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Nourmahnad A, Javad Shariyate M, Khak M, Grinstaff MW, Nazarian A, Rodriguez EK. Relaxin as a treatment for musculoskeletal fibrosis: What we know and future directions. Biochem Pharmacol 2024; 225:116273. [PMID: 38729446 PMCID: PMC11179965 DOI: 10.1016/j.bcp.2024.116273] [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: 01/05/2024] [Revised: 04/23/2024] [Accepted: 05/07/2024] [Indexed: 05/12/2024]
Abstract
Fibrotic changes in musculoskeletal diseases arise from the abnormal buildup of fibrotic tissue around the joints, leading to limited mobility, compromised joint function, and diminished quality of life. Relaxin (RLX) attenuates fibrosis by accelerating collagen degradation and inhibiting excessive extracellular matrix (ECM) production. Further, RLX disrupts myofibroblast activation by modulating the TGF-β/Smads signaling pathways, which reduces connective tissue fibrosis. However, the mechanisms and effects of RLX in musculoskeletal pathologies are emerging as increasing research focuses on relaxin's impact on skin, ligaments, tendons, cartilage, joint capsules, connective tissues, and muscles. This review delineates the actions of relaxin within the musculoskeletal system and the challenges to its clinical application. Relaxin shows significant potential in both in vivo and in vitro studies for broadly managing musculoskeletal fibrosis; however, challenges such as short biological half-life and sex-specific responses may pose hurdles for clinical use.
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Affiliation(s)
| | - Mohammad Javad Shariyate
- Musculoskeletal Translational Innovation Initiative, Carl J. Shapiro Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Mohammad Khak
- Musculoskeletal Translational Innovation Initiative, Carl J. Shapiro Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | | | - Ara Nazarian
- Musculoskeletal Translational Innovation Initiative, Carl J. Shapiro Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Department of Orthopaedic Surgery, Yerevan State Medical University, Yerevan, Armenia
| | - Edward K Rodriguez
- Musculoskeletal Translational Innovation Initiative, Carl J. Shapiro Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
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Golomb D, Shemesh A, Goldberg H, Hen E, Atmana F, Barkai E, Shalom B, Cooper A, Raz O. Effect of gender on presentation and outcome of renal colic. Urologia 2023; 90:653-658. [PMID: 36635856 DOI: 10.1177/03915603221150039] [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: 01/14/2023]
Abstract
OBJECTIVES To examine gender-related differences in the presentation, management, and outcomes of patients admitted to the emergency department ED with ureteral stones. METHODS Retrospective analysis of all patients admitted to the ED at our institution, found to have a ureteral stone on CT. Clinical, laboratory, imaging parameters, and outcomes were collected. RESULTS 778 patients were admitted with ureteral stones between January 2018 and December 2020. 78% (n = 609) were males and 22% (n = 169) were females. The mean ages were 49.4 (SD 14.4) and 51.6 (SD 15.7) in males and females, respectively (p = 0.08). Female patients presented with a higher body temperature (p = 0.01), pulse rate (p < 0.0001), nausea and vomiting (p < 0.0001), elevated serum C-reactive protein (CRP) (p = 0.002) compared to males. The prevalence of elevated serum creatinine was higher in males (p < 0.0001). Alpha-blockers were recommended on discharge in 54.8% (334) of males, compared to only 29.6% (50) of females (p < 0.0001). Spontaneous stone expulsion was significantly higher in males compared to females (p = 0.01). CONCLUSIONS Our results demonstrate that gender does effect presentation and outcome of patients presenting with renal colic. Females were found to have elevated infectious parameters, more nausea and vomiting and a higher incidence of positive urine cultures. Males admitted to the ED were found to have significantly higher serum creatinine levels. Medical expulsive therapy (MET) with alpha-blockers was prescribed significantly less in female patients, which may have resulted in a lower spontaneous stone expulsion rate.
