Deficiency with Quxie Fushen Decoction

Bayesian network Meta-analysis of Chinese medicine injections in treatment of chronic renal insufficiency

In this study, Honghua Injection, Danshen Injection, Shenkang Injection, Shuxuetong Injection, Lulutong Injection, Shenxiong Glucose Injection and Chuanxiong Injection were compared for their clinical efficacy on chronic renal insufficiency by using the method of network Meta-analysis, with Western medicine as the common reference. The randomized controlled trial(RCT) of Hong-hua Injection, Danshen Injection, Shenkang Injection, Shuxuetong Injection, Lulutong Injection, Shenxiong Glucose Injection and Chuanxiong Injection for the treatment of chronic renal insufficiency were obtained by computer-based retrieval. The literature quality was evaluated by using the method in Cochrane Reviewer's Handbook 5.1 after independent screening of the included literature by two reviewers. The RJAGS package and GEMTC package of RevMan 5.3, GEMTC software, R software were used for statistical analysis to compare and sort the different injections in terms of efficacy. A total of 6 197 patients with chronic renal failure were included in 79 RCTs, involving 8 treatment measures. The effective rates of conventional treatment combined with Shenxiong Injection(OR=3.55, 95%CI[1.98, 6.37], P<0.000 1), Honghua Injection(OR=3.77, 95%CI[2.45, 5.81], P<0.000 01), Shuxuetong Injection(OR=6.71, 95%CI[3.30, 13.65], P<0.000 01) and Shenkang Injection(OR=4.14, 95%CI[3.42, 5.03], P<0.000 01) were all better than that in control group, and the effective rate of Honghua Injection combined with conventional treatment(OR=3.89, 95%CI[1.73, 8.74], P=0.001) was better than that in Danshen Injection combined with conventional treatment, all with statistically significant differences. By comprehensive comparison, Shuxuetong Injection, Honghua Injection and Shenkang Injection combined with Western medicine had good clinical effect on the effective rate, serum creatinine reduction and urea nitrogen reduction in patients with chronic renal insufficiency. However, due to the relatively low quality of the included literature, the conclusion has yet to be verified clinically.

Transplantation of induced mesenchymal stem cells for treating chronic renal insufficiency.

Discovering a new cell transplantation approach for treating chronic renal insufficiency is a goal of many nephrologists. In vitro-cultured peripheral blood mononuclear cells (PBMCs) were reprogrammed into induced mesenchymal stem cells (iMSCs) by using natural inducing agents made in our laboratory. The stem cell phenotype of the iMSCs was then identified. Unilateral ureteral obstruction (UUO) was used to create an animal model of chronic renal insufficiency characterized by renal interstitial fibrosis. The induced and non-induced PBMCs were transplanted, and the efficacy of iMSCs in treating chronic renal insufficiency was evaluated using a variety of methods. The ultimate goal was to explore the effects of iMSC transplantation on the treatment of chronic renal insufficiency, with the aim of providing a new therapeutic modality for this disease.

MP23-01 HUMAN URINE-DERIVED STEM CELLS LESSEN INFLAMMATION AND FIBROSIS WITHIN KIDNEY TISSUE IN A RODENT MODEL OF AGING-RELATED RENAL INSUFFICIENCY

