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Elhusseiny GA, Saleh W. Oral Health in Children with Chronic Kidney Disease, Hemodialysis, and Renal Transplantation: A Comprehensive Narrative Review of the Oral Manifestations and Dental Implications. Clin Med Insights Pediatr 2024; 18:11795565241271689. [PMID: 39206206 PMCID: PMC11350538 DOI: 10.1177/11795565241271689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 06/05/2024] [Indexed: 09/04/2024] Open
Abstract
Chronic kidney disease (CKD) in children presents multifaceted challenges, impacting various aspects of health, including oral health. This narrative review provides a comprehensive synthesis of literature focusing on the oral health status of pediatric CKD patients, encompassing oral manifestations, dental considerations, and management challenges associated with hemodialysis and kidney transplantation. A comprehensive search strategy was employed, utilizing databases such as PubMed, Scopus, Web of Science, and Google Scholar, to identify relevant literature on oral manifestations in children with CKD, including those undergoing hemodialysis or renal transplantation. Search terms were carefully selected to capture studies examining enamel hypoplasia, dental caries, delayed tooth eruption, gingival diseases, periodontal diseases, radiographic alterations, craniofacial development, dry mouth, and changes in the oral mucosa. Our narrative review meticulously selected articles through a systematic process. Ultimately, 12 studies meeting the inclusion criteria were included in the review. Relevant data from each included study were independently extracted and synthesized, focusing on oral manifestations and their implications in pediatric CKD patients. The synthesized findings were organized and presented in a structured manner within the review article, considering their clinical implications and informing recommendations for dental management of children with CKD. This article highlights the importance of a coordinated effort between nephrologists, dentists, and other healthcare professionals in providing holistic care for pediatric CKD patients. A comprehensive understanding of the oral health status of these children, along with proactive dental management strategies, contributes to improved overall health outcomes and a better quality of life. This review aims to serve as a valuable resource for the oral healthcare providers involved in the care of pediatric CKD patients.
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Affiliation(s)
- Ghada A Elhusseiny
- Oral Medicine, Periodontology, Diagnosis and Oral Radiology Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Wafaa Saleh
- Oral Medicine, Periodontology, Diagnosis and Oral Radiology Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
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Singh A, Singh R, Gupta DK, Singh RS. A novel study on the quality of life index in canine chronic kidney disease treated with incremental intermittent hemodialysis. Vet World 2024; 17:1702-1714. [PMID: 39328443 PMCID: PMC11422637 DOI: 10.14202/vetworld.2024.1702-1714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Accepted: 07/08/2024] [Indexed: 09/28/2024] Open
Abstract
Background and Aim In veterinary medicine, health-related quality-of-life index (QOLi) measurements are becoming increasingly important because they are a multifaceted concept that represents not only patients' physical well-being but also clients' emotional health. This study assessed QOLi in dogs receiving incremental intermittent hemodialysis (i-IHD) with high- and low-flux dialyzers. Materials and Methods Thirty dogs diagnosed with chronic kidney disease (CKD) Stage IV were randomly divided into two groups of 15 dogs each. A high-flux dialyzer was used in Group I, whereas a low-flux dialyzer was used in Group II. i-IHD was performed on days 0, 2, 4, 19, and 34, whereas QOLi evaluation was performed on days 0, 15, 30, and 45. Results Both groups exhibited considerable decreases in post-dialysis creatinine, blood urea nitrogen, and phosphorus levels, while Group I experienced notable reductions in post-dialysis triglyceride and cholesterol levels. Dialysis adequacy did not show any significant difference between the clearance rates of high- and low-flux dialyzers. The QOLi assessment showed better post-dialysis scores in all categories except for water balance in Group I, while Group II demonstrated a worsening trend in scores for mental status, appetite, mobility, general health, and pain. Conclusion In the first three sessions of i-IHD, dogs with CKD should be treated every other day, and the schedule can be extended by 15 days after that. A high-flux membrane, which effectively decreases triglyceride and cholesterol levels more than a low-flux membrane, warrants consideration for dogs with cardiovascular complications undergoing dialysis. The dialysis-related QOLi aids in clinical decision-making and encourages client engagement.
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Affiliation(s)
- Akashpreet Singh
- Department of Veterinary Medicine, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana - 141 004, Punjab, India
| | - Randhir Singh
- Department of Teaching Veterinary Clinical Complex, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana - 141 004, Punjab, India
| | - Dhiraj Kumar Gupta
- Department of Veterinary Medicine, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana - 141 004, Punjab, India
| | - Raj Sukhbir Singh
- Department of Teaching Veterinary Clinical Complex, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana - 141 004, Punjab, India
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Wilkinson SL. Urine Output Monitoring and Acute Kidney Injury in Non-mammalian Exotic Animal Critical Care. Vet Clin North Am Exot Anim Pract 2023; 26:673-710. [PMID: 37516459 DOI: 10.1016/j.cvex.2023.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/31/2023]
Abstract
Acute kidney injury (AKI) is a sudden, severe decrease in kidney function which can occur in any species. There are various causes of AKI, some of which are seen in domestic species and some that are unique to birds, reptiles, and amphibians. These species present unique challenges with AKI management, such as differences in anatomy and physiology, intravenous and urinary catheterization, repeated blood sampling, and their tendency to present in advanced states of illness. This article will discuss AKI, diagnosis, treatment, and prognosis for non-mammalian exotic species.
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Affiliation(s)
- Stacey Leonatti Wilkinson
- Avian and Exotic Animal Hospital of Georgia, 118 Pipemakers Circle Suite 110, Pooler, GA 31322, USA.
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Wilkinson SL. Urine Output Monitoring and Acute Kidney Injury in Mammalian Exotic Animal Critical Care. Vet Clin North Am Exot Anim Pract 2023:S1094-9194(23)00023-3. [PMID: 37302935 DOI: 10.1016/j.cvex.2023.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Acute kidney injury (AKI) is a sudden, severe decrease in kidney function which can occur in any species. There are various causes of AKI, some of which are seen in domestic species and some that are unique to exotics. Exotic animals present unique challenges with AKI management such as differences in anatomy and physiology, intravenous and urinary catheterization, repeated blood sampling, and their tendency to present in advanced states of illness. This article will discuss AKI, diagnosis, treatment, and prognosis for exotic companion mammals. The following article will discuss the same in non-mammalian patients.
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Affiliation(s)
- Stacey Leonatti Wilkinson
- Avian and Exotic Animal Hospital of Georgia, 118 Pipemakers Circle Suite 110, Pooler, GA 31322, USA.
