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Mitochondrial DNA (mtDNA) copy number (CN) is a biomarker of mitochondrial function and has been reported associated with kidney disease. However, its association with IgA nephropathy (IgAN), the most common cause of glomerulonephritis (GN), has not been evaluated. We included 664 patients with biopsy-proven IgAN and measured mtDNA-CN in peripheral blood by multiplexed real-time quantitative polymerase chain reaction (RT-qPCR). We examined the associations between mtDNA-CN and clinical variables and found that patients with higher mtDNA-CN had higher estimated glomerular filtration rate (eGFR) (r = 0.1009, p =.0092) and lower serum creatinine (SCr), blood urea nitrogen (BUN), and uric acid (UA) (r=−0.1101, −0.1023, −0.07806, respectively, all p values <.05). In terms of pathological injury, mtDNA-CN was higher in patients with less mesangial hypercellularity (p =.0385, M0 vs. M1 score by Oxford classification). Multivariable logistic regression analyses also showed that mtDNA-CN was lower for patients with moderate to severe renal impairment (defined as eGFR < 60 mL/min/1.73 m2) vs. mild renal impairment, with the odds ratio of 0.757 (95% confidence interval: 0.579–0.990, p =.042). In conclusion, mtDNA-CN was correlated with better renal function and less pathological injury in patients with IgAN, proposing that systemic mitochondrial dysfunction may be involved in or reflect the development of IgAN. [ABSTRACT FROM AUTHOR]

Chronic kidney disease (CKD) is a long-term condition characterized by poor prognosis and a high mortality rate. Panax notoginseng saponins (PNS) are the main active ingredient of the traditional Chinese herb Panaxnotoginseng(Burk.)F.H.Chen, which has been widely reported to have various pharmacological effects. Here, we examined the effect of PNS on renal function and the modulation of intestinal flora and intestinal barrier in a rat model of adenine-induced CKD. Adenine was used to establish a rat model of CKD, biochemical testing, histopathologic examination, ELISA, immunohistochemical assay, western blot assay, and fecal microbiota 16s rRNA analysis was used to test the effect of PNS on CKD rats. Adenine induced a significant decrease in glomerular filtration rate, an increase in urinary protein excretion rate, and pathological damage to renal tissue in CKD rats. TNF-α, MCP-1, IL-1β, IL-18, TMAO, and endotoxin levels were increased in the blood of the model rats. Application of PNS countered the effects of adenine, restoring the above parameters to the level observed in healthy rats. In addition, activation of the inflammatory proteins NF-κB (p65) and NLRP3 and the fibrosis-associated proteins α-SMA and smad3 were inhibited in the kidneys of CKD rats. Furthermore, PNS promoted the expression of the tight junction proteins Occludin and ZO-1, increased SIgA levels, strengthened intestinal immunity, reduced mechanical damage to the intestine, was reduced levels of DAO and D-LA. Our data suggest PNS may delay CKD by restoring gut microbiota, and through the subsequent generation of a microbial barrier and modulation of microbiota metabolites. In conclusion, PNS may inhibit the development of inflammation and fibrosis in the kidney tissue through regulation of intestinal microorganisms and inhibition of the activation of pro-inflammatory and pro-fibrotic proteins in the kidney. [ABSTRACT FROM AUTHOR]

Acute kidney injury (AKI) is a serious complication related to cardiac surgery. Several studies have been conducted to investigate the effect of dexmedetomidine administration on AKI prevention. To assess if dexmedetomidine is associated with a protective effect of renal function after cardiac surgery. And the aim of conducting this meta-analysis is to summarize the literature and determine the clinical utility of dexmedetomidine administration in patients undergoing cardiac surgery. PubMed, Cochrane Library, and EMBASE databases were comprehensively searched for all randomized controlled trials (RCTs) published before 1 December, 2021 that investigated the effect of dexmedetomidine on AKI prevention. Our analysis included 16 studies involving 2148 patients. Compared with the control group, dexmedetomidine administration significantly reduced AKI incidence (OR, 0.47; 95% CI, 0.36–0.61; p < 0.00001; I2 = 26%) and the length of stay in the intensive care unit (ICU) but did not alter mortality rate, length of stay in the hospital, and mechanical ventilation time. Furthermore, the incidence of delirium among patients treated with dexmedetomidine was significantly decreased. Dexmedetomidine administration has a positive effect on preventing AKI and postoperative delirium after cardiac surgery and significantly reduces the length of stay in the ICU. [ABSTRACT FROM AUTHOR]

This study aims to analyze the characteristics of idiopathic membranous nephropathy (iMN) with nondiabetic urine glucose during the follow-up. We retrospectively analyzed the data of 1313 patients who were diagnosed iMN. The prevalence of nondiabetic urine glucose during follow-up was 10.89%. There were significant differences between the patients with nondiabetic urine glucose and those without urine glucose in gender, hypertension ratio, proteinuria, N-acetyl-β-glucosaminidase, retinol binding protein, serum albumin, serum creatinine (Scr), cholesterol, triglyceride and positive anti-phospholipase A2 receptor antibody ratio, glomerular sclerosis ratio, acute and chronic tubular injury lesion at baseline. To exclude the influence of the baseline proteinuria and Scr, case control sampling of urine glucose negative patients was applied according to gender, baseline proteinuria and Scr. The proteinuria nonremission (NR) ratio was 45.83 versus 12.50% of the urine glucose positive group and case control group. Partial remission (PR) ratio of the two groups was 36.46 versus 23.96% and complete remission (CR) ratio was 19.79% versus 63.54%, respectively. Patients with urine glucose had higher risk of 50% estimated glomerular filtration rate (eGFR) reduction. Cox regression showed that urine glucose and baseline Scr were risk factors of 50% reduction of eGFR. Urine glucose remission ratio of the patients with proteinuria NR, PR, and CR was 13.33, 56.25, and 94.73% (p < 0.005). Patients who got urine glucose remission also had better renal survival. In conclusion, non-diabetic urine glucose was closely related to proteinuria. It could be applied as a tubular injury marker to predict renal function. [ABSTRACT FROM AUTHOR]

Although casts in urine may imply the underlying pathogenesis and the diagnosis, the waxy cast is poorly understood yet. We aim to investigate the association between waxy casts and clinicopathological indices. Patients undergone renal biopsy and urine sediment examination were enrolled. Waxy casts referred to those presented with a homogeneous melted wax appearance and pre-waxy casts referred to those in which one or more segments demonstrated a waxy-cast appearance. Multivariable logistic regression was used to assess the factors associated with waxy casts. In 1282 patients, the detection rate of waxy casts was 26.3%. If either waxy or pre-waxy cast was considered as a diagnostic marker for renal insufficiency (eGFR < 60 ml/min/1.73 m2), the sensitivity was 0.58 and the specificity was 0.88. If the only waxy cast was considered as the diagnostic marker, the sensitivity was 0.29 and the specificity was 0.97. The patients with waxy or pre-waxy casts had higher blood pressure, more proteinuria, and worse renal function. Waxy or pre-waxy cast was independently associated with eGFR (odds ratio: 0.73 per 10 mL/min/1.73 m2 increase, 95% confidence interval: 0.69–0.77, p < 0.001), proteinuria (odds ratio: 1.07 per 1 g/day increase, 95% confidence interval: 1.03–1.10, p < 0.001) and pathological lesions. Waxy or pre-waxy casts are closely related to impaired renal function. Their presence is a specific indicator of renal insufficiency but is not sensitive enough. [ABSTRACT FROM AUTHOR]

The role of probiotics in the management of diabetic kidney disease (DKD) has been shown. Several current trials are investigating the effect of probiotics, which are widely used to modulate biomarkers of renal function, glucose, lipids, inflammation and oxidative stress in patients with DKD. However, their findings are controversial. This study aimed to systematically evaluate the impact of probiotics on patients with DKD via meta-analysis. PubMed, The Cochrane Library, Web of Science, Scopus, Embase, China National Knowledge Infrastructure, Chinese Wanfang Database and Chinese VIP Database were searched for relevant studies from the establishment of these databases to September 2021. The pooled results evaluated the impact of probiotics on renal function, glucose, lipids, inflammation and oxidative stress indicators in patients with DKD. Additionally, subgroup analysis was performed based on intervention duration, probiotic dose and probiotic consumption patterns, respectively. Ten trials that included 552 participants were identified for analysis. Compared with the controls, probiotics significantly decreased serum creatinine (Scr) [WMD = −0.17 mg/dL; 95%CI = −0.29, −0.05; p = 0.004], blood urea nitrogen (BUN) [WMD = −1.36 mg/dL; 95%CI = −2.20, −0.52; p = 0.001], cystatin C (Cys C) [WMD = −29.50 ng/mL; 95%CI = −32.82, −26.18; p < 0.00001], urinary albumin/creatinine ratio (UACR) [WMD = −16.05 mg/g; 95%CI = −27.12, −4.99; p = 0.004] and natrium (Na) [WMD = −0.94 mmol/L; 95%CI = −1.82, −0.05; p = 0.04] in patients with DKD. Enhanced glycemic control was observed in patients with DKD receiving probiotics compared with controls, as demonstrated by reduced levels of fasting plasma glucose (FPG), hemoglobin A1c (HbA1c), homeostasis model of assessment-estimated insulin resistance (HOMA-IR), and increased quantitative insulin sensitivity check index (QUICKI). Probiotics affected lipid metabolism parameters with decreasing triglycerides (TG), total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-c) levels in patients with DKD. Probiotics could also could improve inflammation and oxidative stress by decreasing high-sensitivity C-reactive protein (hs-CRP), plasma malondialdehyde (MDA), total antioxidant capacity (TAC), glutathione (GSH) and nitric oxide (NO). Additionally, subgroup analysis showed that those who received multiple species probiotics had a statistically significant difference in BUN, FPG, HOMA-IR, high-density lipoprotein cholesterol (HDL-c), MDA, TAC, and NO. Meanwhile, Scr, LDL-c, HDL-c, MDA, and TAC were ameliorated when the intervention duration was more than eight weeks and BUN, FPG, HOMA-IR, and MDA were improved when the probiotic dose was greater than four billion CFU/day. Our analysis revealed that probiotics could delay the progression of renal function injury, improve glucose and lipid metabolism, and reduce inflammation and oxidative stress in patients with DKD. Subgroup analysis showed that intervention duration, probiotic dose and probiotic consumption patterns had an effect of probiotics on outcomes. [ABSTRACT FROM AUTHOR]