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Affiliation(s)
- Dor Golomb
- Department of Urology, Samson Assuta Ashdod University Hospital, Ashdod, Israel
| | - Amit Shemesh
- Department of Urology, Samson Assuta Ashdod University Hospital, Ashdod, Israel
| | - Hanan Goldberg
- Department of Urology, State University of New York, Upstate Medical University, Syracuse, NY, USA
| | - Eyal Hen
- Department of Urology, Samson Assuta Ashdod University Hospital, Ashdod, Israel
| | - Fahed Atmana
- Department of Urology, Samson Assuta Ashdod University Hospital, Ashdod, Israel
| | - Eyal Barkai
- Department of Urology, Samson Assuta Ashdod University Hospital, Ashdod, Israel
| | - Ben Shalom
- Department of Urology, Samson Assuta Ashdod University Hospital, Ashdod, Israel
| | - Amir Cooper
- Department of Urology, Samson Assuta Ashdod University Hospital, Ashdod, Israel
| | - Orit Raz
- Department of Urology, Samson Assuta Ashdod University Hospital, Ashdod, Israel
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Hurtig C, Bendtsen M, Årestedt L, Uhlin F, Eldh AC. Patient participation in end-stage kidney disease care: variation over time and effects of staff-directed interventions - a quasi-experimental study. BMC Nephrol 2023; 24:265. [PMID: 37691126 PMCID: PMC10494352 DOI: 10.1186/s12882-023-03313-z] [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: 04/11/2023] [Accepted: 08/29/2023] [Indexed: 09/12/2023] Open
Abstract
BACKGROUND Among those elements establishing decent quality of care from a patient perspective, opportunities to participate in accord with one's individual needs and preferences are central. To date, little is known the extent of preference-based patient participation in kidney care, and what facilitates optimal conditions. This study investigated i) preference-based patient participation in kidney care over time, and ii) the effects of interventions designed to enhance person-centred patient participation. METHODS A quasi-experimental study was conducted across nine kidney care sites in southeast Sweden. A cohort of 358 patients with stage IV chronic kidney disease (eGRF 15-19 ml/min) or V (eGRF < 15 mL/min) entered the study. Of these, 245 patients (with kidney replacement therapy or intermittent outpatient visits only) completed a survey on patient participation at four time points: every six months from August 2019 to May 2021, patients reported their preferences for and experiences of participation using the validated Patient Preferences for Patient Participation tool, the 4Ps. Between the first and second data collection points, interventions were provided for designated staff to facilitate person-centred participation, using two strategies for two subgroups at three sites each: the managers receiving a bundle of information via e-mail on patient participation in a standard dissemination procedure (three sites), or an additional half-year support program for implementation offered to 1-2 staff per site (three sites), with no intervention for a control group (three sites). The differences in 4Ps data between groups were analysed using multilevel ordinal regression. RESULTS Over time and across all sites, most patients' experiences of participation fully or almost fully matched their engagement preferences (57%-90%). Still, up to 12% of patient reports indicated that their preferences and experiences were insufficiently matched: in these cases, the patients had preferred to be more involved than they had experienced, for example, in making healthcare plans and setting health-related goals. The interventions did not affect the levels of preference-based participation, but patients in the control group sites had slightly more consistent matches. CONCLUSIONS Living with kidney failure necessitates patient engagement, but opportunities to participate in accordance with one's preferences are not fully provided for all patients. Additional efforts to support a common understanding and to ensure person-centred patient participation is still needed.
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Affiliation(s)
- Caroline Hurtig
- Department of Health, Medicine and Caring Sciences, Linköping University, 581 83, Linköping, Sweden.