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The Role of Ketone Bodies in Various Animal Models of Kidney Disease. ENDOCRINES 2023. [DOI: 10.3390/endocrines4010019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2023] Open
Abstract
The kidney is a vital organ that carries out significant metabolic functions in our body. Due to the complexity of its role, the kidney is also susceptible to many disease conditions, such as acute kidney injury (AKI) and chronic kidney disease (CKD). Despite the prevalence and our increased understanding of the pathophysiology of both AKI and CKD as well as the transition of AKI to CKD, no well-established therapeutics have been applied clinically to these conditions, rendering an urgent need for a novel potential therapeutic target to be developed. In this article, we reviewed the function of ketone bodies in some common kidney conditions, such as drug-induced nephrotoxicity, ischemia and reperfusion injury, fibrosis development, diabetic kidney disease, kidney aging, hypertension, and CKD progression. All the selected studies reviewed were performed in animal models by primarily utilizing rodents, which also provide invaluable sources for future clinical applications. Ketone bodies have shown significant renal protective properties via attenuation of oxidative stress, increased expression of anti-inflammatory proteins, gene regulation, and a reduction of apoptosis of renal cells. A physiological level of ketone bodies could be achieved by fasting, a ketogenic diet, and an exogenous ketone supplement. Finally, the limitations of the long-term ketogenic diet were also discussed.
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Ruby M, Gifford CC, Pandey R, Raj VS, Sabbisetti VS, Ajay AK. Autophagy as a Therapeutic Target for Chronic Kidney Disease and the Roles of TGF-β1 in Autophagy and Kidney Fibrosis. Cells 2023; 12:cells12030412. [PMID: 36766754 PMCID: PMC9913737 DOI: 10.3390/cells12030412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 01/17/2023] [Accepted: 01/19/2023] [Indexed: 01/27/2023] Open
Abstract
Autophagy is a lysosomal protein degradation system that eliminates cytoplasmic components such as protein aggregates, damaged organelles, and even invading pathogens. Autophagy is an evolutionarily conserved homoeostatic strategy for cell survival in stressful conditions and has been linked to a variety of biological processes and disorders. It is vital for the homeostasis and survival of renal cells such as podocytes and tubular epithelial cells, as well as immune cells in the healthy kidney. Autophagy activation protects renal cells under stressed conditions, whereas autophagy deficiency increases the vulnerability of the kidney to injury, resulting in several aberrant processes that ultimately lead to renal failure. Renal fibrosis is a condition that, if chronic, will progress to end-stage kidney disease, which at this point is incurable. Chronic Kidney Disease (CKD) is linked to significant alterations in cell signaling such as the activation of the pleiotropic cytokine transforming growth factor-β1 (TGF-β1). While the expression of TGF-β1 can promote fibrogenesis, it can also activate autophagy, which suppresses renal tubulointerstitial fibrosis. Autophagy has a complex variety of impacts depending on the context, cell types, and pathological circumstances, and can be profibrotic or antifibrotic. Induction of autophagy in tubular cells, particularly in the proximal tubular epithelial cells (PTECs) protects cells against stresses such as proteinuria-induced apoptosis and ischemia-induced acute kidney injury (AKI), whereas the loss of autophagy in renal cells scores a significant increase in sensitivity to several renal diseases. In this review, we discuss new findings that emphasize the various functions of TGF-β1 in producing not just renal fibrosis but also the beneficial TGF-β1 signaling mechanisms in autophagy.
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Affiliation(s)
- Miss Ruby
- Centre for Drug Design Discovery and Development (C4D), SRM University, Delhi-NCR, Rajiv Gandhi Education City, Sonepat 131029, Haryana, India
| | - Cody C. Gifford
- Renal Division, Department of Medicine, Brigham and Women’s Hospital, Boston, MA 02115, USA
- Department of Medicine, Harvard Medical School, Boston, MA 02115, USA
| | - RamendraPati Pandey
- Centre for Drug Design Discovery and Development (C4D), SRM University, Delhi-NCR, Rajiv Gandhi Education City, Sonepat 131029, Haryana, India
- Correspondence: (R.P.); (A.K.A.); Tel.: +91-130-2203757 (R.P.); +1-(617)-525-7414 (A.K.A.); Fax: +1-(617)-525-7386 (A.K.A.)
| | - V. Samuel Raj
- Centre for Drug Design Discovery and Development (C4D), SRM University, Delhi-NCR, Rajiv Gandhi Education City, Sonepat 131029, Haryana, India
| | - Venkata S. Sabbisetti
- Renal Division, Department of Medicine, Brigham and Women’s Hospital, Boston, MA 02115, USA
- Department of Medicine, Harvard Medical School, Boston, MA 02115, USA
| | - Amrendra K. Ajay
- Renal Division, Department of Medicine, Brigham and Women’s Hospital, Boston, MA 02115, USA
- Department of Medicine, Harvard Medical School, Boston, MA 02115, USA
- Correspondence: (R.P.); (A.K.A.); Tel.: +91-130-2203757 (R.P.); +1-(617)-525-7414 (A.K.A.); Fax: +1-(617)-525-7386 (A.K.A.)
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Mehmood HR, Khan Z, Jahangir HMS, Hussain A, Elahi A, Askari SMH. Assessment of serum biochemical derangements and associated risk factors of chronic kidney disease. J Taibah Univ Med Sci 2022; 17:376-383. [PMID: 35722231 PMCID: PMC9170744 DOI: 10.1016/j.jtumed.2021.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/23/2021] [Accepted: 09/04/2021] [Indexed: 12/03/2022] Open
Abstract
Objective Chronic kidney disease and/or disturbance in renal excretory function may lead to nitrogenous waste collection beyond the term as well as derangements of several serum biochemicals. There is no previous study from Pakistan that reveals serum electrolyte derangements in confirmed chronic kidney disease (CKD) patients and other biochemicals associated with CKD. This study aims to examine the derangements of serum biochemicals and the association of several risk factors with CKD. Methods The study enrolled 612 confirmed CKD patients with a glomerular filtration rate (GFR) < 15 ml/min that were treated as a part of the integrated care programme at Mayo Hospital Lahore (one of the largest hospitals in Pakistan). Serum biochemicals were estimated on AU 680 (Beckman Coulter) using the spectrophotometric technique. Results All the CKD patients had elevated creatinine and urea levels, but only 63.4% were suffering from hyperuricemia. The incidence of diabetes and malnutrition assessed by serum albumin (hypoalbuminemia) was 27.4% and 72%, respectively. Among electrolyte disorders, hyperphosphatemia (71.8%) and hypocalcaemia (61.9%) were found to be more prevalent. Furthermore, gender, malnutrition, diabetes, hyperuricemia, and phosphorus and magnesium derangements were found to be statistically significant risk factors for CKD, whereas malnutrition and magnesium derangement were associated with hyperuricemia. Conclusion It is imperative to improve dietary protein and monitor serum electrolyte concentration in renal dysfunction patients to slow the progression of CKD to end-stage renal disease (ESRD) and other serious complications.
