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Background: Diabetes mellitus (DM) is characterized by irregular carbohydrate, protein, and fat metabolism, leading to elevated blood glucose levels. DM patients are at a high risk of developing dyslipidemia and cardiovascular and chronic kidney diseases. This study evaluated the impact of Jimson weed on blood glucose, lipid profile, and renal indices using rat models. Methodology: The rats were divided into six classes, with rats in each class receiving alloxan intraperitoneally orally twice daily for 14 days. The rats were assigned into six classes (A-F), (n = 6). Rats in classes A-E were intraperitoneally injected with 2 g of alloxan dissolved in 20 mL of distilled water (100 mg/kg body weight). Rats in class F received neither alloxan nor any form of treatment. Rats in classes A, B, and C were given 100, 200, and 400 mg/kg of Jimson weed leaf extract, while rats in class D received 5 mg/kg body weight of Glibenclamide. Rats in class E were given normal saline (0.1 mL) only. Blood glucose levels were measured using a Glucometer, and lipid profile and renal markers were assayed using approved procedures. Docking analysis targeted key proteins with potential roles in lipid dysregulation and renal dysfunction associated with diabetes. Results: The study found that diabetes in the rats led to abnormalities in lipid profiles, electrolytes, urea, and creatinine serum levels. In diabetic control rats, the level of total cholesterol increased by over 216.67%, while the concentrations of triacyglycerol and low density lipoprotein also showed a similar trend. Notably, there was a reciprocal impact on the high-density lipoprotein, which decreased by a similar magnitude in diabetic controls compared to normal control rats. In the other calculated indices; atherogenic and coronary risk indices, Cl-, urea, and creatinine levels were elevated, and a decreased cardio-protective index, Na+, and K +. Jimson weed ethanol extract alleviated these impacts. The study also investigated compounds' molecular properties and docking results targeting key proteins in lipid metabolic pathways and immune response. The compounds showed promising binding affinities to acetyl-CoA carboxylase (ACC), fatty acid synthase (FASN), 3-hydroxyl-3-methyl-glutaryl-CoA reductase (HMG-CoAR), and melanoma 2 (AIM2) proteins. Conclusion: Jimson weed offers a promising option for treating T2DM, cardiovascular, and renal complications, as it exhibits hypolipidemic, cardioprotective, and renal protective properties, overcoming limitations in traditional medicines. [ABSTRACT FROM AUTHOR]

Background: In veterinary medicine, previous studies regarding the diagnostic performance of shear wave elastography (SWE) in chronic kidney disease (CKD) are not consistent with each other. Moreover, there has been no study evaluating the relationship between symmetric dimethyl arginine (SDMA) concentration and renal shear wave velocity (SWV) using twodimensional SWE (2D SWE) in dogs with CKD. Objectives: This study aimed to evaluate the diagnostic capability of 2D SWE in dogs with CKD and to assess the relationship between renal SWV and SDMA concentration. Methods: Dogs with healthy kidneys and dogs with CKD underwent 2D SWE and SDMA assay. Renal stiffness was estimated as renal SWV in m/s. Results: SDMA concentration had a weak positive correlation with the left (r = 0.338, p = 0.022) and right renal SWV (r = 0.337, p = 0.044). Renal SWV was not significantly different between healthy kidney and CKD groups in the left (p = 0.085) and right (p = 0.171) kidneys. Conclusions: 2D SWE may could not distinguish between dogs with healthy kidney and dogs with early stage of CKD, but it would be useful for assessing the serial change of renal function in dogs. [ABSTRACT FROM AUTHOR]

Chronic kidney disease has been recognized as a major public health problem worldwide and renal fibrosis is a common pathological process occurring in chronic renal failure. It is very promising to find the strategies to slow or even prevent the progression of fibrosis. This study focused on whether renal fibrosis decellularized scaffolds has the potential to be a model of cellular mechanisms of tissue fibrosis or donors for tissue engineering. In order to evaluate the feasibility of decellularized scaffolds derived from pathological kidneys, histology, proteomics and ELISA will be used to analysis the changes in the structure and main components of fibrotic tissue. The fibrosis model in this paper was induced by adenine-fed and the results showed that the structure of fibrotic scaffold was changed and some protein were up-regulated or down-regulated, but the cytokines associated with renal regeneration after injury were remained. In cell experiments, endothelial progenitor cells proliferated well, which proved that the fibrotic scaffolds have non-cytotoxic. All these conclusions indicate that the renal fibrosis decellularized scaffolds model has the ability to study fibrosis mechanism and the potential to be engineering donors as well as normal scaffolds.