| | - Marcus Bendtsen
- Department of Health, Medicine and Caring Sciences, Linköping University, 581 83, Linköping, Sweden
| | - Liselott Årestedt
- Department of Health and Caring Sciences, Linnaeus University, 391 82, Kalmar, Sweden
| | - Fredrik Uhlin
- Department of Health, Medicine and Caring Sciences, Linköping University, 581 83, Linköping, Sweden
- Department of Nephrology, Region Östergötland, 581 85, Linköping, Sweden
- Department of Health Technologies, Tallinn University of Technology (TalTech), 19086, Tallinn, Estonia
| | - Ann Catrine Eldh
- Department of Health, Medicine and Caring Sciences, Linköping University, 581 83, Linköping, Sweden
- Department of Public Health and Caring Sciences, Uppsala University, 751 22, Uppsala, Sweden
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Bernstein SR, Kelleher C, Khalil RA. Gender-based research underscores sex differences in biological processes, clinical disorders and pharmacological interventions. Biochem Pharmacol 2023; 215:115737. [PMID: 37549793 PMCID: PMC10587961 DOI: 10.1016/j.bcp.2023.115737] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 08/03/2023] [Accepted: 08/04/2023] [Indexed: 08/09/2023]
Abstract
Earlier research has presumed that the male and female biology is similar in most organs except the reproductive system, leading to major misconceptions in research interpretations and clinical implications, with serious disorders being overlooked or misdiagnosed. Careful research has now identified sex differences in the cardiovascular, renal, endocrine, gastrointestinal, immune, nervous, and musculoskeletal systems. Also, several cardiovascular, immunological, and neurological disorders have shown differences in prevalence and severity between males and females. Genetic variations in the sex chromosomes have been implicated in several disorders at young age and before puberty. The levels of the gonadal hormones estrogen, progesterone and testosterone and their receptors play a role in the sex differences between adult males and premenopausal women. Hormonal deficiencies and cell senescence have been implicated in differences between postmenopausal and premenopausal women. Specifically, cardiovascular disorders are more common in adult men vs premenopausal women, but the trend is reversed with age with the incidence being greater in postmenopausal women than age-matched men. Gender-specific disorders in females such as polycystic ovary syndrome, hypertension-in-pregnancy and gestational diabetes have attained further research recognition. Other gender-related research areas include menopausal hormone therapy, the "Estrogen Paradox" in pulmonary arterial hypertension being more predominant but less severe in young females, and how testosterone may cause deleterious effects in the kidney while having vasodilator effects in the coronary circulation. This has prompted the National Institutes of Health (NIH) initiative to consider sex as a biological variable in research. The NIH and other funding agencies have provided resources to establish state-of-the-art centers for women health and sex differences in biology and disease in several academic institutions. Scientific societies and journals have taken similar steps to organize specialized conferences and publish special issues on gender-based research. These combined efforts should promote research to enhance our understanding of the sex differences in biological systems beyond just the reproductive system, and provide better guidance and pharmacological tools for the management of various clinical disorders in a gender-specific manner.
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Affiliation(s)
- Sofia R Bernstein
- Vascular Surgery Research Laboratories, Division of Vascular and Endovascular Surgery, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA 02115, USA
| | - Caroline Kelleher
- Vascular Surgery Research Laboratories, Division of Vascular and Endovascular Surgery, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA 02115, USA
| | - Raouf A Khalil
- Vascular Surgery Research Laboratories, Division of Vascular and Endovascular Surgery, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA 02115, USA.
