Treatment Of Renal Damage Research Articles

Age- and Gender-Specific Diagnostic Value of the Albumin-to-Creatinine Ratio for the Early Screening of Chronic Kidney Disease Among Middle-Aged and Elderly Males in Southeast China.

To evaluate the potential diagnostic value of the albumin-to-creatinine ratio (ACR) in screening for early kidney injury in a physically examined population from Southeast China. A total of 13,250 candidates were selected. Urinary ACR values <30, 30-300, and >300 mg/g were utilized as positive cut-off points to denote normal proteinuria, microalbuminuria, and macroalbuminuria, respectively. Age, systolic blood pressure, diastolic blood pressure, body mass index, waistline, fasting blood glucose, glycated hemoglobin, triglycerides, and high-density lipoprotein cholesterol were significantly different among the three groups. eGFR was negatively correlated with the levels of sCr, BUN, and UA in the microalbuminuria and macroalbuminuria groups. Furthermore, there was a significant difference in CKD stage between the normal and abnormal urine ACR groups. Meanwhile, for the 20-40 years patients, the eGFR, sCr and BUN showed no significant difference between microalbuminuria group compared with the normal proteinuria group; in contrast, for the 41-60 years and >61 years patients, eGFR, sCr, BUN and UA were all markedly increase in microalbuminuria and macroalbuminuria group in comparison with the normal proteinuria group. Finally, for the 41-60 males, only eGFR significantly decreased in microalbuminuria group compared with the normal proteinuria group, while for the 41-60 females, only UA showed no significant difference between microalbuminuria group and normal proteinuria group. On the other hand, for the >61 males, eGFR, sCr and BUN all significantly changed between microalbuminuria group and normal proteinuria group, while for the >61 females, eGFR, sCr and BUN all showed no significant difference between microalbuminuria group and normal proteinuria group, as well as microalbuminuria group and macroalbuminuria group. We proposed using the urinary ACR for the screening of physically examined patients, especially among the elderly males. This approach would assist in the early diagnosis and treatment of renal damage.

Značaj nefroprotektivnog efekta sartana u terapiji hipertenzije

Arterial hypertension can be both a cause and a consequence of renal dysfunction. Assessment of the existence of impaired renal function, determination of serum creatinine and urate, as well as the ratio of albumin and creatinine in urine, is an integral part of the diagnostic algorithm for patients with arterial hypertension. The main postulates for the treatment of hypertension in patients with renal dysfunction, regardless of the presence of diabetes mellitus, include good control of blood pressure and reduction of proteinuria. Attenuation of the renin-angiotensin-aldosterone system by angiotensin-converting enzyme inhibitors and angiotensin II receptor type 1 blockers (sartans) slows renal impairment in diabetic and hypertensive nephropathy. However, their simultaneous use is contraindicated, because it does not lead to a reduction in cardiovascular mortality and morbidity, and increases the risk of hypotension, hyperkalemia and adverse renal outcomes. In this review article, we summarize in a practical way the most important aspects of early detection and treatment of renal damage in patients with hypertension, with special emphasis on the importance of nephroprotective effects of sartan.

Nephrological disorders and neurological involvement in pediatric primary Sjogren syndrome:a case report and review of literature

BackgroundSjögren syndrome (SS) is a rare disease in pediatrics, and little attention has been paid to the clinical feature in these patients. To date, there are few cases concern about neurological and nephrological disorders in childhood Sjögren syndrome. We describe a case of Sjögren syndrome in a 12-year-old girl who developed neurological disorders and interstitial nephritis and review the literature currently available on this topic.Case presentationA 12-year-old girl was admitted to our hospital for arthritis and glucosuria. She was required to do labial gland and renal biopsy, because the positive for anti-nuclear antibody and anti-Sjögren syndrome B (anti-SSB) antibody. Then the biopsy was performed revealing the lymphocytic infiltrate in the small area and renal tubular interstitial damage,thus the diagnosis of Sjögren syndrome with tubular interstitial damage was made. Three months later, she presented again with headache, fever, nausea, vomiting and was recovered without drug therapy. Based on the patient’s medical history, laboratory and imaging examination, and treatment, we speculate that the disorders of the nervous system were caused by the Sjögren syndrome. The girl has stable renal function and no residual nervous system damage in the next 1.5 years, but she underwent low dose prednisone therapy because of persistent renal glucosuria.ConclusionsNephrological disorders and neurological involvement are rare manifestations of Sjögren syndrome in children, and rarely presented as the initial symptoms. It should be suspected in children presenting with unexplained renal diseases, neurological abnormalities, or unexplained fever. Although there is no guidelines on the diagnosis and treatment of children Sjögren syndrome are currently available, early recognition and the appropriate treatment of renal damage and neurologic involvement would improve prognosis and prevent complications.

