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Yang Q, Zou Y, Lang Y, Yang J, Wu Y, Xiao X, Qin C, Zhao Y, Liu F. Estimated small dense low-density lipoprotein-cholesterol and the risk of kidney and cardiovascular outcomes in diabetic kidney disease. Ren Fail 2024; 46:2369701. [PMID: 38952279 PMCID: PMC467091 DOI: 10.1080/0886022x.2024.2369701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 06/13/2024] [Indexed: 07/03/2024] Open
Abstract
AIMS This study aimed to investigate the correlations between estimated small dense low-density lipoprotein-cholesterol (esd-LDL-c) and the development of end-stage kidney disease (ESKD), cardiovascular mortality, and all-cause mortality in individuals with diabetic kidney disease (DKD) or diabetes mellitus (DM) concomitant chronic kidney disease (CKD). METHODS We analyzed the data from a biopsy-proven DKD cohort conducted at West China Hospital of Sichuan University between 2009 and 2021 (the DKD cohort) and participants with DM and CKD in the National Health and Nutrition Examination Survey (NHANES) 2011-2014 (the NHANES DM-CKD cohort). Cox regression analysis was also used to estimate associations between esd-LDL-c and the incidence of ESKD, cardiovascular mortality, and all-cause mortality. RESULTS There were 175 ESKD events among 338 participants in the DKD cohort. Patients were divided into three groups based on esd-LDL-c tertiles (T1 < 33.7 mg/dL, T2 ≥ 33.7 mg/dL to <45.9 mg/dL, T3 ≥ 45.9 mg/dL). The highest tertile of esd-LDL-c was associated with ESKD (adjusted HR 2.016, 95% CI 1.144-3.554, p = .015). Furthermore, there were 99 deaths (39 cardiovascular) among 293 participants in the NHANES DM-CKD cohort. Participants were classified into three groups in line with the tertile values of esd-LDL-c in the DKD cohort. The highest tertile of esd-LDL-c was associated with cardiovascular mortality (adjusted HR 3.95, 95% CI 1.3-12, p = .016) and all-cause mortality (adjusted HR 2.37, 95% CI 1.06-5.32, p = .036). CONCLUSIONS Higher esd-LDL-c was associated with increased risk of ESKD in people with biopsy-proven DKD, and higher cardiovascular and all-cause mortality risk among those with DM-CKD.
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Affiliation(s)
- Qing Yang
- Division of Nephrology, West China Hospital of Sichuan University, Chengdu, China
- Laboratory of Diabetic Kidney Disease, Centre of Diabetes and Metabolism Research, West China Hospital of Sichuan University, Chengdu, China
| | - Yutong Zou
- Division of Nephrology, West China Hospital of Sichuan University, Chengdu, China
- Laboratory of Diabetic Kidney Disease, Centre of Diabetes and Metabolism Research, West China Hospital of Sichuan University, Chengdu, China
| | - Yanlin Lang
- Division of Nephrology, West China Hospital of Sichuan University, Chengdu, China
- Laboratory of Diabetic Kidney Disease, Centre of Diabetes and Metabolism Research, West China Hospital of Sichuan University, Chengdu, China
| | - Jia Yang
- Division of Nephrology, West China Hospital of Sichuan University, Chengdu, China
- Laboratory of Diabetic Kidney Disease, Centre of Diabetes and Metabolism Research, West China Hospital of Sichuan University, Chengdu, China
| | - Yucheng Wu
- Division of Nephrology, West China Hospital of Sichuan University, Chengdu, China
- Laboratory of Diabetic Kidney Disease, Centre of Diabetes and Metabolism Research, West China Hospital of Sichuan University, Chengdu, China
| | - Xiang Xiao
- Division of Nephrology, West China Hospital of Sichuan University, Chengdu, China
- Laboratory of Diabetic Kidney Disease, Centre of Diabetes and Metabolism Research, West China Hospital of Sichuan University, Chengdu, China
| | - Chunmei Qin
- Division of Nephrology, West China Hospital of Sichuan University, Chengdu, China
- Laboratory of Diabetic Kidney Disease, Centre of Diabetes and Metabolism Research, West China Hospital of Sichuan University, Chengdu, China
| | - Yuancheng Zhao
- Division of Nephrology, West China Hospital of Sichuan University, Chengdu, China
- Laboratory of Diabetic Kidney Disease, Centre of Diabetes and Metabolism Research, West China Hospital of Sichuan University, Chengdu, China
| | - Fang Liu
- Division of Nephrology, West China Hospital of Sichuan University, Chengdu, China
- Laboratory of Diabetic Kidney Disease, Centre of Diabetes and Metabolism Research, West China Hospital of Sichuan University, Chengdu, China
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Hajdys J, Fularski P, Leszto K, Majchrowicz G, Stabrawa M, Młynarska E, Rysz J, Franczyk B. New Insights into the Nephroprotective Potential of Lercanidipine. Int J Mol Sci 2023; 24:14048. [PMID: 37762350 PMCID: PMC10531189 DOI: 10.3390/ijms241814048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 09/10/2023] [Accepted: 09/12/2023] [Indexed: 09/29/2023] Open
Abstract
Kidneys are responsible for many crucial biological processes in the human body, including maintaining the water-electrolyte balance, pH, and blood pressure (BP), along with the elimination of toxins. Despite this, chronic kidney disease (CKD), which affects more and more people, is a disease that develops insidiously without causing any symptoms at first. The main purpose of this article is to summarize the existing literature on lercanidipine, with a particular focus on its nephroprotective properties. Lercanidipine is a third-generation dihydropyridine (DHP) blocker of calcium channels, and as such it possesses unique qualities such as high lipophilicity and high vascular selectivity. Furthermore, it acts by reversibly inhibiting L-type and T-type calcium channels responsible for exerting positive renal effects. It has been shown to reduce tissue inflammation and tubulointerstitial fibrosis, contributing to a decrease in proteinuria. Moreover, it exhibited antioxidative effects and increased expression of molecules responsible for repairing damaged tissues. It also decreased cell proliferation, preventing thickening of the vascular lumen. This article summarizes studies simultaneously comparing the effect of lercanidipine with other antihypertensive drugs. There is still a lack of studies on the medications used in patients with CKD, and an even greater lack of studies on those used in patients with concomitant hypertension. Therefore, further studies on lercanidipine and its potential in hypertensive patients with coexisting CKD are required.
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Affiliation(s)
| | | | | | | | | | - Ewelina Młynarska
- Department of Nephrology, Hypertension and Family Medicine, Medical University of Lodz, Ul. Żeromskiego 113, 90-549 Lodz, Poland
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Mallén A, Rodriguez-Urquia R, Alvarez R, Dorca-Duch E, Navarro E, Hueso M. Sex Differences in Glomerular Lesions, in Atherosclerosis Progression, and in the Response to Angiotensin-Converting Enzyme Inhibitors in the ApoE -/- Mice Model. Int J Mol Sci 2023; 24:13442. [PMID: 37686247 PMCID: PMC10487579 DOI: 10.3390/ijms241713442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 08/21/2023] [Accepted: 08/28/2023] [Indexed: 09/10/2023] Open
Abstract
This study analyzes sex-based differences in renal structure and the response to the Angiotensin-Converting Enzyme (ACE) inhibitor enalapril in a mouse model of atherosclerosis. Eight weeks old ApoE-/- mice received enalapril (5 mg/kg/day, subcutaneous) or PBS (control) for an additional 14 weeks. Each group consisted of six males and six females. Females exhibited elevated LDL-cholesterol levels, while males presented higher creatinine levels and proteinuria. Enalapril effectively reduced blood pressure in both groups, but proteinuria decreased significantly only in females. Plaque size analysis and assessment of kidney inflammation revealed no significant sex-based differences. However, males displayed more severe glomerular injury, with increased mesangial expansion, mesangiolysis, glomerular foam cells, and activated parietal epithelial cells (PECs). Enalapril mitigated mesangial expansion, glomerular inflammation (particularly in the female group), and hypertrophy of the PECs in males. This study demonstrates sex-based differences in the response to enalapril in a mouse model of atherosclerosis. Males exhibited more severe glomerular injury, while enalapril provided renal protection, particularly in females. These findings suggest potential sex-specific considerations for ACE inhibitor therapy in chronic kidney disease and atherosclerosis cardiovascular disease. Further research is needed to elucidate the underlying mechanism behind these observations.
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Affiliation(s)
- Adrián Mallén
- Experimental Nephrology Laboratory, Institut d’Investigació Biomèdica de Bellvitge-IDIBELL, 08907 L’Hospitalet de Llobregat, Spain; (A.M.); (E.N.)
| | - Ronny Rodriguez-Urquia
- Department of Nephrology, Hospital Universitari Bellvitge, 08907 L’Hospitalet de Llobregat, Spain; (R.R.-U.); (R.A.)
| | - Rafael Alvarez
- Department of Nephrology, Hospital Universitari Bellvitge, 08907 L’Hospitalet de Llobregat, Spain; (R.R.-U.); (R.A.)
| | - Eduard Dorca-Duch
- Department of Pathology, Hospital Universitari Bellvitge, 08907 L’Hospitalet de Llobregat, Spain;
| | - Estanis Navarro
- Experimental Nephrology Laboratory, Institut d’Investigació Biomèdica de Bellvitge-IDIBELL, 08907 L’Hospitalet de Llobregat, Spain; (A.M.); (E.N.)
| | - Miguel Hueso
- Experimental Nephrology Laboratory, Institut d’Investigació Biomèdica de Bellvitge-IDIBELL, 08907 L’Hospitalet de Llobregat, Spain; (A.M.); (E.N.)
- Department of Nephrology, Hospital Universitari Bellvitge, 08907 L’Hospitalet de Llobregat, Spain; (R.R.-U.); (R.A.)
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Kim KW, Koh HB, Kim HW, Park JT, Yoo TH, Kang SW, Oh KH, Hyun YY, Jung JY, Sung SA, Kim J, Han SH. Systolic blood pressure, low-density lipoprotein cholesterol levels, and adverse kidney outcome: results from KNOW-CKD. Hypertens Res 2023; 46:1395-1406. [PMID: 36849581 DOI: 10.1038/s41440-023-01230-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 01/14/2023] [Accepted: 02/06/2023] [Indexed: 03/01/2023]
Abstract
It is unknown whether intensive control of blood pressure (BP) and lipids can delay the progression of chronic kidney disease (CKD). This study examined the combined association of strict targets of systolic BP (SBP) and low-density lipoprotein cholesterol (LDL-C) levels with adverse kidney outcomes. In total, 2012 patients from the KoreaN Cohort Study for Outcomes in Patients With CKD (KNOW-CKD) were classified into four groups according to SBP of 120 mmHg and LDL-C of 70 mg/dl: group 1, <120 and <70; group 2, <120 and ≥70; group 3, ≥120 and <70; group 4, ≥120 and ≥70. We constructed time-varying models treating two variables as time-varying exposures. The primary outcome was the progression of CKD, defined as a ≥50% decrease in estimated glomerular filtration rate from the baseline or the onset of kidney failure requiring replacement therapy. The primary outcome events occurred in 27.9%, 26.7%, 40.3%, and 39.1% from groups 1 to 4. In the time-varying model, the hazard ratios (95% confidence intervals) for the primary outcome were 0.48 (0.33-0.69), 0.78 (0.63-0.96), and 0.96 (0.74-1.23) for groups 1 to 3, respectively, compared with group 4. When less stringent cut-offs of SBP of 130 mmHg and LDL-C of 100 mg/dl were used, this graded association was lost, while only SBP was associated with adverse kidney outcomes. In this study, the lower targets of SBP of <120 mmHg and LDL-C < 70 mg/dl were synergistically associated with a lower risk of adverse kidney outcomes.
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Affiliation(s)
- Kyung Won Kim
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Republic of Korea
| | - Hee Byung Koh
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Republic of Korea
| | - Hyung Woo Kim
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Republic of Korea
| | - Jung Tak Park
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Republic of Korea
| | - Tae-Hyun Yoo
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Republic of Korea
| | - Shin-Wook Kang
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Republic of Korea
| | - Kook-Hwan Oh
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Young Youl Hyun
- Division of Nephrology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Ji Yong Jung
- Division of Nephrology, Department of Internal Medicine, Gachon University of Gil Medical Center, Incheon, Republic of Korea
| | - Su Ah Sung
- Department of Internal Medicine, Eulji Medical Center, Eulji University, Seoul, Republic of Korea
| | - Jayoun Kim
- Medical Research Collaborating Center, Seoul National University Hospital, Seoul, Republic of Korea
| | - Seung Hyeok Han
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Republic of Korea.