You have accessJournal of UrologyInfections/Inflammation/Cystic Disease of the Genitourinary Tract: Kidney & Bladder II1 Apr 2017MP23-01 HUMAN URINE-DERIVED STEM CELLS LESSEN INFLAMMATION AND FIBROSIS WITHIN KIDNEY TISSUE IN A RODENT MODEL OF AGING-RELATED RENAL INSUFFICIENCY Ting Long, Yaodong Jiang, Hua Shi, Liren Zhong, Deying Zhang, Wei Li, Yong Zhang, Dong Chen, Yan Jiao, Debra Diz, and Yuanyuan Zhang Ting LongTing Long More articles by this author , Yaodong JiangYaodong Jiang More articles by this author , Hua ShiHua Shi More articles by this author , Liren ZhongLiren Zhong More articles by this author , Deying ZhangDeying Zhang More articles by this author , Wei LiWei Li More articles by this author , Yong ZhangYong Zhang More articles by this author , Dong ChenDong Chen More articles by this author , Yan JiaoYan Jiao More articles by this author , Debra DizDebra Diz More articles by this author , and Yuanyuan ZhangYuanyuan Zhang More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.729AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Kidney function declines with age; older adults have renal function only 50-60% that of healthy young people. Most older patients have some degree of impaired renal function after renal surgery. Cell-based therapy is a promising alternative method to restore renal function in the treatment of chronic renal insufficiency. The goal of this study is to determine whether human urine-derived stem cells (USCs) can prompt renal tissue remolding in a rodent model of age-related kidney insufficiency. METHODS Urine samples were obtained from healthy men (n=6, 28-35 years old). USCs were isolated and expanded at passage 5. Eighteen male SD rats (50-62 week old) with renal insufficiency (increased levels of urine protein and serum creatinine) were divided into 3 groups (G). G1, animals received 5 intravenous cell implantations of 2 x106 cells/0.2 ml serum-free medium /rat/time period weekly; G2, as in G1 but intraperitoneally delivered; G3, as in G1 but serum-free medium alone. Healthy male SD rats at the same age were controls. RESULTS Cultured USCs secreted >20 kinds of trophic factors, including high levels of matrix metallopeptidase 9, which is involved in extracellular matrix degradation. Histologic and immunocytochemical staining showed that ED1 (inflammatory marker), alpha-smooth muscle actin (myofibroblast marker), and collagen deposition were significantly less within the medulla or cortex in rats with renal insufficiency vs. controls. G1 and G2 rats showed significantly inhibited inflammation and fibrosis in interstitial tissue, and reduced collagen deposits around renal vessels and the basement membrane of renal tubule and glomerular tissue, compared to G3. CONCLUSIONS Renal fibrosis is potentially reversible and therapeutic use of USCs can reverse specifically targeted decrease of influx of inflammatory macrophages, interstitial fibrosis formation and collagen deposition through their paracrine effects. Implantation of USCs has potential in the prevention and treatment of renal insufficiency. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e293 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Ting Long More articles by this author Yaodong Jiang More articles by this author Hua Shi More articles by this author Liren Zhong More articles by this author Deying Zhang More articles by this author Wei Li More articles by this author Yong Zhang More articles by this author Dong Chen More articles by this author Yan Jiao More articles by this author Debra Diz More articles by this author Yuanyuan Zhang More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Clinical efficacy and safety of domestic produced amlodipine in the treatment of chronic renal insufficiency with hypertension

Objective To evaluate the antihypertensive effect and safety of domestic produced amlodipine(Lan Di) in the treatment of chronic renal insufficiency with mild-mnderate hypertension and to compare with the effect of imported amledipine.Methods Sixty-onc patients with chronic renal insufficiency(Scr:265～442 μmol/L,seated DBP 90 ～105mmHg and seated SBP≤170mmHg) were enrolled in this study.Patients were randomly assigned to receive Lan Di 5mg or novasc 5mg once daily for 4 weeks.Doses were titrating to 10mg/d for another 4 weeks in patients hating seated DBP≥80mmHg or SBP≥130mmHg at the end of 4 weeks.Blood pressure,heart rate,laboratory examinations were performed at baseline and the end of the trial,and side effects were assessed pre and post Lan Di or novasc treatment.Results Lan Di group(31 cases) and novasc group(30 cases) finished a 8 week clinical trial.At the end of 4,8 weeks,seated SBP and DBP were significantly lowered compared with those at baseline(P＜0.01 ).There was no significant difference in the reduction of seated DBP or SBP between the two groups at the end of 4,8 weeks(P＞0.05).At the end of 8 weeks ,the response rate was 87% in Lan Di group and 90% in novasc group.If the target value of blood pressure is below 130/80mmHg,the response rate was 36% in Lan Di group and 30% in novasc group.At the end of 8 weeks,no difference was found in laboratory findings compared with those at baseline in two groups(P＞0.05).Side effects were comparable during the period of treatment.Condusion Domestic produced amlodipine 5mg or 10mg daily is as effective and safe as imported amolodipine in chronic renal insufficiency patients with mild to moderate hypertension. Key words: Kidney failure,ehronic; Hypertension; Ampldipine

Efficacy and safely of domestic produced amlodipine in the treatment of chronic renal insufficiency with hypertension

目的 评价国产苯磺酸氨氯地平(兰迪)治疗慢性肾功能不全高血压的降压疗效和安全性.方法 慢性肾功能不全高血压病患者60例,给予苯磺酸氨氯地平5 mg/d治疗4周.治疗4周末坐位DBP＜80mm Hg,且SBP≤130 mm Hg者继续原剂量治疗至8周末;坐位DBP＞90 mm Hg或SBP＞140 mmm Hg者剂量分别加倍至10mg每日1次治疗至8周末.分别观察患者服药前后血压、心率和肝肾功能等生化指标变化及其不良反应.结果 60例患者均完成8周的临床试验.与试验前比较,用药第4周起,患者的收缩压和舒张压均有显著性下降(P＜0.01),降压总有效率达83.3%.不良反应轻而少.结论 国产苯磺酸氨氯地平治疗慢性肾功能不全合并轻中度肾性高血压有效,且安全。

Evaluation of the Clinical Efficacy of Benazepril in the Treatment of Chronic Renal Insufficiency in Cats