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Affiliation(s)
- Hafiz Rehman Mehmood
- University Institute of Medical Laboratory Technology, Faculty of Allied Health Sciences, The University of Lahore, Lahore, Pakistan
| | - Zaman Khan
- University Institute of Medical Laboratory Technology, Faculty of Allied Health Sciences, The University of Lahore, Lahore, Pakistan
| | | | - Abid Hussain
- Department of Medical Lab Technology, Faculty of Rehabilitation and Allied Health Sciences, Riphah International University Islamabad, QIE Campus Lahore, Pakistan
| | - Amina Elahi
- University Institute of Medical Laboratory Technology, Faculty of Allied Health Sciences, The University of Lahore, Lahore, Pakistan
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Ross L. Acute Kidney Injury in Dogs and Cats. Vet Clin North Am Small Anim Pract 2022; 52:659-672. [DOI: 10.1016/j.cvsm.2022.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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9
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The Grocery Store Dilemma. PHYSICIAN ASSISTANT CLINICS 2022. [DOI: 10.1016/j.cpha.2021.11.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Duan S, Sun L, Zhu H, Nie G, Zhang C, Huang Z, Zhang B, Xing C, Yuan Y. Association of urinary calcium and phosphorus excretion with renal disease progression in type 2 diabetes. Diabetes Res Clin Pract 2021; 178:108981. [PMID: 34311020 DOI: 10.1016/j.diabres.2021.108981] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 06/07/2021] [Accepted: 07/21/2021] [Indexed: 01/23/2023]
Abstract
OBJECTIVES Diabetes is associated with a high incidence of microvascular disease, including nephropathy. The current study aimed to investigate the association of urinary calcium and phosphorus excretion with chronic kidney disease (CKD) progression in type 2 diabetes mellitus. METHODS A total of 159 T2DM patients with chronic kidney disease (CKD stage G1-G4) were retrospectively included. Patients were categorized into three groups according to the tertiles of 24-h urinary calcium and phosphorus excretion, respectively. Clinical parameters and laboratory findings were compared among the three groups. Cox proportional hazards models were used to estimate the associations of urinary calcium and phosphorus excretion with CKD progression and adjusted for baseline eGFR, urinary protein excretion, mean arterial pressure, and use of RAAS inhibitor. A cubic spline curve was used to explore the association between urinary calcium excretion and CKD progression, as well as urinary phosphorus excretion and CKD progression. Moreover, the subgroup effects of urinary calcium and phosphorus excretion on CKD progression were estimated using Cox regression. CKD progression was defined as double of baseline serum creatinine or occurrence of ESRD. RESULTS During a median of 18.23 months of follow-up, the composite renal outcomes were noted in 27%. Cumulative renal outcomes were significantly lower in the highest tertile of urinary calcium excretion and phosphorus excretion in Kaplan-Meier analyses. The multivariate Cox proportional hazards regression analyses indicated that both the highest tertile of urinary calcium and phosphorus excretion was associated with a lower risk for CKD progression compared with the lowest tertile. Restricted cubic spline analyses of the association between urinary calcium excretion and CKD progression indicated a linear association. Additionally, there was also a linear association between urinary phosphorus excretion and CKD progression. Subgroup analyses showed that higher urinary phosphorus excretion was particularly associated with a lower risk of CKD progression in non-diabetic kidney disease (NDKD) patients. CONCLUSION Higher urinary calcium and phosphorus excretion were associated with decreased risk of CKD progression in T2DM patients.
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Affiliation(s)
- Suyan Duan
- Department of Nephrology, The First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, China
| | - Lianqin Sun
- Department of Nephrology, The First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, China
| | - Huanhuan Zhu
- Department of Nephrology, The First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, China
| | - Guangyan Nie
- Department of Nephrology, The First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, China
| | - Chengning Zhang
- Department of Nephrology, The First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, China
| | - Zhimin Huang
- Department of Nephrology, The First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, China
| | - Bo Zhang
- Department of Nephrology, The First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, China.
| | - Changying Xing
- Department of Nephrology, The First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, China.
| | - Yanggang Yuan
- Department of Nephrology, The First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, China.
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Donati PA, Londoño L, Benavides G, Mouly J, González S, Otero PE. Clinicopathological factors associated with the presence of hypercapnia at admission in hospitalised cats with decompensated chronic kidney disease. N Z Vet J 2021; 69:343-348. [PMID: 34085906 DOI: 10.1080/00480169.2021.1939188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
AIMS To evaluate associations between clinicopathological variables and hypercapnia measured in cats with decompensated chronic kidney disease (CKD) on admission to a veterinary hospital. METHODS This is a retrospective, cross-sectional study of cats (n = 39) that presented to a tertiary veterinary hospital in Argentina between June 2015 and December 2017 with blood creatinine concentrations >140 μmol/L, and abdominal ultrasound results consistent with CKD. Data recorded included venous partial pressure of CO2 (PvCO2), blood pH, haematocrit and concentrations of glucose, potassium, sodium, corrected sodium (Na+c), and ionised calcium in blood. A logistic regression model was used to assess associations between the presence of hypercapnia (PvCO2 ≥ 44.7 mmHg) and the other clinicopathologic variables. The duration of hospitalisation was compared in cats with and without hypercapnia using the Wilcoxon Rank Sum test. RESULTS The final study population comprised 39 cats. Eleven cats (28.2%) had hypercapnia. In the logistic regression model, two independent variables were associated with the presence of hypercapnia at admission in cats with CKD: the concentration of creatinine in blood (OR = 1.06 (95% CI = 1.016-1.108); p = 0.007) and Na+c (OR = 1.33 (95% CI = 1.08-1.63); p = 0.005). There were no statistically significant differences in the length of hospital stay between the two groups. CONCLUSIONS AND CLINICAL RELEVANCE There appears to be an association between elevated concentrations of creatinine and Na+c in blood, and hypercapnia in cats with CKD, suggesting careful assessment of blood gas and electrolyte parameters during hospitalisation is required. Further prospective studies are needed to evaluate the mechanisms behind this association and the association of hypercapnia with disease outcome including mortality.