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Elmarakby AA, Saad KM, Crislip GR, Sullivan JC. Acute nitric oxide synthase inhibition induces greater increases in blood pressure in female versus male Wistar Kyoto rats. Physiol Rep 2023; 11:e15771. [PMID: 37549936 PMCID: PMC10406564 DOI: 10.14814/phy2.15771] [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: 04/27/2023] [Revised: 06/29/2023] [Accepted: 07/02/2023] [Indexed: 08/09/2023] Open
Abstract
Nitric oxide (NO) contributes to blood pressure (BP) regulation via its vasodilatory and anti-inflammatory properties. We and others previously reported sex differences in BP in normotensive and hypertensive rat models where females have lower BP than age-matched males. As females are known to have greater NO bioavailability than age-matched males, the current study was designed to test the hypothesis that anesthetized female normotensive Wistar Kyoto rats (WKY) are more responsive to acute NOS inhibition-induced increases in BP compared to male WKY. Twelve-week-old male and female WKY were randomized to infusion of the nonspecific NOS inhibitor NG -nitro-L-arginine methyl ester (L-NAME, 1 mg/kg/min) or selective NOS1 inhibition with vinyl-L-NIO (VNIO, 0.5 mg/kg/min) for 60 min. Mean arterial BP, glomerular filtration rate (GFR), urine volume, and electrolyte excretion were assessed before, and during L-NAME or VNIO infusion. L-NAME and VNIO significantly increased BP in both sexes; however, the increase in BP with L-NAME infusion was greater in females versus males compared to baseline BP values. Acute infusion of neither L-NAME nor VNIO for 60 min altered GFR in either sex. However, urine volume, sodium, chloride and potassium excretion levels increased comparably in male and female WKY with L-NAME and VNIO infusion. Our findings suggest sex differences in BP responses to acute non-isoform-specific NOS inhibition in WKY, with females being more responsive to L-NAME-induced elevations in BP relative to male WKY. However, sex differences in the BP response did not coincide with sex differences in renal hemodynamic responses to acute NOS inhibition.
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Affiliation(s)
- Ahmed A. Elmarakby
- Departments of Oral Biology & Diagnostic SciencesAugusta UniversityAugustaGeorgiaUSA
- Department of Pharmacology and Toxicology, Faculty of PharmacyMansoura UniversityMansouraEgypt
| | - Karim M. Saad
- Departments of Oral Biology & Diagnostic SciencesAugusta UniversityAugustaGeorgiaUSA
- Department of Pharmacology and Toxicology, Faculty of PharmacyMansoura UniversityMansouraEgypt
| | - G. Ryan Crislip
- Departments of PhysiologyAugusta UniversityAugustaGeorgiaUSA
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Frydman S, Freund O, Banai A, Zornitzki L, Banai S, Shacham Y. Relation of Gender to the Occurrence of AKI in STEMI Patients. J Clin Med 2022; 11:jcm11216565. [PMID: 36362793 PMCID: PMC9655780 DOI: 10.3390/jcm11216565] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 10/26/2022] [Accepted: 11/03/2022] [Indexed: 11/09/2022] Open
Abstract
Patients undergoing percutaneous coronary interventions (PCIs) are prone to a wide range of complications; one complication that is constantly correlated with a worse prognosis is acute kidney injury (AKI). Gender as an independent risk factor for said complications has raised some interest; however, studies have shown conflicting results so far. We aimed to investigate the possible relation of gender to the occurrence of AKI in STEMI patients undergoing PCI. This retrospective observational study cohort included 2967 consecutive patients admitted with STEMI between the years 2008 and 2019. Their renal outcomes were assessed according to KDIGO criteria (AKI serum creatinine ≥ 0.3 mg/dL from baseline within 48 h from admission), and in-hospital complications and mortality were reviewed. Our main results show that female patients were older (69 vs. 60, p < 0.001) and had higher rates of diabetes (29.2% vs. 23%, p < 0.001), hypertension (62.9% vs. 41.3%, p < 0.001), and chronic kidney disease (26.7% vs. 19.3%, p < 0.001). Females also had a higher rate of AKI (12.7% vs. 7.8%, p < 0.001), and among patients with AKI, severe AKI was also more prevalent in females (26.1% vs. 14.5%, p = 0.03). However, in multivariate analyses, after adjusting for the baseline characteristics above, the female gender was a non-significant predictor for AKI (adjusted OR 1.01, 95% CI 0.73−1.4, p = 0.94) or severe AKI (adjusted OR 1.65, 95% CI 0.80−1.65, p = 0.18). In conclusion, while females had higher rates of AKI and severe AKI, gender was not independently associated with AKI after adjusting for other confounding variables. Other comorbidities that are more prevalent in females can account for the difference in AKI between genders.