Background: Chronic kidney disease (CKD) has emerged as a significant public health issue affecting millions of individuals of all races and ethnic groups. It's also a major health burden in Nepal. Hyperuricemia is widely established as a risk factor for glomerulosclerosis, interstitial fibrosis, and atherosclerosis. However, reversing and preventing it in CKD will delay the course of chronic renal failure. Therefore, this research was designed to examine the uric acid profile in CKD patients who are receiving conservative therapy to avoid the worsening of CKD. Methods: The study included a total of 90 CKD patients at stages II-V. The complete history taking, clinical examination, and laboratory testing were done and the data were analyzed using SPSS version 22. The prevalence of hyperuricemia was determined and compared at various stages of CKD. Results: Among the enrolled patients (n = 90), the majority were male (66%) in gender. The maximum number of patients (44%) were elderly (60-80 years). Hyperuricemia was present in 80% of patients. Among them, two patients were in stage II (7.4±0.42), five in stage IIA (8.8±1.22), 25 in stage IIIB (8.59±1.63), 36 in stage IV (9.21±1.49), and three patients were in stage V (10.70±1.609). Conclusion: Serum uric acid levels were elevated in various stages of CKD patients. Thus, serum uric acid may be used as a predictive indicator of CKD. However, large-scale cohort research of the Nepalese population is suggested to corroborate the results of this study.

The autosomal dominant polycystic kidney disease (ADPKD) accounts for one out of 400–1000 live births, being a hereditary disorder with cystic and noncystic manifestations as well as extrarenal involvement. The pericardial effusion (PE) in the context of a patient with ADPKD is complex, and it is not entirely defined. Several theories have been proposed. The most accepted, so far, is linked to mutations in the PKD1 gene which can entail an abnormal production of matrix components, matrix-degrading enzymes, and inhibitors of metalloproteinases, and defects in connective tissue which would lead to an abnormal distensibility of the connective tissue. We report the case of a 35-year-old female Moroccan patient with the diagnosis of ADPKD associated with arterial hypertension who came into the Emergency Department with lower abdominal pain lasting for five days being diagnosed as salpingitis. Abdominal computed tomography scan with contrast showed both kidneys with several cystic images with a thin wall. A transthoracic echocardiogram revealed the presence of moderate PE more in the anterior aspect. A greater set of standard tests to rule out collagen vascular disease, rheumatoid diseases, autoimmune disorders, and malignancies was ordered. These tests yielded no abnormality. The association of ADPKD with PE is rare. The awareness of this connection by the emergency physicians is key to prevent misplaced concern.