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Affiliation(s)
- P A Donati
- UCICOOP, Ciudad Autónoma de Buenos Aires, Argentina.,Cátedra de Anestesiología y Algiología, Facultad de Ciencias Veterinarias, Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - L Londoño
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - G Benavides
- UCICOOP, Ciudad Autónoma de Buenos Aires, Argentina
| | - J Mouly
- Veterinaria del Sol, La Plata, Provincia de Buenos Aires, Argentina
| | - S González
- Cátedra de Patología Clínica y Enfermedades Médicas, Facultad de Ciencias Veterinarias, Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - P E Otero
- Cátedra de Anestesiología y Algiología, Facultad de Ciencias Veterinarias, Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
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Vincent AM, Okonkowski LK, Brudvig JM, Refsal KR, Berghoff N, Olivier NB, Langlois DK. Low-dose desoxycorticosterone pivalate treatment of hypoadrenocorticism in dogs: A randomized controlled clinical trial. J Vet Intern Med 2021; 35:1720-1728. [PMID: 34114259 PMCID: PMC8295656 DOI: 10.1111/jvim.16195] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 05/21/2021] [Accepted: 05/27/2021] [Indexed: 12/17/2022] Open
Abstract
Background Desoxycorticosterone pivalate (DOCP) is a commonly used mineralocorticoid replacement for dogs with primary hypoadrenocorticism (HA), but manufacturer‐recommended dosing protocols can be cost‐prohibitive. Recent reports also have raised concerns that label dose protocols could be excessive. Objective To investigate the relative efficacy and adverse effects of 2 DOCP dosages in dogs with primary glucocorticoid and mineralocorticoid deficient HA. Animals Thirty‐seven dogs, including 19 test population dogs and 18 controls. Methods Randomized controlled double‐blinded clinical trial. Dogs with newly diagnosed primary HA were assigned to standard (2.2 mg/kg q30d, control population) or low‐dose (1.1 mg/kg q30d, test population) DOCP treatment. Clinical and laboratory variables were assessed 10 to 14 days and approximately 30 days after each DOCP treatment for 90 days. Results Mean serum sodium to potassium ratios at reevaluations were ≥32 in both populations throughout the study. No dog developed electrolyte abnormalities warranting medical treatment, although hypokalemia occurred on at least 1 occasion in 9 controls and 6 test population dogs. Urine specific gravities (median, interquartile range) were lower in control dogs (1.022, 1.016‐1.029) as compared to test population dogs (1.033, 1.023‐1.039; P = .006). Plasma renin activity was overly suppressed on 84 of 104 (80.8%) assessments in control dogs whereas increased renin activity occurred on 23 of 112 (20.5%) assessments in test population dogs. Conclusions and Clinical Importance Low‐dose DOCP protocols appear to be safe and effective for treatment of HA in most dogs. Standard‐dose protocols are more likely to result in biochemical evidence of overtreatment.
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Affiliation(s)
- Alysha M Vincent
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan, USA
| | - Linda K Okonkowski
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan, USA
| | - Jean M Brudvig
- Veterinary Diagnostic Laboratory, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan, USA
| | - Kent R Refsal
- Department of Pathobiology and Diagnostic Investigation, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan, USA
| | - Nora Berghoff
- Veterinary Diagnostic Laboratory, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan, USA
| | - N Bari Olivier
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan, USA
| | - Daniel K Langlois
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan, USA
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Parker VJ. Nutritional Management for Dogs and Cats with Chronic Kidney Disease. Vet Clin North Am Small Anim Pract 2021; 51:685-710. [PMID: 33773648 DOI: 10.1016/j.cvsm.2021.01.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The nutritional management of canine and feline chronic kidney disease and protein-losing nephropathy is discussed. Special attention is paid to assessment of body composition (body weight, body condition score, and muscle condition score) and the dysrexia that often occurs with kidney disease. Various nutrients of concern are discussed and specific dietary options are provided.
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Affiliation(s)
- Valerie J Parker
- The Ohio State University, 601 Vernon L. Tharp Street, Columbus, OH 43210, USA.
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López-Torres O, Azpeitia-Martínez C, González-Gross M, Reihmane D, Guadalupe-Grau A. Multicomponent Home-Based Training Program for Chronic Kidney Disease Patients during Movement Restriction. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3416. [PMID: 33806120 PMCID: PMC8037906 DOI: 10.3390/ijerph18073416] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 03/18/2021] [Accepted: 03/19/2021] [Indexed: 12/12/2022]
Abstract
Both intradialytic and out-of-clinic exercise programs (EP) have been proven to be a safe and effective way to increase fitness levels in end-stage chronic kidney disease (CKD) patients. The actual COVID-19 pandemic situation has forced the suspension of EP offered in hemodialysis centers in many countries; as well as all activities considered as "non-essential" (i.e., sport facilities and fitness centers). Therefore, there is a high risk that movement restrictions would promote physical inactivity and its associated diseases in CKD patients; especially those undergoing domiciliary confinement situations. Given the importance for CKD patients' overall health to maintain exercise levels and reach physical activity recommendations, the aim of this Protocol was to design a personalized, well-structured, multicomponent physical EP that CKD patients can safely follow at home. We also aimed to provide an initial fitness evaluation tool that allows patients to adapt the EP to their fitness level. Current general exercise recommendations for people living with chronic conditions have been analyzed to develop the present home-based EP proposal.
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Affiliation(s)
- Olga López-Torres
- ImFINE Research Group, Health and Human Performance Department, Facultad de Ciencias de la Actividad Física y del Deporte-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (C.A.-M.); (M.G.-G.); (A.G.-G.)
| | - Celia Azpeitia-Martínez
- ImFINE Research Group, Health and Human Performance Department, Facultad de Ciencias de la Actividad Física y del Deporte-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (C.A.-M.); (M.G.-G.); (A.G.-G.)
| | - Marcela González-Gross
- ImFINE Research Group, Health and Human Performance Department, Facultad de Ciencias de la Actividad Física y del Deporte-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (C.A.-M.); (M.G.-G.); (A.G.-G.)
| | - Dace Reihmane
- Department of Human Physiology and Biochemistry, Riga Stradiņš University, Dzirciema Street 16, LV-1007 Riga, Latvia;
| | - Amelia Guadalupe-Grau
- ImFINE Research Group, Health and Human Performance Department, Facultad de Ciencias de la Actividad Física y del Deporte-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (C.A.-M.); (M.G.-G.); (A.G.-G.)
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Schmitz KL, Jeffery U, Heinz JA, Rutter CR. Evaluation of two benchtop blood gas analyzers for measurement of electrolyte concentrations in venous blood samples from dogs. Am J Vet Res 2021; 82:105-109. [PMID: 33480275 DOI: 10.2460/ajvr.82.2.105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To assess agreement between 2 benchtop blood gas analyzers developed by 1 manufacturer (BGA 1 and BGA 2 [a newer model with reduced maintenance requirements]) and a reference chemistry analyzer for measurement of electrolyte (sodium, chloride, and potassium) in blood samples from dogs. ANIMALS 17 healthy staff- and student-owned dogs and 23 client-owned dogs admitted to an emergency and intensive care service. PROCEDURES Blood collected by venipuncture was placed in lithium heparin-containing tubes. Aliquots were analyzed immediately with each BGA. Samples were centrifuged, and plasma was analyzed with the reference analyzer. Results for each BGA were compared with results for the reference analyzer by Passing-Bablok regression analysis. Percentage differences between BGA and reference analyzer results were compared with published guidelines for total allowable error. RESULTS Proportional bias was detected for measurement of chloride concentration (slope, 0.7; 95% CI, 0.7 to 0.8), and constant positive bias was detected for measurement of chloride (y-intercept, 34, mmol/L; 95% CI, 16.9 to 38 mmol/L) and potassium (y-intercept, 0.1 mmol/L; 95% CI, 0.1 to 0.2 mmol/L) concentrations with BGA 1. There was no significant bias for measurement of potassium or chloride concentration with BGA 2 or sodium concentration with either BGA. Differences from the reference analyzer result exceeded total allowable error guidelines for ≥ 1 sample/analyte/BGA, but median observed measurement differences between each BGA and the reference analyzer did not. CONCLUSIONS AND CLINICAL RELEVANCE Good agreement with reference analyzer results was found for measurement of the selected electrolyte concentrations in canine blood samples with each BGA.