Diabetes mellitus is a common "non-gout" disease with high incidence. Several studies have shown that serum uric acid level in patients with diabetes is higher than that in healthy individuals, and is accompanied by severe albuminuria and high serum creatinine (Scr). Recent clinical studies have found that uric acid-lowering therapy (such as allopurinol) could reduce urinary albumin excretion rates (UAER) and Scr, increase eGFR, and thus reduce kidney damage in patients with diabetes. Therefore, this meta-analysis [PROSPERO CRD42021274465] intended to evaluate the efficacy and safety of allopurinol in patients with diabetes mellitus. We thoroughly searched five electronic resource databases for randomized controlled trials (RCTs) that compared the efficacy and safety of allopurinol versus conventional treatment or placebo for the treatment of patients with diabetes mellitus. Predetermined outcomes were considered continuous variables, mean difference (MD) was used for the determination of effect size (standardized mean difference [SMD] was used to determine the effect size when there were different evaluation criteria in different articles), and the corresponding 95% confidence interval (CI) was calculated. All outcome measures were analyzed using a random-effects model for data analysis. Ten eligible trials with a total of 866 participants were included in the meta-analysis. Allopurinol was more effective in decreasing serum uric acid (SUA) levels compared with conventional treatment (p = 0.0001) or placebo (p < 0.00001). Moreover, the levels of 24-hour urine protein were significantly lower in the allopurinol group (p < 0.00001). The subgroup analysis of Scr showed that the Scr of patients with an allopurinol treatment duration of fewer than six months was significantly lower than that of the control group (p = 0.03). No significant difference in adverse events (AEs) was identified between the treatment and control groups. Our meta-analysis of RCTs showed that oral administration of allopurinol effectively reduced SUA levels in patients with diabetes, and patients' renal function was protected. More RCTs with larger sample sizes and higher quality are needed to clarify the role of allopurinol use in decreasing blood pressure, maintaining blood glucose levels, and improving renal function in patients with diabetes. [ABSTRACT FROM AUTHOR]

Mesenchymal stem cells (MSCs)-based therapy has shown promising results for renal injury. In this study, the efficacy and safety of autologous bone marrow-derived mesenchymal stem cells (BM-MSCs) in treating nonspecific interstitial fibrosis and tubular atrophy (IFTA) were evaluated. From March 2011 to January 2013, 11 renal transplanted patients with IFTA were recruited. At baseline, patients were given one intra-arterial infusion of BM-MSCs; 7 days and 1 month later, another two intravenous infusions of cells were followed. Serum creatinine, creatinine clearance rate, and serum cystatin-C at baseline and 7 days, 1 month, 3 months, 6 months, and 12 months after the intra-arterial infusion of BM-MSCs were used to assess renal function. At baseline and 6 months, histological examination based on hematoxylin-eosin, Masson's trichrome and periodic acid-Schiff staining and immunohistochemistry for transforming growth factor β1 (TGF-β1) and connective tissue growth factor (CTGF) was performed. Adverse events were recorded to evaluate the safety of BM-MSCs treatment. At 12 months, the renal function of 6 patients (54.5%) was improved, 3 (27.3%) were stable and 2 (18.2%) were worsened. At 6 months, the mean IFTA scores of all participators were similar with the baseline (1.73 ± 0.41 vs.1.50 ± 0.0.77, p = 0.242); however, it was significantly decreased when only 6 patients with improved renal function were analyzed (1.67 ± 0.41 vs. 1.08 ± 0.20, p = 0.013). Besides, decreased expression of TGF-β1 and CTGF were also observed at 6 months. During 1 year follow-up period, only two minor complications including infection and allergy were observed. Our results demonstrated that autologous BM-MSCs are safe and beneficial for IFTA patients. Abbreviations: MSCs: mesenchymal stem cells; BM-MSCs: marrow-derived mesenchymal stem cells; IFTA: interstitial fibrosis and tubular atrophy; CAN: chronic allograft nephropathy; CNIs: calcineurin inhibitors; Scr: serum creatinine; CCr: creatinine clearance rate; Cys-C: cystatin-C; TGF-β1: transforming growth factor β1; CTGF: connective tissue growth factor [ABSTRACT FROM AUTHOR]

Studies have shown that the use of statins could significantly improve lipid profiles; however, it remains controversial whether the use of statins could improve renal function in patients with chronic kidney disease (CKD). Therefore, we conducted a meta-analysis of randomized controlled trials (RCTs) to evaluate the effects of statins on renal function in patients with CKD. We systematically searched PubMed, EMBASE, and the Cochrane Library databases for eligible RCTs from inception to October 2020. Pooled effect estimates were assigned as weighted mean differences (WMDs) with 95% confidence intervals (CIs) using the random-effects model. We selected 33 RCTs that recruited 37,391 patients with CKD patients. The summary results suggested that statin use significantly reduced urinary albumin (WMD: −2.04; 95%CI: −3.53 to −0.56; p =.007) and protein (WMD: −0.58; 95%CI: −0.95 to −0.21; p =.002) excretions and increased creatinine clearance (WMD: 0.86; 95%CI: 0.32–1.41; p =.002). However, there were no significant differences between statin and control groups in terms of changes in estimated glomerular filtration rate (WMD: 0.38; 95%CI: −0.04 to 0.79; p =.075), and serum creatinine levels (WMD: −0.07; 95%CI: −0.25, 0.12; p =.475). We found that statin use in patients with CKD may slow CKD progression by lowering urinary albumin and protein excretions or increasing creatinine clearance. Further large-scale RCTs should be conducted to evaluate the long-term effects of statins on renal outcomes. Abbreviations: CKD: chronic kidney disease; RCT: randomized controlled trials; WMD: weighted mean differences; CI: confidence intervals; ACEI: angiotensin-converting enzyme inhibitors; eGFR: estimated glomerular filtration rate [ABSTRACT FROM AUTHOR]

The well-documented benefits of physical activity (PA) are still poorly characterized in long-term kidney transplant outcome. This study analyzed the impact over a 10-year follow-up of PA on graft function in Italian kidney transplant recipients (KTRs). Since 2002, the Italian Transplant-Information-System collected donor and recipient baseline and transplant-related parameters in KTRs. In 2015, 'penchant for PA' (PA ≥ 30-min, 5 times/week) was added. Stable patients aged ≥18 years at the time of first-transplantation were eligible. KTRs with at least 10-year follow-up were also analyzed. Mixed-effect regression models were used to compare eGFR changes over time in active versus non-active patients. PA information was available for 6,055 KTRs (active 51.6%, non-active 48.4%). Lower penchant for PA was found in overweight and obese patients (OR = 0.84; OR = 0.48, respectively), in those with longer dialysis vintage (OR = 0.98 every year of dialysis), and older age at transplant. Male subjects showed greater penchant for PA (OR = 1.25). A slower decline of eGFR over time was observed in active KTRs compared to non-active, and this finding was confirmed in the subgroup with at least 10-year follow-up (n = 2,060). After applying the propensity score matching to reduce confounding factors, mixed-effect regression models corroborated such better long-term trend of graft function preservation in active KTRs. Penchant for PA is more frequent among male and younger KTRs. Moreover, in our group of Italian KTRs, active patients revealed higher eGFR values and preserved kidney function over time, up to 10-years of follow-up. [ABSTRACT FROM AUTHOR]

Objective: To study the efficacy and safety of sustained low-efficiency diafiltration (SLEDf) versus hemodialysis (HD) for patients with wasp stings who developed stage III acute kidney injury (AKI). Methods: We retrospectively analyzed the clinical data of consecutive patients who developed AKI following wasp stings. All eligible patients received renal replacement therapy in combination with hemoperfusion. Thereafter, blood purification therapy and HD were performed with a volumetrically controlled machine and 1.7 m2 surface, Fresenius Polysulfone HD filter and SLEDf was undertaken with a volumetrically controlled machine and 1.3 m2 surface, Fresenius Polysulfone HD filter. Results: Forty patients developed stage III AKI following wasp stings, including 14 patients that received SLEDf and 26 patients underwent HD. Thirteen patients were aged less than 60 years and underwent HD (group I), 27 patients were aged at least 60 years, including 13 patients undergoing HD (group II) and 14 patients receiving SLEDf (group III). Groups I and II completed 150 and 162 sessions of HD, respectively, and group III completed 156 sessions of sustained low-efficiency blood purification therapy, including 50 sessions of SLEDf. The time to return to normal serum creatinine levels was 38.8 ± 2.7 days for group I, 47.2 ± 5.3 days for group II, and 39.2 ± 3.3 days for group III. A statistically significant difference was observed in time to normal serum creatinine levels among the three groups. Conclusion: Elderly wasp victims have more severe illness than younger wasp victims and SLEDf is safe and superior to HD in recovery of renal function of elderly wasp victims. [ABSTRACT FROM AUTHOR]