Aim. To investigate the level of aldosterone, angiotensin-converting enzyme and the blood proteolytic system activity in patients with acute myocardial infarction on the background of chronic kidney disease. Materials and methods. The observation group consisted of 106 patients who underwent in-patient treatment for acute Q-myocardial infarction. Patients were divided into 2 groups depending on the glomerular filtration rate (GFR): Group I consisted of patients with GFR ≤90 ml / h, Group II – with GFR >90 ml / h. Results. It was found that in patients with AMI of Group I the level of aldosterone was significantly higher than in the Group II patients (P < 0.05). The concentration of angiotensin-converting enzyme in patients of the Group I was significantly higher than in the comparison group (P < 0.05). The increase in blood serum proteolytic activit was observed in the Group I patients: azoalbumin (P > 0.05), azocasein (P < 0.05) and azocollagen (P > 0.05). A highly probable negative correlation of aldosterone level with proteolysis activity when tested on azocollagen (P < 0.01) was revealed, and it confirms the role of aldosterone in the processes of collagen formation. The pathogenetically substantiated classification of myocardial fibrosis proposed by the authors should be up for discussion: 1. replacement fibrosis: - local (with aneurysm of the left ventricle or without it); diffuse (with a left ventricular preserved ejection fraction – more than 40 % or with a decrease in the left ventricular ejection fraction – less than 40 %); 2. interstitial fibrosis; 3. endomyocardial fibrosis. Conclusions. In patients with acute myocardial infarction at the stage II of chronic kidney disease a significant increase in the aldosterone and angiotensin-converting enzyme levels has been found, which could result in heart failure progression. An increase in the serum proteolytic activity by the level of azocasein lysis and a highly probable negative correlation between aldosterone level and activity of proteolysis when tested on azocollagen (r-0,36; P < 0.01) indicate an unfavorable course of myocardial infarction in patients with renal dysfunction.

Objective: The aim of the present study was to show the important effectof a uremic environmenton the development of insulin resistance and if insulin resistance might be reversible with the treatment of metabolic disordersin patients with hypothyroid. Materials and Methods: Patients with stage 2, stage 3, and stage 4 chronic renal disease and dialysis treatment and patients with hypothyroid with normal renal function and thyroxine replacement treatment were included in the study. Patients with some metabolic disorders, such as obesity, dyslipidemia, anemia, and severe vitamin Ddeficiency, were excluded from the study. Insulin, fasting blood glucose, and thyroid function levels were measured. Homeostatic model assessments of insulin resistance (HOMA-IR) values were calculated. Results: The mean age, body mass index, and distribution of gender were found to be similar in the patient groups. No statistical significance was found in HOMA-IR values between the patient groups. The important effects of chronic kidney disease and hemodialysis replacement treatment were determined to the development of insulin resistance. Conclusion: A uremic environment might be affected by the development of insulin resistance as in the development of metabolic disorders, such asthyroid dysfunction and glucose and lipid metabolism disorders. Understanding of the molecular mechanism and effects of uremic toxins can contribute to the development of new treatment targets. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the effects of the chronic disease self-management program on empowering haemodialysis patients and their quality of life (QoL). A before and after interventional approach with no control group was designed. Based on convenience sampling, 53 patients were selected with respect to the inclusion criteria. First, the information required for evaluating the QoL of patients was collected using kidney disease quality of life instrument. Next, the self-management program was implemented. Three months later, the effects of the intervention were assessed using the same questionnaire. Results indicated that the average of total scores of QoL (general and specific domains) increased after the intervention (P = 0.000). The relationships between the QoL scores and socio-demographic characteristics were not statistically significant. Moreover, it was found that the intervention had no effect on cognitive abilities, social interactions, and sexual performance (P > 0.05). This article outlined an organized approach for applying project management principles to quality improvement in health system. The program will be useful if it is accompanied by other therapeutic and welfare actions and comprehensive supports of public and private charity organizations. [ABSTRACT FROM PUBLISHER]

Individuals born after intrauterine growth restriction (IUGR) have an increased risk of perinatal morbidity/mortality, and those who survive face long-term consequences such as cardiovascular-related diseases, including systemic hypertension, atherosclerosis, coronary heart disease and chronic kidney disease. In addition to the demonstrated long-term effects of decreased nephron endowment and hyperactivity of the hypothalamic–pituitary–adrenal axis, individuals born after IUGR also exhibit early alterations in vascular structure and function, which have been identified as key factors of the development of cardiovascular-related diseases. The endothelium plays a major role in maintaining vascular function and homeostasis. Therefore, it is not surprising that impaired endothelial function can lead to the long-term development of vascular-related diseases. Endothelial dysfunction, particularly impaired endothelium-dependent vasodilation and vascular remodeling, involves decreased nitric oxide (NO) bioavailability, impaired endothelial NO synthase functionality, increased oxidative stress, endothelial progenitor cells dysfunction and accelerated vascular senescence. Preventive approaches such as breastfeeding, supplementation with folate, vitamins, antioxidants, L-citrulline, L-arginine and treatment with NO modulators represent promising strategies for improving endothelial function, mitigating long-term outcomes and possibly preventing IUGR of vascular origin. Moreover, the identification of early biomarkers of endothelial dysfunction, especially epigenetic biomarkers, could allow early screening and follow-up of individuals at risk of developing cardiovascular and renal diseases, thus contributing to the development of preventive and therapeutic strategies to avert the long-term effects of endothelial dysfunction in infants born after IUGR. [ABSTRACT FROM PUBLISHER]

