Current Issue : October - December Volume : 2012 Issue Number : 4 Articles : 8 Articles
Ambulatory arterial stiffness index (AASI) is a parameter obtained from ambulatory blood pressure monitoring (ABPM) that\r\ncorrelates with clinical endpoints. The aim of this study was to compare AASI in nondiabetic hypertensive patients with and\r\nwithout chronic kidney disease (CKD). Subjects with systemic arterial hypertension (SAH, n = 30) with normal renal function,\r\naged 40 to 75 years, were compared to hypertensive patients with CKD (n = 30) presenting estimated glomerular filtration rate\r\n(eGFR) <60 mL/min by MDRD formula. ABPM was carried out in all patients. In CKD group, eGFR was 35.3 �± 2.8 ml/min. The\r\nmean 24-hour systolic and diastolic blood pressure (BP) was similar in both groups. AASI was significantly higher in CKD group\r\n(0.45 �± 0.03 versus 0.37 �± 0.02, P < 0.05), positively correlated to age (r = 0.38, P < 0.01) and pulse pressure (r = 0.43, P < 0.01)\r\nand negatively correlated to nocturnal BP fall (r = -0.28, P = 0.03). These findings indicate the presence of stiffer vessels in CKD\r\nhypertensive patients....
Objectives: To report our experience in treatment and course of patients\r\nhad BK virus infections following kidney transplantation in our center.\r\nMethods: We evaluated four renal transplant patients with BKVN\r\namong the patients transplanted and followed in our clinic in between\r\n2000 ââ?¬â?? 2010. We screened the presence of plasma and urine BK virus\r\nDNA by quantitative real-time polymerase chain reaction in renal\r\ntransplant recipients with graft dysfunction and evaluated evidence of\r\nBK virus nephropathy (BKVN) in their graft biopsy specimens.\r\nResults: Overall, four patients were studied (mean age was13.5 years;\r\nmean donor age was 26.5 years). In all patients in plasma BK virus\r\nDNA was detected. Time elapsed from transplantation to BKVN\r\ndiagnosis ranged from 3 to 24 months. We reduced their\r\nimmunosuppressive drugs and also IVIG treatment (2g/kg/day) was\r\nadministered in two patients (patient 1 and 4). The all grafts are still\r\nfunctioning with a mean creatinine level of 1.15 mg/dl.\r\nConclusions: Early diagnosis of BKV infection with reduction of\r\nimmunosuppression may potentially counter BK viremia and retard\r\nprogression of BKV nephropathy....
Background: Contrast induced nephropathy (CIN) is a cause of acute renal\r\nfailure in hospitalized patients. The major organosulfur compounds in the aged\r\ngarlic, which are of structural similarities with N-acetylcysteine, have potent\r\nantioxidant activities. The aim of this study was to assess the renoprotective\r\neffects of aged garlic following radiocontrast administration.\r\nMethods: In a randomized clinical trial, 395 patients who underwent coronary\r\nangiography randomly assigned into two groups. Control group (n = 206)\r\nreceived isotonic saline (before and after angiography). Garlic group (n = 189)\r\nadditionally received aged garlic (15 gr/day) from one week before to three days\r\nfollowing angiography. High-osmolar ionic contrast and non-ionic hypo-osmolar\r\ncontrast were used for non-diabetic (n = 327) and diabetic (n = 68) patients,\r\nrespectively. Contrast-induced nephropathy defined as an absolute increase in the\r\nserum creatinine of at least 0.5 mg/dl at day 2 to 5 of contrast administration.\r\nResults: In non-diabetic group, the rate of CIN significantly diminished in the\r\ngarlic group at day 5 (2% versus 9.5% in the control group at day 5, P = 0.005).\r\nThough diabetic patients who received a hypo-osmolar non-ionic contrast had a\r\nlower rate of CIN with garlic consumption (2.4% versus 14.8% in the control\r\ngroup at day 5), such an effect did not reach statistical significance (P = 0.077).\r\nConclusion: In conclusion, the aged garlic consumed before and after coronary\r\nangiography could prevent CIN in non-diabetic patient who had received a highosmolar\r\nionic contrast....
The persistent inflammatory state is common in diabetes and chronic kidney disease (CKD). These patients present exercise\r\nintolerance and increased arterial stiffness. Long-term aerobic exercise has been associated with better arterial compliance,\r\nantidiabetic and antiinflammatory benefits. We assessed the hypothesis that in patients with diabetes and CKD, better aerobic\r\ncapacity is associated with less inflammatory state and arterial stiffness. Thirty-nine CKD patients (17 in hemodialysis) were\r\nevaluated. According to CKD etiology two patient groups were obtained: group of diabetics (GD) was formed by 11 patients and\r\nnondiabetics (GND) formed by 28 patients. Central blood pressure and arterial stiffness were evaluated by Sphygmocor device.\r\nCarotida intima-media thickness (CA-IMT) was evaluated by ultrasonography. Aerobic capacity was measured by estimated\r\nVO2max according to treadmill test by Bruce protocol. The GD showed a higher frequency of C-reactive protein above laboratory\r\ncutoff (P = 0.044), higher frequency of male gender, and a non significant higher value of VO2max (P = 0.099). The CA-IMT was\r\nsimilar. Only better aerobic capacity was associated with lower frequency of high C-reactive protein when adjusted to diabetes and\r\ngender in a logistic regression model. In conclusion, aerobic capacity was associated with inflammatory state, in CKD patients,\r\nindependently of diabetes presence....
