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Niinomi I, Oyama S, Inada A, Wakabayashi T, Iida T, Kambara H, Uchida M, Sano Y, Hosohata K. Current Status of Adverse Event Profile of Cyclosporine in Kidney, Stem Cell, and Heart Transplantations Using the Japanese Pharmacovigilance Database. Cureus 2022; 14:e29383. [PMID: 36159360 PMCID: PMC9490292 DOI: 10.7759/cureus.29383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2022] [Indexed: 11/18/2022] Open
Abstract
Background: Cyclosporine is widely used to prevent allograft rejection after transplantation. The purpose of this study was to clarify the adverse events profiles associated with cyclosporine in transplant patients using a spontaneous reporting system database. Methods: Retrospective pharmacovigilance disproportionality analysis was conducted using the Japanese Adverse Drug Event Report (JADER) database, with the reporting odds ratio (ROR) and 95% confidence interval (CI) for each adverse event. Results: The database comprised 3,327, 958, and 956 reports associated with cyclosporine in the kidney, stem cell, and heart transplant patients, respectively. Infectious and renal disorders were commonly detected in these transplant patients. The signal scores of cyclosporine for toxic nephropathy were noteworthy in the kidney (ROR: 15.1, 95% CI: 11-20.8) and stem cell (ROR, 216; 95% CI, 29.3-1593) transplantation. Cyclosporine in heart transplantation was strongly associated with gastric cancer (ROR, 39.4; 95% CI, 16.7-93.2), but not kidney or stem cell transplantation. Conclusion: It was suggested that there is a diversity in the strength of the association between cyclosporine and adverse events in the kidney, stem cell, and heart transplantation. Our results may provide useful information for treatment with cyclosporine, although further research with more data is needed.
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Molaei E, Molaei A, Abedi F, Hayes AW, Karimi G. Nephroprotective activity of natural products against chemical toxicants: The role of Nrf2/ARE signaling pathway. Food Sci Nutr 2021; 9:3362-3384. [PMID: 34136201 PMCID: PMC8194945 DOI: 10.1002/fsn3.2320] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 04/15/2021] [Accepted: 04/19/2021] [Indexed: 12/18/2022] Open
Abstract
Nephropathy can occur following exposure of the kidneys to oxidative stress. Oxidative stress is the result of reactive oxygen species (ROS) formation due to intracellular catabolism or exogenous toxicant exposure. Many natural products (NPs) with antioxidant properties have been used to demonstrate that oxidative damage-induced nephrotoxicity can be ameliorated or at least reduced through stimulation of the nuclear factor erythroid 2-related factor 2 (Nrf2) signaling pathway. Nrf2 is a basic leucine zipper (bZip) transcription factor that regulates gene expression of the antioxidant response elements (ARE). Nrf2 is involved in the cellular antioxidant-detoxification machinery. Nrf2 activation is a major mechanism of nephroprotective activity for these NPs, which facilitates its entry into the nucleus, primarily by inhibiting Kelch like-ECH-associated protein 1 (Keap1). The purpose of this article was to review the peer-reviewed literature of NPs that have shown mitigating effects on renal disorder by stimulating Nrf2 and thereby suggesting potential new therapeutic or prophylactic strategies against kidney-damaging xenobiotics.
