Current Issue : July - September Volume : 2015 Issue Number : 3 Articles : 7 Articles
Introduction.The presence of aortic arch calcification (AoAC) and cardiomegaly on chest radiography has been demonstrated as\nimportant risk factors for cardiovascular mortality in patients with chronic kidney disease (CKD). However, the interrelationship\namong AoAC, cardiomegaly, and renal function progression remains unclear. The aim of this study is to assess whether AoAC\nand cardiomegaly are independently associated with the renal function progression in patients with stages 3ââ?¬â??5 CKD. Methods. We\nretrospectively determined AoAC and cardiomegaly by chest X-ray in 237 patients, followed up for at least three years without\nentering dialysis and classified into 4 groups according to the presence or absence of AoAC and cardiomegaly. The change in renal\nfunction was measured by the slope of estimated glomerular filtration rate (eGFR). Results. Of the 237 patients, the rate of eGFR\ndecline was significantly higher in the group with coexistence of AoAC and cardiomegaly than any other groups. Baseline AoAC\nand proteinuria were independently associated with eGFR decline. AoAC were independently determined by age, eGFR slope,\nand cardiomegaly. Conclusions. The coexistence of AoAC and cardiomegaly is associated with faster eGFR decline. AoAC is an\nindependent determinant of renal outcomes in patients with CKD stages 3ââ?¬â??5....
Background. The aim of our study was to assess the subgingival profile of 9 periodontal pathogens, by means of real-time PCR,\nin a group of predialysis chronic kidney disease patients with and without periodontal disease and to identify the risk factors\nassociated with periodontal disease in these patients. Material and Methods. This is a single centre cross-sectional cohort study\nperformed on 70CKDpatients. Patients received a full-mouth periodontal examination and the following parameterswere assessed:\nperiodontal pocket depth (PPD), clinical attachment level, bleeding on probing, and plaque index; subgingival biofilm samples\nwere collected from the deepest periodontal pocket of each quadrant and were pooled in one transporting unit. Clinical data\nwere drawn from the medical file of the patients. Results. T. denticola (???? = 0.001), T. forsythia (P < 0.001), and P. micros (P =\n0.003) are significantly associated with periodontal disease in CKD subjects but in a multivariate model only age and T. forsythia\nremain independent risk factors for periodontal disease in patients with CKD. Conclusions. In our cohort, age and T. forsythia are\nindependently associated with periodontitis in CKD patients.Within the limits of this study, CKD was not significantly associated\nwith a particular subgingival periodontal pathogens profile in periodontitis patients....
Within this prospective, open-label, self-controlled study, we evaluated the long-term effects of the calcimimetic cinacalcet on\ncalcium and phosphate homeostasis in 44 kidney transplant recipients (KTRs) with hypercalcemic hyperparathyroidism by\ncomparing biochemical parameters of mineral metabolism between pre- and posttreatment periods. Results are described as mean\ndifferences (95% CIs) between pre- and posttreatmentmedians that summarize all repeated measurements of a parameter of interest\nbetween the date of initial hypercalcemia and cinacalcet initiation (median of 1.6 (IQR: 0.6ââ?¬â??3.8) years) and up to four years after\ntreatment start, respectively. Cinacalcet was initiated after 1.8 (0.8ââ?¬â??4.7) years posttransplant and maintained for 6.2 (3.9ââ?¬â??7.6) years. It\nsignificantly decreased total serum calcium (?0.30 (?0.34 to ?0.26)mmol/L, P < 0.001) and parathyroid hormone levels (?79 (?103\nto ?55) pg/mL, P < 0.001). Serum levels of inorganic phosphate (Pi) and renal tubular reabsorption of phosphate to glomerular\nfiltration rate (TmP/GFR) increased simultaneously (Pi: 0.19 (0.15ââ?¬â??0.23)mmol/L, P < 0.001, TmP/GFR: 0.20 (0.16ââ?¬â??0.23)mmol/L,\nP < 0.001). In summary, cinacalcet effectively controlled hypercalcemic hyperparathyroidism in KTRs in the long-term and\nincreased low Pi levels without causing hyperphosphatemia, pointing towards a novel indication for the use of cinacalcet in KTRs....
Traditional Chinese medicine (TCM) is an important treatment for male infertility, and its application to therapy is dependent\non differentiation of TCM syndromes. This study aims to investigate the changes in metabolites and metabolic pathways in\ninfertile males with Kidney-Yang Deficiency syndrome (KYDS) via metabolomics approaches. Seminal plasma samples were\ncollected from 18 infertile males with KYDS and 18 fertile males. Liquid chromatography and mass spectrometry were used to\ncharacterize metabolomics profiles. Principal component analysis (PCA), partial least squares-discriminate analysis (PLS-DA),\nand pathway analysis were used for pattern recognition and metabolite identification. PCA and PLS-DA results differentiated the\ntwo groups of patients. Forty-one discriminating metabolites (18 in positive mode and 23 in negative mode) were identified. Seven\nmetabolites were related to five potential metabolic pathways associated with biosynthesis and metabolism of aromatic amino acids,\ntricarboxylic acid cycle, and sphingolipidmetabolism. The changes inmetabolic pathways may play an important role in the origin\nof KYDS-associated male infertility. Metabolomics analysis of seminal plasma may be used to differentiate TCM syndromes of\ninfertile males, but further research must be conducted....