Background: Preeclampsia is a common medical complication in pregnancy. It has been reported to be associated with decreased serum magnesium levels. However, there has not been evidence demonstrating utilization of change in magnesium for prediction of preeclampsia. The purpose of this study was to develop magnesium fraction-based equations which took other significant clinical risk factors into consideration for prediction of preeclampsia. Methods: We collected serum total and ionized magnesium ionized magnesium levels from 84 pregnant women diagnosed with preeclampsia after week 20 of pregnancy. The ionized magnesium fraction was then calculated by the percentage ratio of ionized and total magnesium level. Results: Sixty-four (76.19%) women had normal pregnancy and 20 (23.81%) developed preeclampsia. The ionized magnesium fraction was significantly lower in preeclampsia group (23.95 ± 4.7% vs. 26.28 ± 2.3%, p = .04). Additionally, lower ionized magnesium fraction (24.67%), teenage and elderly primigravida were significantly associated with preeclampsia (OR = 4.41, 95% CI: 1.46-13.40, OR = 5.47, 95% CI: 1.85-35.42 and OR = 11.11, 95% CI: 1.09-113.78, respectively). Consequently, we attempted to develop ionized magnesium fraction-based equations calculate risk scores for preeclampsia. The area of ROC for predictive accuracy of the model was 0.77 (p < .001) and ROC suggested that the score of 0.27 would be a threshold for screening preeclampsia with 70% sensitivity and 81% specificity. Conclusions: Ionized magnesium fraction may have been appropriate for screening of preeclampsia. We suggested blood testing on total and ionized magnesium concentrations as well as calculation of ionized magnesium fraction in addition to routine antenatal care for better screening of the disease. [ABSTRACT FROM AUTHOR]

Objectives:For many years, creation of an orthotopic neobladder after cystectomy has been popular. In the present study, we measured the extent of metabolic acidosis in patients with ileal neobladders compared with ileal conduits and defined risk factors for development of metabolic acidosis. Methods:We retrospectively studied 95 patients, who underwent radical cystectomy and urinary diversion to treat invasive bladder cancer from January 2001 to December 2014 at Hallym University Kangnam Sacred Heart Hospital, through investigation of acid-base balance, serum electrolyte levels and renal function one month and one year after operation. Results:One month after the operation, metabolic acidosis was found from 18 patients (31.0%) in an ileal neobladder group and from 4 (14.8%) in an ileal conduits group. One year after the operation, the numbers became 11 (22.9%) and 2 (10.0%), respectively. However, there was not a statistical difference. The blood biochemical profiles of the two groups did not differ significantly after urinary diversion. Logistic analysis revealed that lower estimated glomerular filtration rate (eGFR) was associated with metabolic acidosis at one month (odds ratio, OR = 0.94 [0.91–0.97];p < 0.001) and one year (OR = 0.94 [0.92–0.97];P = 0.001) after urinary diversion. In multivariate analysis, lower eGFR is a significant risk factor for metabolic acidosis at one month. Conclusions:Patients with ileal neobladders and conduits are at the similar risk of metabolic acidosis. A close association between renal function and development of metabolic acidosis was observed, especially stronger in an early period after operation. [ABSTRACT FROM AUTHOR]

Purpose:Urinary biomarkers of renal injury urinary may identify loss of renal function following nephron-sparing surgery (NSS). This study was designed to evaluate whether urinaryl-type fatty acid-binding protein (l-FABP) is an early biomarker of loss of renal function after NSS. Specifically, the kinetics of urinaryl-FABP level after NSS and its correlation with factors related to ischemic renal injury were analyzed. Methods:This study prospectively evaluated 18 patients who underwent NSS between July and December 2014, including 12 who underwent laparoscopic and six who underwent robot-assisted partial nephrectomy. Urinaryl-FABP concentrations were measured preoperatively and 1, 2, 3, 6, 12, 24, 48, and 72 h after renal artery declamping. Loss of renal function loss was calculated by comparing the effective renal plasma flow, as determined by99mTc-mercaptoacetyltriglycine (MAG3) clearance, on the operated and normal sides. The decrease in estimated glomerular filtration rate from before surgery to six months after surgery was also measured. Results:Urinaryl-FABP concentration peaked within 2 h of declamping, which may quantify nephron damage caused by ischemia. The decrease in MAG3 reduction ratio correlated with both the ischemia time and peak urinaryl-FABP concentration. Peak urinaryl-FABP concentration showed a significant correlation with MAG3 reduction ratio. Conclusions:l-FABP is a suitable urinary biomarker for predicting the extent of ischemic renal injury. [ABSTRACT FROM PUBLISHER]

To investigate the role of mast cells (MCs) renal infiltration in the progression of human anti-GBM nephritis, 38 patients diagnosed with anti-GBM nephritis were enrolled. Renal biopsies were performed. Immunohistochemistry was conducted to detect MCs in renal tissues. Patients were divided into group 1 (MCs <50 mm−2,n = 18) and group 2 (MCs ≥50 mm−2,n = 20) according to the infiltrating renal MC count. The clinical–pathological indices were compared. And, correlation between MCs and the clinical–pathological indices was analyzed. Patients of group 2 had more severe renal dysfunctions, expressed as higher levels of serum creatinine (SCr 8.95 ± 3.66 vs. 4.75 ± 2.73 mg/dL,p < 0.001), urine retinol-binding protein (RBP 29.8 ± 13.9 vs. 15.7 ± 11.5 mg/dL,p = 0.005), and lower urinary osmotic pressure. Pathologically, patients of group 2 had a higher percentage of fibrous/fibrocellular crescents (66.7 ± 21.9 vs. 47.0 ± 33.6%,p = 0.037) but a lower percentage of cellular crescents. More CD8 (268 mm−2vs. 180 mm−2,p = 0.045) and CD68 (268 mm−2vs. 180 mm−2,p = 0.045) positive cells infiltrating the interstitium were observed in group 2. Furthermore, renal MCs correlated significantly with the total number of crescents and the tubular interstitial CD8 and CD68 positive cells. And, the number of MCs was associated with the histological types. The renal function was significantly different between the two groups at presentation. However, at 3 and 6 month follow-up, the patient outcome was associated with the histological types. Our study showed that MC infiltrations were associated with chronic lesions in anti-GBM nephritis and may be involved in the loss of renal function with pathological changes. [ABSTRACT FROM PUBLISHER]

Background: Although there are many available data about renal involvement in patients with beta thalassemia major (TM), the changes in renal functions of other types, such as thalassemia intermedia (TI) and thalassemia minor (TMin), were reported less. Therefore, we aimed to evaluate renal tubular and glomerular functions in patients with three types of beta thalassemia.Methods: This prospective case–control study was conducted on 118 beta-thalassemia patients (49 in TM, 18 in TI and 51 TMin) and 51 healthy controls. Glomerular functions [estimated glomerular filtration rate (GFR), serum cystatin C and urinary protein creatinine ratio] and tubular functions [fractioned sodium excretion (FENa), tubular reabsorption of phosphorus, urinary excretion of uric acid, levels of retinol-binding protein, alpha-1 macroglobulin (alpha-1M), and beta-2 microglobulin, calcium creatinine ratio] were assessed in all patients and controls.Results: The mean ages of the groups and controls at presentation were similar. Although GFR was similar in all patients and control groups, serum levels of cystatin C in patients with TM and TI were significantly higher compared to TMin and controls. Alpha-1M, FENa, urinary excretion of uric acid, and urine protein/creatinine ratio in TM and TI groups were significantly higher than the others. Mean cystatin C level was also higher in patients with TMin compared the controls. However, there were no significant differences according to all tubular and other glomerular functions between TMin and control groups.Conclusions: Although all types of beta thalassemia patients should be closely monitored to prevent further decrease in renal functions, the patients with TI should be considered to have a higher risk of glomerular and tubular deterioration as well as TM. [ABSTRACT FROM PUBLISHER]

Early stage of vascular disease and diabetic kidney disease (DKD stages 1 and 2) has been under-recognized, under common practice worldwide. The lack of sensitive diagnostic marker leads to late diagnosis and a progression of underlying vascular disease associated with chronic renal ischemia, which eventually intensifies the magnitude of DKD damage. Treatment at this late stage fails to correct the renal ischemia, or restore renal function, due to the altered vascular homeostasis associated with an impaired nitric oxide production. In contrast to the above information, early recognition of vascular disease and DKD with sensitive diagnostic markers would be able to implement an effective prevention of progression of vascular disease and DKD. Treatment at early stage under environment favorable for adequate vascular homeostasis is able to correct the renal ischemia and improve the renal function. [ABSTRACT FROM AUTHOR]

Objective: To determine the impact of percutaneous nephrolithotomy (PNL) on global and regional renal function in children.Methods: In total, 40 children (41 renal units) undergoing PNL were included in this prospective study. All patients were evaluated using quantitative single-photon emission computed tomography (QSPECT) with technetium-99 m-dimercaptosuccinic acid (99mTc-DMSA) examinations before and 3 months after surgery.Results: The mean age was 9.5 years (range, 3–16), and the mean stone size was 3.4 cm (range, 2–6.5). Of the cases, 39 (95%) were managed as being stone-free after a single session of PNL. After additional treatment procedures, 40 (97.5%) of the cases were managed as being stone-free. Of the 41 renal units, new focal cortical defects on99mTc-DMSA scans were seen in 4 (9.7%) patients. Total relative uptake in the treated kidneys increased from 42.3% to 44.1%. The mean creatinine level before PNL was 1.18 ± 0.45 (0.8–1.6) mg/dL compared with 1.16 (0.7–1.5) mg/dL by the end of the follow-up period (not statistically significantly different,p > 0.05).Conclusions: PNL in children is a safe and feasible method for the maximal clearance of stones. QSPECT of99mTc-DMSA confirmed that renal function is preserved or even improved after percutaneous stone removal. [ABSTRACT FROM PUBLISHER]