Background: In veterinary medicine, previous studies regarding the diagnostic performance of shear wave elastography (SWE) in chronic kidney disease (CKD) are not consistent with each other. Moreover, there has been no study evaluating the relationship between symmetric dimethyl arginine (SDMA) concentration and renal shear wave velocity (SWV) using two-dimensional SWE (2D SWE) in dogs with CKD., Objectives: This study aimed to evaluate the diagnostic capability of 2D SWE in dogs with CKD and to assess the relationship between renal SWV and SDMA concentration., Methods: Dogs with healthy kidneys and dogs with CKD underwent 2D SWE and SDMA assay. Renal stiffness was estimated as renal SWV in m/s., Results: SDMA concentration had a weak positive correlation with the left ( r = 0.338, p = 0.022) and right renal SWV ( r = 0.337, p = 0.044). Renal SWV was not significantly different between healthy kidney and CKD groups in the left ( p = 0.085) and right ( p = 0.171) kidneys., Conclusions: 2D SWE may could not distinguish between dogs with healthy kidney and dogs with early stage of CKD, but it would be useful for assessing the serial change of renal function in dogs., (© 2023 The Korean Society of Veterinary Science.)

Ochratoxin A (OTA) is a nephrotoxic mycotoxin with carcinogenic properties. Its presence was detected in various foodstuffs all over the world but with significantly higher frequency and concentrations in areas with endemic nephropathy (EN). Even though food is often contaminated with more than one mycotoxin, earlier studies focused on the occurrence and toxicology of only OTA. Only a limited number of surveys showed that OTA co-occurs in food with mycotoxins (citrinin-CIT, penicilic acid, fumonisin B1-FB1, aflatoxins-AF) which exert nephrotoxic, carcinogenic or carcinogen-promoting activity. This review summarises the findings on OTA and its co-occurrence with the mentioned mycotoxins in food as well as experimental data on their combined toxicity. Most of the tested mycotoxin mixtures involving OTA produced additive or synergistic effects in experimental models suggesting that these combinations represent a significant health hazard. Special attention should be given to mixtures that include carcinogenic and cancer-promoting mycotoxins.

Aim Nephrotic syndrome is the most common childhood glomerular disorder, but data on the associated complications are limited and predisposing risk factors have not been fully defined. The aim of this study was to evaluate disease- and treatment-related acute and chronic complications in patients with childhood idiopathic nephrotic syndrome (INS), and to identify the risk factors involved in the development of complications. Methods This single-center study was performed at the pediatric nephrology department of a tertiary pediatric hospital in Turkey. The study included 411 patients with a diagnosis of childhood INS, 128 of whom had disease-related and treatment-related complications. Patients diagnosed and followed-up between January 2010 and January 2022 were evaluated retrospectively. Results Complications occurred in 31.1% of the 411 patients. Mean age at the time of diagnosis was 7.54 ± 4.37 years, and the male/female ratio was 0.9:1. Among the patients with complications, 96.9% were disease-related, and 50.8% were treatment-related complications. In older age, high proteinuria level, a low estimated glomerular filtration rate (eGFR) level at diagnosis, and female gender were significant risk factors for complication development (P = 0.000, P = 0.006, P = 0.04, and P = 0.07, respectively). Chronic kidney disease (CKD) developed in 7% of patients and 2.9% of patients had end-stage renal disease (ESRD). Additionally, three of 12 patients with progressive ESRD underwent transplantation. Also the incidence of ESRD was significantly higher in the patients with complications than in those without complications (P < 0.05). Conclusion The present findings suggest that careful monitoring of patients with childhood INS at risk for complications and implementation of personalized treatment programs can improve long-term outcomes, especially in patients that progress to ESRD and are followed-up with dialysis or transplantation as targeted therapy., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Karakaya et al.)