Prospective Protective Effect of Ellagic Acid as a SIRT1 Activator in Iron Oxide Nanoparticle-Induced Renal Damage in Rats.

Despite the wide application of iron oxide nanoparticles (IONPs), little is known about the specific mechanism of their nephrotoxic effect. We aimed to evaluate the nephrotoxic effects of iron oxide nanoparticles (IONPs) in vivo and the protective effect of ellagic acid (EA) as a silent information regulator sirtuin 1 (SIRT1) activator against the induced nephrotoxicity. Forty male albino Wistar rats were randomly distributed into four equal groups (10 rats each): the control group (oral saline for 30days), ellagic acid (EA) group (10mg/kg b.w. EA, orally for 30days), IONP group (20mg/kg b.w. IONP I/P injection at the 24th-30th day), and EA + IONP group (10mg/kg b.w./day EA for 30days + 20mg/kg b.w. IONPs at the 24th-30th day). In the present study, the potent antioxidant and antiapoptotic effects of EA were indicated by the significant overexpression of SIRT1 in renal tissues that leads to significant decreases in renal MDA content, P53 protein level and forkhead-box transcription factor1 (FOXO1) expression, and significant increases in renal GSH level, catalase activity, growth arrest and DNA damage-inducible protein 45 alpha (GADDα45), and renal inhibition of apoptosis protein (KIAP) gene expression levels in the EA + IONP-treated group. These results were confirmed by the improved histopathological renal features with EA administration. In conclusion, the present study provides the first evidence for the usefulness of EA as a sirtuin1 activator in the prevention or treatment of renal damage. Thus, EA could be used as a promising therapy for the prevention of IONP-induced nephrotoxicity.

Autologous-Versus Allogeneic-Bone Marrow Cell Grafting in Prevention of Obstructive Nephropathy in Rats

Background: The increasing number of patients suffering from chronic renal disease (CRD) and end-stage renal disease (ESRD) are a challenge for the development of ingenious therapies. Bone marrow (BM) stem cells are an attractive therapy in the treatment of CRD. Aim of the work: This study aims to compare autologous and allogeneic BM cells in treatment of renal damage in a model of unilateral ureteral obstruction (UUO). Materials and methods: Sixty adult female Sprague-Dawley rats were divided randomly into four groups of 15 animals each: Rats of first group served as (Sham group). The sham-operated animals underwent identical surgical procedures, except that the left ureter was manipulated without ligation and sectioning. Rats underwent UUO with direct intra-renal injection of saline were considered as (UUO) group. The remaining rats were injected with autologous (Auto group) or allogeneic (Allo group) BM cells directly into the renal parenchyma at the same day of operation. In Allo group, the ages of the donor rats were approximately the same as the recipient rats. Results: In the present study, we showed that both types BM cells provided a protective effect and ameliorated interstitial fibrosis as reflected by reduced tubular dilation, decreased interstitial expression of .-smooth muscle actin and significant decline in expression of both transforming growth factor-.1 and caspase-3 in the tubular cells. Autologous BM cells reduced the tubular dilation index from 36.6 (as in UUO rats) to 8.13. Allogeneic BM cells reduced tubular dilation index to 16.87. Conclusion: Our results show that a single intra-renal administration of autologous or allogeneic BM cells strongly associated with a reno-protective role with enhanced proliferation and reduced apoptosis of tubular cells promoted by UUO.

The Effect Of Taxifolin In The Treatment Of Renal Damage Induced By Ischemia Reperfusion In Rats

The Effect Of Taxifolin In The Treatment Of Renal Damage Induced By Ischemia Reperfusion In Rats

Protective effects of fraction 4a of polysaccharides isolated from Lycium barbarum against KBrO3-induced renal damage in rats.