MicroRNAs (miRNAs) are endogenous small RNAs of 18ââ?¬â??23 nucleotides that regulate gene expression. Recently, plasma miRNAs\nhave been investigated as biomarkers for various diseases. In the present study, we assessed whether the miRNA expression profiles\nof tubular tissues could discriminate proximal tubule injury and diagnose acute kidney injury (AKI) and renal tubular dysfunction\nwithoutmorphological changes. miRNAexpression was assessed with miRNAarray and real-time reverse transcriptase-polymerase\nchain reaction (RT-PCR) using a reverse primer for a stem loop structure. Profiling of human and rat tubular tissues, including the\nkidney, lung, small intestine, and various exocrine glands, indicated that the profiles of miR-200a/b/c, miR-145, miR-192, miR-194,\nmiR-216a/b, miR-217, and miR-449a were adequate for discriminating tubular tissues. In the kidney, miR-192 and miR-194 were\nhighly expressed, whereas miR-145 and miR-449a were absent. In addition, the combination of miR-200a/b/c, miR-192, and miR-\n194 in plasma was extremely useful for diagnosing AKI.Urinary miR-200a levels increased in renal tubular dysfunction. Our results\nsuggest that expression profiling is useful for the discrimination of injured tissues with a tubular structure....
Purpose Peptide receptor radionuclide therapy (PRRT) has\nbecome an important treatment option in the management of\nadvanced neuroendocrine tumours. Long-lasting responses\nare reported for a majority of treated patients, with good tolerability\nand a favourable impact on quality of life. The treatment\nis usually limited by the cumulative absorbed dose to the\nkidneys, where the radiopharmaceutical is reabsorbed and\nretained, or by evident haematological toxicity. The aim of\nthis study was to evaluate how renal function affects (1)\nabsorbed dose to the kidneys, and (2) the development of\nhaematological toxicity during PRRT treatment.\nMethods The study included 51 patients with an advanced\nneuroendocrine tumour who received 177Lu-DOTATATE\ntreatment during 2006 ââ?¬â?? 2011 at Sahlgrenska University Hospital\nin Gothenburg. An average activity of 7.5 GBq\n(3.5 ââ?¬â?? 8.2 GBq) was given at intervals of 6 ââ?¬â?? 8 weeks on\none to five occasions. Patient baseline characteristics according\nto renal and bone marrow function, tumour burden and\nmedical history including prior treatment were recorded. Renal\nand bone marrow function were then monitored during\ntreatment. Renal dosimetry was performed according to the\nconjugate view method, and the residence time for the radiopharmaceutical\nin the whole body was calculated.\nResults A significant correlation between inferior renal function\nbefore treatment and higher received renal absorbed dose\nper administered activity was found (p<0.01). Patients with\ninferior renal function also experienced a higher grade of haematological\ntoxicity during treatment (p=0.01). The residence\ntime of 177Lu in the whole body (range 0.89 ââ?¬â?? 3.0 days) was\ncorrelated with grade of haematological toxicity (p=0.04) but\nnot with renal absorbed dose (p=0.53).\nConclusion Patients with inferior renal functionwere exposed\nto higher renal absorbed dose per administered activity and\ndeveloped a higher grade of haematological toxicity during\n177Lu-DOTATATE treatment. The study confirms the tolerability\nof PRRT in patients with an advanced neuroendocrine\ntumour but indicates that patients with inferior renal function\nare at risk of being exposed to higher absorbed doses to normal\ntissue on treatment....
Acute kidney injury (AKI) is a primarily described complication after unbalanced systemic perfusion in neonates with congenital\nheart defects, including hypoplastic left heart syndrome (HLHS). The aim of the study was to compare the umbilical NGAL\nconcentrations between neonates born with HLHS and healthy infants, as well as to analyze whether the determination of NGAL\nlevel could predict AKI in neonates with prenatally diagnosed HLHS. Twenty-one neonates with prenatally diagnosed HLHS were\nenrolled as study group and 30 healthy neonates served as controls. Perinatal characteristics and postnatal parameterswere extracted\nfromthe hospital neonatal database. In umbilical cord blood, we determined plasma NGAL concentrations, acid base balance, and\nlactate and creatinine levels. In neonates with HLHS, complications (respiratory insufficiency, circulatory failure, NEC, IVH, and\nAKI) were recorded until the day of cardiosurgery.We observed in neonates with HLHS higher umbilical NGAL levels compared\nto controls. Among 8 neonates with HLHS and diagnosed AKI stage 1, we observed elevated NGAL levels in comparison to those\nnewborns without AKI. Umbilical NGAL could predict, with high sensitivity and specificity, AKI development in study neonates.\nWe suggest that the umbilical blood NGAL concentration may be an early marker to predict AKI in neonates with HLHS....
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