Copyright of Revista de Salud Pública is the property of Universidad Nacional de Colombia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The incidence of renal diseases continues to rise worldwide and as a consequence, increasing number of renal patients will probably require oral healthcare. Renal osteodystrophy refers to the wide spectrum of bone diseases in context to chronic renal diseases (CRD). Radiographic alterations affecting the jaws and facial skeleton are common and among the earliest signs of renal bone diseases. The aim of the present study is to review and highlight the various radiographic alterations affecting the maxillofacial region in renal osteodystrophy and enabling the general and specialty oral physicians to identify and diagnose them effectively. [ABSTRACT FROM AUTHOR]

Background: Chronic kidney disease (CKD) is a major risk factor for cardiovascular disease (CVD) and European guidelines advocate assessment of CVD risk. QRISK and JBS3 risk calculators do not use the consensus definition of CKD stages 3-5 but instead use a definition referring to renal pathologies and CKD stages 4 and 5. Consequently, there is potential for doctors to misclassify their patients when using these risk calculators.Objectives: To quantify the number of people who may be affected by such misclassifications.Methods: Database analysis using the Clinical Practice Research Datalink (CPRD).We identified 2512053 adults aged 25-84 without prior history of CVD on 1st January 2014. We identified those with 'chronic renal disease' and/or CKD by searching medical event history data.Results: The study population was 48.7% male with mean age of 50.2 years. A total of 80718 had diagnostic READ codes for CKD stages 3, 4 or 5. Of these, 6585 individuals (8.2%) were classified as having 'chronic renal disease' according to the updated QRISK 2014, up from 3365 according to QRISK 2013. Whilst the updated QRISK definition of 'chronic renal disease' in total identified 62% more people than previously and had improved sensitivity for CKD stages 3 to 5, sensitivity remained poor (8.16%; 95% CI: 7.97-8.35%).Conclusion: Misuse of risk scores by general practitioners could result in clinically important differences in risk estimates. Users of risk scores should recognize the potential for error and developers should aim to label risk factors more clearly. [ABSTRACT FROM AUTHOR]

Objective: Our objective was to evaluate pathological and functional changes in chronic kidney disease (CKD) using diffusion tensor imaging (DTI) at 3 T. Methods: There were fifty-one patients with CKD who required biopsy and 19 healthy volunteers who were examined using DTI at 3 T. The mean values of fractional anisotropy (FA) and the apparent diffusion coefficient (ADC) were obtained from the renal parenchyma (cortex and medulla). Correlations between imaging results and the estimated glomerular filtration rate (eGFR), as well as pathological damage (glomerular lesion and tubulointerstitial injury), were evaluated. Results: The renal cortical FA was significantly lower than the medullary in both normal and affected kidneys ( p < 0.001). The parenchymal FA was significantly lower in patients than healthy controls, regardless of whether eGFR was reduced. There were positive correlations between eGFR and FA (cortex, r = 0.689, p = 0.000; and medulla, r = 0.696, p = 0.000), and between eGFR and ADC (cortex, r = 0.310, p = 0.017; and medulla, r = 0.356, p = 0.010). Negative correlations were found between FA and the glomerular lesion (cortex, r = -0.499, p = 0.000; and medulla, r = -0.530, p = 0.000), and between FA and tubulointerstitial injury (cortex, r = -0.631, p = 0.000; and medulla, r = -0.724, p = 0.000). Conclusion: DTI is valuable for noninvasive assessment of renal function and pathology in patients with CKD. A decrease in FA could identify the glomerular lesions, tubulointerstitial injuries, and eGFR. Key Points: • DTI can evaluate CKD regardless of whether the eGFR is reduced. • DTI allows the assessment of renal pathology changes. • FA appears sensitive and stable in detecting renal pathology and function. [ABSTRACT FROM AUTHOR]