Background: The kidney is often affected in plasma cell dyscrasias, usually due to the effects of nephrotoxic monoclonal-free light chains. Renal failure due to a monoclonal gammopathy may be detected by the highly sensitive serum-free light-chain (sFLC) ratio yet missed by electrophoretic assays. The aim of this study was to assess sFLC levels in relation to markers of renal function.Methods: Five-hundred thirteen patients were included in this study. sFLC levels were measured by Freelite® (The Binding Site Group Ltd, Birmingham, UK) assay using the BNII nephelometer (Siemens Diagnostics, Germany). Kappa/lambda (κ/λ) sFLC ratio was calculated. Serum creatinine levels were analyzed by modified Jaffe method in Cobas 8000 analyser. GFR was estimated by the CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) equation. Patients were assigned to two groups depending on their eGFR values: ≤60 mL/min/1.73 m2(Group 1,n = 103) and >60 mL/min/1.73 m2(Group 2,n = 410). Data were expressed as median and min–max. All the statistical analyses were done with SPSS version 20.0 and a significance level of 0.05 was considered.Results: Serum κ-FLC median value was 36.4 (5.62–16,000) mg/L, serum λ-FLC was 21.7 (4.91–8770) mg/L, κ/λ sFLC ratio was 1.33 (0.01–3258) and serum creatinine was 1.56 (0.63–7.21) mg/dL in Group 1. Both λ sFLC and κ/λ sFLC ratios were correlated with eGFR (r = −0.318,r = 0.198,p < 0.05, respectively). We did not find any significant correlation between κ/λ sFLC ratio and eGFR in Group 2.Conclusions: We examined the association between sFLC concentrations and renal function. Our preliminary findings suggest that serum λ-FLC might be considered as a useful marker for predicting renal function. Prospective studies are needed to clarify the usefulness of these parameters for identifying renal failure due to a monoclonal gammopathy. [ABSTRACT FROM AUTHOR]

Background: Elderly patients are particularly susceptible to polypharmacy. The present study evaluated the renal effects of optimizing potentially nephrotoxic medications in an older population.Methods: Retrospective study of patients’ ≥60 years treated between January of 2013 and February of 2015 in a Nephrology Clinic. The renal effect of avoiding polypharmacy was studied.Results: Sixty-one patients were studied. Median age was 81 years (range 60–94). Twenty-five patients (41%) were male. NSAIDs alone were stopped in seven patients (11.4%), a dose reduction in antihypertensives was done in 11 patients (18%), one or more antihypertensives were discontinued in 20 patients (32.7%) and discontinuation and dose reduction of multiple medications was carried out in 23 patients (37.7%). The number of antihypertensives was reduced from a median of 3 (range of 0–8) at baseline to a median of 2 (range 0–7),p < 0.001 after intervention. After intervention, the glomerular filtration rate (GFR) improved significantly, from a baseline of 32 ± 15.5 cc/min/1.73m2to 39.5 ± 17 cc/min/1.73m2at t1 (p < 0.001) and 44.5 ± 18.7 cc/min/1.73m2at t2 (p < 0.001 vs. baseline). In a multivariate model, after adjusting for ACEIs/ARBs discontinuation/dose reduction, NSAIDs use and change in DBP, an increase in SBP at time 1 remained significantly associated with increments in GFR on follow-up (estimate = 0.20,p = 0.01).Conclusions: Avoidance of polypharmacy was associated with an improvement in renal function. [ABSTRACT FROM PUBLISHER]

Our objective in this experimental study is to research the effect of the intra-abdominal pressure which rises following pneumoperitoneum and whether Theophylline has a possible protective activity on this situation. In our study, 24 Wistar Albino rats were used. Rats were divided into two groups. The first group was set for only pneumoperitoneum model. The second group was given 15 mg/kg of Theophylline intraperitoneally before setting pneumoperitoneum model. Then urea, creatinine, cystatin-C, tissue and serum total antioxidant capacity, total oxidant capacity and oxidative stress index in two groups were measured and compared with each other. Apoptosis and histopathological conditions in the renal tissues were examined. The differences between the groups were analyzed with the Mann–WhitneyUtest. Results were considered significant atp < 0.05. No statistically significant difference was determined between tissue and serum averages in two groups in terms of TAS, TOS and OSI values (p > 0.05). The mean value of urea were similar in pneumoperitoneum and pneumoperitoneum + theophylline groups (p = 0.12). The mean cystatin-C value was 2.2 ± 0.3 µg/mL in pneumoperitoneum, 1.74 ± 0.33 µg/mL in pneumoperitoneum + theophylline (p = 0.002). According to our study, lower cystatin-C levels in the group, where Theophylline was given, are suggestive of lower renal injury in this group. However, this opinion is interrogated as there is no difference in terms of tissue and serum TAS, TOS, OSI and urea values between the groups. [ABSTRACT FROM AUTHOR]

We assessed whether red cell distribution width (RDW) is associated with microalbuminuria (MAU) in a group of 320 patients with newly diagnosed type 2 diabetes mellitus (T2DM), recruited in Zhengzhou. Patients were divided into normal group and MAU group. Compared with the normal group, the patients with MAU had higher red blood cell count ( p = 0.005) and RDW ( p < 0.001). The multiple logistic regression indicated that RDW (OR = 3.89, 95% CI: 1.98-7.66, p < 0.001) was an independent risk factor of MAU in newly diagnosed T2DM. Other factors include smoking (OR = 4.44, 95% CI: 2.90-8.72, p < 0.001), higher waist index (OR = 2.17, 95% CI: 1.89-5.26, p = 0.002), FBG level (OR = 2.05, 95% CI: 1.21-3.84, p = 0.008) and uric acid level (OR = 2.18, 95% CI: 1.05-4.52, p = 0.037). The receiver operating characteristic (ROC) curves explored the relationship between MAU and RDW. The area under the curve was 0.79 (95% CI: 0.74-0.84; p < 0.001). Using a cut-off point of 12.8, the RDW predicted MAU in the T2DM patients with a sensitivity of 71.3% and specificity of 66.9%. RDW may be independently associated with MAU in patients with newly diagnosed T2DM. RDW may be treated as effective predictive index in the evaluation of diabetes nephropathy or diabetes-associated complications. [ABSTRACT FROM AUTHOR]

Diabetic nephropathy (DN) is a serious complication and it leads to kidney failure. The endothelial nitric oxide synthases (eNOS) seems to be involved in the development and progression of DN. The Puerarin is a well-known Chinese traditional formula, which is widely used in clinical practice for the treatment of kidney disease. The present study was designed to investigate the renal protective effects of Puerarin on streptozotocin (STZ)-induced diabetic rats. Thirty Sprague-Dawley (SD) male rats were divided into three groups at random. The diabetic group and the Puerarin-treated group were intraperitoneally injected with STZ 65 mg/kg and the Puerarin-treated rats were intraperitoneally injected Puerarin 100 mg/kg/day for 4 weeks. The results showed the Puerarin could improve body weight, blood sugar, BUN and SCr levels, and reduce ultrastructural changes of kidney in diabetic rats. It also attenuated eNOS expression in glomerular endothelial cells and tubular cells of diabetic rats with Puerarin treatment ( p < 0.05). The Puerarin had significant renal-protective effects for the diabetic nephropathy, possibly through regulating eNOS expression, and it may be used as a potential therapeutic reagent. [ABSTRACT FROM AUTHOR]

Background: The renoprotective pleiotropic effect of 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) has recently been reported by several investigators. However, the effect of statins on IgA nephropathy (IgAN) is still unknown. Methods: We selected 24 IgAN patients who had newly started statin therapy and were not treated with steroids and immunosuppressive agents during the observation period. We analyzed and compared clinical findings 1 year before and after treatment. Results: Mean age was 50.5 ± 9.91 years and mean blood pressure was 90.9 ± 10.8 mmHg. Renal function was slightly deteriorated, serum creatinine was 1.03 (0.71-1.24) mg/dL and estimated glomerular filtration rate (eGFR) was 55.8 ± 22.8 mL/min. Lipid metabolism was poorly controlled [total cholesterol 247.7 ± 35.7 mg/dL, low-density lipoprotein cholesterol 151.5 (140.8-172.8) mg/dL, and triglyceride 163.0 (126.3-243.8) mg/dL]. Mild urinary abnormality was observed [proteinuria: 0.50 (0.22-1.29) g/g creatinine, urinary red blood cells 1.0 (0.2-5.0) per high power field]. After 1 year of statin treatment, lipid control was significantly better than at baseline. Proteinuria was not significantly decreased but renal function was improved. eGFR changed from a −5.9% decrease to a 2.4% increase ( p = 0.0098). Conclusion: Our results indicated that statins stabilized the renal function of IgAN patients independent of their reduction of proteinuria. [ABSTRACT FROM AUTHOR]

Nonalcoholic fatty liver disease (NAFLD) is associated with an increased prevalence of chronic kidney disease in patients with type 1 diabetes. The aim of this study was to explore the relationship between markers of NAFLD, namely concentrations of aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALK), γ-glutamyltransferase (GGT), bilirubin, and renal function in type 1 diabetic patients. This study included 313 normoalbuminuric type 1 diabetic patients with estimated glomerular filtration rate (eGFR) >60 mL/min/1.73 m2, without clinical evidence of cirrhosis or other causes of chronic liver disease and before any interventions with statins, angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers. ALT, GGT, and bilirubin levels were significantly higher in subjects in the highest quartile of serum creatinine compared to those in lowest quartile (21 vs. 20 U/L, 18 vs. 14 U/L, and 14 vs. 10 µmol/L, respectively, for all p < 0.05). ALK levels were significantly higher in subjects in the highest quartile of urinary albumin excretion rate compared to those in lowest quartile (71 vs. 69 U/L, p = 0.03), as well as in hyperfiltrating subjects compared to those with normal or mildly impaired eGFR (81 vs. 68 and 64 U/L, p < 0.001). In a multiple logistic regression model adjusted for age, sex, duration of diabetes, HbA1c, and body mass index (BMI), only ALK levels were significantly associated with disturbances in serum creatinine and eGFR in our subjects ( p ≤ 0.007), with odds ratios of 0.98-1.02. NAFLD associated markers, particularly ALK, are associated with renal function in normoalbuminuric type 1 diabetic patients. [ABSTRACT FROM AUTHOR]