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Othmène YB, Hamdi H, Salem IB, Annabi E, Amara I, Neffati F, Najjar MF, Abid-Essefi S. Oxidative stress, DNA damage and apoptosis induced by tebuconazole in the kidney of male Wistar rat. Chem Biol Interact 2020; 330:109114. [PMID: 32735800 DOI: 10.1016/j.cbi.2020.109114] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 04/03/2020] [Accepted: 04/22/2020] [Indexed: 12/18/2022]
Abstract
Tebuconazole (TEB) is a broad-spectrum conazole fungicide that has been used in agriculture in the control of foliar and soil-borne diseases of many crops. The present study has investigated the adverse effects of subchronic exposure to TEB on the kidney of male rats. Animals were divided into four equal groups and treated with TEB at increasing doses 0.9, 9 and 27 mg/kg body weight for 28 consecutive days. The results showed that TEB induced oxidative stress in the kidney demonstrated by an increase in malondialdehyde (MDA), protein carbonyl (PC), advanced oxidation protein product (AOPP) levels and DNA damage, as compared to the controls. Furthermore, superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx) activities were increased in the renal tissue of treated rats. Moreover, significant decrease in reduced glutathione (GSH) content in TEB-treated rats was observed, while oxidized glutathione (GSSG) levels were increased, thus a marked fall in GSH/GSSG ratio was registered in the kidney. Glutathione reductase (GR) activity showed a significant increase after TEB exposure. Moreover, TEB down-regulated the expression of Bcl2 and up-regulated the expression of Bax and caspase 3, which triggered apoptosis via the Bax/Bcl2 and caspase pathway. Also, TEB administration resulted in altered biochemical indicators of renal function and varying lesions in the overall histo-architecture of renal tissues. Taken together, our findings brought into light the renal toxicity induced by TEB, which was found to be significant at low doses.
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Affiliation(s)
- Yosra Ben Othmène
- University of Monastir, Faculty of Dental Medicine of Monastir, Laboratory for Research on Biologically Compatible Compounds, LR01SE17, Rue Avicenne, 5000, Monastir, Tunisia
| | - Hiba Hamdi
- University of Monastir, Faculty of Dental Medicine of Monastir, Laboratory for Research on Biologically Compatible Compounds, LR01SE17, Rue Avicenne, 5000, Monastir, Tunisia
| | - Intidhar Ben Salem
- University of Monastir, Faculty of Dental Medicine of Monastir, Laboratory for Research on Biologically Compatible Compounds, LR01SE17, Rue Avicenne, 5000, Monastir, Tunisia; University of Sousse, Faculty of Medicine of Sousse, Rue Mohamed Karoui, 4000, Tunisia
| | - Emna Annabi
- University of Monastir, Faculty of Dental Medicine of Monastir, Laboratory for Research on Biologically Compatible Compounds, LR01SE17, Rue Avicenne, 5000, Monastir, Tunisia
| | - Ines Amara
- University of Monastir, Faculty of Dental Medicine of Monastir, Laboratory for Research on Biologically Compatible Compounds, LR01SE17, Rue Avicenne, 5000, Monastir, Tunisia
| | - Fadwa Neffati
- Fattouma Bourguiba University Hospital, Laboratory of Biochemistry-Toxicology, Avenue 1 Juin 1955, 5000, Monastir, Tunisia
| | - Mohamed Fadhel Najjar
- Fattouma Bourguiba University Hospital, Laboratory of Biochemistry-Toxicology, Avenue 1 Juin 1955, 5000, Monastir, Tunisia
| | - Salwa Abid-Essefi
- University of Monastir, Faculty of Dental Medicine of Monastir, Laboratory for Research on Biologically Compatible Compounds, LR01SE17, Rue Avicenne, 5000, Monastir, Tunisia.
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Geraldes SS, Le Sueur ANV, Sant'Ana PB, de Azevedo MGP, Takahira RK, Melchert A, Lourenço MLG, Mamprim MJ, Guimarães-Okamoto PTC. The Effect of Intermittent Hemodialysis on the Hematological and Serum Biochemistry Profile in Dogs With Chronic Kidney Disease. Top Companion Anim Med 2019; 38:100389. [PMID: 32115078 DOI: 10.1016/j.tcam.2019.100389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 11/21/2019] [Accepted: 11/22/2019] [Indexed: 11/15/2022]
Abstract
Intermittent hemodialysis (IHD) is a type of kidney replacement therapy commonly prescribed in veterinary medicine for cases of drug removal, fluid, acid-base, and electrolyte disorders, acute kidney injury, and cases of chronic kidney disease (CKD) in uremic crisis. This study aimed to evaluate the effects of intermittent hemodialysis in dogs with IRIS stage 4 CKD in contrast to dogs treated only with standard medical management, without dialysis, to improve their quality of life. Twenty-five dogs previously diagnosed with IRIS stage 4 CKD were selected for the study according to the inclusion criteria. Dogs were randomized to 2 distinct groups: the control group (n = 11), which underwent a conventional clinical treatment for CKD; and the hemodialysis group (n = 14), which underwent intermittent hemodialysis in addition to the clinical treatment. Both groups had a period of 15 days of clinical and laboratory evaluation. Laboratory analysis consisted of chemistry and hematological evaluation before and after both treatments at a minimum interval of 48 hours. Clinical parameters and eventual complications were assessed every 30 minutes during the IHD. When compared with conventional treatment, IHD was highly efficient in removing urea, creatinine, and phosphorus, but presented a hematological risk to the patient, requiring constant monitoring of hematological and biochemical profiles in order to correct alterations. Therefore, IHD is a highly recommended treatment if adequately monitored by trained professionals.