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Deng L, Li W, Xu G. Update on pathogenesis and diagnosis flow of normoalbuminuric diabetes with renal insufficiency. Eur J Med Res 2021; 26:144. [PMID: 34895352 PMCID: PMC8665546 DOI: 10.1186/s40001-021-00612-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 11/16/2021] [Indexed: 12/11/2022] Open
Abstract
In recent decades, the prevalence of diabetic kidney disease has remained stable and appears to be a wide heterogeneity. Normoalbuminuric diabetes with renal insufficiency, which is characterized by a decline in the glomerular filtration rate in the absence of albuminuria, has been identified as an albuminuria-independent phenotype of diabetic kidney disease. Epidemiological data demonstrate that normoalbuminuric phenotype is prevalent. Compared to albuminuric phenotype, normoalbuminuric phenotype has distinct clinical characteristics and a wide heterogeneity of pathological features. Currently, the pathogenesis of normoalbuminuric phenotype remains unclear. Additionally, the flow of diagnosing normoalbuminuric phenotype is not perfect. In this article, we review the latest studies addressing the epidemiology, clinical characteristics, and pathology of normoalbuminuric phenotype. Based on the studies of clinical features and renal histopathologic changes, we attempt to propose an underlying pathogenesis model and a flow chart for diagnosing normoalbuminuric phenotype.
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Affiliation(s)
- Le Deng
- Department of Nephrology, The Second Affiliated Hospital of Nanchang University, No. 1, Minde Road, Donghu District, Nanchang, Jiangxi, 330006, People's Republic of China
| | - Wenjie Li
- Department of Nephrology, The Second Affiliated Hospital of Nanchang University, No. 1, Minde Road, Donghu District, Nanchang, Jiangxi, 330006, People's Republic of China
| | - Gaosi Xu
- Department of Nephrology, The Second Affiliated Hospital of Nanchang University, No. 1, Minde Road, Donghu District, Nanchang, Jiangxi, 330006, People's Republic of China.
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Emanuelsson F, Benn M. LDL-Cholesterol versus Glucose in Microvascular and Macrovascular Disease. Clin Chem 2021; 67:167-182. [PMID: 33221847 DOI: 10.1093/clinchem/hvaa242] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 09/10/2020] [Indexed: 01/06/2023]
Abstract
BACKGROUND The causal relationships between increased concentrations of low density lipoprotein (LDL)-cholesterol and glucose and risk of ischemic heart disease are well established. The causal contributions of LDL-cholesterol and glucose to risk of peripheral micro- and macrovascular diseases are less studied, especially in prediabetic stages and in a general population setting. CONTENT This review summarizes the current evidence for a causal contribution of LDL-cholesterol and glucose to risk of a spectrum of peripheral micro- and macrovascular diseases and reviews possible underlying disease mechanisms, including differences between vascular compartments, and finally discusses the clinical implications of these findings, including strategies for prevention and treatment. SUMMARY Combined lines of evidence suggest that LDL-cholesterol has a causal effect on risk of peripheral arterial disease and chronic kidney disease, both of which represent manifestations of macrovascular disease due to atherosclerosis and accumulation of LDL particles in the arterial wall. In contrast, there is limited evidence for a causal effect on risk of microvascular disease. Glucose has a causal effect on risk of both micro- and macrovascular disease. However, most evidence is derived from studies of individuals with diabetes. Further studies in normoglycemic and prediabetic individuals are warranted. Overall, LDL-cholesterol-lowering reduces risk of macrovascular disease, while evidence for a reduction in risk of microvascular disease is inconsistent. Glucose-lowering has a beneficial effect on risk of microvascular diseases and on risk of chronic kidney disease and estimated glomerular filtration rate (eGFR) in some studies, while results on risk of peripheral arterial disease are conflicting.
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Affiliation(s)
- Frida Emanuelsson
- Department of Clinical Biochemistry, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.,The Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Copenhagen, Denmark.,The Copenhagen City Heart Study, Frederiksberg Hospital, Copenhagen University Hospital, Copenhagen, Denmark.,Faculty of Health and Medical Sciences, Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Marianne Benn
- Department of Clinical Biochemistry, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.,The Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Copenhagen, Denmark.,The Copenhagen City Heart Study, Frederiksberg Hospital, Copenhagen University Hospital, Copenhagen, Denmark.,Faculty of Health and Medical Sciences, Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Jamshidi P, Najafi F, Mostafaei S, Shakiba E, Pasdar Y, Hamzeh B, Moradinazar M. Investigating associated factors with glomerular filtration rate: structural equation modeling. BMC Nephrol 2020; 21:30. [PMID: 31996154 PMCID: PMC6990472 DOI: 10.1186/s12882-020-1686-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 01/06/2020] [Indexed: 12/18/2022] Open
Abstract
Background Glomerular filtration rate (GFR) is a valid indicator of kidney function. Different factors can affect GFR. The purpose of this study is to assess the direct and indirect effects of GFR-related factors using structural equation modeling. Patients and methods We analyzed data from the baseline phase of the Ravansar Non-Communicable Disease cohort study. Data on socio-behavioral, nutritional, cardiovascular, and metabolic risk factors were analyzed using a conceptual model in order to test direct and indirect effects of factors related to GFR, separately in male and female, using the structural equation modeling. Results Of 8927 individuals who participated in this study, 4212 subjects were male (47.20%). The mean and standard deviation of GFR was 76.05 (±14.31) per 1.73 m2. GFR for 0.2, 11.3, 73.0 and 15.5% of people were < 30, 30 − 59, 60 − 90 and >90, respectively. Hypertension and aging in both sexes and atherogenic factor in males directly, and in females, directly and indirectly, had decreasing effects on GFR. Blood urea nitrogen and smoking in male and female, directly or indirectly through other variables, were associated with a lower GFR. In females, diabetes had a direct and indirect decreasing effect on GFR. Obesity in females was directly associated with upper and indirectly associated with lower GFR. Conclusion According to our results, aging, hypertension, diabetes, obesity, high lipid profile, and BUN had a decreasing direct and indirect effect on GFR. Although low GFR might have different reasons, our findings, are in line with other reports and provide more detailed information about important risk factors of low GFR. Public awareness of such factors can improve practice of positive health behaviors.
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Affiliation(s)
- Parastoo Jamshidi
- School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Farid Najafi
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Shayan Mostafaei
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran.,Epidemiology and Biostatistics Unit, Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Ebrahem Shakiba
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Yahya Pasdar
- Nutritional Sciences Department, School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Behrooz Hamzeh
- Promotion Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mehdi Moradinazar
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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Saito T, Matsunaga A, Fukunaga M, Nagahama K, Hara S, Muso E. Apolipoprotein E-related glomerular disorders. Kidney Int 2019; 97:279-288. [PMID: 31874799 DOI: 10.1016/j.kint.2019.10.031] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 10/25/2019] [Accepted: 10/28/2019] [Indexed: 11/30/2022]
Abstract
Of the glomerular disorders that occur due to apolipoprotein E (apoE) mutations, apoE2 homozygote glomerulopathy and lipoprotein glomerulopathy (LPG) have been characterized. ApoE2 homozygote glomerulopathy has been found in individuals expressing homozygous apoE2/2. This was characterized histologically by glomerulosclerosis with marked infiltration of foam cells derived from macrophages, and occasionally with non-lamellated lipoprotein thrombi. Recently, several cases of apoE Toyonaka (Ser197Cys) combined with homozygous apoE2/2 have been reported, in which non-immune membranous nephropathy-like features were observed in glomeruli. Interestingly, in these cases, apoE accumulation was identified by tandem mass spectrometry. Therefore, it is speculated that these findings may arise from apoE molecules without lipids, which result from hinge damage by apoE Toyonaka and may cross the glomerular basement membrane as small molecules. LPG is primarily associated with heterozygous apoE mutations surrounding the low-density lipoprotein-receptor binding site, and it is histologically characterized by lamellated lipoprotein thrombi that lack foam cells. Recent studies have suggested that LPG can be induced by thermodynamic destabilization, hydrophobic surface exposure, and the aggregation of apoE resulting from the incompatibility of apoE mutated residues within helical regions. Additionally, apoE5 may play a supporting role in the development of LPG and in lipid-induced kidney diseases via hyperlipoproteinemia. Thus, it is interesting that many apoE mutations contribute to characteristic glomerular disorders through various mechanisms. In particular, macrophages may uptake lipoproteins into the cytoplasm and contribute to the development of apoE2 homozygote glomerulopathy as foam cells, and their dysfunction may contribute to the accumulation of lipoproteins in the glomerulus, causing lipoprotein thrombi in LPG.
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Affiliation(s)
- Takao Saito
- Sanko Clinic, Fukuoka, Japan; Faculty of Medicine, Fukuoka University, Fukuoka, Japan.
| | - Akira Matsunaga
- Department of Laboratory Medicine, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | | | - Kiyotaka Nagahama
- Department of Pathology, Kyorin University School of Medicine, Tokyo, Japan
| | - Shigeo Hara
- Department of Diagnostic Pathology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Eri Muso
- Division of Nephrology and Dialysis, Kitano Hospital, Osaka, Japan; Department of Food and Nutrition, Faculty of Contemporary Home Economics, Kyoto Kacho University, Kyoto, Japan
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Yan Y, Huang Y, Zhou D, Tang S, Feng YQ. Visit-to-Visit Variability in Total Cholesterol Correlates with the Progression of Renal Function Decline in a Chinese Community-Based Hypertensive Population. Kidney Blood Press Res 2019; 44:727-742. [PMID: 31387100 DOI: 10.1159/000501367] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 06/05/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Studies have demonstrated that cholesterol variability is an independent predictor of cerebrovascular and cardiovascular events. OBJECTIVE This study aimed to investigate the association of visit-to-visit variability in total cholesterol (TC) with kidney decline in a Chinese community-based population. METHODS We assessed intraindividual variability in TC among 6,465 hypertensive participants and correlated the results with endpoints. TC variability was measured using standard deviation (SD), average successive variability (ASV), coefficient of variation (CV), and variability independent of the mean (VIM). The endpoint of this study was progression of renal function decline defined as a decrease in estimated glomerular filtration rate (eGFR) ≥30% and to a level <60 mL/min/1.73 m2 during follow-up if the baseline eGFR was ≥60 mL/min/1.73 m2, or a decrease in eGFR ≥50% during follow up if the baseline eGFR was <60 mL/min/1.73 m2. RESULTS After a median follow-up of 27 months, 13.5% (n = 877) of the participants experienced progression of renal function decline. In the multivariable-adjusted Cox model, each 1-SD increase in TC variability (by SD) increased the risk of renal function decline by 11% (HR = 1.11; 95% CI 1.034-1.197; p = 0.004); this was independent of the baseline eGFR, mean follow-up TC levels, and the lipid-lowering therapy. Similar results were found for the 3 other measures of variability, i.e., ASV, CV, and VIM. CONCLUSION In subjects with hypertension, visit-to-visit variability in TC is an independent predictor of renal function decline.
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Affiliation(s)
- Yuqin Yan
- Department of Cardiology, Guangdong Cardiovascular Institute, Hypertension Research Laboratory, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, South China University of Technology School of Medicine, Guangzhou, China
| | - Yuqin Huang
- Department of Cardiology, Guangdong Cardiovascular Institute, Hypertension Research Laboratory, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, South China University of Technology School of Medicine, Guangzhou, China
| | - Dan Zhou
- Department of Cardiology, Guangdong Cardiovascular Institute, Hypertension Research Laboratory, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, South China University of Technology School of Medicine, Guangzhou, China
| | - Songtao Tang
- Community Health Center of Liaobu County, Dongguan, China
| | - Ying-Qing Feng
- Department of Cardiology, Guangdong Cardiovascular Institute, Hypertension Research Laboratory, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, South China University of Technology School of Medicine, Guangzhou, China,
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Abstract
The apolipoprotein L1 (APOL1) gene is unique to humans and gorillas and appeared ~33 million years ago. Since the majority of the mammals do not carry APOL1, it seems to be dispensable for kidney function. APOL1 renal risk variants (RRVs; G1 and G2) are associated with the development as well as progression of chronic kidney diseases (CKDs) at higher rates in populations with African ancestry. Cellular expression of two APOL1 RRVs has been demonstrated to induce cytotoxicity, including necrosis, apoptosis, and pyroptosis, in several cell types including podocytes; mechanistically, these toxicities were attributed to lysosomal swelling, K+ depletion, mitochondrial dysfunction, autophagy blockade, protein kinase receptor activation, ubiquitin D degradation, and endoplasmic reticulum stress; notably, these effects were found to be dose dependent and occurred only in overtly APOL1 RRV-expressing cells. However, cellular protein expressions as well as circulating blood levels of APOL1 RRVs were not elevated in patients suffering from APOL1 RRV-associated CKDs. Therefore, the question arises as to whether it is gain or loss of function on the part of APOL1 RRVs contributing to kidney cell injury. The question seems to be more pertinent after the recognition of the role of APOL1 nonrisk (G0) in the transition of parietal epithelial cells and preservation of the podocyte molecular phenotype through modulation of the APOL1-miR-193a axis. With this background, the present review analyzed the available literature in terms of the known function of APOL1 nonrisk and how the loss of these functions could have contributed to two APOL1 RRV-associated CKDs.
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Affiliation(s)
- Vinod Kumar
- Institute of Molecular Medicine, Feinstein Institute for Medical Research and Department of Medicine, Zucker School of Medicine at Hofstra-Northwell, Hempstead, New York
| | - Pravin C Singhal
- Institute of Molecular Medicine, Feinstein Institute for Medical Research and Department of Medicine, Zucker School of Medicine at Hofstra-Northwell, Hempstead, New York
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Abstract
This study aimed to investigate the association between reproductive period and menarche age and chronic kidney disease (CKD) in South Korean postmenopausal women.This was a cross-sectional study of the data for 8510 postmenopausal women using the results of Korean National Health and Nutrition Examination Surveys over the past 6 years.Of the total 8510 postmenopausal women, 790 (10.23%) were CKD patients. The menarche age in the CKD group was 16.2 ± 1.9 years old, which was higher than that in the non-CKD group (P < .001). The reproductive period of the CKD group was 32.4 ± 5.7 years, which was shorter than 33.3 ± 5.4 years in the non-CKD group (P < .001). The prevalence of CKD was 4.7% at a menarche age of 11 years or younger, which increased with increasing of menarche age, reaching 9.9% at menarche age of 16 years or older. According to the length of the reproductive period, the prevalence of CKD was 13.9% for the group less than 20 years of period and decreased significantly with increasing length of reproductive period. The prevalence of proteinuria was 7.2% in women with reproductive period of less than 20 years and significantly less in women with a reproductive period longer than 45 years (2.3%). The prevalence of CKD and proteinuria increased with increasing of menarche age, and the prevalence of CKD and proteinuria decreased with increasing of reproductive period.The results suggest that CKD was associated with older menarche age and a short reproductive period. Management of life patterns and medical problems in women with old age at menarche and a short reproductive period should be considered.
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Affiliation(s)
| | - Hoseok Koo
- Department of Medicine, Seoul Paik Hospital, College of Medicine, Inje University of Korea, Seoul, Republic of Korea
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12
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Kosmeri C, Siomou E, Vlahos AP, Milionis H. Review shows that lipid disorders are associated with endothelial but not renal dysfunction in children. Acta Paediatr 2019; 108:19-27. [PMID: 30066344 DOI: 10.1111/apa.14529] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 06/14/2018] [Accepted: 07/30/2018] [Indexed: 02/02/2023]
Abstract
AIM We undertook this review to assess the effects of lipid metabolism abnormalities on endothelial and renal function in children. METHODS A search of relevant literature published in English from January 1988 to May 2018 was performed, and this included randomised controlled trials, observational cohort studies, systematic reviews and case reports. RESULTS The search process identified 2324 relevant studies and 29 were finally included. Noninvasive ultrasound markers of endothelial dysfunction, such as flow-mediated dilation and carotid intima-media thickness, were impaired in children with dyslipidaemia. Dietary interventions and statin therapy reversed the effects of dyslipidaemia on endothelial function in children. Most data from adult studies failed to prove a causative relationship between dyslipidaemia and renal disease progression or a beneficial effect of lipid-lowering treatment on renal outcomes. The limited paediatric data did not indicate dyslipidaemia as an independent risk factor for renal dysfunction, which was mainly estimated by cystatin C levels or proteinuria. Therefore, further investigation is needed to clarify a potential relationship. CONCLUSION In view of limited available paediatric evidence, dyslipidaemia may be adversely associated with endothelial function. However, the association between lipid metabolism disorders and renal function in childhood needs to be further investigated.
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Affiliation(s)
- Chrysoula Kosmeri
- Child Health Department School of Health Sciences Faculty of Medicine University of Ioannina Ioannina Greece
| | - Ekaterini Siomou
- Child Health Department School of Health Sciences Faculty of Medicine University of Ioannina Ioannina Greece
| | - Antonios P. Vlahos
- Child Health Department School of Health Sciences Faculty of Medicine University of Ioannina Ioannina Greece
| | - Haralampos Milionis
- Department of Internal Medicine School of Health Sciences Faculty of Medicine University of Ioannina Ioannina Greece
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13
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Sasaki M, Yasuno T, Ito K, Matsunaga A, Hisano S, Abe Y, Miyake K, Masutani K, Nakashima H, Saito T. Focal segmental glomerulosclerosis with heterozygous apolipoprotein E5 (Glu3Lys). CEN Case Rep 2018; 7:225-228. [PMID: 29740794 DOI: 10.1007/s13730-018-0331-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 04/16/2018] [Indexed: 11/26/2022] Open
Abstract
Apolipoprotein (apo) E5 is a rare apoE isoform. The apoE5 (Glu3Lys) variant, which is caused by the substitution of lysine with glutamic acid at codon 3, has a relative frequency of 0.1% in Japan. Previous studies have reported that apoE5 (Glu3Lys) is associated with hyperlipidemia and cardiovascular diseases, but this isoform has higher LDL receptor-binding activity than that of normal apoE3. Nephropathy associated with apoE5 (Glu3Lys) alone has not yet been reported. We present a case of a 51-year-old man with nephrotic syndrome. On renal biopsy, three glomeruli showed segmental sclerosis with hypertrophy of podocytes and intracapillary marked infiltration of intraglomerular foam cells. These findings were compatible with focal segmental glomerulosclerosis (FSGS). The patient had mild diabetes mellitus and monoclonal gammopathy of undetermined significance, but there were no specific findings of nephrolopathy related to these diseases. Various factors are involved in the pathogenesis of FSGS, including dyslipidemia and apoE activity. Our findings suggest that abnormal lipid metabolism by ApoE5 (Glu3Lys) is involved in the onset of FSGS.
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Affiliation(s)
- Masaru Sasaki
- Division of Nephrology and Rheumatology, Department of Internal Medicine, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan
| | - Tetsuhiko Yasuno
- Division of Nephrology and Rheumatology, Department of Internal Medicine, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan.
| | - Kenji Ito
- Division of Nephrology and Rheumatology, Department of Internal Medicine, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan
| | - Akira Matsunaga
- Department of Laboratory Medicine, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Satoshi Hisano
- Department of Pathology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Yasuhiro Abe
- Division of Nephrology and Rheumatology, Department of Internal Medicine, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan
| | - Katsuhisa Miyake
- Division of Nephrology and Rheumatology, Department of Internal Medicine, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan
| | - Kosuke Masutani
- Division of Nephrology and Rheumatology, Department of Internal Medicine, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan
| | - Hitoshi Nakashima
- Division of Nephrology and Rheumatology, Department of Internal Medicine, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan
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Preoperative Low-Density Lipoprotein Apheresis for Preventing Recurrence of Focal Segmental Glomerulosclerosis after Kidney Transplantation. J Transplant 2018; 2018:8926786. [PMID: 29808114 PMCID: PMC5901999 DOI: 10.1155/2018/8926786] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 02/09/2018] [Accepted: 03/01/2018] [Indexed: 12/12/2022] Open
Abstract
Background Focal segmental glomerulosclerosis (FSGS) often develops rapidly and frequently progresses to renal failure, while the recurrence rate after kidney transplantation is 20–50%. We performed low-density lipoprotein (LDL) apheresis before kidney transplantation in FSGS patients to prevent recurrence. Methods Five adult patients with chronic renal failure due to FSGS undergoing living related donor kidney transplantation were investigated retrospectively. LDL apheresis was done 1-2 times before transplantation. Postoperative renal function and recurrence of FSGS were assessed. Results The patients were two men and three women aged 24 to 41 years. The observation period ranged from 60 days to 22 months. Preoperative LDL apheresis was performed once in one patient and twice in four patients. Blood LDL cholesterol levels were normal before LDL apheresis and remained normal both after LDL apheresis and after kidney transplantation. Additional LDL apheresis was performed once in one patient with mild proteinuria after transplantation. The renal graft survived in all patients and there was no evidence of recurrent FSGS. Conclusions Although the observation period was short, FSGS did not recur in all 5 patients receiving preoperative LDL apheresis. These results suggest that LDL apheresis can be effective in preventing recurrence of FSGS after kidney transplantation.
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15
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Kim MK, Han K, Koh ES, Kim HS, Kwon HS, Park YM, Yoon KH, Lee SH. Variability in Total Cholesterol Is Associated With the Risk of End-Stage Renal Disease: A Nationwide Population-Based Study. Arterioscler Thromb Vasc Biol 2017; 37:1963-1970. [PMID: 28860222 DOI: 10.1161/atvbaha.117.309803] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 08/15/2017] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Recent data suggest that visit-to-visit variability of cholesterol is associated with cardiovascular events. We evaluated the role of lipid variability as a determinant of end-stage renal disease (ESRD). APPROACH AND RESULTS Using nationally representative data from the Korean National Health Insurance System, 8 493 277 subjects who were free of ESRD and who underwent ≥3 health examinations during 2005 to 2010 were followed to the end of 2015. Total cholesterol (TC) variability was measured using the coefficient of variation, SD, and the variability independent of the mean. The primary outcome was the development of ESRD, defined as a combination of the relevant disease code and the initiation of renal replacement therapy. There were 11 247 cases of ESRD during a median follow-up of 6.1 years. There was a graded association between a higher TC variability and incident ESRD. In the multivariable adjusted model, the hazard ratios and 95% confidence intervals comparing the highest versus lowest quartiles of coefficient of variation of TC were 2.66 (95% confidence interval, 2.52-2.82). The results were consistent when the variability of TC was modeled using SD and variability independent of the mean and were independent of preexisting chronic kidney disease. CONCLUSIONS Increasing TC variability was associated with an increasing incidence of ESRD.
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Affiliation(s)
- Mee Kyoung Kim
- From the Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary's Hospital (M.K.K., H.-S. Kwon), Department of Medical Statistics (K.H.), Division of Nephrology, Department of Internal Medicine, Yeouido St. Mary's Hospital (E.S.K.), Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital (H.-S. Kim, K.-H.Y., S.-H.L.), and Department of Medical Informatics (H.-S. Kim, K.-H.Y.), College of Medicine, The Catholic University of Korea, Seoul; and Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC (Y.-M.P.)
| | - Kyungdo Han
- From the Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary's Hospital (M.K.K., H.-S. Kwon), Department of Medical Statistics (K.H.), Division of Nephrology, Department of Internal Medicine, Yeouido St. Mary's Hospital (E.S.K.), Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital (H.-S. Kim, K.-H.Y., S.-H.L.), and Department of Medical Informatics (H.-S. Kim, K.-H.Y.), College of Medicine, The Catholic University of Korea, Seoul; and Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC (Y.-M.P.)
| | - Eun Sil Koh
- From the Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary's Hospital (M.K.K., H.-S. Kwon), Department of Medical Statistics (K.H.), Division of Nephrology, Department of Internal Medicine, Yeouido St. Mary's Hospital (E.S.K.), Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital (H.-S. Kim, K.-H.Y., S.-H.L.), and Department of Medical Informatics (H.-S. Kim, K.-H.Y.), College of Medicine, The Catholic University of Korea, Seoul; and Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC (Y.-M.P.)
| | - Hun-Sung Kim
- From the Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary's Hospital (M.K.K., H.-S. Kwon), Department of Medical Statistics (K.H.), Division of Nephrology, Department of Internal Medicine, Yeouido St. Mary's Hospital (E.S.K.), Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital (H.-S. Kim, K.-H.Y., S.-H.L.), and Department of Medical Informatics (H.-S. Kim, K.-H.Y.), College of Medicine, The Catholic University of Korea, Seoul; and Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC (Y.-M.P.)
| | - Hyuk-Sang Kwon
- From the Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary's Hospital (M.K.K., H.-S. Kwon), Department of Medical Statistics (K.H.), Division of Nephrology, Department of Internal Medicine, Yeouido St. Mary's Hospital (E.S.K.), Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital (H.-S. Kim, K.-H.Y., S.-H.L.), and Department of Medical Informatics (H.-S. Kim, K.-H.Y.), College of Medicine, The Catholic University of Korea, Seoul; and Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC (Y.-M.P.)
| | - Yong-Moon Park
- From the Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary's Hospital (M.K.K., H.-S. Kwon), Department of Medical Statistics (K.H.), Division of Nephrology, Department of Internal Medicine, Yeouido St. Mary's Hospital (E.S.K.), Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital (H.-S. Kim, K.-H.Y., S.-H.L.), and Department of Medical Informatics (H.-S. Kim, K.-H.Y.), College of Medicine, The Catholic University of Korea, Seoul; and Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC (Y.-M.P.)
| | - Kun-Ho Yoon
- From the Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary's Hospital (M.K.K., H.-S. Kwon), Department of Medical Statistics (K.H.), Division of Nephrology, Department of Internal Medicine, Yeouido St. Mary's Hospital (E.S.K.), Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital (H.-S. Kim, K.-H.Y., S.-H.L.), and Department of Medical Informatics (H.-S. Kim, K.-H.Y.), College of Medicine, The Catholic University of Korea, Seoul; and Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC (Y.-M.P.)
| | - Seung-Hwan Lee
- From the Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary's Hospital (M.K.K., H.-S. Kwon), Department of Medical Statistics (K.H.), Division of Nephrology, Department of Internal Medicine, Yeouido St. Mary's Hospital (E.S.K.), Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital (H.-S. Kim, K.-H.Y., S.-H.L.), and Department of Medical Informatics (H.-S. Kim, K.-H.Y.), College of Medicine, The Catholic University of Korea, Seoul; and Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC (Y.-M.P.).
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16
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Lv J, Wang Z, Wang Y, Sun W, Zhou J, Wang M, Liu WJ, Wang Y. Renoprotective Effect of the Shen-Yan-Fang-Shuai Formula by Inhibiting TNF- α/NF- κB Signaling Pathway in Diabetic Rats. J Diabetes Res 2017; 2017:4319057. [PMID: 28713834 PMCID: PMC5497613 DOI: 10.1155/2017/4319057] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Accepted: 12/15/2016] [Indexed: 12/02/2022] Open
Abstract
Diabetic kidney disease (DKD) is the leading cause of end-stage kidney disease, and satisfactory therapeutic strategies have not yet been established. The Shen-Yan-Fang-Shuai Formula (SYFSF) is a traditional Chinese formula composed of Astragali radix, Radixangelicae sinensis, Rheum officinale Baill, and four other herbs. It has been widely used as an effective treatment for DKD patients in China. However, little is known about the molecular mechanisms underlying SYFSF's renoprotection. In this study, we compared the protective effect of SYFSF to irbesartan on the histology and renal cells in type 2 DKD rat model and high-glucose (HG) cultured mesangial cells, respectively. We found that SYFSF could significantly decrease urinary albumin, cholesterol, and triglyceride. And a decrease in serum creatinine was also found in SYFSF-treated group compared with irbesartan-treated rats. In addition, SYFSF inhibited the interstitial expansion and glomerulosclerosis in diabetic rats. Notably, SYFSF markedly downregulated the expression of MCP-1, TGF-β1, collagen IV, and fibronectin in diabetic rat models and HG-induced mesangial cell models. The renoprotection was closely associated with a reduced expression of TNF-α and phosphorylated NF-κBp65. Our study suggests that SYFSF may ameliorate diabetic kidney injury. The observed renoprotection is probably attributable to an inhibition of inflammatory response and extracellular matrix (ECM) accumulation mediated by TNF-α/NF-κBp65 signaling pathway.
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Affiliation(s)
- Jie Lv
- Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Renal Research Institution, Beijing University of Chinese Medicine, Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing 100700, China
| | - Zhen Wang
- Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Renal Research Institution, Beijing University of Chinese Medicine, Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing 100700, China
| | - Ying Wang
- Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Renal Research Institution, Beijing University of Chinese Medicine, Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing 100700, China
| | - Weiwei Sun
- Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Renal Research Institution, Beijing University of Chinese Medicine, Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing 100700, China
| | - Jingwei Zhou
- Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Renal Research Institution, Beijing University of Chinese Medicine, Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing 100700, China
| | - Mengdi Wang
- Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Renal Research Institution, Beijing University of Chinese Medicine, Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing 100700, China
| | - Wei Jing Liu
- Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Renal Research Institution, Beijing University of Chinese Medicine, Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing 100700, China
- Zhanjiang Key Laboratory of Prevention and Management of Chronic Kidney Disease, Guangdong Medical University, Zhanjiang, Guangdong 524001, China
| | - Yaoxian Wang
- Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Renal Research Institution, Beijing University of Chinese Medicine, Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing 100700, China
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17
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Qingping L, Ribao W, Yang W, Tingyu S, Xi Y, Mengjie H, Hui M, Xiangmei C. Dynamic Analysis of Kidney Function and Its Correlation with Nutritional Indicators in a Large Sample of Hospitalized Elderly Patients. Med Sci Monit 2017; 23:1956-1962. [PMID: 28434010 PMCID: PMC5411021 DOI: 10.12659/msm.904374] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background The aim of this study was to analyze changes in kidney function and its correlation with nutritional metabolism indicators in hospitalized elderly patients in a large medical center over the past 7 years. Material/Methods The renal function of patients over 60 years old in the Chinese PLA General Hospital in 2008, 2011, and 2014 were comparatively analyzed. The hemoglobin, serum albumin, triglycerides, cholesterol, uric acid, and urea nitrogen data were collected and used as the nutritional metabolism indicators. In addition, the correlation between these indicators and the eGFR was analyzed. Results The numbers of patients who received kidney function assessments in the 3 years were 15 752, 23 539, and 49 828; their mean ages were 69.97±6.99, 69.51±7.11, and 69.45±7.74 years. The median values of serum creatinine were 75.4, 76.5, and 77.5 μmol/L in the men and 59.6, 60.7, and 62.1 μmol/L in the women. The eGFR in both sexes demonstrated a gradual decreasing trend over the 3 years. According to the CKD staging method, analysis of the different percentages of eGFR intervals in the patients showed that the percentages of the 3 groups with an eGFR lower than 60 mL/min/1.73 m2 exhibited a rising trend annually. Correlational analysis of the nutritional indicators showed that the correlations between Hb, ALB, TG, TC, Ur, and BUN with an eGFR lower than 60 mL/min/1.73 m2 were 0.582, 0.780, 1.219, 1.364, 2.180, and 3.677, respectively. Conclusions Serum creatinine showed a gradually increasing trend over the 3 study years. The CKD-EPI equation calculation results showed that the eGFR in elderly people of both sexes gradually decreased. Reduction of hemoglobin and albumin was a risk factor for decreased kidney function, while increases in uric acid and blood lipids affected the progression of renal insufficiency.
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Affiliation(s)
- Li Qingping
- Department of Nephrology, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research, Beijing, China (mainland)
| | - Wei Ribao
- Department of Nephrology, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research, Beijing, China (mainland)
| | - Wang Yang
- Department of Nephrology, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research, Beijing, China (mainland)
| | - Su Tingyu
- Department of Nephrology, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research, Beijing, China (mainland)
| | - Yang Xi
- Department of Nephrology, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research, Beijing, China (mainland)
| | - Huang Mengjie
- Department of Nephrology, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research, Beijing, China (mainland)
| | - Miao Hui
- Department of Nephrology, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research, Beijing, China (mainland)
| | - Chen Xiangmei
- Department of Nephrology, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research, Beijing, China (mainland)
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18
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Bae JC, Han JM, Kwon S, Jee JH, Yu TY, Lee MK, Kim JH. LDL-C/apoB and HDL-C/apoA-1 ratios predict incident chronic kidney disease in a large apparently healthy cohort. Atherosclerosis 2016; 251:170-176. [DOI: 10.1016/j.atherosclerosis.2016.06.029] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Revised: 05/25/2016] [Accepted: 06/15/2016] [Indexed: 11/27/2022]
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19
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Youssef F, Gupta P, Seifalian AM, Myint F, Mikhailidis DP, Hamilton G. The Effect of Short-Term Treatment with Simvastatin on Renal Function in Patients with Peripheral Arterial Disease. Angiology 2016; 55:53-62. [PMID: 14759090 DOI: 10.1177/000331970405500108] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The objective of this study was to investigate the effects of lipid-lowering treatment on renal function in patients with peripheral arterial disease (PAD). This was a retrospective study of hyperlipidemic claudicants referred to a vascular surgery and risk modification clinic. Serum creatinine and urate concentrations and the fasting lipid profile were measured pretreatment and after 3-4 months of treatment with 20 mg/day simvastatin. In 103 consecutive patients with PAD (57 men; 46 women), median age 67 years (range: 51 to 83) there was a significant decrease in serum creatinine from a mean (SD) of 87 (12) μmol/L pretreatment to 84 (12) μmol/L post-treatment (p<0.0001). This difference was more marked in the tertile of patients with the highest baseline creatinine levels. There was also a significant reduction in serum urate from 0.37 (0.07) mmol/L to 0.35 (0.07) mmol/L (p<0.0001). Both these effects were independent of the degree of total cholesterol (TC) or low-density lipoprotein (LDL) cholesterol reduction. There was a significant reduction in TC from 6.6 (1.0) to 5.2 (0.8) mmol/L and LDL cholesterol from 4.3 (1.0) to 2.8 (0.7) mmol/L; both p<0.0001. Significant improvement also occurred in the high-density lipoprotein cholesterol and triglyceride levels. Cholesterol lowering with simvas tatin 20 mg/day improved indices of renal function after 3-4 months of treatment in hyper lipidemic patients with PAD. Further studies are needed to establish and define the clinical relevance of these findings, especially in patients with different degrees of renal failure.
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Affiliation(s)
- Fahed Youssef
- University Department of Surgery, Royal Free Hospital NHS Trust and Royal Free and University College Medical School, London, United Kingdom
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20
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Deambrosis I, Scalabrino E, Deregibus MC, Camussi G, Bussolati B. CD40-Dependent Activation of Phosphatidylinositol 3-Kinase/Akt Pathway Inhibits Apoptosis of Human Cultured Mesangial Cells Induced by Oxidized LDL. Int J Immunopathol Pharmacol 2016; 18:327-37. [PMID: 15888255 DOI: 10.1177/039463200501800215] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Deposition of atherogenic lipoproteins is associated with various glomerular diseases. In particular, oxidized LDL (oxLDL) may affect mesangial cells and favour the development of glomerulosclerosis. The aim of the present study was to investigate on cultured human mesangial cells (HMC) whether oxLDL induces apoptosis by a mechanism dependent on the inhibition of Akt survival pathway, and whether the engagement of mesangial CD40 by its ligand CD154 inhibits the apoptotic effect of oxLDL. Tunel assays demonstrated that incubation of HMC for 24h with oxLDL, but not with unmodified LDL, induced a dose-dependent increase in apoptosis of HMC associated with a decrease in Akt phosphorylation. Enzymatic kinase assay showed that also the Akt activity was reduced in a dose-dependent manner by treatment with oxLDL. Stimulation of mesangial CD40 with sCD154 rescued HMC from oxLDL-dependent apoptosis, while two unrelated pharmacological inhibitors of PI3K LY294002 and wortmannin abrogated this anti-apoptotic effect, suggesting an involvement of the PI3K/Akt pathway. Moreover CD40 stimulation maintained an elevated phosphorylation of Akt and preserved its enzymatic activity in the presence of oxLDL. Indeed, CD154 induced a rapid enhancement in Akt enzymatic activity, that was temporarily correlated with the association of CD40 with TRAF3, TRAF6, c-Cbl and the p85 subunit of PI3K. In conclusion, these results suggest that CD40 stimulation protects HMC from toxic effects of oxLDL by promoting PI3K/Akt-dependent cell survival.
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Affiliation(s)
- I Deambrosis
- Cattedra di Nefrologia, Dipartimento di Medicina Interna, Università di Torino, Italy
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Güneş H, Kıvrak T, Tatlısu M, Kaya H, Yılmaz MB. Relationship between endothelial dysfunction and microalbuminuria in familial Mediterranean fever. Eur J Rheumatol 2016; 3:61-64. [PMID: 27708973 PMCID: PMC5042232 DOI: 10.5152/eurjrheum.2016.15079] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Accepted: 12/07/2015] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVE The aim of our study is to investigate the relationship between microalbuminuria and flow-mediated dilatation in familial Mediterranean fever (FMF) patients. MATERIAL AND METHODS In our study, there were two groups consisting of 54 patients who were out of the attack period (43 of whom had no microalbuminuria and 11 of whom had microalbuminuria) and 40 healthy controls (M/F: 12/28). RESULTS There was no statistically difference between patient and control groups'age (25.06±8.07, 22.89±6.00 years, respectively). Flow-mediated dilatation (FMD) percentages were significantly different between the three groups (p=0.01). It was observed that there was a correlation between microalbuminuria and FMD percentage. CONCLUSION Endothelial dysfunction and renal damage occurred as a result of low-grade chronic inflammation. Microalbuminuria, which is the indicator of renal damage and endothelial dysfunction, and FMD show that endothelial functions can be used in the following of early detection of renal damage and endothelial functions in FMF patients.
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Affiliation(s)
- Hakan Güneş
- Clinic of Cardiology, Sivas Numune Hospital, Sivas, Turkey
| | - Tarık Kıvrak
- Clinic of Cardiology, Sivas Numune Hospital, Sivas, Turkey
| | | | - Hakkı Kaya
- Department of Cardiology, Cumhuriyet University Hospital, Sivas, Turkey
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Abstract
PURPOSE OF REVIEW Foam cells in human glomeruli can be encountered in various renal diseases including focal segmental glomerulosclerosis and diabetic nephropathy. Although foam cells are key participants in atherosclerosis, surprisingly little is known about their pathogenicity in the kidney. We review our understanding (or lack thereof) of foam cells in the kidney, as well as insights gained in studies of foam cells and macrophages involved in atherosclerosis to suggest areas of investigation that will allow better characterization of the role of these cells in renal disease. RECENT FINDINGS There is a general dearth of animal models of disease with renal foam cell accumulation, limiting progress in our understanding of the pathobiology of these cells. Recent genetic modifications of hyperlipidemic mice have resulted in some new disease models with renal foam cell accumulation. Recent studies have challenged older paradigms by findings that indicate that many tissue macrophages are derived from cells permanently residing in the tissue from birth rather than circulating monocytes. SUMMARY Renal foam cells remain an enigma. Extrapolating from studies of atherosclerosis suggests that therapeutics targeting mitochondrial reactive oxygen species production, or modulating cholesterol and lipoprotein uptake or egress from these cells, may prove beneficial for kidney diseases in which foam cells are present.
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Zhang Y, Ma KL, Liu J, Wu Y, Hu ZB, Liu L, Lu J, Zhang XL, Liu BC. Inflammatory stress exacerbates lipid accumulation and podocyte injuries in diabetic nephropathy. Acta Diabetol 2015; 52:1045-56. [PMID: 25896009 DOI: 10.1007/s00592-015-0753-9] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2015] [Accepted: 04/02/2015] [Indexed: 02/06/2023]
Abstract
AIMS Diabetic nephropathy (DN) is a chronic inflammatory disease that is accompanied by different degrees of lipid disorders. The present study was conducted to determine whether inflammatory stress exacerbates lipid accumulation in podocytes and to investigate its underlying mechanisms in DN using in vitro and in vivo studies. METHODS We used IL-1β stimulation in podocytes in vitro and casein injections in db/db mice in vivo to induce inflammatory stress. The plasma levels of serum inflammatory cytokines were determined using an enzyme-linked immunosorbent assay. The renal pathology was evaluated using pathological staining and electron microscopy. Intracellular lipid accumulation was evaluated by Oil Red O staining and a cholesterol quantitative assay. The gene and protein expression levels of extracellular matrix proteins, biomarkers of podocyte injury, and molecules involved in the LDLr pathway were evaluated using immunofluorescence staining, real-time PCR, and western blot analysis. RESULTS Increased plasma levels of inflammatory cytokines in the casein-injected db/db mice indicated a successful induction of the inflamed DN model. The kidney morphological changes, podocyte injury, and epithelial mesenchymal transition (EMT) were more significant in casein-injected db/db mice. Moreover, inflammation increased the lipid droplet accumulation in the kidneys of db/db mice, which resulted from the increased protein expression levels of LDLr, sterol regulatory element-binding protein (SREBP) cleavage-activating protein (SCAP), and SREBP-2 in the kidneys of db/db mice. The in vitro studies further demonstrated that inflammation increased the lipid accumulation in the podocytes and induced podocyte EMT, which were correlated with inflammation-mediated increases in the expression levels of LDLr, SCAP, and SREBP-2, and increased translocation of the SCAP/SREBP-2 complex from the endoplasmic reticulum to the Golgi in the podocytes. CONCLUSION Inflammation induced lipid accumulation and the EMT of podocytes through the dysregulation of the LDLr pathway, which contributed to podocyte injury and accelerated the progression of DN.
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Affiliation(s)
- Yang Zhang
- Institute of Nephrology, Zhong Da Hospital, Southeast University School of Medicine, No. 87, Ding Jia Qiao Road, Nanjing City, 210009, Jiangsu Province, China
| | - Kun Ling Ma
- Institute of Nephrology, Zhong Da Hospital, Southeast University School of Medicine, No. 87, Ding Jia Qiao Road, Nanjing City, 210009, Jiangsu Province, China.
| | - Jing Liu
- Institute of Nephrology, Zhong Da Hospital, Southeast University School of Medicine, No. 87, Ding Jia Qiao Road, Nanjing City, 210009, Jiangsu Province, China
| | - Yu Wu
- Institute of Nephrology, Zhong Da Hospital, Southeast University School of Medicine, No. 87, Ding Jia Qiao Road, Nanjing City, 210009, Jiangsu Province, China
| | - Ze Bo Hu
- Institute of Nephrology, Zhong Da Hospital, Southeast University School of Medicine, No. 87, Ding Jia Qiao Road, Nanjing City, 210009, Jiangsu Province, China
| | - Liang Liu
- Institute of Nephrology, Zhong Da Hospital, Southeast University School of Medicine, No. 87, Ding Jia Qiao Road, Nanjing City, 210009, Jiangsu Province, China
| | - Jian Lu
- Institute of Nephrology, Zhong Da Hospital, Southeast University School of Medicine, No. 87, Ding Jia Qiao Road, Nanjing City, 210009, Jiangsu Province, China
| | - Xiao Liang Zhang
- Institute of Nephrology, Zhong Da Hospital, Southeast University School of Medicine, No. 87, Ding Jia Qiao Road, Nanjing City, 210009, Jiangsu Province, China
| | - Bi Cheng Liu
- Institute of Nephrology, Zhong Da Hospital, Southeast University School of Medicine, No. 87, Ding Jia Qiao Road, Nanjing City, 210009, Jiangsu Province, China
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Hara S, Kobayashi N, Sakamoto K, Ueno T, Manabe S, Takashima Y, Hamada J, Pastan I, Fukamizu A, Matsusaka T, Nagata M. Podocyte injury-driven lipid peroxidation accelerates the infiltration of glomerular foam cells in focal segmental glomerulosclerosis. THE AMERICAN JOURNAL OF PATHOLOGY 2015; 185:2118-31. [PMID: 26072030 DOI: 10.1016/j.ajpath.2015.04.007] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Received: 12/31/2014] [Revised: 04/15/2015] [Accepted: 04/16/2015] [Indexed: 02/07/2023]
Abstract
Intracapillary foam cell infiltration with podocyte alterations is a characteristic pathology of focal segmental glomerulosclerosis (FSGS). We investigated the possible role of podocyte injury in glomerular macrophage and foam cell infiltration in a podocyte-selective injury model (NEP25 mice) and hypercholesterolemic model [low-density lipoprotein receptor deficiency (LDLR(-/-)) mice] with doxorubicin-induced nephropathy. Acute podocyte selective injury alone failed to induce glomerular macrophages in the NEP25 mice. However, in the doxorubicin-treated hypercholesterolemic LDLR(-/-) mice, glomerular macrophages/foam cells significantly increased and were accompanied by lipid deposition and the formation and ingestion of oxidized phospholipids (oxPLs). Glomerular macrophages significantly correlated with the amount of glomerular oxPL. The NEP25/LDLR(-/-) mice exhibited severe hypercholesterolemia, glomerular lipid deposition, and renal dysfunction. Imaging mass spectrometry revealed that a major component of oxidized low-density lipoprotein, lysophosphatidylcholine 16:0 and 18:0, was present only in the glomeruli of NEP25/LDLR(-/-) mice. Lysophosphatidylcholine 16:0 stimulated mesangial cells and macrophages, and lysophosphatidylcholine 18:0 stimulated glomerular endothelial cells to express adhesion molecules and chemokines, promoting macrophage adhesion and migration in vitro. In human FSGS, glomerular macrophage-derived foam cells contained oxPLs accompanied by the expression of chemokines in the tuft. In conclusion, glomerular lipid modification represents a novel pathology by podocyte injury, promoting FSGS. Podocyte injury-driven lysophosphatidylcholine de novo accelerated glomerular macrophage-derived foam cell infiltration via lysophosphatidylcholine-mediated expression of adhesion molecules and chemokines in glomerular resident cells.
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Affiliation(s)
- Satoshi Hara
- Department of Kidney and Vascular Pathology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan; Division of Rheumatology, Department of Internal Medicine, Kanazawa Graduate School of Medicine, Kanazawa, Japan
| | - Namiko Kobayashi
- Department of Kidney and Vascular Pathology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Kazuo Sakamoto
- Department of Kidney and Vascular Pathology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Toshiharu Ueno
- Department of Kidney and Vascular Pathology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Shun Manabe
- Department of Kidney and Vascular Pathology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Yasutoshi Takashima
- Department of Kidney and Vascular Pathology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Juri Hamada
- Life Science Center, Tsukuba Advanced Research Alliance, Graduate School of Life and Environmental Sciences, University of Tsukuba, Tsukuba, Japan
| | - Ira Pastan
- Laboratory of Molecular Biology, Center for Cancer Research, National Cancer Institute, NIH, Bethesda, Maryland
| | - Akiyoshi Fukamizu
- Life Science Center, Tsukuba Advanced Research Alliance, Graduate School of Life and Environmental Sciences, University of Tsukuba, Tsukuba, Japan
| | - Taiji Matsusaka
- Department of Internal Medicine, Institute of Medical Science, Tokai University School of Medicine, Isehara, Japan
| | - Michio Nagata
- Department of Kidney and Vascular Pathology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
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Ramezani A, Devaney JM, Cohen S, Wing MR, Scott R, Knoblach S, Singhal R, Howard L, Kopp JB, Raj DS. Circulating and urinary microRNA profile in focal segmental glomerulosclerosis: a pilot study. Eur J Clin Invest 2015; 45:394-404. [PMID: 25682967 PMCID: PMC4903079 DOI: 10.1111/eci.12420] [Citation(s) in RCA: 83] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Accepted: 02/06/2015] [Indexed: 12/22/2022]
Abstract
BACKGROUND MicroRNAs (miRNAs) are noncoding RNA molecules that play important roles in the pathogenesis of various kidney diseases. We investigated whether patients with minimal change disease (MCD) and focal segmental glomerulosclerosis (FSGS) have distinct circulating and urinary miRNA expression profiles that could lead to potential development of noninvasive biomarkers of the disease. MATERIALS AND METHODS Exosome miRNAs were extracted from plasma and urine samples of patients with primary FSGS (n = 16) or MCD (n = 5) and healthy controls (n = 5). Differences in miRNA abundance were examined using Affymetrix GeneChip miRNA 3.0 arrays. QRT-PCR was used to validate the findings from the array. RESULTS Comparison analysis of FSGS versus MCD revealed 126 and 155 differentially expressed miRNAs in plasma and in urine, respectively. Only 38 of these miRNAs were previously cited, whereas the remaining miRNAs have not been described. Comparison analysis showed that a significant number of miRNAs were downregulated in both plasma and urine samples of patients with FSGS compared to those with MCD. Plasma levels of miR-30b, miR-30c, miR-34b, miR-34c and miR-342 and urine levels of mir-1225-5p were upregulated in patients with MCD compared to patients with FSGS and controls (P < 0.001). Urinary levels of mir-1915 and miR-663 were downregulated in patients with FSGS compared to MCD and controls (P < 0.001), whereas the urinary levels of miR-155 were upregulated in patients with FSGS when compared to patients with MCD and controls (P < 0.005). CONCLUSIONS Patients with FSGS and MCD have a unique circulating and urinary miRNA profile. The diagnostic and prognostic potential of miRNAs in FSGS and MCD warrants further studies.
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Affiliation(s)
- Ali Ramezani
- Division of Renal Diseases and Hypertension, The George Washington University School of Medicine, Washington, DC, USA
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26
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Lee HO, Bak HJ, Shin JY, Song YM. Association between Metabolic Syndrome and Microalbuminuria in Korean Adults. Korean J Fam Med 2015; 36:60-71. [PMID: 25802687 PMCID: PMC4369662 DOI: 10.4082/kjfm.2015.36.2.60] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Accepted: 02/25/2015] [Indexed: 01/12/2023] Open
Abstract
Background We conducted a population-based cross-sectional study of Korean adults to evaluate the association between metabolic syndrome and microalbuminuria as a marker for early-stage chronic kidney disease. Methods A total of 8,497 adults (3,625 men and 4,872 women) who participated in the Korea National Health and Nutrition Examination Survey between 2011 and 2012 were included. Metabolic syndrome was defined according to recommendation from a joint interim statement of international organizations published in 2009. Microalbuminuria was defined as a urinary albumin-to-creatinine ratio of 30 to 300 mg/g. The association between metabolic syndrome and microalbuminuria was evaluated using logistic regression analysis with adjustment for covariates while considering sampling weights and the complex survey design. Results The prevalence of microalbuminuriain subjects with metabolic syndrome was 11% for men and 14.4% for women, whereas the prevalence in subjects without metabolic syndrome was 3.1% for men and 6.7% for women. Metabolic syndrome was significantly associated with an increased risk of microalbuminuriain both women (odds ratio, 2.79; 95% confidence interval, 2.01 to 3.88) and men (odds ratio, 3.00; 95% confidence interval, 2.11 to 4.27). All components of the metabolic syndrome were associated with a significantly increased risk of microalbuminuria with the strongest association for high blood pressure. The risk of microalbuminuria increased in a dose-dependent manner (P-value for trend < 0.001) with the number of metabolic syndrome components observed for both sexes. Conclusion These findings suggest that metabolic syndrome is a risk factor for chronic kidney disease from an early stage.
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Affiliation(s)
- Hyun-Ok Lee
- Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hyun-Ju Bak
- Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jin-Young Shin
- Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yun-Mi Song
- Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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27
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Lan X, Wen H, Saleem MA, Mikulak J, Malhotra A, Skorecki K, Singhal PC. Vascular smooth muscle cells contribute to APOL1-induced podocyte injury in HIV milieu. Exp Mol Pathol 2015; 98:491-501. [PMID: 25796344 DOI: 10.1016/j.yexmp.2015.03.020] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Accepted: 03/12/2015] [Indexed: 02/07/2023]
Abstract
Clinical reports have demonstrated that higher rates of non-diabetic glomerulosclerosis in African Americans can be attributed to two coding sequence variants (G1 and G2) in the APOL1 gene; however, the underlying mechanism is still unknown. Kidney biopsy data suggest enhanced expression of APOL1/APOL1 variants (Vs) in smooth muscle cells (SMCs) of renal vasculature. Since APOL1 is a secretory protein of relatively low molecular weight (41kDa), SMCs may be a contributory endocrine/paracrine source of APOL1 wild type (WT)/APOL1Vs in the glomerular capillary perfusate percolating podocytes. In the present study, we tested the hypothesis that an HIV milieu stimulated secretion of APOL1 and its risk variants by arterial SMCs contributes to podocyte injury. Human umbilical artery smooth muscle cells (HSMCs)-treated with conditioned media (CM) of HIV-infected peripheral mononuclear cells (PBMC/HIV-CM), CM of HIV-infected U939 cells, or recombinant IFN-γ displayed enhanced expression of APOL1. Podocytes co-cultured in trans-wells with HSMCs-over expressing APOL1WT showed induction of injury; however, podocytes co-cultured with HSMC-over expressing either APOL1G1 or APOL1G2 showed several folds greater injury when compared to HSMC-over expressing APOL1WT. Conditioned media collected from HSMC-over-expressing APOL1G1/APOL1G2 (HSMC/APOL1G1-CM or HSMC/APOL1G2-CM) also displayed higher percentages of injured podocytes in the form of swollen cells, leaky lysosomes, loss of viability, and enhanced sensitivity to adverse host factors when compared to HSMC/APOL1WT-CM. Notably, HSMC/APOL1WT-CM promoted podocyte injury only at a significantly higher concentrations compared to HSMC/APOL1G1/G2-CM. We conclude that HSMCs could serve as an endocrine/paracrine source of APOL1Vs, which mediate accelerated podocyte injury in HIV milieu.
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Affiliation(s)
- Xiqian Lan
- Renal Molecular Research Laboratory, Feinstein Institute for Medical Research, Department of Medicine, Hofstra North Shore LIJ Medical School, NY, USA
| | - Hongxiu Wen
- Renal Molecular Research Laboratory, Feinstein Institute for Medical Research, Department of Medicine, Hofstra North Shore LIJ Medical School, NY, USA
| | - Moin A Saleem
- Renal Academic Unit, Department of Pediatrics, University of Bristol, Bristol, UK
| | - Joanna Mikulak
- Unit of Clinical and Experimental Immunology, Humanitas Clinical and Research Center, Rozzano, Milan, Italy
| | - Ashwani Malhotra
- Renal Molecular Research Laboratory, Feinstein Institute for Medical Research, Department of Medicine, Hofstra North Shore LIJ Medical School, NY, USA
| | - Karl Skorecki
- Nephrology and Molecular Medicine, Technion Institute of Technology, Rambam Medical Center, Haifa, Israel
| | - Pravin C Singhal
- Renal Molecular Research Laboratory, Feinstein Institute for Medical Research, Department of Medicine, Hofstra North Shore LIJ Medical School, NY, USA.
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Zhang S, Guo Y, Zou H, Sun N, Zhao D, Liu W, Dong Y, Cheng G, Yuan Q. Effect of estrogen deficiency on the fixation of titanium implants in chronic kidney disease mice. Osteoporos Int 2015; 26:1073-80. [PMID: 25366374 DOI: 10.1007/s00198-014-2952-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2014] [Accepted: 10/27/2014] [Indexed: 02/05/2023]
Abstract
UNLABELLED We established a chronic kidney disease (CKD) mouse model with estrogen deficiency and inserted titanium implants into the femur of such mice to investigate the fixation of the implants. Both the histomorphometry and implant resistance indicated that estrogen deficiency impaired the fixation of titanium implants inserted into such mice. INTRODUCTION CKD has been regarded as a worldwide public health problem. Estrogen is a critical factor for both renal protection and bone remodeling. A previous study demonstrated that CKD impairs the early healing of titanium implants. However, the combined effect of estrogen deficiency and CKD on the fixation of titanium implants is largely unknown. METHODS Forty 9-week-old female C57BL mice were randomly divided into sham, ovariectomy (OVX), CKD, and CKD + OVX groups. Uremia and estrogen deficiency were induced by 5/6 nephrectomy and OVX, respectively. Experimental titanium implants were inserted into the distal end of the femur. Bone-implant contact (BIC) ratio and bone volume (BV/TV) around the implants were histomorphometrically analyzed. The fixation strength of the implant was measured by a biomechanical push-in resistance test. RESULTS Serum measurement confirmed a significant increase in serum blood urea nitrogen (BUN) in the CKD group, which was further increased by OVX. Estrogen deficiency led to significant decreases in the BIC ratio, BV/TV, and the push-in resistance in CKD animals. There was a significant interaction between the effects of OVX and CKD, with OVX exacerbating the effects of CKD on BIC ratio and push-in resistance. CONCLUSIONS The results indicated that estrogen deficiency exerts a synergistic effect with CKD and further impairs the fixation of titanium implants in CKD mice.
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Affiliation(s)
- S Zhang
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, 14 Third Section, Renmin Nan Road, 610041, Chengdu, China
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29
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Lu W, Liu S, Zhao Z, Liu Y, Li T. The effect of connective tissue growth factor on renal fibrosis and podocyte injury in hypertensive rats. Ren Fail 2014; 36:1420-7. [DOI: 10.3109/0886022x.2014.934692] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
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Hung CC, Tsai JC, Kuo HT, Chang JM, Hwang SJ, Chen HC. Dyslipoproteinemia and impairment of renal function in diabetic kidney disease: an analysis of animal studies, observational studies, and clinical trials. Rev Diabet Stud 2013; 10:110-20. [PMID: 24380087 DOI: 10.1900/rds.2013.10.110] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Dyslipoproteinemia is highly prevalent in diabetes, chronic kidney disease, and diabetic kidney disease (DKD). Both diabetes and chronic kidney disease (CKD) are associated with hypertriglyceridemia, lower high-density lipoprotein, and higher small, dense low-density lipoprotein. A number of observational studies have reported that dyslipidemia may be associated with albuminuria, renal function impairment, and end-stage renal disease (ESRD) in the general population, and especially in CKD and DKD patients. Diabetic glomerulopathy and the related albuminuria are the main manifestations of DKD. Numerous animal studies support the finding that glomerular atherosclerosis is the main mechanism of glomerulosclerosis in CKD and DKD. Some randomized, controlled trials suggest the use of statins for the prevention of albuminuria and renal function impairment in CKD and DKD patients. However, a large clinical study, the Study of Heart and Renal Protection (SHARP), does not support that statins could reduce ESRD in CKD. In this article, we analyze the complex association of dyslipoproteinemia with DKD and deduce its relevance from animal studies, observational studies, and clinical trials. We show that special subgroups could benefit from the statin treatment.
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Affiliation(s)
- Chi-Chih Hung
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan
| | - Jer-Chia Tsai
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan
| | - Hung-Tien Kuo
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan
| | - Jer-Ming Chang
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan
| | - Shang-Jyh Hwang
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan
| | - Hung-Chun Chen
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan
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Pirisi M, Faedda R, Satta A, Bartoli E. Immunosuppressive treatment for idiopathic nephrotic syndrome with corticosteroids and cyclophosphamide: factors associated with a favourable outcome. Clin Drug Investig 2013; 16:211-8. [PMID: 18370542 DOI: 10.2165/00044011-199816030-00005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
OBJECTIVE We report the results of a combined immunosuppressive schedule for the treatment of patients with idiopathic nephrotic syndrome, in which prednisone and cyclophosphamide were given in four phases: induction, maintenance, tapering and discontinuation. PATIENTS AND OUTCOME MEASURES Sixty-seven patients with nephrotic syndrome, followed for an average of 7.1 +/- 4.5 years, were studied. Treatment outcomes were remission, progression, end-stage renal disease and death. RESULTS At the end of the follow-up, 72% of patients maintained a complete remission. Stepwise logistic regression showed that the cumulative dose of cyclophosphamide was the only independent predictor of a favourable outcome, being associated both with complete remission of the nephrotic syndrome and with lack of progression to chronic renal failure. CONCLUSION We suggest that the combination treatment may be indicated in all histological subgroups of nephrotic syndrome, provided that prednisone is given at high doses on alternate days, cyclophosphamide is given for 6 months, and relapses are treated with the same schedule. The adverse effects of treatment, however, require the adoption of a programme to prevent bone loss, infertility, bladder cancer and infections.
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Affiliation(s)
- M Pirisi
- Cattedra di Medicina Interna, DPMSC, Università degli Studi, Udine, Italy
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32
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Metabolic syndrome component combinations and chronic kidney disease: The severance cohort study. Maturitas 2013; 75:74-80. [DOI: 10.1016/j.maturitas.2013.02.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2012] [Revised: 02/07/2013] [Accepted: 02/15/2013] [Indexed: 11/18/2022]
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Mäkinen VP, Soininen P, Kangas AJ, Forsblom C, Tolonen N, Thorn LM, Viikari J, Raitakari OT, Savolainen M, Groop PH, Ala-Korpela M. Triglyceride-cholesterol imbalance across lipoprotein subclasses predicts diabetic kidney disease and mortality in type 1 diabetes: the FinnDiane Study. J Intern Med 2013; 273:383-95. [PMID: 23279644 DOI: 10.1111/joim.12026] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Circulating cholesterol (C) and triglyceride (TG) levels are associated with vascular injury in type 1 diabetes (T1DM). Lipoproteins are responsible for transporting lipids, and alterations in their subclass distributions may partly explain the increased mortality in individuals with T1DM. DESIGN AND SUBJECTS A cohort of 3544 individuals with T1DM was recruited by the nationwide multicentre FinnDiane Study Group. At baseline, six very low-density lipoprotein VLDL, one intermediate-density lipoprotein IDL, three low-density lipoprotein LDL and four higher high-density lipoprotein HDL subclasses were quantified by proton nuclear magnetic resonance spectroscopy. At follow-up, the baseline data were analysed for incident micro- or macroalbuminuria (117 cases in 5.3 years), progression from microalbuminuria (63 cases in 6.1 years), progression from macroalbuminuria (109 cases in 5.9 years) and mortality (385 deaths in 9.4 years). Univariate associations were tested by age-matched cases and controls and multivariate lipoprotein profiles were analysed using the self-organizing map (SOM). RESULTS TG and C levels in large VLDL were associated with incident albuminuria, TG and C in medium VLDL were associated with progression from microalbuminuria, and TG and C in all VLDL subclasses were associated with mortality. Large HDL-C was inversely associated with mortality. Three extreme phenotypes emerged from SOM analysis: (i) low C (<3% mortality), (ii) low TG/C ratio (6% mortality), and (iii) high TG/C ratio (40% mortality) in all subclasses. CONCLUSIONS TG-C imbalance is a general lipoprotein characteristic in individuals with T1DM and high vascular disease risk.
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Affiliation(s)
- V-P Mäkinen
- Computational Medicine, Institute of Clinical Medicine, Faculty of Medicine, University of Oulu, Oulu, Finland.
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Odden MC, Tager IB, Gansevoort RT, Bakker SJL, Fried LF, Newman AB, Katz R, Satterfield S, Harris TB, Sarnak MJ, Siscovick D, Shlipak MG. Hypertension and low HDL cholesterol were associated with reduced kidney function across the age spectrum: a collaborative study. Ann Epidemiol 2013; 23:106-11. [PMID: 23313266 PMCID: PMC3570601 DOI: 10.1016/j.annepidem.2012.12.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2012] [Revised: 12/06/2012] [Accepted: 12/06/2012] [Indexed: 01/01/2023]
Abstract
PURPOSE To determine if the associations among established risk factors and reduced kidney function vary by age. METHODS We pooled cross-sectional data from 14,788 nondiabetics aged 40 to 100 years in 4 studies: Cardiovascular Health Study, Health, Aging, and Body Composition Study, Multi-Ethnic Study of Atherosclerosis, and Prevention of Renal and Vascular End-Stage Disease cohort. RESULTS Hypertension and low high-density lipoprotein (HDL) cholesterol were associated with reduced cystatin C-based estimated glomerular filtration rate (eGFR) across the age spectrum. In adjusted analyses, hypertension was associated with a 2.3 (95% confidence interval [CI], 0.1, 4.4), 5.1 (95% CI, 4.1, 6.1), and 6.9 (95% CI, 3.0, 10.4) mL/min/1.73 m(2) lower eGFR in participants 40 to 59, 60 to 79, and at least 80 years, respectively (P for interaction < .001). The association of low HDL cholesterol with reduced kidney function was also greater in the older age groups: 4.9 (95% CI, 3.5, 6.3), 7.1 (95% CI, 6.0, 8.3), 8.9 (95% CI, 5.4, 11.9) mL/min/1.73 m(2) (P for interaction < .001). Smoking and obesity were associated with reduced kidney function in participants under 80 years. All estimates of the potential population impact of the risk factors were modest. CONCLUSIONS Hypertension, obesity, smoking, and low HDL cholesterol are modestly associated with reduced kidney function in nondiabetics. The associations of hypertension and HDL cholesterol with reduced kidney function seem to be stronger in older adults.
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Affiliation(s)
- Michelle C Odden
- School of Biological and Population Health Sciences, Oregon State University, Corvallis, OR, USA.
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Kim JY, Kang HT, Lee HR, Lee YJ, Shim JY. Comparison of lipid-related ratios for prediction of chronic kidney disease stage 3 or more in Korean adults. J Korean Med Sci 2012; 27:1524-9. [PMID: 23255852 PMCID: PMC3524432 DOI: 10.3346/jkms.2012.27.12.1524] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2012] [Accepted: 10/11/2012] [Indexed: 12/04/2022] Open
Abstract
Dyslipidemia is implicated in increased cardiovascular risk associated with chronic kidney disease (CKD) and in the progression of renal damage. This study compared 4 different lipid-related ratios (total cholesterol [TC]/high-density lipoprotein cholesterol [HDL-C], triglyceride [TG]/HDL-C, calculated low-density lipoprotein cholesterol [c-LDL-C]/HDL-C, and non-HDL-C/HDL-C ratio) for prediction of CKD stage 3 or more to investigate the association between them. This cross-sectional study included 8,650 adults who participated in the 2007-2008 Korean National Health and Nutrition Examination Survey. The overall prevalence of CKD stage 3 or more was 6.4%. For TG/HDL-C, the prevalence with CKD stage 3 or more increased with increasing quartile group in both sexes (P value for trend = 0.046 in men, 0.002 in women) while other lipid-related ratios showed increasing prevalence only in women. In comparison with the lowest quartile of the lipid-related ratios, only the fourth quartile of TG/HDL-C was associated with the prevalence of CKD stage 3 or more in both sexes after adjustment for multiple covariates (odds ratio [OR] for TG/HDL-C-Q(4), 1.82; 95% CI [confidence interval], 1.09-3.03 in men, OR 2.45; 95% CI, 1.52-3.95 in women). In conclusion, TG/HDL-C is the only lipid-related ratio that is independently associated with CKD stage 3 or more in both sexes of Koreans.
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Affiliation(s)
- Ji-Young Kim
- Department of Family Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Hee-Taik Kang
- Department of Family Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Hye-Ree Lee
- Department of Family Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Yong-Jae Lee
- Department of Family Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea
| | - Jae-Yong Shim
- Department of Family Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
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Zhang G, Li Q, Wang L, Chen Y, Zhang W, Yang H. The effects of inflammation on lipid accumulation in the kidneys of children with primary nephrotic syndrome. Inflammation 2012; 34:645-52. [PMID: 21103916 DOI: 10.1007/s10753-010-9274-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
This study aimed to characterize the relationship between inflammation and lipid accumulation in children with primary nephrotic syndrome (PNS). Local expression of interleukin-1β (IL-1β), transforming growth factor-β1 (TGF-β1), low-density lipoprotein receptor (LDLr), sterol regulatory element binding protein-2 (SREBP-2), SREBP cleavage-activating protein (SCAP), and apolipoprotein B100 (apoB100) was analyzed by immunohistochemistry in kidney tissues obtained from children with PNS. Renal histopathology was evaluated by hematoxylin and eosin and periodic acid-Schiff staining. Serum levels of IL-1β and TGF-β1 were measured by enzyme-linked immunosorbent assays. Expression of IL-1β, TGF-β1, LDLr, SREBP-2, SCAP, and apoB100 was higher in samples from patients with non-minimal change necrotic syndrome (NMCNS) compared to both controls and patients with minimal change necrotic syndrome. Deposition of apoB100 was significantly correlated with expression of IL-1β, TGF-β1, LDLr, SREBP-2, and SCAP and with the glomerulosclerosis index, but not with plasma lipid levels. Expression of IL-1β and TGF-β1 was significantly correlated with expression of LDLr, SREBP-2, and SCAP. These findings suggest that inflammation leads to lipid accumulation in the kidney through disruption of the expression of proteins in the SCAP/SREBP-2/LDLr signaling pathway, which may underlie glomerulosclerosis and tubulointerstitial fibrosis in NMCNS.
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Affiliation(s)
- Gaofu Zhang
- Department of Nephroimmunology, Children's Hospital of Chongqing Medical University, Chongqing, 136 Zhongshan Er Road, Yu Zhong District, Chongqing, 400014, People's Republic of China
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Gava AL, Freitas FPS, Meyrelles SS, Silva IV, Graceli JB. Gender-dependent effects of aging on the kidney. Braz J Med Biol Res 2011; 44:905-13. [PMID: 21956533 DOI: 10.1590/s0100-879x2011007500101] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2011] [Accepted: 08/05/2011] [Indexed: 11/22/2022] Open
Abstract
It is well known that the kidney plays an important role in the development of cardiovascular diseases such as hypertension. The normal aging process leads to changes in kidney morphology, hemodynamics and function, which increase the incidence of cardiovascular events in the elderly population. These disturbances are influenced by several factors, including gender. In general, females are protected by the effects of estrogens on the cardiorenal system. Several studies have demonstrated the beneficial effects of estrogens on renal function in the elderly; however, the relationships between androgens and kidney health during one's lifetime are not well understood. Sex steroids have many complex actions, and the decline in their levels during aging clearly influences kidney function, decreases the renal reserve and facilitates the development of cardiovascular disorders. Therefore, in this review, we discuss the cellular, biochemical, and molecular mechanisms by which sex hormones may influence renal function during the aging process.
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Affiliation(s)
- A L Gava
- Laboratório de Transgenes e Controle Cardiovascular, Programa de Pós-Graduação em Ciências Fisiológicas, Universidade Federal do Espírito Santo, Vitória, ES, Brasil
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Tien KJ, Tu ST, Chou CW, Yang CY, Hsiao JY, Shin SJ, Chen HC, Hsieh MC. Apolipoprotein E polymorphism and the progression of diabetic nephropathy in type 2 diabetes. Am J Nephrol 2011; 33:231-8. [PMID: 21346330 DOI: 10.1159/000324561] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2010] [Accepted: 01/25/2011] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIMS Three different apo E alleles (E2, E3 and E4) produce apo E isoproteins, which regulate the metabolism of lipoproteins. This study investigated the apo E polymorphisms as a prognostic factor for the development of diabetic nephropathy (DN). METHODS A total of 525 type 2 diabetic patients were enrolled to participate in this prospective observational study. Apo E gene polymorphisms were analyzed by polymerase chain reaction. The progression of DN was defined as a shift to a higher stage of DN or a doubling of the baseline serum creatinine level by the end of the study. RESULTS The mean follow-up period was 42.4 months. The patients whose DN progressed had significantly higher urine albumin/creatinine ratios and fewer used diuretics than those in whom DN did not progress. In the Cox regression analysis, the apo E4 carriers were found to be at greater risk of progression of DN than non-apo E4 carriers (p = 0.007, hazard ratio 2.252). After adjusting for confounding factors, apo E4 carriers remained at increased risk of progression to more severe DN (p = 0.002, hazard ratio 2.820). CONCLUSION Our study suggests the apo E4 carrier might serve as a predictor of DN progression in Taiwan.
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Affiliation(s)
- Kai-Jen Tien
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan, ROC
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Kang HT, Shim JY, Lee YJ, Lee JE, Linton JA, Kim JK, Lee HR. Association between the Ratio of Triglycerides to High-Density Lipoprotein Cholesterol and Chronic Kidney Disease in Korean Adults: The 2005 Korean National Health and Nutrition Examination Survey. ACTA ACUST UNITED AC 2011; 34:173-9. [DOI: 10.1159/000323895] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2010] [Accepted: 12/23/2010] [Indexed: 01/26/2023]
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Abdel-Rahman MK. Influence of dietary fat on renal function, lipid profile, sex hormones, and electrolyte balance in rats. EUR J LIPID SCI TECH 2010. [DOI: 10.1002/ejlt.200900297] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Abstract
Renal injury distal to an atherosclerotic renovascular obstruction reflects multiple intrinsic factors producing parenchymal tissue injury. Atherosclerotic disease pathways superimposed on renal arterial obstruction may aggravate damage to the kidney and other target organs, and some of the factors activated by renal artery stenosis may in turn accelerate the progression of atherosclerosis. This cross-talk is mediated through amplified activation of renin-angiotensin system, oxidative stress, inflammation, and fibrosis-pathways notoriously involved in renal disease progression. Oxidation of lipids also accelerates the development of fibrosis in the stenotic kidney by amplifying profibrotic mechanisms and disrupting tissue remodeling. The extent to which actual ischemia modulates injury in the stenotic kidney has been controversial, partly because the decrease in renal oxygen consumption usually parallels a decrease in renal blood flow, and because renal vein oxygen pressure in the affected kidney is not decreased. However, recent data using novel methodologies demonstrate that intra-renal oxygenation is heterogeneously affected in different regions of the kidney. Activation of such local injury within the kidney may lead to renal dysfunction and structural injury, and ultimately unfavorable and irreversible renal outcomes. Identification of specific pathways producing progressive renal injury may enable development of targeted interventions to block these pathways and preserve the stenotic kidney.
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Ye Q, Chen Y, Lei H, Liu Q, Moorhead JF, Varghese Z, Ruan XZ. Inflammatory stress increases unmodified LDL uptake via LDL receptor: an alternative pathway for macrophage foam-cell formation. Inflamm Res 2009; 58:809-18. [PMID: 19533020 DOI: 10.1007/s00011-009-0052-4] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2009] [Revised: 05/12/2009] [Accepted: 05/20/2009] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVE To investigate if inflammatory stress increases intracellular accumulation of unmodified low-density lipoprotein (LDL) in human monocyte cell line (THP-1) macrophages by disrupting the sterol regulatory element binding proteins (SREBPs) cleavage-activating protein (SCAP)-SREBP2-mediated feedback regulation of LDL receptor. MATERIALS AND METHODS THP-1 macrophages were incubated in serum-free medium in the absence or presence of LDL alone, LDL plus lipopolysaccharide (LPS) and LPS alone, then intracellular cholesterol content, tumor necrosis factor alpha level in the supernatants, mRNA and protein expression of LDL receptor, and SREBP2 and SCAP in the treated cells were assessed by Oil Red O staining, cholesterol enzymatic assay, enzyme-linked immunosorbent assay, real-time quantitative polymerase chain reaction, and Western blotting analysis, respectively. RESULTS We demonstrated that LPS enhanced transformation of THP-1 macrophages into foam cells by increased uptake of unmodified LDL as evidenced by Oil Red O staining and direct assay of intracellular cholesterol. In the absence of LPS, 25 microg/ml LDL decreased LDL receptor mRNA and protein expression (p < 0.05). However, LPS enhanced LDL receptor expression, overcoming the suppression of LDL receptor induced by 25 microg/ml LDL and inappropriately increasing LDL uptake (p < 0.05). Exposure to LPS also caused overexpression of mRNA and protein of SCAP and SREBP2 (p < 0.05). These observations indicate that LPS disrupts cholesterol-mediated LDL receptor feedback regulation, permitting intracellular accumulation of unmodified LDL and causing foam-cell formation. CONCLUSION The implication of these findings is that inflammatory stress may contribute to intracellular LDL accumulation in THP-1 macrophages without previous modification of LDL.
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Affiliation(s)
- Qiang Ye
- Centre for Lipid Research, Key Laboratory of Molecular Biology on Infectious Diseases, Ministry of Education, Chongqing Medical University, Chongqing, China.
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Lipoprotein glomerulopathy induced by ApoE-Sendai is different from glomerular lesions in aged apoE-deficient mice. Clin Exp Nephrol 2009; 13:430-437. [PMID: 19459027 DOI: 10.1007/s10157-009-0195-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2009] [Accepted: 04/20/2009] [Indexed: 10/20/2022]
Abstract
OBJECTIVE A mutant of apolipoproteinE (apoE), ApoE-Sendai (Arg145Pro), is one of the major causative factors of human lipoprotein glomerulopathy (LPG). An apoE-deficient mouse with introduced ApoE-Sendai gene (ApoE-Sendai mouse) developed a murine counterpart of LPG, whereas it was also reported that apoE-deficient mouse (apoE KO mouse) spontaneously developed LPG-like lesion regardless of introduction of ApoE-Sendai gene. In the present study, we differentiated renal lesions between these two models by detailed analyses of histology and lipoprotein profile, and clarified the role of apoE variants. METHOD ApoE-Sendai mice were induced by injection of adenovirus vectors. The kidneys showing LPG-like lesions in apoE-Sendai and apoE KO mice were histopathologically evaluated. Plasma lipids and lipoproteins of both mice were also examined. RESULTS Histological alteration of the kidney in ApoE-Sendai mice was observed with light microscopy (in 40 out of 50 mice; mild 24, moderate 13, severe 3). Characteristic lesions were dilated vascular lumens mimicking lipoprotein thrombi in human LPG. Similar changes were found in hematoxylin-eosin stained sections of aged apoE KO mice. Meanwhile, periodic acid-Schiff, Azan Mallory, and Oil red O/Sudan III stained sections revealed that the dilated lumens of ApoE-Sendai mice mainly contained lipids and lipoproteins but those of aged apoE KO mice contained much other materials, e.g., proteins and fibrils. These findings were supported by electron micrographs, in which round-shaped droplets indicating lipoproteins were observed in ApoE-Sendai mice but not in aged apoE KO mice. In the kidney of apoE KO mice many anti-mouse CD68 Ab positive cells were detected. This contrasts with the result seen in ApoE-Sendai mice. The plasma lipoprotein compositions of the two types of mice were totally different. CONCLUSION It was certain that the kidneys of aged apoE KO mice showed morphological alteration, but the histological findings of glomerular lesions were different from those seen in the kidneys of ApoE-Sendai mice. According to the histological findings and plasma lipoprotein profile, ApoE-Sendai mice, not apoE KO mice, is a murine model for human LPG. This means that apoE variants are essential to LPG.
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Blood pressure, atherosclerosis, and albuminuria in 10,113 participants in the atherosclerosis risk in communities study. J Hypertens 2009; 27:397-409. [PMID: 19226709 DOI: 10.1097/hjh.0b013e32831aede6] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Albuminuria predicts cardiovascular risk, but its function as a marker of endothelial damage and atherosclerosis is uncertain, as is the complex relationship with hypertension and diabetes. OBJECTIVE To determine whether hypertension contributes to albuminuria across levels of atherosclerosis and type 2 diabetes. METHODS Cross-sectional associations of cardiovascular risk factors and albuminuria were examined in 10,113 middle-aged participants in the atherosclerosis risk in communities study divided into four subgroups: type 2 diabetes with marked atherosclerosis, type 2 diabetes without marked atherosclerosis, without diabetes with marked atherosclerosis, and without diabetes without marked atherosclerosis. Marked atherosclerosis was defined as high levels of carotid atherosclerosis or prevalent coronary heart disease. RESULTS Hyperglycemia and hypertriglyceridemia were associated with albuminuria, but only among patients with type 2 diabetes. In multivariate models, increasing blood pressure levels (but not albuminuria) were significantly associated (P-trend <0.001) with carotid atherosclerosis when stratified by prevalent coronary heart disease. Excluding individuals on hypertension medication, higher blood pressure was associated with albuminuria in all groups (P-trend<0.05). The association was strong even for high-normal blood pressure among individuals without diabetes without marked atherosclerosis (odds ratio 2.7, 95% confidence interval 1.6-4.6) and patients with type 2 diabetes with marked atherosclerosis (12.0, 1.3-108.2). CONCLUSION Blood pressure, even at high-normal levels, is consistently associated with albuminuria across categories of type 2 diabetes and atherosclerosis. Our results suggest that the effects of blood pressure on albuminuria are not solely mediated through generalized vascular damage, as represented by degree of atherosclerosis.
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Cheung GTY, Siow YL, O K. Homocysteine stimulates monocyte chemoattractant protein-1 expression in mesangial cells via NF-kappaB activation. Can J Physiol Pharmacol 2008; 86:88-96. [PMID: 18418435 DOI: 10.1139/y08-002] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Hyperhomocysteinemia is regarded as an independent risk factor for cardiovascular disorders. Although renal dysfunction or failure is one of the important factors causing hyperhomocysteinemia, the role of homocysteine (Hcy) in the development of glomerulosclerosis is largely unknown. One of the key events in the pathogenesis of glomerulosclerosis is the infiltration of circulating monocytes into affected glomeruli. The objective of the present study was to investigate the effect of Hcy on the expression of monocyte chemoattractant protein-1 (MCP-1) in kidney mesangial cells and the mechanisms involved. Levels of MCP-1 and mRNA were significantly elevated in Hcy-treated rat mesangial cells. This increase was associated with activation of NF-kappaB as a result of increased phosphorylation of the inhibitor protein IkappaBalpha. Monocyte chemotactic activity in these cells was also enhanced. In addition, there was a significant elevation of superoxide anion produced by Hcy-treated cells, which preceded the increased phosphorylation of IkappaBalpha. Addition of superoxide dismutase or NF-kappaB inhibitors to the culture medium abolished Hcy-induced NF-kappaB activation and MCP-1 expression. Taken together, these results indicate that Hcy induced MCP-1 expression in mesangial cells. Such a process was mediated by oxidative stress and NF-kappaB activation. This may further aggravate renal function in patients with hyperhomocysteinemia.
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Affiliation(s)
- Giselle T Y Cheung
- Department of Animal Science, University of Manitoba, Integrative Biology Laboratory, St. Boniface Hospital Research Centre, Winnipeg, MB R2H2A6, Canada
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Kawamoto R, Kohara K, Tabara Y, Miki T. An association between metabolic syndrome and the estimated glomerular filtration rate. Intern Med 2008; 47:1399-406. [PMID: 18670145 DOI: 10.2169/internalmedicine.47.1202] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE Metabolic syndrome (MetS) is a major public health problem. However, few studies have examined the significance of MetS as a risk factor for the development of chronic kidney disease (CKD) in the general Japanese population. METHODS Study participants without a clinical history of stroke, transient ischemic attack, myocardial infarction, angina, or renal failure (1,158 men, aged 61+/-15 years and 1,606 women, aged 63+/-12 years) were recruited from a single community. We examined the cross-sectional relationship between MetS and renal function as evaluated by estimated glomerular filtration rate (eGFR). RESULTS The presence of MetS was consistently associated with reduced eGFR, with the level of reduction proportional to the number of MetS components present. Multiple linear regression analysis using eGFR as an objective variable showed that BMI, DBP, antihypertensive drug use, high-density lipoprotein cholesterol, antilipidemic drug use and fasting blood glucose, which were components of MetS, were significantly and independently associated with eGFR, in addition to age and low-density lipoprotein cholesterol. Individuals with MetS showed a multivariate-adjusted odds ratio of 1.53 (95% confidence interval, 1.10-2.13) for CKD compared to those without MetS. CONCLUSIONS MetS was significantly associated with decreased eGFR in the general population.
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Affiliation(s)
- Ryuichi Kawamoto
- Department of Internal Medicine, Nomura Municipal Hospital, Seiyo.
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Athyros VG, Kakafika AI, Papageorgiou AA, Pagourelias ED, Savvatianos SD, Elisaf M, Karagiannis A, Tziomalos K, Mikhailidis DP. Statin-Induced Increase in HDL-C and Renal Function in Coronary Heart Disease Patients. Open Cardiovasc Med J 2007; 1:8-14. [PMID: 18949085 PMCID: PMC2570568 DOI: 10.2174/1874192400701010008] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2007] [Revised: 06/21/2007] [Accepted: 06/22/2007] [Indexed: 02/02/2023] Open
Abstract
Background Little is known about the potential of statin-induced high-density lipoprotein cholesterol (HDL-C) increase to improve renal function in coronary heart disease (CHD) patients. Methods and Results In thispost hocanalysis of the GREek Atorvastatin and Coronary heart disease Evaluation (GREACE) Study we investigated the effect of HDL-C increase after statin treatment on renal function. From a total of 1,600 patients, 880 were on various statins (mainly atorvastatin) and 720 were not. Other secondary prevention therapies were similar in the 2 groups. After a 3 year follow up, the lipid profile was unchanged in the statin untreated group and estimated glomerular filtration rate (eGFR) was reduced by 5.1% compared with baseline (P<0.0001). In contrast, in the statin treated group non-HDL-C was reduced by 43%, HDL-C was increased by 7% and there was a significant increase in eGFR compared with baseline by 9.8% (P<0.0001). In multiple regression analysis, the mean 7% increase in HDL-C in the treated arm during the entire study was associated with a 5.6% increase in eGFR recorded after the 6th week of treatment. The odds ratio of eGFR increase with every 5% statin-induced rise in HDL-C was 1.78 (95% confidence interval 1.19-3.34; P=0.001). Conclusions Statin treatment significantly improved renal function. Statin-induced HDL-C increase significantly and independently contributed to this improvement. This finding supports the concept that improving lipid variables other than low density lipoprotein cholesterol is also beneficial to preserving renal function.
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Affiliation(s)
- Vasilios G Athyros
- Atherosclerosis and Metabolic Syndrome Units, 2nd Propedeutic Department of Internal Medicine, Aristotelian University, Hippocration Hospital, 49 Konstantinoupoleos St, Thessaloniki 546 42, Greece
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Chen Y, Ruan XZ, Li Q, Huang A, Moorhead JF, Powis SH, Varghese Z. Inflammatory cytokines disrupt LDL-receptor feedback regulation and cause statin resistance: a comparative study in human hepatic cells and mesangial cells. Am J Physiol Renal Physiol 2007; 293:F680-7. [PMID: 17634396 DOI: 10.1152/ajprenal.00209.2007] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
LDL receptor (LDLr) is widely expressed in both liver and peripheral tissue. We aimed to clarify tissue-specific regulation of LDLr in hepatic cell line (HepG2) cells and human kidney mesangial cells (HMCs) under physiological and inflammatory conditions. We have demonstrated that the concentration of LDL required for 50% inhibition of LDLr mRNA expression (IC50) in HepG2 was 75 microg/ml, but only 30 microg/ml in HMCs. The concentration of mevastatin, a 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor, which achieved 200% upregulation of LDLr (UC200) in HepG2 cells, was 0.7 microM, which is much lower than 2.8 microM in HMCs. Inflammatory stress increased IC50 to 80 and 75 microg/ml of LDL, UC(200) to 2.8 microM, and 4.2 microM of mevastatin in HepG2 and HMCs. There was obvious sterol-regulatory element binding protein cleavage-activating protein accumulation in the Golgi in HepG2 cells, but not in HMCs in the presence of high concentration of LDL. IL-1beta further increased sterol-regulatory element binding protein cleavage-activating protein accumulation in HepG2 and HMCs in the presence of high concentration of LDL. These results indicate that LDLr in HepG2 cells have a relative resistant phenotype for downregulation, while LDLr in HMCs is very sensitive for downregulation. Inflammatory cytokine disrupts LDLr negative feedback regulation induced by intracellular cholesterol in both cell types, to a greater degree in HMCs, which could be one reason why HMCs are more prone to become foam cells under inflammatory stress. Inflammation also causes statin resistance; therefore, a high concentration of statin may be required to achieve the same biological effect.
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Affiliation(s)
- Yaxi Chen
- Centre for Lipid Research, Key Laboratory of Molecular Biology on Infectious Diseases, Chongqing Medical University, Peoples Republic of China
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Riambau V, Guerrero F, Montañá X, Gilabert R. [Abdominal aortic aneurysm and renovascular disease]. Rev Esp Cardiol 2007; 60:639-54. [PMID: 17580053 DOI: 10.1157/13107121] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Recent technological advances in the diagnosis and therapy of abdominal aortic aneurysm and renovascular disease are continuing to bring about changes in the way patients suffering from these conditions are treated. The prevalence of both these conditions is increasing. This is due to greater life-expectancy in patients with arteriosclerosis, a pathogenetic factor underlying both conditions. The application of diagnostic imaging techniques to non-vascular conditions has led to the early diagnosis of abdominal aortic aneurysm. Clinical suspicion of reno-vascular disease can be confirmed easily using high-resolution diagnostic imaging modalities such as CT angiography and magnetic resonance angiography. Endovascular intervention is successfully replacing conventional surgical repair techniques, with the result that it may be possible to improve outcome in both conditions using effective and minimally invasive approaches. Future technological developments will enable these endovascular techniques to be applied in the large majority of patients with abdominal aortic aneurysm or renovascular disease.
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Affiliation(s)
- Vicente Riambau
- Cirugía vascular, Instituto del Tórax, Hospital Clínic, Barcelona, Spain
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