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Affiliation(s)
- Shir Frydman
- Correspondence: ; Tel.: +972-3-6973395; Fax: +972-3-6962334
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Park Y, Lee SJ. Association of Blood Heavy Metal Levels and Renal Function in Korean Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116646. [PMID: 35682230 PMCID: PMC9180650 DOI: 10.3390/ijerph19116646] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 05/26/2022] [Accepted: 05/27/2022] [Indexed: 02/01/2023]
Abstract
This study aimed to investigate the association between the levels of lead, mercury, cadmium, and nickel in the blood and renal function and to provide basic data for the development of health programs for the prevention of renal failure. This study included 1984 participants aged 19 and older who participated in the Korean National Health and Nutrition Examination Survey from 2019. Differences in values according to general characteristics and the estimated glomerular filtration rate (eGFR) stage were analyzed using a chi-square test, t-test, ANOVA, and the influencing factors were analyzed through multiple regression analysis. The concentrations of lead, mercury, cadmium, and nickel, and the risk of elevated eGFR were analyzed using linear regression. The correlation between the variables was determined using Pearson’s correlation analysis. Analysis of the correlation between blood lead, mercury, cadmium, and nickel levels and blood eGFR levels revealed that blood eGFR levels were significantly negatively correlated with blood lead, cadmium, and nickel levels (p ≤ 0.001). This study is significant in that it found a significant association between decreased eGFR and heavy metal levels and provided meaningful basic data on the association between heavy metals and renal function.
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Affiliation(s)
- Yoonjin Park
- Department of Nursing, Joongbu University, Geumsan-gun 32713, Korea;
| | - Su-Jung Lee
- School of Nursing, Research Institute of Nursing Science, Hallym University, Chuncheon-si 24252, Korea
- Correspondence: ; Tel.: +82-33-248-2722
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Lin M, Heizhati M, Wang L, Gan L, Li M, Yang W, Yao L, Wang Z, Yang Z, Abudoyreyimu R, Wu Z, Li N. Prevalence and Associated Factors of Kidney Dysfunction in Patients with Hypertension and/or Diabetes Mellitus from a Primary Care Population in Northwest China. Int J Gen Med 2021; 14:7567-7578. [PMID: 34754229 PMCID: PMC8572047 DOI: 10.2147/ijgm.s329604] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 09/28/2021] [Indexed: 12/12/2022] Open
Abstract
Purpose The burden of kidney dysfunction (KD) is rapidly increasing in developing countries due to an ongoing epidemic of hypertension and diabetes. We aimed to evaluate the prevalence and associated factors of KD among population with hypertension and/or diabetes from primary care setting. Methods This study was part of a cross-sectional study conducted in Northwest China, which aimed to investigate the epidemiological status of hypertension and other chronic noninfectious diseases. Subjects aged ≥18 years old with hypertension and/or diabetes were included in this study. KD was defined as estimated glomerular filtration rate (eGFR) less than 60 mL/min/1.73m2. Least absolute shrinkage and selection operator and multivariable logistic regression were used to identify factors associated with KD. Sensitivity analysis was performed by comparing the results of different estimated equations for GFR. Results A total of 8899 participants with hypertension and/or diabetes were included. Prevalence of KD was 8.69% (n=144) among patients with both hypertension and DM, 3.36% (n=198) among patients with only hypertension, and 5.22% (n=70) among patients with only diabetes. Women showed higher prevalent KD than men. Modifiable factors independently associated with KD among patients with hypertension and/or diabetes included physical activity, duration of hypertension or DM, anemia, fasting plasma glucose and triglyceride. Results of different estimated equations showed similar trends of difference in the prevalence of KD among groups. Conclusion KD is common in patients with hypertension and/or DM in Northwest China. More attention should be paid to high-risk patients, especially to those with co-existence of hypertension and DM. Control of blood glucose and triglyceride may further improve KD management in this patient population.