Background. Mannan-binding lectin (MBL) is involved in the development of diabetic nephropathy. MBL is a part of the innate\r\nimmune system where it can activate the complement system. Serum MBL level predicts later renal impairment in diabetes\r\npatients. Direct involvement of MBL in the development of diabetic kidney disease is observed in one animal strain. However,\r\nthis involvement may differ among the animal strains. We thus examined the impact of the genetic background on the role of\r\nMBL in diabetic nephropathy. Materials/Methods. C57BL/6JBomTac and 129S6/SvEvTac mice were compared. In both strains,\r\nexperimental type 1 diabetes was induced in wild-type (WT) and MBL-knockout (MBL-KO) mice by streptozotocin. Nondiabetic\r\nWT and MBL-KO mice were used as controls. We tested if MBL modified the diabetes-induced kidney changes by two-way\r\nANOVA allowing for interaction. Results. MBL aggravated diabetes-induced kidney growth and glomerulus enlargement in\r\nC57BL/6JBomTac mice. MBL did not modify diabetes effects on glomerular basement membrane thickness or mesangial volume\r\nin any strain. Diabetes-induced changes in renal gene transcription of growth factors and matrix components were unaffected\r\nby MBL. Conclusions. Strain-specific MBL effects were found on downstream diabetic kidney changes. This emphasizes the\r\nimportance of genetic background in this model of diabetic complications....
Background: Reports show that patients with end stage renal failure and\r\ntransplants present with reduced immunity to infections especially with\r\nHepatitis B Virus. This may make the patients respond poorly to hepatitis\r\nB vaccine with resultant poor seroconversion rate. This study examines\r\nthe efficacy of hepatitis B vaccine, in chronic renal failure (CRF), Post\r\nKidney Transplantation (PKT), and renal patients as compared to controls\r\nhealthy. Methods: A total of 303 subjects participated: One hundred and thirtythree\r\nimmunocompetent and immunocomprised individuals and 170\r\ncontrols were enrolled in this study. They were categorized into four\r\ngroups. Group I: Comprised 54 Chronic Renal Failure, Group II:\r\nComprised 21 End Stage Renal Disease patients, Group III: Comprised\r\n38 Post Kidney Transplant patients, Group IV: Control group comprised\r\n170 vaccinated blood donors and hospital staff. Detection of serological\r\nmarkers - HBsAg, Anti-HBs, HBeAg, Anti-HBe, HBcIgG, and HBcIgM\r\nwere performed by enzyme immune assays (EIA). The vaccination\r\nschedule comprised recombinant hepatitis B vaccine (Engerix B) 40 g\r\nintramuscularly at 0, 1, and 6 months.\r\nResults: Our results have documented successful vaccination in only\r\ngroup I, and III, with primary seroconversion 20.4% and 15.8%\r\nrespectively while none in group II, seroconvert and 100% of group lV\r\ndemonstrated successful vaccination. The remaining patients were HBV\r\ninfected.\r\nConclusions: It was concluded that controlling HBV infection in end\r\nstage of renal disease still pose a great deal of challenges. Based upon\r\nthis study results, we highly recommend stating vaccination strategy at\r\nan earlier stage of chronic renal disease. Furthermore, regular\r\nserological testing and booster injections are necessary for hyporesponders...
Renal calculi is the formation of stones in the urinary tract, causing pain and bleeding, and may lead to secondary infection. Of many types of stones that are formed, the most common are calcium oxalate. Urolithiasis (renal stone formation) is a recurrent disorder predominant in males. The present day medical management of urolithiasis is either costly or not without side effects. Hence, the search for antilithiatic drugs from natural sources has assumed greater importance1. Many Indian plants have been quoted to be useful as antilithiatic agents. They are effective with fewer side effects and are also inexpensive. One of the important phenomena that characterize renal calculi is its high recurrence. Thus, a protective system is required including ESWL and medicament treatment. Unfortunately, these means remain costly and in most case are invasive and with side effects. Therefore, it is worthwhile to look for an alternative to these conventional methods by using medicinal plants or phytotherapy. Therefore, it is highly recommended to explore new drugs coming from medicinal plants to treat and prevent the formation of kidney stones. Ideally, conventional and phytotherapy should supplement one another and have all the need available for renal calculi patients. Musa AAB stem extract showed promising results in the size reduction of kidney stones by invitro method. Musa AAB stem juice showed good antioxidant activity by superoxide scavanging activity and thiobarbituric acid methods. Invivo studies can further confirm and revalidate the use of these agents in real time clinical settings...
Renal disease is a major cause of morbidity and mortality. Pediatric patients with renal disease, especially younger ones may present\r\nwith nonspecific signs and symptoms unrelated to the urinary tract. Pediatricians, therefore, should be familiar with the modes of\r\npresentation of renal disease and should have a high index of suspicion of these conditions. Affected patients may present with signs\r\nand symptoms of the disease, abnormal urinalysis, urinary tract infection, electrolyte and acid-base abnormalities, decreased renal\r\nfunction, renal involvement in systemic disease, glomerular and renal tubular diseases, congenital abnormalities, and hypertension.\r\nPediatricians may initiate evaluation of renal disease to the extent that they feel comfortable with. The role of the pediatrician in\r\nthe management of the child with renal disease and guidelines for patient referral to the pediatric nephrologist are presented....
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