Background: Chronic renal insufficiency (CRI) is a common disease in cats. Angiotensin‐converting enzyme inhibitors (ACEI) have beneficial effects in humans with CRI by reducing the loss of protein in the urine and increasing life expectancy.Hypothesis: The ACEI benazepril has beneficial effects on survival, clinical variables, or both as compared with placebo in cats with CRI.Animals: 61 cats with naturally occurring CRI.Methods: The cats were enrolled into a prospective, randomized, double‐blind, placebo‐controlled clinical trial. Cats received placebo or 0.5–1 mg/kg benazepril once daily for up to 6 months.Results: Urine protein/urine creatinine ratios were significantly (P < .05) lower with benazepril as compared with placebo at days 120 and 180. Three cats with placebo and 1 cat with benazepril were removed prematurely from the study because of deterioration of CRI or death. Cats were classified into 4 stages of CRI according to the International Renal Interest Society (IRIS) classification scheme. Incidence rates of cats with IRIS classification stage 2 or stage 3 that remained in stage 2 or 3 without progressing to stage 4 were higher with benazepril (93 ± 5%) as compared with placebo (73 ± 13%).Clinical Importance: These results suggest a potential for benazepril to delay the progression of disease, extend survival time, or both in cats with CRI.

Treatment of chronic renal insufficiency with losartan and traditional Chinese drug for invigorating spleen and kidney

Treatment of chronic renal insufficiency with losartan and traditional Chinese drug for invigorating spleen and kidney

Evaluation of The Clinical Efficacy of Benazepril in The Treatment of Chronic Renal Insufficiency in Cats

Chronic renal insufficiency (CRI) is a common disease in cats. Angiotensin-converting enzyme inhibitors (ACEI) have beneficial effects in humans with CRI by reducing the loss of protein in the urine and increasing life expectancy. The ACEI benazepril has beneficial effects on survival, clinical variables, or both as compared with placebo in cats with CRI. 61 cats with naturally occurring CRI. The cats were enrolled into a prospective, randomized, double-blind, placebo-controlled clinical trial. Cats received placebo or 0.5-1 mg/kg benazepril once daily for up to 6 months. Urine protein/urine creatinine ratios were significantly (P < .05) lower with benazepril as compared with placebo at days 120 and 180. Three cats with placebo and 1 cat with benazepril were removed prematurely from the study because of deterioration of CRI or death. Cats were classified into 4 stages of CRI according to the International Renal Interest Society (IRIS) classification scheme. Incidence rates of cats with IRIS classification stage 2 or stage 3 that remained in stage 2 or 3 without progressing to stage 4 were higher with benazepril (93 +/- 5%) as compared with placebo (73 +/- 13%). These results suggest a potential for benazepril to delay the progression of disease, extend survival time, or both in cats with CRI.

Slowing the progression of renal failure

In recent years several multicentric prospective studies have demonstrated the efficacy of some therapeutic measures to slow the progression of renal diseases. Inhibition of renin-angiotensin system (RAS) both by ACE inhibitors (ACEI) and angiotensin II receptor antagonists (ARA) is probably the strongest therapeutic alternative: The antiproteinuric effect of these drugs is an excellent surrogate marker and a predictor of the beneficial influences on the progression of renal failure. The type of renal disease, an inadequate control of blood pressure, and the presence of obesity may counteract the beneficial influences of RAS inhibition, whereas early treatment of all patients with significant proteinuria before the appearance of renal insufficiency and combined therapy with an ACEI and an ARA may augment it. Dietary protein restriction is a classic treatment of chronic renal insufficiency whose effectiveness has been validated by multicentric studies. However, a poor compliance of the patient and the risk of malnutrition with very strict protein restriction could limit the benefits of this treatment. Treatment of hyperlipidemia, prevention of obesity, avoidance of smoking, and regular physical exercise are interventions whose therapeutic potential is progressively recognized, particularly in type 2 diabetic nephropathy. Early correction of anemia may contribute to the slowing of renal disease progression. Although further studies are required, the accumulated evidence and the likelihood of additive beneficial effect of these therapeutic measures advise their combined implementation in patients with chronic renal diseases.

Disease state and treatment of chronic renal insufficiency.

Disease state and treatment of chronic renal insufficiency.

PERITONEAL DIALYSIS IN THE MANAGEMENT OF CHRONIC RENAL FAILURE.

ALTHOUGH it had been recognized earlier that the peritoneum was a semipermeable membrane, its utilization for dialysis in the treatment of uremia was not described until 1923.^1,2Technical problems and infection prevented popular adoption of peritoneal dialysis for more than 20 years,³although its clinical potentialities were explored.⁴The development of antibiotics and plastic catheters set the stage for Maxwell⁵and Doolan⁶in 1959 to describe simplified procedures for conducting peritoneal dialysis. Peritoneal dialysis has been used primarily in the treatment of acute renal failure. The treatment of chronic renal insufficiency by this method is a more recent development and experience with it is limited.^7-10The purpose of this paper is to report the use of peritoneal dialysis as an adjunct in the management of 54 patients presenting with symptoms due to chronic renal insufficiency and to attempt to assess why certain of these

The Treatment of Chronic Renal Insufficiency

The Treatment of Chronic Renal Insufficiency