Ochratoxin A (OTA) is a nephrotoxic mycotoxin with carcinogenic properties. Its presence was detected in various foodstuffs all over the world but with significantly higher frequency and concentrations in areas with endemic nephropathy (EN). Even though food is often contaminated with more than one mycotoxin, earlier studies focused on the occurrence and toxicology of only OTA. Only a limited number of surveys showed that OTA co-occurs in food with mycotoxins (citrinin-CIT, penicilic acid, fumonisin B1-FB1, aflatoxins-AF) which exert nephrotoxic, carcinogenic or carcinogen-promoting activity. This review summarises the findings on OTA and its co-occurrence with the mentioned mycotoxins in food as well as experimental data on their combined toxicity. Most of the tested mycotoxin mixtures involving OTA produced additive or synergistic effects in experimental models suggesting that these combinations represent a significant health hazard. Special attention should be given to mixtures that include carcinogenic and cancer-promoting mycotoxins. [ABSTRACT FROM AUTHOR]

Objective: To assess renal dysfunction in chronic kidney diseases using diffusion tensor imaging (DTI). Methods: Forty-seven patients with impaired renal function (study group) and 17 patients without renal diseases (control group) were examined using DTI sequences. Cortical and medullary regions of interest (ROIs) were located to obtain the corresponding values of the apparent diffusion coefficient (ADC) and the fractional anisotropy (FA). The mean values of the ADC and FA, for each ROI site, were obtained in each group and were compared. Furthermore, the correlations between the diffusion parameters and the estimated glomerular filtration rate (eGFR) were determined. Results: In both the normal and affected kidneys, we obtained the cortico-medullary difference of the ADC and the FA values. The FA value in the medulla was significantly lower ( P = 0.0149) in patients with renal function impairment as compared to patients with normal renal function. A direct correlation between DTI parameters and the eGFR was not found. Tractography visualised disruption of the regular arrangement of the tracts in patient with renal function alteration. Conclusion: DTI could be a useful tool in the evaluation of chronic kidney disease and, in particular, the medullary FA value seems to be the main parameter for assessing renal damage. Key Points: • Magnetic resonance diffusion tensor imaging (MRDTI) provides new information about renal problems. • DTI allows non-invasive repeatable evaluation of the renal parenchyma, without contrast media. • DTI could become useful in the management of chronic parenchymal disease. • DTI seems more appropriate for renal evaluation than diffusion-weighted imaging. [ABSTRACT FROM AUTHOR]

Hepatitis C virus (HCV) infection and chronic renal diseases can be linked in two different ways. Some forms of renal disease are precipitated by HCV infection, while patients with end-stage renal disease are at increased risk for acquiring HCV infection. Patients with chronic HCV infection and renal disease have a poor prognosis. Most studies on treatment of HCV and renal diseases have been uncontrolled trials with small number of subjects. So, there is a lack of evidence-based recommendations and guidelines on the management of this condition. In this review, we will attempt to provide the most recent insights on HCV infection both as a extrahepatic manifestations and as a complication of end-stage renal patients. [ABSTRACT FROM AUTHOR]