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Affiliation(s)
- Emad Molaei
- Faculty of PharmacyMashhad University of Medical SciencesMashhadIran
| | - Ali Molaei
- Faculty of MedicineMashhad University of Medical SciencesMashhadIran
| | - Farshad Abedi
- Faculty of PharmacyMashhad University of Medical SciencesMashhadIran
| | | | - Gholamreza Karimi
- Pharmaceutical Research CenterInstitute of Pharmaceutical TechnologyMashhad University of Medical SciencesMashhadIran
- Department of Pharmacodynamics and ToxicologyFaculty of PharmacyMashhad University of Medical SciencesMashhadIran
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3
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Sun W, Min B, Du D, Yang F, Meng J, Wang W, Zhao J, Tan X, Li Z, Sun J. miR-181c protects CsA-induced renal damage and fibrosis through inhibiting EMT. FEBS Lett 2017; 591:3588-3599. [PMID: 28976551 DOI: 10.1002/1873-3468.12872] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 09/17/2017] [Accepted: 09/26/2017] [Indexed: 01/09/2023]
Abstract
Cyclosporine A (CsA), a widely used immunosuppressive drug in organ transplantation and autoimmune disorders, frequently induces renal damage and fibrosis. Recent evidence has implicated epithelial-mesenchymal transition (EMT) in CsA-induced nephrotoxicity. Microarray analysis disclosed miR-181c as the microRNA most dramatically repressed by CsA. Downregulation of miR-181c expression at the transcriptional level by CsA is dependent on the transcription factor Nrf2. miR-181c mimics or inhibitors attenuate or aggravate CsA-induced EMT gene changes, respectively. Importantly, in Nrf2-/- mice, CsA-induced renal damage, fibrosis, and EMT gene changes are restored by miR-181c mimics. Mechanistically, we identified Notch2 as a potential target of miR-181c. Collectively, our data support the notion that miR-181c may serve as an important factor for protecting renal tissues from CsA-induced nephrotoxicity.
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Affiliation(s)
- Wenjuan Sun
- Nephrology Division, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China
| | - Binying Min
- Department of Ultrasound, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China
| | - Dewei Du
- Nephrology Division, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China
| | - Feng Yang
- Nephrology Division, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China
| | - Junping Meng
- Nephrology Division, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China
| | - Wen Wang
- Nephrology Division, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China
| | - Jie Zhao
- Nephrology Division, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China
| | - Xiaomeng Tan
- Nephrology Division, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China
| | - Zhanting Li
- Nephrology Division, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China
| | - Jifeng Sun
- Nephrology Division, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China
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4
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Lai Q, Wei J, Mahmoodurrahman M, Zhang C, Quan S, Li T, Yu Y. Pharmacokinetic and nephroprotective benefits of using Schisandra chinensis extracts in a cyclosporine A-based immune-suppressive regime. Drug Des Devel Ther 2015; 9:4997-5018. [PMID: 26355803 PMCID: PMC4560515 DOI: 10.2147/dddt.s89876] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Cyclosporine A (CsA) is a powerful immunosuppressive drug. However, nephrotoxicity resulting from its long-term usage has hampered its prolonged therapeutic usage. Schisandra chinensis extracts (SCE) have previously been used in traditional Chinese medicine and more recently coadministered with Western medicine for the treatment of CsA-induced side effects in the People’s Republic of China. This study aimed to investigate the possible effects of SCE on the pharmacokinetics of CsA in rats and elucidate the potential mechanisms by which it hinders the development of CsA-induced nephrotoxicity. A liquid chromatography/tandem mass spectrometry method was developed and validated for determining the effect of SCE on the pharmacokinetics of CsA. Male Sprague Dawley rats, which were administered with CsA (25 mg/kg/d) alone or in combination with SCE (54 mg/kg/d and 108 mg/kg/d) for 28 days, were used to evaluate the nephroprotective effects of SCE. Our study showed that SCE increased the mean blood concentration of CsA. Furthermore, we found that the concomitant administration of SCE alongside CsA prevented the disruption of catalase activity and reduction in creatinine, urea, renal malondialdehyde, and glutathione peroxidase levels that would have otherwise occurred in the absence of SCE administration. SCE treatment markedly suppressed the expression of 4-hydroxynonenal, Bcl-2-associated X protein, cleaved caspase 3, and autophagy-related protein LC3 A/B. On the other hand, the expression of heme oxygenase-1, nuclear factor erythroid 2-related factor 2 (Nrf2), and P-glycoprotein was enhanced by the very same addition of SCE. SCE was also able to increase the systemic exposure of CsA in rats. The renoprotective effects of SCE were thought to be mediated by its antiapoptotic and antioxidant abilities, which caused the attenuation of CsA-induced autophagic cell death. All in all, these findings suggest the prospective use of SCE as an effective adjunct in a CsA-based immunosuppressive regimen.