Background: Decreased tryptophan (TRP) and increased kynurenine (KYN) and kynurenic acid (KYNA) in blood have been reported in patients and experimental animals with renal diseases. We investigated if these compounds could be used as new biomarkers for the assessment of renal function. Methods: Eighty hospitalized hypertensive patients (20 with chronic kidney disease (CKD), and other 60 were considered as control) were enrolled for the investigation. Plasma TRP, KYN, and KYNA were determined by high-performance liquid chromatography. Change rate (CR) was employed to evaluate the sensitivity of the parameters of renal function. Results: CR of plasma KYNA/TRP ratio (+103%) was much higher than the CRs of blood urea nitrogen (+44%), serum creatinine (+56%) and estimated glomerular filtration rate (-35%). Plasma KYNA/TRP ratio was in close relationship with blood urea nitrogen ( r = 0.622), serum creatinine ( r = 0.797), urine micro-albumin/24-h ( r = 0.518) and estimated glomerular filtration rate ( r = -0.662), respectively, with all p-values <0.001. Conclusions: Plasma KYNA/TRP ratio was sensitive and reliable to indicate renal function and could be used as a new biomarker to assess the risk or presence of kidney disease. [ABSTRACT FROM AUTHOR]

Background: Association of methylenetetrahydrofolate reductase (MTHFR) 677C>T gene polymorphism with hyperhomocysteinemia, renal failure, and cardiovascular events is controversial. We investigated the relationship of MTHFR 677C>T polymorphisms with left ventricular hypertrophy (LVH) and renal insufficiency. Methods: Glomerular filtration rate (GFR) and left myocardial ventricular mass/m2 were assessed in 138 non-diabetic subjects (age, 50.93 ± 14.85 years; body mass index, 27.95 ± 5.98 kg/m2), 38 no-mutation wild MTHFR C677CC, 52 heterozygous MTHFR C677CT, and 48 homozygous MTHFR C677TT, all with adequate adherence to current international healthy dietary guidelines. Serum homocysteine, insulin resistance, high-sensitivity C-reactive-protein (hsCRP), parathyroid hormone, and renal artery resistive index (RRI) were challenged by odds ratio analysis and multiple linear regression models. Results: MTHFR 677C>T polymorphism showed higher GFR (73.8 ± 27.99 vs. 58.64 ± 29.95; p= 0.001) and lower renal failure odds (OR, 0.443; 95% confidence interval, 0.141-1.387) in comparison with wild MTHFR genotype. A favorable effect on GFR of MTHFR polymorphism is presented independently by the negative effects of LVH, increased intra-renal arterial resistance, and hyperparathyroidism; GFR is the significant predictive factor to LVH. Conclusions: Renal insufficiency in non-diabetic subjects is explained by interactions of MTHFR C677T polymorphism mutation with LVH, hsCRP, intact parathyroid hormone (iPTH), and RRI. Sign of these predictive effects is opposite: subjects with MTHFR 677C>T polymorphism have lower likelihood of renal insufficiency; differently, wild-type MTHFR genotype subjects have lower GFR and greater hsCRP, iPTH, RRI, and LVH. [ABSTRACT FROM AUTHOR]

Objectives: To show renal parenchymal injury depending on extracorporeal shock wave lithotripsy (ESWL). Methods: The patients with one renal stone and in whom ESWL is planned among the patients in whom renal stone was determined. Their 24-h urine samples were collected just before and after the ESWL treatment. Cit (citrate), UrA (uric acid), RBP (retinol-binding protein), NAG ( N-acetyl-β- Đ-glucosaminidase), Cr (creatinine), Na (sodium), K (potassium), P (phosphor), Ca (calcium), and Cl (chlorine) metabolites excreted in urine were evaluated after urine samples were taken on the study day. Changes in the metabolites excreted; the number, frequency, and duration of ESWL shock wave; the energy; and the body mass index were recorded. The results for p < 0.05 will be accepted as statistically significant. Results: Two sessions of ESWL were applied to a total of 20 patients. When metabolites excreted in the urine before (B1E) and after (A1E) the first session of ESWL, and before (B2E) and after (A2E) the second session of ESWL, were evaluated, no statistically significant result for Ca and Cl excretion was noted. For NAG and Cr, a significant difference was observed in terms of metabolite excretion between B1E and B2E. For other metabolites, we saw that there is no difference between B1E and B2E. While a significant metabolite change was observed for RBP, NAG, Cr, and Na as long as A1E and A2E ESWL session number increases, other metabolites were not significant. Conclusion: Shock waves induce significant damage to the renal and adjacent tissues as indicated by a significant increase in cell-escaped enzymes and electrolytes and the extent of damage depends on the energy and the number of shock wave exposure. [ABSTRACT FROM AUTHOR]

Objectives: Several equations for the estimation of glomerular filtration rate (GFR) from serum cystatin C have been reported. We compared the results obtained using these equations to test the homogeneity of their results as well as their usefulness in clinical practice. Design and methods: Seven hundred and twenty-seven outpatients were studied. Of these, 439 were male and 288 were female, and their mean age was 60.8 ± 24.1 years. GFR was estimated from serum creatinine using the abbreviated Modification of Diet in Renal Disease (MDRD-4) equation. GFR was estimated from serum cystatin C levels using five different equations. Results: The simplest (100/cystatin C) formula rendered the highest estimated GFR and the Hoek's equation rendered the lowest GFR, even significantly lower than the MDRD-4 equation ( p < 0.001, Student's t-test). From the simplest formula to the Hoek equation the mean difference calculated was 25.1 ± 8.7 mL/min ( p < 0.001, Student's t-test). No differences by gender were found among the results of different equations. All cystatin C-derived equations reduced the number of patients diagnosed of chronic renal failure when compared with MDRD-4 formula. No patient with normal renal function was shifted to the renal disease group. Conclusions: A higher value could be expected when GFR is estimated from cystatin C. Nevertheless, vast differences were found in the results when tested using several equations. Physicians should be aware of this problem to avoid a wrong clinical diagnosis of renal function. [ABSTRACT FROM AUTHOR]

Background/aim: Epidemiological studies have shown that low birth weight (LBW) is associated with a higher incidence of hypertension in adulthood. LBW may affect the kidney development, which in turn leads to impaired renal function and hypertension. Methods: Sprague-Dawley rats were fed isocaloric diets containing either 21% (w/w) (control group) or 10% (w/w) (LBW group) protein throughout pregnancy and chow during lactation. Renal function and structure of the offspring were measured from birth to 3 months. Results: At 3 weeks and 2 months, there was no difference in the volume of 24 h urine protein between the two groups. However, the volume was higher (117.17 ± 10.40 vs. 79.28 ± 14.26, p < 0.01) in LBW group at 3 months. Maternal protein intake did not alter serum creatinine in this study, but urine creatinine was lower in LBW group at 2 and 3 months. The creatinine clearance rate (Ccr) was significantly lower in LBW group than in control group at all time points. Glomerular number was reduced significantly in LBW group (22,720 ± 639 vs. 28,520 ± 526, p < 0.01) at 2 months, which was accompanied by an increase in blood pressure. There was a statistically significant negative correlation between the blood pressure and the glomerular number at 2 months ( r = −0.919, p = 0.008). Conclusions: These data showed that abnormal kidney development and renal dysfunction occurred in LBW rats due to a maternal low-protein diet. Possessing a decreased glomerular number might be a risk factor for hypertension in LBW rats. [ABSTRACT FROM AUTHOR]

Studies indicate that Syzygium spp-derived oleanolic acid (OA) enhances renal function of streptozotocin (STZ)-induced diabetic rats as evidenced by its reversal of the previously reported inability of the kidney to excrete Na+ in these animals. We postulated that OA influences Na+ excretion in the proximal tubule, the site where two-thirds of filtered NaCl is reabsorbed through a process mediated by transport proteins. Therefore, the study investigated the effects of OA on proximal tubular Na+ handling in male Sprague-Dawley rats using renal lithium clearance ( CLi). Renal CLi has been used widely in animal and clinical studies to assess proximal tubular function. Sub-chronic doses of OA were administered to rats twice every third day for 5 weeks. Rats treated with deionized water served as control animals. Cytotoxicity of OA on kidney and liver cell lines was assessed by the MTT and comet assays. OA increased Na+ excretion of conscious male Sprague-Dawley rats from week 3 to week 5. By the end of the 5-week experimental period, OA treatment significantly reduced ( p < 0.05) plasma creatinine concentration of STZ-induced diabetic rats with a concomitant elevation in glomerular filtration rate (GFR). Acute OA infusion was also associated with increases in fractional excretion of sodium (FENa) and lithium (FELi) in anesthetized rats in the absence of significant changes in GFR. The MTT assay studies demonstrated that OA increased the metabolic activity of kidney and liver cell lines. Taken together with previous observations, this study implicates the proximal tubule in OA-evoked increases in urinary Na+ output. [ABSTRACT FROM AUTHOR]