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Affiliation(s)
- Silvano Salgueiro Geraldes
- Department of Veterinary Clinics, School of Veterinary Medicine and Animal Science, São Paulo State University - UNESP, São Paulo, SP, Brazil
| | - André Nanny Vieira Le Sueur
- Department of Veterinary Clinics, School of Veterinary Medicine and Animal Science, São Paulo State University - UNESP, São Paulo, SP, Brazil
| | - Paula Bilbau Sant'Ana
- Department of Veterinary Clinics, School of Veterinary Medicine and Animal Science, São Paulo State University - UNESP, São Paulo, SP, Brazil
| | - Maria Gabriela Picelli de Azevedo
- Department of Veterinary Clinics, School of Veterinary Medicine and Animal Science, São Paulo State University - UNESP, São Paulo, SP, Brazil
| | - Regina Kiomi Takahira
- Department of Veterinary Clinics, School of Veterinary Medicine and Animal Science, São Paulo State University - UNESP, São Paulo, SP, Brazil
| | - Alessandra Melchert
- Department of Veterinary Clinics, School of Veterinary Medicine and Animal Science, São Paulo State University - UNESP, São Paulo, SP, Brazil
| | - Maria Lucia G Lourenço
- Department of Veterinary Clinics, School of Veterinary Medicine and Animal Science, São Paulo State University - UNESP, São Paulo, SP, Brazil
| | - Maria Jaqueline Mamprim
- Department of Animal Reproduction and Veterinary Radiology, School of Veterinary Medicine and Animal Science, São Paulo State University - UNESP, São Paulo, SP, Brazil
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18
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Sharp CR, deLaforcade AM, Koenigshof AM, Lynch AM, Thomason JM. Consensus on the Rational Use of Antithrombotics in Veterinary Critical Care (CURATIVE): Domain 4-Refining and monitoring antithrombotic therapies. J Vet Emerg Crit Care (San Antonio) 2019; 29:75-87. [PMID: 30654420 DOI: 10.1111/vec.12794] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 12/08/2018] [Indexed: 01/22/2023]
Abstract
OBJECTIVES To systematically review the evidence for therapeutic monitoring of antithrombotic drugs in small animals, develop guidelines regarding antithrombotic monitoring, and identify knowledge gaps in the field. DESIGN First, a standardized, systematic literature review was conducted to address predefined PICO (Population/Patient, Intervention, Control, Outcome) questions, with categorization of relevant articles according to level of evidence and quality. Preliminary guidelines were developed by PICO worksheet authors and the domain chair. Thereafter, a Delphi-style survey was used to develop consensus on guidelines regarding therapeutic monitoring of antithrombotics in dogs and cats. SETTING Academic and referral veterinary medical centers. RESULTS PICO questions regarding the utility of therapeutic monitoring were developed for 6 different antithrombotic drugs or drug classes, including aspirin, clopidogrel, warfarin, unfractionated heparin, the low molecular weight heparins, and rivaroxaban, The majority of the literature pertaining to therapeutic monitoring of antithrombotic drugs was either performed in experimental animal models of disease or involved studies of drug pharmacokinetics and pharmacodynamics in healthy laboratory animals. There was a paucity of high level of evidence studies directly addressing the PICO questions, which limited the strength of recommendations that could be provided. The final guidelines recommend that therapeutic monitoring should be performed when using warfarin or unfractionated heparin in dogs and cats at risk of thrombosis. There is insufficient evidence to make strong recommendations for therapeutic monitoring of aspirin or low molecular weight heparin in dogs and cats at this time. CONCLUSIONS As in other CURATIVE domains, significant knowledge gaps were highlighted, indicating the need for substantial additional research in this field. Ongoing investigation of the role of therapeutic monitoring of antithrombotic therapies will undoubtedly facilitate improved outcomes for dogs and cats at risk of thrombosis.
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Affiliation(s)
- Claire R Sharp
- School of Veterinary and Life Sciences, Murdoch University, Murdoch, WA, Australia
| | - Armelle M deLaforcade
- Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, MA
| | - Amy M Koenigshof
- College of Veterinary Medicine, Michigan State University, East Lansing, MI
| | - Alex M Lynch
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC
| | - John M Thomason
- Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, MS
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19
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Karunanithy M, Thakur N, Dey S. Prevalence of renal disorders in dogs of Bareilly area of Uttar Pradesh, India. BIOL RHYTHM RES 2019. [DOI: 10.1080/09291016.2019.1587840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
| | - Neeraj Thakur
- Division of Medicine, ICAR-Indian Veterinary Research Institute, Bareilly, India
| | - Sahadeb Dey
- Division of Medicine, ICAR-Indian Veterinary Research Institute, Bareilly, India
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20
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Jazani NH, Savoj J, Lustgarten M, Lau WL, Vaziri ND. Impact of Gut Dysbiosis on Neurohormonal Pathways in Chronic Kidney Disease. Diseases 2019; 7:diseases7010021. [PMID: 30781823 PMCID: PMC6473882 DOI: 10.3390/diseases7010021] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 01/29/2019] [Accepted: 02/08/2019] [Indexed: 02/06/2023] Open
Abstract
Chronic kidney disease (CKD) is a worldwide major health problem. Traditional risk factors for CKD are hypertension, obesity, and diabetes mellitus. Recent studies have identified gut dysbiosis as a novel risk factor for the progression CKD and its complications. Dysbiosis can worsen systemic inflammation, which plays an important role in the progression of CKD and its complications such as cardiovascular diseases. In this review, we discuss the beneficial effects of the normal gut microbiota, and then elaborate on how alterations in the biochemical environment of the gastrointestinal tract in CKD can affect gut microbiota. External factors such as dietary restrictions, medications, and dialysis further promote dysbiosis. We discuss the impact of an altered gut microbiota on neuroendocrine pathways such as the hypothalamus⁻pituitary⁻adrenal axis, the production of neurotransmitters and neuroactive compounds, tryptophan metabolism, and the cholinergic anti-inflammatory pathway. Finally, therapeutic strategies including diet modification, intestinal alpha-glucosidase inhibitors, prebiotics, probiotics and synbiotics are reviewed.
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Affiliation(s)
- Nima H Jazani
- Division of Nephrology, Department of Medicine, University of California-Irvine, Irvine, CA 92697, USA.
| | - Javad Savoj
- Department of Internal Medicine, Riverside Community Hospital, University of California-Riverside School of Medicine, Riverside, CA 92501, USA.
| | - Michael Lustgarten
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA 02111, USA.
| | - Wei Ling Lau
- Division of Nephrology, Department of Medicine, University of California-Irvine, Irvine, CA 92697, USA.
| | - Nosratola D Vaziri
- Division of Nephrology, Department of Medicine, University of California-Irvine, Irvine, CA 92697, USA.
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21
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Abstract
Chronic kidney disease (CKD) is an inherently systemic disease that refers to a long-term loss of kidney function. The progression of CKD has repercussions for other organs, leading to many kinds of extrarenal complications. Intensive studies are now being undertaken to reveal the risk factors and pathophysiological mechanism of this disease. During the past 20 years, increasing evidence from clinical and basic studies has indicated that klotho, which was initially known as an anti-aging gene and is mainly expressed in the kidney, is significantly correlated with the development and progression of CKD and its complications. Here, we discuss in detail the role and pathophysiological implications of klotho in ion disorders, the inflammation response, vascular calcification, mineral bone disorders, and renal fibrosis in CKD. Based on the pathogenic mechanism of klotho deficiency and klotho decline in urine early in CKD stage 2 and even earlier in CKD stage 1, it is not difficult to understand that soluble klotho can serve as an early and sensitive marker of CKD. Moreover, the prevention of klotho decline by several mechanisms can attenuate renal injuries, retard CKD progression, ameliorate extrarenal complications, and improve renal function. In this review, we focus on the functions and pathophysiological implications of klotho in CKD and its extrarenal complications as well as its potential applications as a diagnostic and/or prognostic biomarker for CKD and as a novel treatment strategy to improve and decrease the burden of comorbidity in CKD.