The adverse reactions of antibacterial drugs are an important problem in medical therapeutics. Nonconvulsive status epilepticus is an unusual side effect of cephalosporin therapy, with only a few isolated cases reported. Cases of ceftazidime(3rd generation cephalosporin) neurotoxicity have been sporadically reported in patients with chronic renal insufficiency and recurrent urinary tract infections. We retrospectively studied the neurological adverse reactions of patients with chronic renal insufficiency and recurrent urinary tract infections who were treated with ceftazidime .In this study were include a number of 216 adult patients hospitalized in Galati County Hospital, Nephrology and Urology Departments.Our data showed that 5 cases of ceftazidime treated patients developed temporospatial disorientation, confusion, agitation, myoclonus and convulsions. Nonconvulsive status epilepticus developed in 2 men and 3 women, with a mean (+/- SD) age of 63 +/- 4 years, while receiving intravenous ceftazidime. The latency, the period between the start of treatment and neurological deterioration, was 2 and 4 days (range: 1-10 days). With temporospatial disorientation 3 patients, myoclonus 1 patient and convulsions 1 patient. Intravenous diazepam suppressed the epileptiform activity completely in 4 patients and partially in the other 1. Ceftazidime were withdrawn, and antiepileptic therapy was started for all patients. All patients improved, 2 patients in less than 24 hours and the remainder within 2 to 7 days. The neurotoxicity of ceftazidime might be underestimated in clinical practice and the frequency of its neurotoxic effects may be insufficiently recognized. [ABSTRACT FROM AUTHOR]

Abstract: In the present study, we examined the effects of kynurenine metabolites on cultured mesangial cells (MCs) and demonstrated for the first time that they affect MC proliferation and gene expression. Anthranilic acid and 3-hydroxy-dl-kynurenine suppressed MC proliferation by 32% and 43%, respectively at 10−6 M compared to the control. In contrast, quinolinic acid and l-kynurenine promoted MC proliferation by 49% and 35% at 10−8 M respectively, although promoting activities declined at higher concentrations. In addition, quinolinic acid upregulated the gene expression of platelet-derived growth factor-B, collagen type-Iα1, and collagen type-IVα1. However, the gene expression of hepatocyte growth factor (HGF) was downregulated. We further examined the gene expressions in the glomeruli of high serum IgA (HIGA) mice with IgA nephropathy using microarray technology and found that the gene expression of insulin-like growth factor-1 was higher, but that of HGF was lower at 40 weeks of age compared to 8 weeks of age. In Balb/c mice, the gene expression of three kynurenine pathway enzymes (kynurenine aminotransferase I, kynurenine aminotransferase II, and quinolinate phospho-ribosyltransferase) increased 2- to 3.5-fold, whereas those in HIGA mice did not change significantly. These results suggest that abnormalities in the kynurenine pathway are associated with the dysfunction of MCs and progression of chronic kidney diseases. [Copyright &y& Elsevier]

Copyright of Néphrologie & Thérapeutique is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Medullary cystic kidney disease/familial juvenile hyperuricemic nephropathy (MCKD/FJHN) are autosomal dominant renal disorders characterized by tubulo-interstitial fibrosis, hyperuricemia and medullary cysts. They are caused by mutations in the gene encoding uromodulin, the most abundant protein in urine. Uromodulin (or Tamm–Horsfall protein) is a glycoprotein that is exclusively expressed by epithelial tubular cells of the thick ascending limb of Henle’s loop and distal convoluted tubule. To date, 37 different uromodulin mutations have been described in patients with MCKD/FJHN. Interestingly, 60% of them involve one of the 48 conserved cysteine residues. We have previously shown that cysteine-affecting mutations could lead to partial endoplasmic reticulum (ER) retention. In this study, as a further step in understanding uromodulin biology in health and disease, we provide the first extensive study of intracellular trafficking and subcellular localization of wild-type and mutant uromodulin isoforms. We analyzed a set of 12 different uromodulin mutations that were representative of the different kind of mutations identified so far by different experimental approaches (immunofluorescence, electron microscopy, biochemistry and in vivo imaging) in transiently transfected HEK293 and Madin–Darby canine kidney cells. We assessed protein processing in the secretory pathway and could demonstrate that although to different extent, all uromodulin mutations lead to defective ER to Golgi protein transport, suggesting a common pathogenetic mechanism in MCKD/FJHN. [ABSTRACT FROM AUTHOR]