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Affiliation(s)
- Qiao Lai
- Department of Formulas of Traditional Chinese Medicine, School of Chinese Materia Medica, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, People's Republic of China
| | - Jiabao Wei
- Department of Formulas of Traditional Chinese Medicine, School of Chinese Materia Medica, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, People's Republic of China
| | | | - Chenxue Zhang
- Department of Formulas of Traditional Chinese Medicine, School of Chinese Materia Medica, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, People's Republic of China
| | - Shijian Quan
- Department of Formulas of Traditional Chinese Medicine, School of Chinese Materia Medica, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, People's Republic of China
| | - Tongming Li
- Department of Formulas of Traditional Chinese Medicine, School of Chinese Materia Medica, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, People's Republic of China
| | - Yang Yu
- Department of Formulas of Traditional Chinese Medicine, School of Chinese Materia Medica, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, People's Republic of China
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5
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Wilmes A, Aschauer L, Limonciel A, Pfaller W, Jennings P. Evidence for a role of claudin 2 as a proximal tubular stress responsive paracellular water channel. Toxicol Appl Pharmacol 2014; 279:163-72. [DOI: 10.1016/j.taap.2014.05.013] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2014] [Revised: 05/16/2014] [Accepted: 05/27/2014] [Indexed: 01/04/2023]
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6
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Application of integrated transcriptomic, proteomic and metabolomic profiling for the delineation of mechanisms of drug induced cell stress. J Proteomics 2013; 79:180-94. [DOI: 10.1016/j.jprot.2012.11.022] [Citation(s) in RCA: 138] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2012] [Revised: 11/08/2012] [Accepted: 11/24/2012] [Indexed: 01/01/2023]
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Cyclophilin C-associated protein regulation of phagocytic functions via NFAT activation in macrophages. Brain Res 2011; 1397:55-65. [DOI: 10.1016/j.brainres.2011.03.036] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2011] [Accepted: 03/15/2011] [Indexed: 11/21/2022]
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8
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Shin DH, Park HM, Jung KA, Choi HG, Kim JA, Kim DD, Kim SG, Kang KW, Ku SK, Kensler TW, Kwak MK. The NRF2-heme oxygenase-1 system modulates cyclosporin A-induced epithelial-mesenchymal transition and renal fibrosis. Free Radic Biol Med 2010; 48:1051-63. [PMID: 20096777 PMCID: PMC3586736 DOI: 10.1016/j.freeradbiomed.2010.01.021] [Citation(s) in RCA: 90] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2009] [Revised: 01/12/2010] [Accepted: 01/14/2010] [Indexed: 02/06/2023]
Abstract
Epithelial-mesenchymal transition (EMT) is an underlying mechanism of tissue fibrosis, generating myofibroblasts, which serve as the primary source of extracellular matrix production from tissue epithelial cells. Recently, EMT has been implicated in immunosuppressive cyclosporin A (CsA)-induced renal fibrosis. In this study, the potential role of NRF2, which is the master regulator of genes associated with the cellular antioxidant defense system, in CsA-induced EMT renal fibrosis has been investigated. Pretreatment of rat tubular epithelial NRK-52E cells with sulforaphane, an activator of NRF2, could prevent EMT gene changes such as the loss of E-cadherin and the increase in alpha-smooth muscle actin (alpha-SMA) expression. Conversely, genetic inhibition of NRF2 in these cells aggravated changes in CsA-induced EMT markers. These in vitro observations could be confirmed in vivo: CsA treatment resulted in severe renal damage and fibrosis with increased expression of alpha-SMA in NRF2-deficient mice compared to wild-type mice. NRF2-mediated amelioration of CsA-caused EMT changes could be accounted for in part by the regulation of heme oxygenase-1 (HO-1). CsA treatment increased HO-1 expression in an NRF2-dependent manner in NRK cells as well as in murine fibroblasts. Induction of HO-1 by CsA seems to be advantageous in that it counteracts EMT gene changes: specific increase in HO-1 expression caused by cobalt protoporphyrin prevented CsA-mediated alpha-SMA induction, whereas genetic inhibition of HO-1 by siRNA substantially enhanced alpha-SMA induction compared to control cells. Collectively, our results suggest that the NRF2-HO-1 system plays a protective role against CsA-induced renal fibrosis by modulating EMT gene changes.