Objective: This study investigated the relationship between the levels of serum creatinine (SCr), the estimated glomerular filtration rate (eGFR), and the degree of tubulointerstitial injury. Methods: A total of 511 patients of Zhongshan hospital in China were hospitalized due to physical abnormalities and diagnosed with kidney disease by renal biopsy. The clinical and pathological data were retrospectively analyzed. The level of SCr was determined in all patients, and the eGFR was calculated with modification of diet in renal disease and Cockcroft-Gault formulae, whereas the renal histopathology was quantified according to the Katafuchi semi-quantitative standards. Results: With the aggravation of tubulointerstitial injury, SCr level increased and eGFR decreased gradually. The degree of tubulointerstitial lesion showed a positive correlation with SCr level and negative correlation with Cockcroft-Gault formula and modification of diet in renal disease ( r == 0.627, −0.649, −0.626; p < 0.001). When the SCr was in the normal range, above 90%% of the patients had various degrees of tubulointerstitial damage and 12.2%% of the patients had moderate-to-severe tubulointerstitial lesions. The correlation between SCr level and tubulointerstitial damage became weak. Conclusions: The morphologic changes of tubulointerstitium are closely linked with renal function, but incompletely parallel. SCr in the abnormal range could be used to diagnose tubulointerstitial injury well. However, when the level of SCr was in the so-called normal range, eGFR by the modification of diet in renal disease or Cockcroft-Gault formula may be preferred to assess renal tubulointerstitial injury. [ABSTRACT FROM AUTHOR]

Background: There are few data on the effects of anesthesia and cardiopulmonary bypass (CPB) on perioperative renal function in children with cyanotic congenital heart disease undergoing open heart surgery. This study aims to investigate the perioperative renal function in cyanotic versus acyanotic children undergoing sevoflurane anesthesia for open heart surgery. Methods: After receiving ethical committee approval, 12 acyanotic patients (preoperative oxygen saturation: SaO2 > 85%%) and 12 cyanotic children (SaO2 < 85%%) were included. Sevoflurane was administered at concentration levels of 2%% before CPB and 1-2%% during CPB after standard anesthesia induction. Inorganic fluoride, electrolytes, creatinine, urea nitrogen in serum and urine samples, and N-acetyl-β- d-glucosaminidase (NAG) in urine samples were measured before induction, before CPB, during CPB, after CPB, at the end of surgery, and at 24th h postoperatively. Results: The levels of serum uric acid levels were higher in the cyanotic group ( p < 0.05). There were no differences in the levels of serum creatinine and urine creatinine, urea nitrogen, and electrolytes between the two groups. Serum inorganic fluoride levels were always higher in the acyanotic group than in the cyanotic group, but these differences between the groups reached statistical significance at two measurement times (before CPB and end of surgery) ( p < 0.05). Urinary inorganic fluoride levels increased with time in both groups. Although urinary NAG increased significantly after the CPB in the cyanotic group, the differences between the two groups did not reach statistical significance. Conclusions: We have concluded that renal function was not affected during open heart surgery with sevoflurane anesthesia, in both cyanotic and acyanotic children. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to verify whether preoperative diabetes, hypertension, and renal function had any relationship with postoperative tubule function in patients submitted to anesthesia for arterial surgery. Methods: Prospective observational study. One hundred and forty-four patients submitted to anesthesia for arterial surgery enrolled consecutively and divided into four groups: G1 - diabetes and hypertension; G2 - diabetes; G3 - hypertension; and G4 - without hypertension or diabetes. Urine was obtained for laboratory analysis of urinary creatinine (Ucr), alkaline phosphatase (AP), γ-glutamyltransferase (γGT), and blood for cystatin C and creatinine before the surgery (M1) and 24 h after the surgery (M2). Results: Values of γGT, γGT/Ucr, and AP × γGT/Ucr increased at M2 in G4. Patients without renal function compromise (GFR ≥90 mL/min/1.73 m2) presented increased γGT/Ucr and AP × γGT/Ucr values at M2 and those with slightly compromised renal function (60-89 mL/min/1.73 m2) presented increased γGT values at M2. There was no correlation between deltaCystatin C and deltaAP, deltaγGT, deltaγGT/Ucr, deltaAP/Ucr, and deltaAP × γGT/Ucr. Conclusions: Diabetes, hypertension, and preoperative renal function seem to interfere in tubular enzymuria immediately after surgery in arteriopathic patients. However, when these markers do not increase in postoperative period, renal dysfunction cannot be discarded. [ABSTRACT FROM AUTHOR]

Introduction: Positive pressure ventilation influences hemodynamics and impairs renal function. The effects of inverse ratio ventilation (IRV) on hormonal response and renal function need to be investigated because this represents a highly invasive form of positive pressure ventilation. Materials and methods: Ten male patients were treated postoperatively for 60 min using five different ventilation modes. At the end of these periods, hemodynamics, urine production, fractional excretion of sodium (FESo), as well as the hormones, atrial natriuretic peptide (ANP), renin, angiotensin II, aldosterone, and antidiuretic hormone (ADH), were measured in plasma. Results: Central venous pressure (CVP), ADH, and renin with a positive end-expiratory pressure (PEEP) of 15 cm H2O and an inspiration/expiration ratio (I:E) of 1:2 revealed significant increases from baseline, whereas CVP, renin, and FESo showed an increase with an PEEP of 15 cm H2O and an I:E ratio of 2:1. Urine production significantly decreased with an PEEP of 15 cm H2O and an I:E ratio of 2:1. Conclusions: IRV with PEEP induced clear effects on hemodynamics and hormonal responses (renin) as well as a decrease in urine production in patients with healthy renal and pulmonary systems after an operation. However, all parameters apart from FESo and renin remained within the normal range. Whether pathological values are also observed after longer periods of positive pressure ventilation shall be the subject of other studies. [ABSTRACT FROM AUTHOR]

Diabetes mellitus, a disorder characterized by chronic hyperglycemia and excessive urine excretion, is associated with complications such as atherosclerosis, cardiac dysfunction, and nephropathy. Renal disease, which develops through a number of metabolic pathways in diabetes, is characterized by functional as well as structural abnormalities of the kidney. The most common cause of end-stage renal disease (ESRD) is diabetic nephropathy, which accounts for significant morbidity and mortality. Current conventional diabetes therapy using blood glucose-lowering medications has limitations in averting the development of renal diseases. The onset of diabetic nephropathy is associated with a progressive rate of decline in renal function, urinary albumin excretion, and glomerular filtration rate (GFR). Diabetes mellitus treatment should therefore aim to intervene on promoters of the decline in renal function in diabetes to avert adverse outcomes. Preventing the pathogenesis of nephropathy with therapeutic interventions based on specific alterations in kidney function represents a plausible approach. Cumulative evidence suggests that some herbal extracts with hypoglycaemic properties may have beneficial effects on some processes associated with a decline in renal function, as well as reduce the severity of nephropathy in diabetic experimental animals. On the other hand, some herbal extracts may be hazardous in diabetes, as reports indicate impairment of renal function. This review outlines current evidence supporting plant extracts with the potential of averting progressive renal diabetic complications as well as the nephrotoxicity of some herbal extracts. [ABSTRACT FROM AUTHOR]

The present study aimed to investigate whether genetic variants in the chromogranin A (CHGA) promoter were associated with malignant hypertension (MHT) and renal functional damage. The polymorphisms of CHGA promoter in 39 patients with malignant hypertension secondary to idiopathic IgA nephropathy (IgAN-MHT), 23 patients with primary malignant hypertension and 63 controls were genotyped by sequencing. Four diploid genotypes with minor allele frequencies of approximately ≥10% for individual CHGA SNP loci or haplotypes were compared among the patient with IgAN-MHT, primary MHT and healthy control. Polymorphisms and haplotypes of CHGA promoter were not associated with primary MHT and IgAN-MHT. Within 39 IgAN-MHT patients whose clinical and histological data were available, patients carrying −415TT genotype tended to present with higher serum creatinine (Scr) level than those carrying −415TC/CC genotype (636.94 ± 524.07 μmol/L vs 277.84 ± 196.39 μmol/L, P = 0.014). Consistent with this statistic, we found the haplotype-specific score value of haplotype ATC was 2.25046 ( p = 0.024), and by permutation testing, the empirical p value was 0.014. The present study suggested the genetic variants in the chromogranin A promoter may not involve in the onset of malignant hypertension, but the variants might play a role in the renal dysfunction in patients with IgAN-MHT. [ABSTRACT FROM AUTHOR]

Background and objectives. The rapid increase in end stage renal disease (ESRD) prevalence, plus the enormous cost of treatment, necessitates an urgent approach to implement strategies to prevent development and progression of ESRD, especially in the developing world. Screening that leads to early identification and treatment has been recommended, as it may slow or prevent progression to a more expensive and disabling stage of the disease and thus may save lives as well as finite resources. Methods. In 2007, the Healthy City Office of Tehran municipality conducted a large-scale population-based cross-sectional survey titled “Kidney Disease Screening of Taxi Drivers in Tehran.” Taxi drivers or applicants of purchasing taxi participated in mentioned screening program in the last three months of 2007. Demographic data, blood pressure, and history of hypertension or smoking—and then in specific laboratories creatinine, lipid profile, complete blood count, fasting blood sugar, and urinalysis—have been checked. Results. The survey covered 31,999 people across Tehran (in a population of 12 million) during the study period. The mean and SD of age of participants was 43.77 ± 11.32 (range from18 to 86) years, and 98.4% (31,489) were male. Using the MDRD equation, overall prevalence of eGFR <60 mL/min/1.73 m2 was 6.5%. However, the prevalence was 6.4% (1982/30949) in males in relation to 13.7% (69/503) in females. Mean and SD of BMI in males and females were 25.90 ± 3.91 and 26.48 ± 4.50 g, respectively. The overall prevalence of proteinuria (≥1+ proteinuria) was 0.6% in males vs. 1.8% in females in normal GFR group. Age, LDL cholesterol, hypertension, blood glucose, and BMI showed to be strong risk factors for low GFR. Education level did not show a significant correlation with low GFR. Discussion and conclusions. The findings of the study insist on the fact that CKD prevalence is significantly higher in old age, females, hypertensives, and uncontrolled diabetic patients. Our ability to decrease the incidence of ESRD is predicated on recognizing those patients with CKD and implementing all preventive strategies. [ABSTRACT FROM AUTHOR]