Objectives: Bisphosphonate is the primary cause of bisphosphonate-related osteonecrosis of the jaw (BRONJ). Bisphosphonates are eliminated from the human body by the kidneys. It is anticipated that bisphosphonate levels in the body will increase if the kidney is in a weak state or if there is systemic disease that affects kidney function. The aim of this study was to analyze the relevance of renal function in the severity of BRONJ., Materials and Methods: Ninety-three patients diagnosed with BRONJ in Pusan National University Dental Hospital from January 2012 to December 2014 were included in this study. All patients underwent a clinical exam, radiographs, and serologic lab test, including urine analysis. The patient's medical history was also taken, including the type of bisphosphonate drug, the duration of administration and drug holiday, route of administration, and other systemic diseases. In accordance with the guidelines of the 2009 position paper of American Association of Oral and Maxillofacial Surgeons, the BRONJ stage was divided into 4 groups, from stage 0 to 3, according to the severity of disease. IBM SPSS Statistics version 21.0 (IBM Co., USA) was used to perform regression analysis with a 0.05% significance level., Results: BRONJ stage and renal factor (estimated glomerular filtration rate) showed a moderate statistically significant correlation. In the group with higher BRONJ stage, the creatinine level was higher, but the increase was not statistically significant. Other factors showed no significant correlation with BRONJ stage. There was a high statistically significant correlation between BRONJ stage and 'responder group' and 'non-responder group,' but there was no significant difference with the 'worsened group.' In addition, the age of the patients was a relative factor with BRONJ stage., Conclusion: With older age and lower renal function, BRONJ is more severe, and there may be a decrease in patient response to treatment., Competing Interests: Conflict of Interest: No potential conflict of interest relevant to this article was reported.

Background: Primary care physicians (PCPs) are optimally situated to identify and manage early stage chronic kidney disease (CKD). Nonetheless, studies have documented suboptimal PCP understanding, awareness, and management of early CKD. The TRANSLATE CKD study is an ongoing national, mixed-methods, cluster randomized control trial that examines the implementation of evidence-based guidelines for CKD into primary care practice., Methods: As part of the mixed-methods process evaluation, semistructured interviews were conducted by phone with 27 providers participating in the study. Interviews were audio-taped and transcribed. Thematic content analysis was used to identify themes. Themes were categorized according to the 4 domains of Normalization Process Theory (NPT)., Results: Identified themes illuminated the complex work undertaken to manage CKD in primary care practices. Barriers to guideline implementation were identified in each of the 4 NPT domains, including (1) lack of knowledge and understanding around CKD (coherence), (2) difficulties engaging providers and patients in CKD management (cognitive participation), (3) limited time and competing demands (collective action), and (4) challenges obtaining and using data to monitor progress (reflexive monitoring)., Conclusions: Addressing the barriers to implementation with concrete interventions at the levels at which they occur, informed by NPT, will ultimately improve the quality of CKD patient care., (© Copyright 2015 by the American Board of Family Medicine.)

Chronic kidney disease (CKD) is a significant health problem that most commonly results from congenital abnormalities in children and chronic renal injury in adults. The therapeutic potential of BMP-7 was first recognized nearly two decades ago with studies demonstrating its requirement for kidney development and ability to inhibit the pathogenesis of renal injury in models of CKD. Since this time, our understanding of CKD has advanced considerably and treatment strategies have evolved with the identification of many additional signaling pathways, cell types, and pathologic processes that contribute to disease progression. The purpose of this review is to revisit the seminal studies that initially established the importance of BMP-7, highlight recent advances in BMP-7 research, and then integrate this knowledge with current research paradigms. We will provide an overview of the evolutionarily conserved roles of BMP proteins and the features that allow BMP signaling pathways to function as critical signaling nodes for controlling biological processes, including those related to CKD. We will discuss the multifaceted functions of BMP-7 during kidney development and the potential for alterations in BMP-7 signaling to result in congenital abnormalities and pediatric kidney disease. We will summarize the renal protective effects of recombinant BMP-7 in experimental models of CKD and then propose a model to describe the potential physiological role of endogenous BMP-7 in the innate repair mechanisms of the kidneys that respond to renal injury. Finally, we will highlight emerging clinical approaches for applying our knowledge of BMP-7 toward improving the treatment of patients with CKD., (© 2015 Elsevier Inc. All rights reserved.)