Potassium bromate (KBrO3) is widely used as a food additive and is a major by-product of water disinfection. The aim of this study was to investigate the protective effects of fraction 4a of polysaccharides isolated from Lycium barbarum (LBP-4a) against renal damage induced by KBrO3 in rats and to determine the relevant mechanisms behind these effects. Male Wistar rats were divided into a normal control group, a KBrO3 control group, and LBP-4a(L) and LBP-4a(H) groups. With the exception of the normal control group, the rats in the other three groups were administered KBrO3 by intraperitoneal injection to induce renal damage. Before the induction of renal damage, rats in the LBP-4a(L) and LBP-4a(H) groups were pretreated with 50 mg per kg b.w. or 100 mg per kg b.w. LBP-4a, respectively, by intragastric administration. Clinical biochemical parameters and markers of oxidative damage were also determined. Treatment by administration of LBP-4a prior to challenge with KBrO3 prevented increases in the levels of nitrite, creatinine, urea nitrogen and uric acid in serum and increased the activities of antioxidant enzymes in kidney tissues. A comet assay and FCS results showed that pretreatment with LBP-4a also alleviated DNA damage and decreases in mitochondrial membrane potentials in renal cells. Histological studies further supported the above results and showed extensive renal damage in animals treated with KBrO3 and greatly reduced tissue injury in groups pretreated with LBP-4a. In conclusion, LBP-4a exhibited protective effects against renal damage induced by KBrO3, and the mechanism was closely correlated with a reduction in levels of lipid peroxidation and an increase in the activities of antioxidant enzymes in kidney tissues, which alleviated DNA damage and increased mitochondrial membrane potentials in renal cells. These observations provide the background for the further development of LBP-4a as a protective agent for use in the treatment of renal damage.

Genipin ameliorates hypertension-induced renal damage via the angiotensin II-TLR/MyD88/MAPK pathway

Genipin is a major active component of Fructus Gardenia, which has been widely used in Traditional Chinese Medicine for the treatment of various cardiovascular diseases. The aim of this study was to investigate the potential effects of genipin on hypertension and the related nephropathy and elucidate the underlying mechanisms of action. We first examined the effects of genipin on blood pressure and renal functions in the Spontaneously Hypertensive (SHR) rats. In the subsequent experiments with human mesangial cells (HMCs), the effects of genipin on angiotensin II (Ang II)-induced HMC proliferation, reactive oxygen species (ROS) generation, and cytokine prodution were examined using the MTT method, 2′,7′-dichlorohydrofluorescein (DCFH-DA) staining, and the corresponding enzyme-linked immunosorbent assay (ELISA) kits, respectively. The effects of genipin on Ang II-induced activation of the MAPK pathway and up-regulation of TLR2, TLR4, and MyD88 were detected by real-time PCR and Western blot and further validated in MyD88 siRNA-transfected HMCs. Genipin not only significantly lowered blood pressure in SHR rats after an 8-week treatment, but effectively improved renal functions, evidenced by decreased serum creatinine and blood urea nitrogen (BUN), as well as urinary microalbumin (m-ALB) and N-acetyl-beta-d-glucosaminidase (NAG) upon administration with genipin. Mechanistic studies conducted in Ang II-treated HMCs showed that genipin was able to counteract Ang II-induced cell proliferation, ROS generation, and pro-inflammatory responses. These effects may be mediated through the TLR/MyD88/MAPK signaling pathway. These findings provide new insights into the molecular mechanisms of genipin in the treatment of renal damage in hypertension, which merits a further investigation.

The efficacy of clonidine in the prevention and treatment of renal damage in the fawn-hooded (FHH) rat.

The efficacy of clonidine in the prevention and treatment of renal damage in the fawn-hooded (FHH) rat.

Renal complications of cytotoxic therapy.

The expanding use of cytotoxic drugs in cancer therapy has resulted in a confusing and increasingly frequent array of severe renal complications. This article reviews the nephrotoxicity and other renal and urological complications of commonly used drugs and the clinical setting in which they are prescribed. Emphasis is placed on the mechanisms, prevention and treatment of renal damage.