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Affiliation(s)
- Mengyue Lin
- Xinjiang Medical University, Urumqi, People's Republic of China.,Hypertension Center of the People's Hospital of Xinjiang Uygur Autonomous Region; Xinjiang Hypertension Institute; National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, Xinjiang, People's Republic of China
| | - Mulalibieke Heizhati
- Hypertension Center of the People's Hospital of Xinjiang Uygur Autonomous Region; Xinjiang Hypertension Institute; National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, Xinjiang, People's Republic of China
| | - Lin Wang
- Hypertension Center of the People's Hospital of Xinjiang Uygur Autonomous Region; Xinjiang Hypertension Institute; National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, Xinjiang, People's Republic of China
| | - Lin Gan
- Xinjiang Medical University, Urumqi, People's Republic of China.,Hypertension Center of the People's Hospital of Xinjiang Uygur Autonomous Region; Xinjiang Hypertension Institute; National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, Xinjiang, People's Republic of China
| | - Mei Li
- Hypertension Center of the People's Hospital of Xinjiang Uygur Autonomous Region; Xinjiang Hypertension Institute; National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, Xinjiang, People's Republic of China
| | - Wenbo Yang
- Hypertension Center of the People's Hospital of Xinjiang Uygur Autonomous Region; Xinjiang Hypertension Institute; National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, Xinjiang, People's Republic of China
| | - Ling Yao
- Hypertension Center of the People's Hospital of Xinjiang Uygur Autonomous Region; Xinjiang Hypertension Institute; National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, Xinjiang, People's Republic of China
| | - Zhongrong Wang
- Hypertension Center of the People's Hospital of Xinjiang Uygur Autonomous Region; Xinjiang Hypertension Institute; National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, Xinjiang, People's Republic of China
| | - Zhikang Yang
- Hypertension Center of the People's Hospital of Xinjiang Uygur Autonomous Region; Xinjiang Hypertension Institute; National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, Xinjiang, People's Republic of China
| | - Reyila Abudoyreyimu
- Hypertension Center of the People's Hospital of Xinjiang Uygur Autonomous Region; Xinjiang Hypertension Institute; National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, Xinjiang, People's Republic of China
| | - Zihao Wu
- Hypertension Center of the People's Hospital of Xinjiang Uygur Autonomous Region; Xinjiang Hypertension Institute; National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, Xinjiang, People's Republic of China
| | - Nanfang Li
- Xinjiang Medical University, Urumqi, People's Republic of China.,Hypertension Center of the People's Hospital of Xinjiang Uygur Autonomous Region; Xinjiang Hypertension Institute; National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, Xinjiang, People's Republic of China
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9
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Mehmood HR, Khan Z, Jahangir HMS, Hussain A, Elahi A, Askari SMH. Assessment of serum biochemical derangements and associated risk factors of chronic kidney disease. J Taibah Univ Med Sci 2021; 17:376-383. [PMID: 35722231 PMCID: PMC9170744 DOI: 10.1016/j.jtumed.2021.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/23/2021] [Accepted: 09/04/2021] [Indexed: 12/03/2022] Open
Abstract
Objective Chronic kidney disease and/or disturbance in renal excretory function may lead to nitrogenous waste collection beyond the term as well as derangements of several serum biochemicals. There is no previous study from Pakistan that reveals serum electrolyte derangements in confirmed chronic kidney disease (CKD) patients and other biochemicals associated with CKD. This study aims to examine the derangements of serum biochemicals and the association of several risk factors with CKD. Methods The study enrolled 612 confirmed CKD patients with a glomerular filtration rate (GFR) < 15 ml/min that were treated as a part of the integrated care programme at Mayo Hospital Lahore (one of the largest hospitals in Pakistan). Serum biochemicals were estimated on AU 680 (Beckman Coulter) using the spectrophotometric technique. Results All the CKD patients had elevated creatinine and urea levels, but only 63.4% were suffering from hyperuricemia. The incidence of diabetes and malnutrition assessed by serum albumin (hypoalbuminemia) was 27.4% and 72%, respectively. Among electrolyte disorders, hyperphosphatemia (71.8%) and hypocalcaemia (61.9%) were found to be more prevalent. