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Saaiman Engelbrecht EL, Naidoo V, Botha CJ. Naja nigricincta nigricincta venom, a murine model. Evaluation of skeletal and cardio-myonecrosis, kidney injury and inflammatory response along with neutralisation efficacy by the SAIMR/SAVP - And EchiTAb-Plus-ICP polyvalent antivenoms. Toxicon 2024; 243:107719. [PMID: 38631492 DOI: 10.1016/j.toxicon.2024.107719] [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: 01/28/2024] [Revised: 04/06/2024] [Accepted: 04/10/2024] [Indexed: 04/19/2024]
Abstract
African spitting cobra, Naja nigricincta nigricincta (Zebra snake), envenomation is an important cause of snakebite morbidity and mortality in Namibia. The snake is endemic to central and northern Namibia as well as southern Angola. The venom is mainly cytotoxic, resulting in aggressive dermo-necrosis and often accompanied by severe systemic complications. No specific antivenom exists. Rhabdomyolysis, systemic inflammatory response, haemostatic abnormalities, infective necrotising fasciitis as well as acute kidney failure have been documented. Based on murine models, this study assessed SAVP/SAIMR - and EchiTAb-Plus-ICP polyvalent antivenom neutralisation as well as subdermal necrosis. Additional muscle, cardiac, kidney and lung histology, creatine kinase measurements and post-mortems were performed. An intravenous median lethal dose (LD50) of Naja nigricincta nigricincta venom was determined at 18.4 (CI: 16.3; 20.52) μg and a subdermal lethal dose at 15.3(CI: 12.96; 17.74)μg. The SAIMR/SAVP polyvalent antivenom median effective dose (ED50) was 1.2 ml antivenom/1 mg venom equating to a potency (WHO) of 1 ml antivenom neutralising 0.63 mg venom and approximately 240 ml (24 vials) needed for initial treatment. The ED50 of the EchiTAb-Plus-ICP was 1 ml antivenom/1 mg venom and a potency of 65 mg venom/ml antivenom (3.3 x LD50), estimating 230 ml (23 vials) for treatment. Histology and serology (creatine kinase) evidenced venom induced skeletal myotoxicity, which was not prevented by the antivenoms tested. Cardiac myonecrosis, an inflammatory response, direct venom kidney tubular necrosis and cardio-pulmonary failure were documented.
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Affiliation(s)
- Esta L Saaiman Engelbrecht
- Faculty of Veterinary Science, University of Pretoria, South Africa; Namibian Snakebite Interest Group, Namibia.
| | - Vinny Naidoo
- Faculty of Veterinary Science, University of Pretoria, South Africa
| | - Christo J Botha
- Faculty of Veterinary Science, University of Pretoria, South Africa
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Gaddameedi SR, Cherukuri PB, Khan MA, Atreya S, Bandari V, Ashok M, Shah S. Alcoholism and Immobility Induced Rhabdomyolysis Culminating in Hemodialysis. Cureus 2024; 16:e59316. [PMID: 38694661 PMCID: PMC11061816 DOI: 10.7759/cureus.59316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2024] [Indexed: 05/04/2024] Open
Abstract
Rhabdomyolysis is characterised by muscle breakdown and the release of myoglobin. It is a potentially serious condition that can lead to acute kidney injury (AKI). Factors, such as ischemia, trauma, muscle compression and drug toxicity, can trigger muscle breakdown. Treatment involves aggressive fluid resuscitation to maintain urine output and prevent renal injury. Severe cases with AKI may require temporary renal replacement therapy, such as haemodialysis. It has also been proposed that dialysis can speed up recovery by removing myoglobin that is secreted into the circulation by injured muscles. We present a case of a patient with alcohol abuse and prolonged immobility leading to severe rhabdomyolysis requiring hemodialysis. Our aim is to emphasise the importance of timely identification, and appropriate management of severe rhabdomyolysis not improving on fluids may require HD as soon as possible in order to minimise complications.
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Affiliation(s)
| | | | - Mahrukh A Khan
- Internal Medicine, Rutgers Health/Monmouth Medical Center, Long Branch, USA
| | - Suryansh Atreya
- Internal Medicine, Rutgers Health/Monmouth Medical Center, Long Branch, USA
| | | | - Manjula Ashok
- Nephrology, Rutgers Health/Monmouth Medical center, Long Branch, USA
| | - Shazia Shah
- Internal Medicine, Rutgers Health/Monmouth Medical Center, Long Branch, USA
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Mikacic M, Begovic TI, Jerkovic I, Batinic MM, Kovacic V. Severe rhabdomyolysis after exertional heat stroke treated with a hemoadsorber CytoSorb: lesson for the clinical nephrologist ®. J Nephrol 2024:10.1007/s40620-024-01918-7. [PMID: 38512381 DOI: 10.1007/s40620-024-01918-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 01/28/2024] [Indexed: 03/23/2024]
Affiliation(s)
- Marijana Mikacic
- Division of Emergency and Intensive Medicine with Clinical Pharmacology and Toxicology, Internal Medicine Department, University of Split School of Medicine, University Hospital of Split, Spinciceva 1, 21000, Split, Croatia
| | - Tanja Ilic Begovic
- Division of Emergency and Intensive Medicine with Clinical Pharmacology and Toxicology, Internal Medicine Department, University of Split School of Medicine, University Hospital of Split, Spinciceva 1, 21000, Split, Croatia
| | - Ivan Jerkovic
- Division of Emergency and Intensive Medicine with Clinical Pharmacology and Toxicology, Internal Medicine Department, University of Split School of Medicine, University Hospital of Split, Spinciceva 1, 21000, Split, Croatia
| | - Marina Maras Batinic
- Division of Emergency and Intensive Medicine with Clinical Pharmacology and Toxicology, Internal Medicine Department, University of Split School of Medicine, University Hospital of Split, Spinciceva 1, 21000, Split, Croatia
| | - Vedran Kovacic
- Division of Emergency and Intensive Medicine with Clinical Pharmacology and Toxicology, Internal Medicine Department, University of Split School of Medicine, University Hospital of Split, Spinciceva 1, 21000, Split, Croatia.
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Kumthekar GV, Shukla U, Purandare V. Rhabdomyolysis-Induced Acute Kidney Injury Treated with Medium Cut-Off Membrane: A Case Report. Indian J Nephrol 2023; 33:468-471. [PMID: 38174295 PMCID: PMC10752406 DOI: 10.4103/ijn.ijn_151_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 07/13/2022] [Accepted: 07/30/2022] [Indexed: 01/05/2024] Open
Abstract
Acute kidney injury can complicate rhabdomyolysis in 10-40% patients. Myoglobinuria and elevated creatine kinase (CK) form the basis of diagnosis. When associated with azotemia and/or oliguria, intermittent hemodialysis is a treatment option. 31-year-old young man came with lower limb pain after doing 800 sit ups. At the presentation, blood pressure was high, serum creatinine was 15.7mg/dl and creatine kinase(CK)>20000 IU/L. Intermittent dialysis was initiated. He developed posterior reversible encephalopathy syndrome, generalized tonic clonic convulsions and a further rise in CK. He underwent extracorporeal removal of myoglobin with medium cut-off (MCO) membrane. After 3 sessions with MCO membrane, myoglobin and CK levels reduced. He was transitioned to conventional dialysis and discharged in a stable condition with complete renal recovery. Medium cut-off membrane effectively removes circulating myoglobin without significant albumin loss and is cost effective.
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Affiliation(s)
- Girish V. Kumthekar
- Department of Nephrology, Symbiosis University Hospital and Research Center (SUHRC), Symbiosis Medical College for Women (SMCW), Symbiosis International University (SIU), Lavale, Pune, Maharashtra, India
| | - Urvi Shukla
- Department of Critical Care Medicine, Symbiosis University Hospital and Research Center (SUHRC), Symbiosis Medical College for Women (SMCW), Symbiosis International University (SIU), Lavale, Pune, Maharashtra, India
| | - Veena Purandare
- Department of Internal Medicine, Symbiosis University Hospital and Research Center (SUHRC), Symbiosis Medical College for Women (SMCW), Symbiosis International University (SIU), Lavale, Pune, Maharashtra, India
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Al Khaldi T, Gulreez R, Abdelhamid MM, Louri N. Acute carbon monoxide poisoning as a cause of rhabdomyolysis in a case of flame burn. BMJ Case Rep 2023; 16:e236012. [PMID: 37202107 PMCID: PMC10201226 DOI: 10.1136/bcr-2020-236012] [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] [Indexed: 05/20/2023] Open
Abstract
Carbon monoxide (CO) poisoning typically occurs from inhalation of CO at excessive levels. Rhabdomyolsis is not an uncommon complication following acute CO poisoning, yet there are very few reported cases in the literature. It is characterised by rapid breakdown of skeletal muscles and release of its contents into the circulation, leading to acute kidney injury (AKI). Early diagnosis and treatment are crucial to avoid anticipated morbidity and mortality. We are presenting a case of a woman in her 40s with 28% flame burn in a closed space. The patient developed CO poisoning, which led to rhabdomyolysis as evidenced by clinical manifestations and laboratory findings (creatine kinase had reached an unmeasurable level). The patient developed AKI and was successfully managed in our ICU. Here, we are highlighting the importance of considering CO poisoning as one of the potential causes of rhabdomyolysis in burn victim.
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Affiliation(s)
- Turki Al Khaldi
- Plastic Surgery and Burn, Bahrain Defence Force Royal Medical Services, Riffa, Bahrain
| | - Rasheeqa Gulreez
- Plastic Surgery, Bahrain Defence Force Royal Medical Services, Riffa, Bahrain
| | | | - Nayef Louri
- Plastic Surgery, Bahrain Defence Force Royal Medical Services, Riffa, Bahrain
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Afolabi JM, Kanthakumar P, Williams JD, Kumar R, Soni H, Adebiyi A. Post-injury Inhibition of Endothelin-1 Dependent Renal Vasoregulation Mitigates Rhabdomyolysis-Induced Acute Kidney Injury. FUNCTION 2023; 4:zqad022. [PMID: 37342410 PMCID: PMC10278989 DOI: 10.1093/function/zqad022] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 04/30/2023] [Accepted: 05/01/2023] [Indexed: 06/22/2023] Open
Abstract
In patients with rhabdomyolysis, the overwhelming release of myoglobin into the circulation is the primary cause of kidney injury. Myoglobin causes direct kidney injury as well as severe renal vasoconstriction. An increase in renal vascular resistance (RVR) results in renal blood flow (RBF) and glomerular filtration rate (GFR) reduction, tubular injury, and acute kidney injury (AKI). The mechanisms that underlie rhabdomyolysis-induced AKI are not fully understood but may involve the local production of vasoactive mediators in the kidney. Studies have shown that myoglobin stimulates endothelin-1 (ET-1) production in glomerular mesangial cells. Circulating ET-1 is also increased in rats subjected to glycerol-induced rhabdomyolysis. However, the upstream mechanisms of ET-1 production and downstream effectors of ET-1 actions in rhabdomyolysis-induced AKI remain unclear. Vasoactive ET-1 is generated by ET converting enzyme 1 (ECE-1)-induced proteolytic processing of inactive big ET to biologically active peptides. The downstream ion channel effectors of ET-1-induced vasoregulation include the transient receptor potential cation channel, subfamily C member 3 (TRPC3). This study demonstrates that glycerol-induced rhabdomyolysis in Wistar rats promotes ECE-1-dependent ET-1 production, RVR increase, GFR decrease, and AKI. Rhabdomyolysis-induced increases in RVR and AKI in the rats were attenuated by post-injury pharmacological inhibition of ECE-1, ET receptors, and TRPC3 channels. CRISPR/Cas9-mediated knockout of TRPC3 channels attenuated ET-1-induced renal vascular reactivity and rhabdomyolysis-induced AKI. These findings suggest that ECE-1-driven ET-1 production and downstream activation of TRPC3-dependent renal vasoconstriction contribute to rhabdomyolysis-induced AKI. Hence, post-injury inhibition of ET-1-mediated renal vasoregulation may provide therapeutic targets for rhabdomyolysis-induced AKI.
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Affiliation(s)
- Jeremiah M Afolabi
- Department of Physiology, College of Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USA
| | - Praghalathan Kanthakumar
- Department of Physiology, College of Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USA
| | - Jada D Williams
- Department of Physiology, College of Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USA
| | - Ravi Kumar
- Department of Physiology, College of Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USA
| | - Hitesh Soni
- Department of Physiology, College of Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USA
| | - Adebowale Adebiyi
- Department of Physiology, College of Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USA
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Boparai S, Lakra R, Dhaliwal L, Hansra RS, Bhuiyan MAN, Conrad SA, Krishnan P. Therapeutic Plasma Exchange in Severe Rhabdomyolysis: A Case-Control Study. Cureus 2023; 15:e39748. [PMID: 37398832 PMCID: PMC10310893 DOI: 10.7759/cureus.39748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2023] [Indexed: 07/04/2023] Open
Abstract
INTRODUCTION Rhabdomyolysis is a serious condition that can cause acute kidney injury (AKI), compartment syndrome, severe metabolic and electrolyte derangement leading to arrhythmias, and even death. Total plasma exchange (TPE) has been used as a treatment modality to clear myoglobin, but the evidence is limited. In this study, we aim to investigate the use of TPE in critically ill rhabdomyolysis patients. METHODS We retrospectively chart reviewed adult patients admitted to the intensive care unit (ICU) with a diagnosis of rhabdomyolysis between 2012 and 2021. We dichotomized patients into two groups based on whether TPE was used or not in addition to standard care. PRISMA machines with TPE2000 filters and either 5% albumin or fresh frozen plasma were used in the TPE group. RESULTS The patients' age ranged from 23 years to 87 years (mean 49.4, SD 18.1), and 51% were male. Initial creatinine ranged from 0.6 to 16mg/dL (mean 3.4, SD 2.7), creatinine phosphokinase (CPK) from 403-93,232 U/L, and myoglobin from 934 to >20,000. The Sequential Organ Failure Assessment (SOFA)scores on admission ranged from 6 to 17 (mean 7.23, SD 3.40). Overall, 28.78% (N=19) of the patients received therapeutic plasma exchange. The overall mortality in our study was 31.9%, with the length of ICU stay ranging from 1-25 days (mean 7.10, SD 5.91) among survivors. Older age and the presence of shock were predictive of mortality in univariate and multivariate analyses. There was no statistically significant association in mortality between the TPE and non-TPE groups (36.84% in TPE vs. 36.17% in the non-TPE group, OR 0.7209, p=0.959). Only two patients in the non-TPE group developed CKD/ESRD on long-term follow-up. CONCLUSION Our study showed that TPE administration in critically ill patients with rhabdomyolysis did not improve mortality or length of ICU stay. Further studies are required to elucidate its indication and effect on long-term renal outcomes.
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Affiliation(s)
- Sukhmani Boparai
- Internal Medicine, Louisiana State University (LSU) Health Shreveport, Shreveport, USA
| | - Rachaita Lakra
- Internal Medicine, Louisiana State University (LSU) Health Shreveport, Shreveport, USA
| | - Lovekirat Dhaliwal
- Internal Medicine, Louisiana State University (LSU) Health Shreveport, Shreveport, USA
| | - Rajkamal S Hansra
- Pulmonary and Critical Care Medicine, Louisiana State University (LSU) Health Shreveport, Shreveport, USA
| | | | - Steven A Conrad
- Pulmonary and Critical Care Medicine, Louisiana State University (LSU) Health Shreveport, Shreveport, USA
| | - Prathik Krishnan
- Pulmonary and Critical Care Medicine, Louisiana State University (LSU) Health Shreveport, Shreveport, USA
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8
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Li Q, Bao L, Liu M, Zhang R, Shi H, Chen H. Hypothalamic hypernatremic myopathy: A single-center case series. Muscle Nerve 2023; 67:231-236. [PMID: 36576109 DOI: 10.1002/mus.27781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 12/18/2022] [Accepted: 12/26/2022] [Indexed: 12/29/2022]
Abstract
INTRODUCTION/AIMS Hypernatremia myopathy is a rare disease often unrecognized by clinicians. This study aimed to present a case series of hypernatremic myopathy with an emphasis on profiling its clinical characteristics and exploring its pathogenesis. METHODS We reviewed seven patients with hypernatremic myopathy and reported their demographic data, etiology, clinical manifestations, and laboratory and electrophysiological characteristics. A muscle biopsy was performed on one patient. RESULTS All patients had hypothalamic lesions as the cause of the hypernatremia including craniopharyngioma, germinoma, pituitary adenoma, Langerhans cell histiocytosis, and glioma. The clinical manifestations varied from mild weakness to complete paralysis. Myalgia and muscle cramps were also observed. Four of the patients had rhabdomyolysis on admission and developed acute kidney injury. All patients had markedly elevated serum creatine kinase (CK) and sodium levels. There was a significant positive correlation between serum sodium and CK levels. A high prevalence of hypopituitarism in different axes was observed in our study. Central hypogonadism (5 of 7), central hypothyroidism (3 of 7), and central diabetes insipidus (3 of 7) were the most common manifestations of hypothalamic dysfunction. Myopathic changes were observed on needle electromyography. The muscle biopsy of one patient showed diffuse necrotic fibers and scattered hypercontracted fibers with increased ragged red fibers. DISCUSSION Hypernatremia myopathy should be considered in hypernatremic patients with muscle weakness and myalgia. Rhabdomyolysis frequently occurs and may lead to acute kidney injury in hypernatremia myopathy. Testing of hormone levels and performance of brain magnetic resonance imaging for possible hypothalamic lesions is strongly recommended.
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Affiliation(s)
- Qingjie Li
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China.,Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Lei Bao
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China.,Xuzhou Medical University, Xuzhou, China
| | - Meirong Liu
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Ruixue Zhang
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Hongjuan Shi
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Hao Chen
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
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Masolitin SV, Magomedov MA, Kim TG, Tyurin IN, Smetanina VM, Kalinin EY, Protsenko DN. Use of Selective Hemosorption and Hemodiafiltration in a Patient with Toxic Rhabdomyolysis Complicated by Acute Kidney Injury. MESSENGER OF ANESTHESIOLOGY AND RESUSCITATION 2022. [DOI: 10.21292/2078-5658-2022-19-6-78-85] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
| | - M. A. Magomedov
- N. I. Pirogov City Clinical Hospital no. 1; Pirogov Russian National Research Medical University
| | - T. G. Kim
- N. I. Pirogov City Clinical Hospital no. 1
| | - I. N. Tyurin
- Kommunarka Moscow Multidisciplinary Clinical Center; Pirogov Russian National Research Medical University
| | | | | | - D. N. Protsenko
- Kommunarka Moscow Multidisciplinary Clinical Center; Pirogov Russian National Research Medical University
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10
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Annona muricata mitigates glycerol-induced nephrotoxicities in male albino rats through signaling pathways of angiotensin conversion enzyme, kidney injury molecule-1, and antioxidant properties. SCIENTIFIC AFRICAN 2022. [DOI: 10.1016/j.sciaf.2022.e01225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Shaw-Gallagher M, Rangel FA, Sweeney KA, Digambaranath J, Siddiqui F, McKay M, Gadulka K, Davis JS. Everything Else. PHYSICIAN ASSISTANT CLINICS 2022. [DOI: 10.1016/j.cpha.2021.11.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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12
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Soliemanabad SK, Rasouli K, Zakariaei Z, Soleymani M, Aliabadi PK. Rhabdomyolysis due to warfarin and atorvastatin combination therapy in a patient with ischemic heart disease: (A drug interaction). Ann Med Surg (Lond) 2022; 75:103384. [PMID: 35242328 PMCID: PMC8861410 DOI: 10.1016/j.amsu.2022.103384] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 02/03/2022] [Accepted: 02/10/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction Although atorvastatin has serious adverse effects, including hepatotoxicity and myopathy, it can cause drug interactions and side effects such as rhabdomyolysis and acute kidney injury, especially when combined with warfarin, which uses the same enzyme pathway for metabolism. Case presentation We describe a 66-year-old man with a history of ischemic heart disease who developed renal complications and rhabdomyolysis after concomitant use of atorvastatin and warfarin. Discussion Statins reduce serum LDL cholesterol levels significantly. It is a safe and cost-effective medicine used in the treatment of DLP as well as the primary and secondary prevention of CAD, atherosclerosis, myocardial infarction, and stroke. Despite their benefits, statins can cause side effects in various organs of the body, including the gastrointestinal tract, CNS, liver, and kidneys. Conclusion Statins are widely prescribed to patients with cardiovascular problems. Therefore, clinicians should pay attention to the patient's medical history, current prescribed doses, and drug interactions when adding new drugs or adjusting existing drugs. Rhabdomyolysis due to warfarin and atorvastatin combination therapy. Renal complications and rhabdomyolysis after concomitant use of atorvastatin and warfarin. Rhabdomyolysis is a life-threatening disease that begins with myalgia and progresses to myocyte necrosis, hyperkalemia.
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Affiliation(s)
| | - Kimia Rasouli
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - Zakaria Zakariaei
- Toxicology and Forensic Medicine Division, Toxoplasmosis Research Center, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran
- Toxoplasmosis Research Center, Communicable Diseases Institute, Iranian National Registry Center for Lophomoniasis and Toxoplasmosis, Mazandaran University of Medical Sciences, Sari, Iran
- Corresponding author. Toxicology and Forensic Medicine Division, Toxoplasmosis Research Center, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, P.O box: 48166-33131, Iran.
| | - Mostafa Soleymani
- Toxoplasmosis Research Center, Communicable Diseases Institute, Iranian National Registry Center for Lophomoniasis and Toxoplasmosis, Mazandaran University of Medical Sciences, Sari, Iran
| | - Parastoo Karimi Aliabadi
- Department of Family Medicine, Diabetes Research Center, Mazandaran University of Medical Sciences, Sari, Iran
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Yuan H, Gao Z, Chen G, Peng C, Sun Y, Jiang B, Zhou H, Cheng Y, Hu F, Zhang Q. An integrative proteomics metabolomics based strategy reveals the mechanisms involved in wasp sting induced acute kidney injury. Toxicon 2021; 205:1-10. [PMID: 34773816 DOI: 10.1016/j.toxicon.2021.11.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 11/02/2021] [Accepted: 11/03/2021] [Indexed: 01/06/2023]
Abstract
The pathophysiological mechanisms involved in wasp-sting-induced acute kidney injury (AKI) remain largely unknown. Here, we combined proteomics and metabolomics to investigate the mechanisms behind multiple wasp sting-induced AKI. Interestingly, we found many differentially abundant proteins in the serum of AKI group compared with that of the non-AKI and control groups, involved in several metabolic pathways and the regulation of cellular processes. In addition, we also detected differentially abundant metabolites in the AKI group; among them many were involved in the glycerophospholipid metabolic pathway (the key pathway in the context of AKI): 50 metabolites, all downregulated in the AKI group. Importantly, the convergent analysis of metabolomics and proteomics data revealed that biomarkers of rhabdomyolysis (CA 3, MYL3, and LDH) and hemolysis (ALT and LDH) were integrated into a regulatory network with phospholipid metabolism products in the AKI group, indicating that wasp sting-induced AKI is secondary to rhabdomyolysis and intravascular hemolysis. Of note, such a phenotype suggests the disruption of the membrane of skeletal muscle cells and red blood cells mediated by the phospholipase A1 (PLA1), PLA2, and mastoparan in the wasp venom, via the disruption of membrane glycerophospholipids. Overall, our results highlight a potential new mechanism behind wasp sting-induced AKI and suggest that PLA inhibitors may be potential agents for the treatment of this condition.
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Affiliation(s)
- Hai Yuan
- Department of Nephrology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, 441000, Hubei, China.
| | - Zhao Gao
- Department of Nephrology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, 441000, Hubei, China.
| | - Guang Chen
- Department of Clinical Laboratory, People's Hospital of Weifang, Weifang, 261000, Shandong, China.
| | - Changkun Peng
- Department of Nephrology, People's Hospital of Baokang, Xiangyang, 441000, Hubei, China.
| | - Yujun Sun
- Department of Nephrology, Nanzhang Hospital of Traditional Chinese Medicine, Xiangyang, 441000, Hubei, China.
| | - Binbin Jiang
- Department of Nephrology, Baokang Hospital of Traditional Chinese Medicine, Xiangyang, 441000, Hubei, China.
| | - Hongyu Zhou
- Department of Nephrology, People's Hospital of Gucheng, Xiangyang, 441000, Hubei, China.
| | - Yong Cheng
- Department of Nephrology, People's Hospital of Nanzhang, Xiangyang, 441000, Hubei, China.
| | - Fengqi Hu
- Department of Nephrology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, 441000, Hubei, China.
| | - Qi Zhang
- Department of Oncology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, 441000, Hubei, China.
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Petreski T, Piko N, Petrijan T, Dvoršak B, Hojs R, Bevc S. Statin-Associated Necrotizing Myopathy Leading to Acute Kidney Injury: A Case Report. Case Rep Nephrol Dial 2021; 11:129-135. [PMID: 34250030 PMCID: PMC8255745 DOI: 10.1159/000515584] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 02/28/2021] [Indexed: 11/19/2022] Open
Abstract
Statins or 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors are a mainstay of cardiovascular disease therapy. In addition to their lipid-lowering capabilities, they exhibit several pleiotropic effects. Their adverse reactions such as myalgias are not uncommon, but in rare cases, the resulting rhabdomyolysis can be fatal. Recently, more insight has been brought into the pathogenesis of statin-induced rhabdomyolysis, and immune-mediated necrotizing myopathies are diagnosed more frequently. We present a case of a female patient who was on chronic rosuvastatin therapy and developed necrotizing myopathy. The disease progressed to acute kidney and liver injury. We discontinued the drug, started supportive measures, and initiated renal replacement therapy with a high cutoff dialysis membrane once. Her recovery was prompt, with a normal control electromyography 2 weeks after discharge.
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Affiliation(s)
- Tadej Petreski
- Department of Nephrology, Clinic for Internal Medicine, University Medical Center Maribor, Maribor, Slovenia.,Medical Faculty, University of Maribor, Maribor, Slovenia
| | - Nejc Piko
- Department of Nephrology, Clinic for Internal Medicine, University Medical Center Maribor, Maribor, Slovenia.,Department of Dialysis, Clinic for Internal Medicine, University Medical Center Maribor, Maribor, Slovenia
| | - Timotej Petrijan
- Department of Neurology, University Medical Center Maribor, Maribor, Slovenia
| | - Benjamin Dvoršak
- Department of Nephrology, Clinic for Internal Medicine, University Medical Center Maribor, Maribor, Slovenia.,Medical Faculty, University of Maribor, Maribor, Slovenia
| | - Radovan Hojs
- Department of Nephrology, Clinic for Internal Medicine, University Medical Center Maribor, Maribor, Slovenia.,Medical Faculty, University of Maribor, Maribor, Slovenia
| | - Sebastjan Bevc
- Department of Nephrology, Clinic for Internal Medicine, University Medical Center Maribor, Maribor, Slovenia.,Medical Faculty, University of Maribor, Maribor, Slovenia
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15
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The Cross-Link between Ferroptosis and Kidney Diseases. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2021; 2021:6654887. [PMID: 34007403 PMCID: PMC8110383 DOI: 10.1155/2021/6654887] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 03/31/2021] [Accepted: 04/15/2021] [Indexed: 02/08/2023]
Abstract
Acute and chronic kidney injuries result from structural dysfunction and metabolic disorders of the kidney in various etiologies, which significantly affect human survival and social wealth. Nephropathies are often accompanied by various forms of cell death and complex microenvironments. In recent decades, the study of kidney diseases and the traditional forms of cell death have improved. Nontraditional forms of cell death, represented by ferroptosis and necroptosis, have been discovered in the field of kidney diseases, which have reshuffled the role of traditional cell death in nephropathies. Although interactions between ferroptosis and acute kidney injury (AKI) have been continuously explored, studies on ferroptosis and chronic kidney disease (CKD) remain limited. Here, we have reviewed the therapeutic significance of ferroptosis in AKI and anticipated the curative potential of ferroptosis for CKD in the hope of providing insights into ferroptosis and CKD.
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16
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Zhu D, Li W, Zhang J, Tong J, Xie W, Qin X, Zhang X. Rhabdomyolysis‐associated acute kidney injury: clinical characteristics and intensive care unit transfer analysis. Intern Med J 2021; 52:1251-1257. [PMID: 33813804 DOI: 10.1111/imj.15308] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 02/24/2021] [Accepted: 03/22/2021] [Indexed: 11/28/2022]
Affiliation(s)
- De‐cai Zhu
- Guangdong Provincial Hospital of Traditional Chinese Medicine The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Academy of Chinese Medical Sciences Guangzhou China
| | - Wen‐yan Li
- Guangdong Provincial Hospital of Traditional Chinese Medicine The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Academy of Chinese Medical Sciences Guangzhou China
| | - Jia‐wen Zhang
- Guangdong Provincial Hospital of Traditional Chinese Medicine The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Academy of Chinese Medical Sciences Guangzhou China
| | - Jun‐sheng Tong
- Guangdong Provincial Hospital of Traditional Chinese Medicine The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Academy of Chinese Medical Sciences Guangzhou China
| | - Wen‐yuan Xie
- Guangdong Provincial Hospital of Traditional Chinese Medicine The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Academy of Chinese Medical Sciences Guangzhou China
| | - Xiao‐lan Qin
- Guangdong Provincial Hospital of Traditional Chinese Medicine The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Academy of Chinese Medical Sciences Guangzhou China
| | - Xiao‐chun Zhang
- Guangdong Provincial Hospital of Traditional Chinese Medicine The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Academy of Chinese Medical Sciences Guangzhou China
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17
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Arana C, Del Carpio J, Fayos L, Ars E, Ayasreh N, Guirado L, Bover J. Acute Renal Failure Secondary to an Unusual Familial Metabolic Myopathy. Nephron Clin Pract 2021; 145:199-204. [PMID: 33423032 DOI: 10.1159/000512666] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 10/29/2020] [Indexed: 11/19/2022] Open
Abstract
Rhabdomyolysis is a major cause of acute kidney failure. The etiology is diverse, from full-blown crush syndrome to less frequent causes, such as metabolic myopathy. We describe the case of a 35-year-old male with a history of intermittent myalgias who was admitted to hospital with acute renal failure secondary to rhabdomyolysis. Moderate to intense diffuse uptake of technetium-99m was seen in soft tissues at scintigraphy. The diagnosis of metabolic myopathy was confirmed after careful workup and genetic testing.
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Affiliation(s)
- Carolt Arana
- Department of Nephrology, Fundació Puigvert, IIB Sant Pau, RedinRen, Barcelona, Spain,
| | - Jacqueline Del Carpio
- Department of Nephrology, Fundació Puigvert, IIB Sant Pau, RedinRen, Barcelona, Spain.,Department of Nephrology, Arnau de Villanova Hospital, Lleida, Spain
| | - Leonor Fayos
- Department of Nephrology, Fundació Puigvert, IIB Sant Pau, RedinRen, Barcelona, Spain
| | - Elisabet Ars
- Molecular Biology Laboratory, Fundació Puigvert, Instituto de Investigaciones Biomédicas Sant Pau (IIB-Sant Pau), Universitat Autònoma de Barcelona, REDinREN, Instituto de Investigación Carlos III, Barcelona, Spain
| | - Nadia Ayasreh
- Department of Nephrology, Fundació Puigvert, IIB Sant Pau, RedinRen, Barcelona, Spain
| | - Lluís Guirado
- Department of Nephrology, Fundació Puigvert, IIB Sant Pau, RedinRen, Barcelona, Spain
| | - Jordi Bover
- Department of Nephrology, Fundació Puigvert, IIB Sant Pau, RedinRen, Barcelona, Spain
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18
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Provenzano M, De Nicola L, Pena MJ, Capitoli G, Garofalo C, Borrelli S, Gagliardi I, Antolini L, Andreucci M. Precision Nephrology Is a Non-Negligible State of Mind in Clinical Research: Remember the Past to Face the Future. Nephron Clin Pract 2020; 144:463-478. [PMID: 32810859 DOI: 10.1159/000508983] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 05/26/2020] [Indexed: 11/19/2022] Open
Abstract
CKD is a major public health problem. It is characterized by a multitude of risk factors that, when aggregated, can strongly modify outcome. While major risk factors, namely, albuminuria and low estimated glomerular filtration rate (eGFR) have been well analyzed, a large variability in disease progression still remains. This happens because (1) the weight of each risk factor varies between populations (general population or CKD cohort), countries, and single individuals and (2) response to nephroprotective drugs is so heterogeneous that a non-negligible part of patients maintains a high cardiorenal risk despite optimal treatment. Precision nephrology aims at individualizing cardiorenal prognosis and therapy. The purpose of this review is to focus on the risk stratification in different areas, such as clinical practice, population research, and interventional trials, and to describe the strategies used in observational or experimental studies to afford individual-level evidence. The future of precision nephrology is also addressed. Observational studies can in fact provide more adequate findings by collecting more information on risk factors and building risk prediction models that can be applied to each individual in a reliable fashion. Similarly, new clinical trial designs can reduce the individual variability in response to treatment and improve individual outcomes.
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Affiliation(s)
- Michele Provenzano
- Renal Unit, Department of Health Sciences, "Magna Graecia" University, Catanzaro, Italy,
| | - Luca De Nicola
- Renal Unit, Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli,", Naples, Italy
| | - Michelle J Pena
- Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, Groningen, The Netherlands
| | - Giulia Capitoli
- Center of Biostatistics for Clinical Epidemiology, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Carlo Garofalo
- Renal Unit, Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli,", Naples, Italy
| | - Silvio Borrelli
- Renal Unit, Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli,", Naples, Italy
| | - Ida Gagliardi
- Renal Unit, Department of Health Sciences, "Magna Graecia" University, Catanzaro, Italy
| | - Laura Antolini
- Center of Biostatistics for Clinical Epidemiology, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Michele Andreucci
- Renal Unit, Department of Health Sciences, "Magna Graecia" University, Catanzaro, Italy
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19
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Abstract
Acute kidney injury (AKI) is frequent during wars and other man-made disasters, and contributes significantly to the overall death toll. War-related AKI may develop as a result of polytrauma, traumatic bleeding and hypovolemia, chemical and airborne toxin exposure, and crush syndrome. Thus, prerenal, intrinsic renal, or postrenal AKI may develop at the battlefield, in field hospitals, or tertiary care centers, resulting not only from traumatic, but also nontraumatic, etiologies. The prognosis usually is unfavorable because of systemic and polytrauma-related complications and suboptimal therapeutic interventions. Measures for decreasing the risk of AKI include making preparations for foreseeable disasters, and early management of polytrauma-related complications, hypovolemia, and other pathogenetic mechanisms. Transporting casualties initially to field hospitals, and afterward to higher-level health care facilities at the earliest convenience, is critical. Other man-made disasters also may cause AKI; however, the number of patients is mostly lower and treatment possibilities are broader than in war. If there is no alternative other than prolonged field care, the medical community must be prepared to offer health care and even perform dialysis in austere conditions, which in that case, is the only option to decrease the death toll resulting from AKI.
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Affiliation(s)
- Mehmet Sukru Sever
- Department of Nephrology, Istanbul School of Medicine, Istanbul University, Istanbul, Turkey.
| | - Raymond Vanholder
- Nephrology Section, Department of Internal Medicine, Ghent University Hospital, Ghent, Belgium
| | - Norbert Lameire
- Nephrology Section, Department of Internal Medicine, Ghent University Hospital, Ghent, Belgium
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20
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Martinez B, Yang Y, Harker DMR, Farrar C, Mukundan H, Nath P, Mascareñas D. YAP/TAZ Related BioMechano Signal Transduction and Cancer Metastasis. Front Cell Dev Biol 2019; 7:199. [PMID: 31637239 PMCID: PMC6788381 DOI: 10.3389/fcell.2019.00199] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 09/05/2019] [Indexed: 01/01/2023] Open
Abstract
Mechanoreciprocity refers to a cell's ability to maintain tensional homeostasis in response to various types of forces. Physical forces are continually being exerted upon cells of various tissue types, even those considered static, such as the brain. Through mechanoreceptors, cells sense and subsequently respond to these stimuli. These forces and their respective cellular responses are prevalent in regulating everything from embryogenic tissue-specific differentiation, programmed cell death, and disease progression, the last of which being the subject of extensive attention. Abnormal mechanical remodeling of cells can provide clues as to the pathological status of tissues. This becomes particularly important in cancer cells, where cellular stiffness has been recently accepted as a novel biomarker for cancer metastasis. Several studies have also elucidated the importance of cell stiffness in cancer metastasis, with data highlighting that a reversal of tumor stiffness has the capacity to revert the metastatic properties of cancer. In this review, we summarize our current understanding of extracellular matrix (ECM) homeostasis, which plays a prominent role in tissue mechanics. We also describe pathological disruption of the ECM, and the subsequent implications toward cancer and cancer metastasis. In addition, we highlight the most novel approaches toward understanding the mechanisms which generate pathogenic cell stiffness and provide potential new strategies which have the capacity to advance our understanding of one of human-kinds' most clinically significant medical pathologies. These new strategies include video-based techniques for structural dynamics, which have shown great potential for identifying full-field, high-resolution modal properties, in this case, as a novel application.
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Affiliation(s)
- Bridget Martinez
- Engineering Institute, Los Alamos National Laboratory, Los Alamos, NM, United States
- Applied Modern Physics, Los Alamos National Laboratory, Los Alamos, NM, United States
- Department of Medicine, St. George’s University School of Medicine, St. George’s, Grenada
- Chemistry Division, Physical Chemistry and Applied Spectroscopy, Los Alamos National Laboratory, Los Alamos, NM, United States
| | - Yongchao Yang
- Energy and Global Security, Argonne National Laboratory, Lemont, IL, United States
| | | | - Charles Farrar
- Engineering Institute, Los Alamos National Laboratory, Los Alamos, NM, United States
| | - Harshini Mukundan
- Engineering Institute, Los Alamos National Laboratory, Los Alamos, NM, United States
| | - Pulak Nath
- Applied Modern Physics, Los Alamos National Laboratory, Los Alamos, NM, United States
| | - David Mascareñas
- Engineering Institute, Los Alamos National Laboratory, Los Alamos, NM, United States
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21
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Zamorskii II, Drachuk VM, Shchudrova TS, Goroshko OM, Kopchuk TG. Amelioration of Rhabdomyolysis-Induced Acute Kidney Injury by Ademetionine. Biophysics (Nagoya-shi) 2019. [DOI: 10.1134/s0006350919050257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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