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22
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Cury MFR, Olivares EQ, Garcias RC, Toledo GQ, Anselmo NA, Paskakulis LC, Botelho FFR, Carvalho NZ, Silva AAD, Agren C, Carlos CP. Inflammation and kidney injury attenuated by prior intake of Brazil nuts in the process of ischemia and reperfusion. ACTA ACUST UNITED AC 2018; 40:312-318. [PMID: 30118536 PMCID: PMC6533994 DOI: 10.1590/2175-8239-jbn-2018-0016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Accepted: 06/11/2018] [Indexed: 12/13/2022]
Abstract
Introduction: Ischemia and reperfusion (IR) is a process inherent to the procedures
involved in the transplantation of organs that causes inflammation, cell
death and cell injury, and may lead to rejection of the graft. It is
possible that the anti-inflammatory properties of the Brazil nuts (BN) can
mitigate the renal injury caused by IR. Objective: To investigate whether the previous intake of BN reduces the expression of
markers of inflammation, injury, and cell death after renal IR. Methods: Male Wistar rats were distributed into six groups (N = 6/group): SHAM
(control), SHAM treated with 75 or 150 mg of BN, IR, and IR treated with 75
or 150 mg of BN. The IR procedure consisted of right nephrectomy and
occlusion of the left renal artery with a non-traumatic vascular clamp for
30 min. BN was given daily from day 1 to 7 before surgery (SHAM or IR), and
maintained until sacrifice (48 h after surgery). Inflammation was evaluated
by renal expression of COX-2 and TGF-β, injury by the expression of
vimentin, and cell death by apoptosis through caspase-3 expression
(immunohistochemistry). Results: Pretreatment with 75 mg of BN reduced renal expression of the COX-2, TGF-β,
vimentin, and caspase-3. The dose of 150 mg caused increased expression of
COX-2. Conclusion: In experimental IR, the damage can be minimized with a prior low-dose intake
of BN, improving inflammation, injury, and cell death.
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Affiliation(s)
| | - Estéfany Queiroz Olivares
- Laboratório de Pesquisa Experimental, FACERES Faculdade de Medicina, São José do Rio Preto, SP, Brasil
| | - Renata Correia Garcias
- Laboratório de Pesquisa Experimental, FACERES Faculdade de Medicina, São José do Rio Preto, SP, Brasil
| | - Giovana Queda Toledo
- Laboratório de Pesquisa Experimental, FACERES Faculdade de Medicina, São José do Rio Preto, SP, Brasil
| | - Natassia Alberici Anselmo
- Laboratório de Pesquisa Experimental, FACERES Faculdade de Medicina, São José do Rio Preto, SP, Brasil
| | | | | | - Natiele Zanardo Carvalho
- Laboratório de Pesquisa Experimental, FACERES Faculdade de Medicina, São José do Rio Preto, SP, Brasil
| | - Analice Andreoli da Silva
- Laboratório de Pesquisa Experimental, FACERES Faculdade de Medicina, São José do Rio Preto, SP, Brasil
| | - Camila Agren
- Laboratório de Pesquisa Experimental, FACERES Faculdade de Medicina, São José do Rio Preto, SP, Brasil
| | - Carla Patrícia Carlos
- Laboratório de Pesquisa Experimental, FACERES Faculdade de Medicina, São José do Rio Preto, SP, Brasil
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23
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Anselmo NA, Paskakulis LC, Garcias RC, Botelho FFR, Toledo GQ, Cury MFR, Carvalho NZ, Mendes GEF, Iembo T, Bizotto TSG, Cury PM, Chies AB, Carlos CP. Prior intake of Brazil nuts attenuates renal injury induced by ischemia and reperfusion. ACTA ACUST UNITED AC 2018; 40:10-17. [PMID: 29796584 PMCID: PMC6533976 DOI: 10.1590/1678-46a85-jbn-3819] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Accepted: 08/30/2017] [Indexed: 12/13/2022]
Abstract
Introduction: Ischemia-reperfusion (IR) injury results from inflammation and oxidative
stress, among other factors. Because of its anti-inflammatory and
antioxidant properties, the Brazil nut (BN) might attenuate IR renal
injury. Objective: The aim of the present study was to investigate whether the intake of BN
prevents or reduces IR kidney injury and inflammation, improving renal
function and decreasing oxidative stress. Methods: Male Wistar rats were distributed into six groups (N=6/group): SHAM
(control), SHAM treated with 75 or 150 mg of BN, IR, and IR treated with 75
or 150 mg of BN. The IR procedure consisted of right nephrectomy and
occlusion of the left renal artery with a non-traumatic vascular clamp for
30 min. BN was given daily and individually for 7 days before surgery (SHAM
or IR) and maintained until animal sacrifice (48h after surgery). We
evaluated the following parameters: plasma creatinine, urea, and phosphorus;
proteinuria, urinary output, and creatinine clearance; plasmatic TBARS and
TEAC; kidney expression of iNOS and nitrotyrosine, and macrophage
influx. Results: Pre-treatment with 75 mg of BN attenuated IR-induced renal changes, with
elevation of creatinine clearance and urinary output, reducing proteinuria,
urea, and plasmatic phosphorus as well as reducing kidney expression of
iNOS, nitrotyrosine, and macrophage influx. Conclusion: Low intake of BN prior to IR-induced kidney injury improves renal function by
inhibition of macrophage infiltration and oxidative stress.