The role of renal sympathetic nerves in the pathogenesis of ischemic acute renal failure (ARF) and the immediate changes in the renal excretory functions following renal ischemia were investigated. Two groups of male Sprague Dawley (SD) rats were anesthetized (pentobarbitone sodium, 60 mg kg−1 i.p.) and subjected to unilateral renal ischemia by clamping the left renal artery for 30 min followed by reperfusion. In group 1, the renal nerves were electrically stimulated and the responses in the renal blood flow (RBF) and renal vascular resistance (RVR) were recorded, while group 2 was used to study the early changes in the renal functions following renal ischemia. In post-ischemic animals, basal RBF and the renal vasoconstrictor reperfusion to renal nerve stimulation (RNS) were significantly lower (all p < 0.05 vs. control). Mean arterial pressure (MAP), basal RVR, urine flow rate (UFR), absolute and fractional excretions of sodium (UNaV and FENa), and potassium (UKV and FEK) were higher in ARF rats (all p < 0.05 vs. control). Post-ischemic animals showed markedly lower glomerular filtration rate (GFR) ( p < 0.05 vs. control). No appreciable differences were observed in urinary sodium to potassium ratio (UNa/UK) during the early reperfusion phase of renal ischemia ( p > 0.05 vs. control). The data suggest an immediate involvement of renal sympathetic nerve action in the pathogenesis of ischemic ARF primarily through altered renal hemodynamics. Diuresis, natriuresis, and kaliuresis due to impaired renal tubular functions are typical responses to renal ischemia and of comparable magnitudes. [ABSTRACT FROM AUTHOR]

Previous studies from our laboratories indicate that the anti-diabetic effects of Syzygium cordatum (Hochst.) [Myrtaceae] leaf extract in streptozotocin-induced diabetic rats may be attributed in part to mixtures of triterpenes, oleanolic acid (3ss-hydroxy-olea-12-en-28-oic acid, OA) and ursolic acid (3ss -hydroxyl-urs-12-en-28-oic acid, UA). For the bioactive compounds to have potential in diabetes management, they should alleviate or prevent complications of diabetes mellitus, kidney function, and cardiovascular disorders. This study was, therefore, designed to assess whether S. cordatum leaf derived OA influenced renal function evaluated by the ability to increase urinary Na+ outputs parameters and creatinine clearance (Ccr) of streptozotocin (STZ)-induced diabetic rats. Extraction and fractionation of S. cordatum powdered leaf ethyl acetate-solubles (EAS) yielded mixtures of OA/UA and methyl maslinate/methyl corosolate. Recrystallization of OA/UA mixture using ethanol afforded OA, the structure of which was confirmed by NMR spectroscopy (1H & 13C). Acute effects of OA on kidney function and mean arterial blood pressure (MAP) were investigated in anesthetized rats challenged with hypotonic saline after a 3.5-h equilibration for 4h of 1 h control, 1.5 h treatment, and 1.5 h recovery periods. OA was added to the infusate during the treatment period. Chronic effects of OA were studied in individually caged rats treated twice daily with OA (60 mg/kg, p.o.) for five weeks. By comparison with respective control animals administration, OA significantly increased Na+ excretion rates of non-diabetic and STZ-induced diabetic rats without affecting urine flow, K+ and Cl- rates. At the end of five weeks, OA treatment significantly (p < 0.05) increased Ccr in non-diabetic (2.88 ± 0.14 vs. 3.71 ± 0.30 ml/min) and STZ-diabetic rats (1.81 ± 0.32 vs. 3.07 ± 0.16 ml/min) with concomitant reduction of plasma creatinine concentration (n = 6 in all groups). OA also caused significant decreases in MAP in non-diabetic and STZ-induced diabetic rats. These findings suggest that OA may have beneficial effects on some processes associated with renal derangement of STZ-induced diabetic rats. [ABSTRACT FROM AUTHOR]

Background. Patients with severe congestive heart failure (CHF) often have unexplained elevations in serum concentrations of troponin T (TnT), and it is proposed that this is due to cardiac TnT release because of underlying cardiac disease. We investigated whether impaired renal function is an additional underlying phenomenon contributing to increased TnT levels in patients with CHF. Methods. Sixty-two patients with nonischemic CHF, New York Heart Association (NYHA) class III-IV, with normal coronary angiogram and normal serum creatinine were included in the study. Baseline glomerular filtration rate (GFR) was calculated using the Cockcroft Gault equation. Results. Although mean creatinine level was normal (0.92 ± 0.17 mg/dL), mean GFR was low (56 ± 16 mL/min) in the cohort. Elevated (≥0.02 >g/L) TnT was measured in 33 patients (53%). Compared with patients with normal (<0.02 >g/L) TnT levels, patients with elevated TnT had significantly higher NYHA class (p = 0.02), longer duration of disease (p = 0.02), lower GFR (p = 0.0001), and lower LVEF (p = 0.0001). There were significant associations between TnT levels and duration of disease (r = 0.29, p = 0.01), creatinine (r = 0.30, p = 0.01), GFR (r = -0.55, p < 0.0001), and LVEF (r = -0.39, p = 0.001). Independence of these associations was evaluated in multiple linear regression analysis, and serum TnT was independently and negatively associated only with GFR (p = 0.005). Conclusions. Renal function (GFR) correlated significantly and more strongly than cardiac function (LVEF) with the serum TnT levels in patients with CHF. This supports our hypothesis that impaired renal function causes the accumulation of troponin and is very likely the cause of unexplained elevations of serum TnT in patients severe CHF. [ABSTRACT FROM AUTHOR]

Background. There is no consensus about the renal function outcome after revascularization with stenting in atherosclerotic renovascular disease. In the present study, the outcome in BP control and renal function in patients with renovascular disease treated with percutaneous angioplasty and stent placement is compared with the outcome in patients with renovascular disease treated with medical treatment only. Additionally, the impact of oxidative stress and eosinophil count in peripheral blood as predictors of renal function deterioration in renovascular disease irrespective of treatment is investigated. Methods. Eighty-two patients with renovascular disease were enrolled into a follow-up study (47.5±35.4 months). Thirty-six patients (group 1) underwent revascularization and stenting, and 46 patients (group 2) were on medical treatment only. In all patients, serum creatinine concentration, eosinophil count (EO) in peripheral blood, and estimation of oxidative stress with dROMs test were determined before and at the end of the follow-up. Results. In revascularized patients (group 1), hypertension was cured in 11.1% and improved in 66.6%. Renal function improved in 30.5% and worsened in 36.2% of patients. In the medical treatment arm (group 2), hypertension improved in 71.4% of the patients. Renal function remained stable in 69.8% of patients and worsened in 30.2%. Cox regression analysis showed that higher levels of eosinophil count and higher levels of ROS, irrespectively of mode of treatment, were associated with renal function deterioration (i.e., serum creatinine increase more than 20% during follow-up). Conclusions. Revascularization was not superior to medical treatment in renal survival but had a greater positive impact on blood pressure control. Eosinophil count and oxidative stress were the stronger predictive factors for serum creatinine increase. [ABSTRACT FROM AUTHOR]

The aim of this study was designed to investigate the possible beneficial effects of the angiotensin-converting enzyme (ACE) inhibitor, Quinapril (Q) and, the angiotensin (ang) II T1 (AT1) receptor blocker, irbesartan (Irb), in streptozotocin (STZ)-induced diabetes in rats. The rats were randomly allotted into one of five experimental groups: A (control), B (diabetic untreated), C (diabetic treated with Q), D (diabetic treated with Irb), and E (diabetic treated with Q&Irb), each group containing 10 animals. Groups B-E received STZ. Diabetes was induced in four groups by a single intraperitoneal (i.p) injection of STZ (50 mg/kg, freshly dissolved in 5 mmol/L citrate buffer, pH 4.5). Two days after STZ treatment, development of diabetes in four experimental groups was confirmed by measuring blood glucose levels in a tail vein blood samples. Rats with blood glucose levels of 250 mg/dL or higher were considered to be diabetic. The rats in Q-, Irb-, and Q&Irb-treated groups were given Q (in a dose of 3 mg/kg body weight), Irb (5 mg/kg body weight), and Q&Irb (in a dose of 1.5 mg/kg + 2.5 mg/kg body weight) once a day orally by using intra-gastric intubation for 12 weeks starting two days after STZ injection. Treatment of Q and especially Irb reduced the glomerular size and thickening of capsular, glomerular, and tubular basement membranes; and increased amounts of mesangial matrix and tubular dilatation and renal function as compared with diabetics untreated. Notably, the better effects were obtained when Q and Irb given together. We conclude that Q, Irb, and especially Q+Irb therapy causes renal morphologic and functional improvement after STZ-induced diabetes in rats. We believe that further preclinical research into the utility of Q and Irb treatment, alone or its combination, may indicate its usefulness as a potential treatment in diabetic nephropathy (DNp). [ABSTRACT FROM AUTHOR]

The study evaluates the effect of genistein, a soy isoflavone, on insulin sensitivity and renal functional and structural injury in rats rendered insulin-resistant by feeding on a high-fructose diet for 60 days. Fructose-fed animals (60 g /100 g) displayed insulin resistance as indicated by the measures of insulin sensitivity [insulin sensitivity index (ISI0,120), quantitative insulin check index (QUICKI), and homeostatic model assessment (HOMA)]. Alterations in body weight, kidney weight, urine volume, plasma, and urine electrolytes accompanied by significant increases in plasma and urinary levels of urea, uric acid, creatinine, total protein, and albumin were observed in fructose-fed rats. Oxidative stress in kidney was noted by an elevation in lipid peroxides and a decline in glutathione (GSH). Insulin sensitivity and renal function were improved in fructose-fed rats administered genistein. Histological changes such as fatty infiltration and thickening of glomeruli observed in fructose-fed rats were also ameliorated when genistein was co-administered. The study shows that genistein improves insulin sensitivity and kidney function in a dietary model of insulin resistance. We suggest that genistein may have benefits for patients suffering from kidney disease associated with insulin resistance. [ABSTRACT FROM AUTHOR]

This study evaluated the effect of spironolactone in the renal function alterations induced by cyclosporine A (CsA) in rats. Methods. Male Wistar rats fed with an unrestricted sodium diet received CsA 15 mg/kg/day or CsA at the same dosage plus 20 mg/kg/day of spironolactone. Another group received only saline. The animals that had proteinuria > 50 mg/24h or serum creatinine > 1.0 mg% were excluded, and after five weeks, the remaining rats were analyzed again for these parameters. At the end of the fifth week, these animals were also sacrificed, and their kidneys were analyzed histologically. Results. The animals that received CsA isolated or in association with spironolactone presented increase in serum creatinine. However, the comparison of the relative variation [Δ% = ([final - initial] / initial) × 100] of the serum creatinine concentrations in the beginning and at the end of the experiment among the animal groups showed a significant increase in the CsA group compared with the saline group (44.17 ± 30.7% vs. -6.19 ± 14.5%; p = 0.005), whereas there was no difference between the CsA + spironolactone and the saline group. In all of the animal groups, the values of 24-hour proteinuria were similar at the end of the experiment, and no renal histological alterations were observed. Conclusion. This experimental model of nephrotoxicity by CsA in rats without salt restriction in the diet showed that CsA reduced the glomerular filtration and suggested that the blockage of aldosterone receptors prevented, at least partially, the reduction in renal function induced by CsA. [ABSTRACT FROM AUTHOR]

Aim. The aim of this study was to assess renal function in different stages of type 1 diabetes mellitus by radionuclide methods. Additionally, glomerular and tubular functions were correlated with urinary albumin (UAER) and N-acetyl-β-D-glucosaminidase (NAGA) excretion rates. Patients and methods. Fifty-three patients with diabetes mellitus were classified into four groups: normoalbuminuric (NA, 18 patients), microalbuminuric (MiA, 12 patients), macroalbuminuric (MaA, 13 patients), and chronic renal failure group (CRF, 10 patients). Glomerular filtration rate (GFR) was estimated by diethylenetriamine pentaacetic acid-technetium 99m (99mTc-DTPA) clearance rate while tubular function was calculated as a percentage of net injected activity fixed in both kidneys, 4 h after intravenous injection of dimercaptosuccinate acid-technetium 99m (99mTc-DMSA). Additionally, 99mTc-DTPA clearance was correlated with estimated GFR (eGFR) by using modified Modification of Diet in Renal Disease (MDRD) Study Group formula. Results. 99mTc-DTPA clearance and 99mTc-DMSA fixation were found significantly higher in normoalbuminuric group (p < 0.05 and p < 0.02, respectively), unchanged in microalbuminuric group (p > 0.05, p > 0.05), and decreased in both macroalbuminuric (p < 0.0001, p < 0.00001) and chronic renal failure group (p < 0.0001, p < 0.00001). Renal function was denoted as normal, increased (hyperfunction), or decreased (hypofunction). It was found normal in a high percentage of patients with normalbuminuria (filtration 44.4%, fixation 72.2% pts) and microalbuminuria (66.7% and 66.7%). Renal hyperfunction was not only found frequent in normalbuminuric group (55.6% and 27.8%), but was also recorded in microalbuminuric group (8.3% and 8.3%). Renal hypofunction was present in all macroalbuminuric patients and in one-quarter of those with microalbuminuria as well. Such distribution of renal function conditions indicated normalbuminuric and microalbuminiric groups functionally heterogeneous. Regression analysis showed a significant correlation between 99mTc-DTPA clearance and eGFR in MaA and CRF groups only. Although urinary NAGA excretion rate was shown as a less sensitive staging parameter, being significantly increased when compared to control group only in MaA and CRF groups (p < 0.05), it significantly correlated with 99mTc-DTPA clearance rate (r = -0.485, p = 0.0004) and 99mTc-DMSA tubular fixation (r = -0.526, p = 0.0002). Conclusions. The results of this study favor the performance of radionuclide studies together with the determination of urinary albumin excretion rate in patients with type 1 diabetes mellitus in order to achieve more reliable staging of diabetic kidney disease. The demonstration of glomerular hyperfiltration and tubular hyperfunction by radiopharmaceuticals contributes to the early detection of diabetic kidney disease, while the quantification of renal function enables the follow-up of the progressive function loss in the later course of the disease. [ABSTRACT FROM AUTHOR]

Although the negative effect of increased body mass index on kidney has been examined, the relation between other anthropometric measurements and kidney functions has not been investigated sufficiently. This study looks at the influence of anthropometric measurements on kidney functions. Forty patients were included in the study. Patients who had increased or normal anthropometric measurements were compared by serum levels of the urea, creatinine, albumin, 24 hr urine creatinine clearance, and urinary albumin excretion rate (UAER). Of all patients, 22 (55%) had an increased body mass index (BMI), 19 (47.5%) had an increased waist circumference (WC), and 24 (60%) had an increased waist-hip ratio (WHR). Subjects with increased BMI, WC, and WHR had significantly higher levels of serum creatinine and UAER than the subjects with normal measurements. The relation between CC and BMI was statistically significant only among the anthropometric measurements (p = 0.026). The ratio of microalbuminuria was 27.3%, 21.1%, and 29.2% in persons with increased BMI, WC, and WHR, respectively. Increases of anthropometric measurements affect kidney functions negatively. However, the influence of BMI on kidney function is more prominent. For this reason; individuals with increased anthropometric measurements should be monitored closely in terms of renal functions additional to cardiovascular risk factors. [ABSTRACT FROM AUTHOR]

A pooled analysis was designed to evaluate the effects of fluvastatin on the kidney, in terms of renal adverse events, laboratory abnormalities, and renal function over time. An analysis of adverse events was performed on data from 30 completed clinical trials of fluvastatin in 11,815 patients. An analysis of renal function was also performed on data from patients who participated in long-term studies >6 months in treatment duration. Creatinine clearance was calculated using the Cockcroft-Gault formula. Mean creatinine clearance values were in the normal to near-normal range at baseline. Changes in creatinine clearance and serum creatinine from baseline were similar in fluvastatin-treated patients and placebo-treated patients. In the all-fluvastatin group, mean creatinine clearance (±standard deviation) increased from 87.8 (±42.8) mL/min at baseline to 89.4 (±41.2) mL/min at endpoint. In the placebo group, mean creatinine clearance (± standard deviation) increased from 87.7 (± 43.9) mL/min at baseline to 88.7 (±41.4) mL/min at endpoint. In the all-fluvastatin group, mean serum creatinine (± standard deviation) decreased from 1.14 (±0.20) mg/dL at baseline to 1.11 (±0.20) mg/dL at endpoint. In the placebo group, mean serum creatinine (±standard deviation) decreased from 1.15 (±0.22) mg/dL at baseline to 1.12 (±0.22) mg/dL at endpoint. The incidence of renal adverse events was low and comparable between the fluvastatin and placebo treatment groups. This pooled analysis demonstrates that fluvastatin treatment across the approved daily dose range of 20 mg to 80 mg does not adversely affect creatinine or creatinine clearance over time in dyslipidemic patients. [ABSTRACT FROM AUTHOR]

Current biomedical evidence suggests that Hypoxis hemerocallidea (Fisch. & C.A. Mey.) [Hypoxidaceae] (African Potato [AP]) corm extract may be useful in the management of type 2 diabetes mellitus. However, more recent reports have also indicated that certain herbal extracts attenuate the deterioration of kidney function in diabetes mellitus. Accordingly, this study investigated the effects of short- (acute) and long-term (chronic) administration of H. hemerocallidea corm aqueous extract (APE) on renal fluid and electrolyte handling in male Wistar rats. Acute effects of APE were investigated in separate groups of anesthetized rats challenged with a continuous jugular infusion of 0.077 M NaCl at 9 mL · h - 1 . After a 3.5-h equilibration period, consecutive 30-min urine collections were made over the subsequent 4 h of 1-h control, 1.5-h treatment, and 1.5-h recovery periods for measurements of urine flow, Na + , and K + excretion rates. To establish the effects of acute APE, the extract was added to the infusate at doses of 90, 180, or 360 μg · h - 1 in separate groups of rats during the treatment period. For chronic studies, individually caged rats were administered twice with APE (30 mg · kg - 1 PO) every third consecutive day at 09h00 and 17h00 for 5 weeks. Control rats received distilled water (3 mL · kg - 1 ). Urine volume and total urinary outputs of creatinine, Na + , and K + were determined from 24-h samples. Acute infusion of APE produced a dose-dependent, significant ( p [ABSTRACT FROM AUTHOR]

Fifty-eight patients with thyroid dysfunction were included, comparing 27 healthy subjects to evaluate the relationship between thyroid autoimmunity, thyroid functional status, and renal function. Regardless of clinical status, hypothyroidism was defined as T3–T4 upper limit of normal, and hyperthyroidism was defined as T3–T4>normal limits and TSH p = 0.05). In hypothyroid patients, UAER was significantly higher than in hyperthyroid patients and control subjects (30.1 mg/day, 11.8 mg/day, 10.5 mg/day, respectively; p [ABSTRACT FROM AUTHOR]