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Affiliation(s)
- Dong-ha Shin
- Yeungnam University, College of Pharmacy, Gyeongsan-si, Gyeongsangbuk-do 712-749, South Korea
| | - Hyun-Min Park
- Yeungnam University, College of Pharmacy, Gyeongsan-si, Gyeongsangbuk-do 712-749, South Korea
| | - Kyeong-Ah Jung
- Yeungnam University, College of Pharmacy, Gyeongsan-si, Gyeongsangbuk-do 712-749, South Korea
| | - Han-Gon Choi
- Yeungnam University, College of Pharmacy, Gyeongsan-si, Gyeongsangbuk-do 712-749, South Korea
| | - Jung-Ae Kim
- Yeungnam University, College of Pharmacy, Gyeongsan-si, Gyeongsangbuk-do 712-749, South Korea
| | - Dae-Duk Kim
- Seoul National University, College of Pharmacy, Seoul, South Korea
| | - Sang Geon Kim
- Seoul National University, College of Pharmacy, Seoul, South Korea
| | - Keon Wook Kang
- Chosun University, College of Pharmacy, Gwangju, South Korea
| | - Sae Kwang Ku
- Daegu Hanny University, College of Oriental Medicine, Daegu, South Korea
| | - Thomas W. Kensler
- Johns Hopkins University Bloomberg School of Public Health, Department of Environmental Health Sciences, Baltimore, MD, USA
| | - Mi-Kyoung Kwak
- Yeungnam University, College of Pharmacy, Gyeongsan-si, Gyeongsangbuk-do 712-749, South Korea
- Corresponding Author: M-K Kwak, Yeungnam University, College of Pharmacy, 214-1 Dae-dong, Gyeongsan-si, Gyeongsangbuk-do 712-749, South Korea. Tel: +82-53-810-2823, Fax: +82-53-810-4654,
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Moscoso-Solorzano GT, Ortega F, Rodríguez I, García-Castro M, Gómez E, Díaz-Corte C, Baltar JM, Alvarez V, Ortiz A, Coto E. A search for cyclophilin-A gene variants in cyclosporine A-treated renal transplanted patients. Clin Transplant 2008; 22:722-9. [PMID: 18673375 DOI: 10.1111/j.1399-0012.2008.00867.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND The cyclophilin A (CypA)-cyclosporine (CsA) complex promotes immune response. The variation at the CypA gene could explain CsA-pharmacokinetics and clinical outcomes among CsA-treated patients. METHODS The study included 290 kidney transplanted patients (65% male; mean age 51 +/- 15 yr), treated with CsA. The five CypA- exons and the promoter region were analysed through single-strand conformation analysis, denaturing high performance liquid chromatography, and direct sequencing. The effect of a promoter polymorphism (-11 G/C) on gene expression was analysed in cell-cultures. RESULTS We found two polymorphisms in the promoter (-11 G/C) and exon 1 (+36 G/A). Genotype frequencies did not differ between patients according to their pharmacokinetics status. In vitro studies showed that -11 G/C affected gene expression. The -11 G allele was significantly associated with clinical nephrotoxicity (p = 0.006). The strongest predictors for nephrotoxicity were a donor age > or =55 yr, and the promoter GG + GC genotypes. CONCLUSIONS Our work suggests that a CypA-promoter polymorphism (-11 G/C) could be associated with clinical nephrotoxicity. Replication of this study in other populations is necessary to define the role of CypA-variants in the main clinical outcomes among CsA-treated kidney-transplanted patients.
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Abstract
New indications for organ transplantation combined with a stagnating number of available donor grafts have severely lengthened the waiting list for almost all types of transplantations. This has led to a renewed interest in non-heart beating (NHB) donation, as a possible solution to bridge the gap between supply and demand. In this review, we present an overview of current NHB donation practice, outcome, existing problems and future perspectives. We focus on possible improvements in donor management, recipient care and new methods of organ preservation that may be better suited for these marginal organs. Successful institution of NHB protocols depends on adapting current transplantation practice at all levels, which is one of the greatest challenges for researchers and professionals in this interesting re-emerging field.
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Affiliation(s)
- Cyril Moers
- Surgery Research Laboratory, Department of Surgery, University Medical Center Groningen, 9700 RB Groningen, The Netherlands.
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11
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Li SZ, McDill BW, Kovach PA, Ding L, Go WY, Ho SN, Chen F. Calcineurin-NFATc signaling pathway regulates AQP2 expression in response to calcium signals and osmotic stress. Am J Physiol Cell Physiol 2006; 292:C1606-16. [PMID: 17166937 DOI: 10.1152/ajpcell.00588.2005] [Citation(s) in RCA: 69] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
The aquaporin (AQP)2 channel mediates the reabsorption of water in renal collecting ducts in response to arginine vasopressin (AVP) and hypertonicity. Here we show that AQP2 expression is induced not only by the tonicity-responsive enhancer binding protein (TonEBP)/nuclear factor of activated T cells (NFAT)5-mediated hypertonic stress response but also by the calcium-dependent calcineurin-NFATc pathway. The induction of AQP2 expression by the calcineurin-NFATc pathway can occur in the absence of TonEBP/NFAT5. Mutational and chromatin immunoprecipitation analyses revealed the existence of functional NFAT binding sites within the proximal AQP2 promoter responsible for regulation of AQP2 by NFATc proteins and TonEBP/NFAT5. Contrary to the notion that TonEBP/NFAT5 is the only Rel/NFAT family member regulated by tonicity, we found that hypertonicity promotes the nuclear translocation of NFATc proteins for the subsequent induction of AQP2 expression. Calcineurin activity was also found to be involved in the induction of TonEBP/NFAT5 expression by hypertonicity, thus further defining the signaling mechanisms that underlie the TonEBP/NFAT5 osmotic stress response pathway. The coordinate regulation of AQP2 expression by both osmotic stress and calcium signaling appears to provide a means to integrate diverse extracellular signals into optimal cellular responses.
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MESH Headings
- Active Transport, Cell Nucleus
- Animals
- Aquaporin 2/genetics
- Aquaporin 2/metabolism
- Calcineurin/metabolism
- Calcium Signaling
- Cell Line
- Epithelial Cells/drug effects
- Epithelial Cells/metabolism
- Ionomycin/pharmacology
- Ionophores/pharmacology
- Kidney Tubules, Collecting/cytology
- Kidney Tubules, Collecting/drug effects
- Kidney Tubules, Collecting/metabolism
- Kidney Tubules, Collecting/physiopathology
- Mice
- Mice, Knockout
- Mutation
- NFATC Transcription Factors/genetics
- NFATC Transcription Factors/metabolism
- Osmosis
- Promoter Regions, Genetic
- Saline Solution, Hypertonic/pharmacology
- Signal Transduction/drug effects
- Stress, Physiological/metabolism
- Stress, Physiological/physiopathology
- Tetradecanoylphorbol Acetate/pharmacology
- Transcription Factors/genetics
- Transcription Factors/metabolism
- Transcription, Genetic
- Transfection
- Up-Regulation
- Water-Electrolyte Balance
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Affiliation(s)
- Song-Zhe Li
- Department of Internal Medicine/Renal Division, Campus Box 8126, Washington University School of Medicine, St. Louis, MO 63110, USA
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Proctor R, Kumar N, Stein A, Moles D, Porter S. Oral and dental aspects of chronic renal failure. J Dent Res 2005; 84:199-208. [PMID: 15723858 DOI: 10.1177/154405910508400301] [Citation(s) in RCA: 131] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The present article reviews, in detail, the current knowledge of the oral and dental aspects of chronic renal failure (CRF). Worldwide, increasing numbers of persons have CRF; thus, oral health care staffs are increasingly likely to provide care for patients with such disease. Chronic renal failure can give rise to a wide spectrum of oral manifestations, affecting the hard or soft tissues of the mouth. The majority of affected individuals have disease that does not complicate oral health care; nevertheless, the dental management of such individuals does require that the clinician understand the multiple systems that can be affected. The clinician should also consider the adverse side-effects of drug therapy and appropriate prescribing, in view of compromised renal clearance.
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Affiliation(s)
- R Proctor
- Oral Medicine, Division of Maxillofacial Diagnostic, Medical & Surgical Sciences, Eastman Dental Institute for Oral Health Care Sciences, UCL, University of London, 256 Gray's Inn Road, London WC1X 8LD, UK
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