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Affiliation(s)
- Natassia Alberici Anselmo
- Faculdade de Medicina de São José do Rio Preto - FACERES, Laboratório de Pesquisa Experimental, São José do Rio Preto, SP, Brasil
| | - Leticia Colombo Paskakulis
- Faculdade de Medicina de São José do Rio Preto - FACERES, Laboratório de Pesquisa Experimental, São José do Rio Preto, SP, Brasil
| | - Renata Correia Garcias
- Faculdade de Medicina de São José do Rio Preto - FACERES, Laboratório de Pesquisa Experimental, São José do Rio Preto, SP, Brasil
| | - Fernanda Fortuci Resende Botelho
- Faculdade de Medicina de São José do Rio Preto - FACERES, Laboratório de Pesquisa Experimental, São José do Rio Preto, SP, Brasil
| | - Giovana Queda Toledo
- Faculdade de Medicina de São José do Rio Preto - FACERES, Laboratório de Pesquisa Experimental, São José do Rio Preto, SP, Brasil
| | - Maria Fernanda Ribeiro Cury
- Faculdade de Medicina de São José do Rio Preto - FACERES, Laboratório de Pesquisa Experimental, São José do Rio Preto, SP, Brasil
| | - Natiele Zanardo Carvalho
- Faculdade de Medicina de São José do Rio Preto - FACERES, Laboratório de Pesquisa Experimental, São José do Rio Preto, SP, Brasil
| | - Glória Elisa Florido Mendes
- Faculdade de Medicina de São José do Rio Preto - FACERES, Laboratório de Pesquisa Experimental, São José do Rio Preto, SP, Brasil
| | - Tatiane Iembo
- Faculdade de Medicina de São José do Rio Preto - FACERES, Laboratório de Pesquisa Experimental, São José do Rio Preto, SP, Brasil
| | - Thaís Santana Gastardelo Bizotto
- Faculdade de Medicina de São José do Rio Preto - FACERES, Laboratório de Pesquisa Experimental, São José do Rio Preto, SP, Brasil
| | - Patricia Maluf Cury
- Faculdade de Medicina de São José do Rio Preto - FACERES, Laboratório de Pesquisa Experimental, São José do Rio Preto, SP, Brasil
| | - Agnaldo Bruno Chies
- Faculdade de Medicina de Marília, Laboratório de Farmacologia, Marília, SP, Brasil
| | - Carla Patrícia Carlos
- Faculdade de Medicina de São José do Rio Preto - FACERES, Laboratório de Pesquisa Experimental, São José do Rio Preto, SP, Brasil
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24
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Foster JD, Drobatz KJ, Cowgill LD. Associations between dialysate sodium concentration and plasma sodium concentration of dogs receiving intermittent hemodialysis treatments. Am J Vet Res 2018; 79:450-454. [PMID: 29583052 DOI: 10.2460/ajvr.79.4.450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To compare dialysate sodium concentration and patient plasma sodium concentration of dogs during intermittent hemodialysis treatments. SAMPLE 211 intermittent hemodialysis treatments performed on 40 client-owned dogs for the management of dialysis-dependent uremia. PROCEDURES Medical records were reviewed to determine the plasma sodium concentration of each dog before and after routine hemodialysis treatments. Associations between detected changes in plasma sodium concentration and dialysate sodium concentration were evaluated by use of Spearman rank correlations and linear regression analysis. RESULTS Significant linear correlations were found between the dialysate sodium concentration and patient sodium concentration. The starting dialysate-to-patient sodium gradient was associated with the strongest correlation to the change in patient sodium concentration at the end of the dialysis session. Modest correlations existed between the dialysate sodium concentration and postdialysis patient sodium concentration as well as between the predialysis dialysate-to-patient sodium gradient and postdialysis dialysate-to-patient sodium gradient. CONCLUSIONS AND CLINICAL RELEVANCE The dialysate sodium concentration was correlated with the patient sodium concentration in dogs, and the dialysate-to-patient sodium gradient could be used to further refine this association to predict the postdialysis patient sodium concentration and potentially manage dysnatremia during hemodialysis. Prospective studies should be performed to determine how these associations can be used to correct aberrations as well as to avoid unwanted alterations in patient sodium concentrations.
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25
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Yang F, Zhou L, Qian X, Wang D, He WJ, Tang ZW, Yin J, Huang QY. Adropin Is a Key Mediator of Hypoxia Induced Anti-Dipsogenic Effects via TRPV4-CamKK-AMPK Signaling in the Circumventricular Organs of Rats. Front Mol Neurosci 2017; 10:105. [PMID: 28473751 PMCID: PMC5397471 DOI: 10.3389/fnmol.2017.00105] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Accepted: 03/27/2017] [Indexed: 12/19/2022] Open
Abstract
Water intake reduction (anti-dipsogenic effects) under hypoxia has been well established, but the underlying reason remains unknown. Our previous report indicated that activated TRPV4 neurons in SFO are associated with anti-dipsogenic effects under hypoxia. Although low partial pressure of blood oxygen directly activates TRPV4, humoral factors could also be involved. In the present study, we hypothesize that adropin, a new endogenous peptide hormone, was rapidly increased (serum and brain) concomitant with reduced water intake in early hypoxia. Also, the nuclear expression of c-Fos, a marker for neuronal activation, related to water-consumption (SFO and MnPO) was inhibited. These effects were mitigated by a scavenger, rat adropin neutralizing antibody, which effectively neutralized adropin under hypoxia. Interestingly, injection of recombinant adropin in the third ventricle of the rats also triggered anti-dipsogenic effects and reduced c-Fos positive cells in SFO, but these effects were absent when TRPV4 was knocked down by shRNA. Moreover, adropin-activated CamKK-AMPK signaling related to TRPV4 calcium channel in SFO in normoxia. These results revealed that dissociative adropin was elevated in acute hypoxia, which was responsible for anti-dipsogenic effects by altering TRPV4-CamKK-AMPK signaling in SFO.
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Affiliation(s)
- Fan Yang
- Department of Pathophysiology and High Altitude Pathology, College of High Altitude Military Medicine, Third Military Medical UniversityChongqing, China.,Key Laboratory of High Altitude Medicine, Third Military Medical University, Ministry of EducationChongqing, China.,Key Laboratory of High Altitude Medicine, PLA, Third Military Medical UniversityChongqing, China
| | - Li Zhou
- Department of Pharmacy, Xinqiao Hospital and The Second Affiliated Hospital, The Third Military Medical UniversityChongqing, China
| | - Xu Qian
- Ba Gong li Sanatorium, The Chinese People's Liberation Army 77200 TroopsKunming, China
| | - Dong Wang
- Department of Pathophysiology and High Altitude Pathology, College of High Altitude Military Medicine, Third Military Medical UniversityChongqing, China.,Key Laboratory of High Altitude Medicine, Third Military Medical University, Ministry of EducationChongqing, China.,Key Laboratory of High Altitude Medicine, PLA, Third Military Medical UniversityChongqing, China
| | - Wen-Juan He
- Department of Pathophysiology and High Altitude Pathology, College of High Altitude Military Medicine, Third Military Medical UniversityChongqing, China.,Key Laboratory of High Altitude Medicine, Third Military Medical University, Ministry of EducationChongqing, China.,Key Laboratory of High Altitude Medicine, PLA, Third Military Medical UniversityChongqing, China
| | - Zhong-Wei Tang
- Department of Pathophysiology and High Altitude Pathology, College of High Altitude Military Medicine, Third Military Medical UniversityChongqing, China.,Key Laboratory of High Altitude Medicine, Third Military Medical University, Ministry of EducationChongqing, China.,Key Laboratory of High Altitude Medicine, PLA, Third Military Medical UniversityChongqing, China
| | - Jun Yin
- Department of Pathophysiology and High Altitude Pathology, College of High Altitude Military Medicine, Third Military Medical UniversityChongqing, China.,Key Laboratory of High Altitude Medicine, Third Military Medical University, Ministry of EducationChongqing, China.,Key Laboratory of High Altitude Medicine, PLA, Third Military Medical UniversityChongqing, China
| | - Qing-Yuan Huang
- Department of Pathophysiology and High Altitude Pathology, College of High Altitude Military Medicine, Third Military Medical UniversityChongqing, China.,Key Laboratory of High Altitude Medicine, Third Military Medical University, Ministry of EducationChongqing, China.,Key Laboratory of High Altitude Medicine, PLA, Third Military Medical UniversityChongqing, China
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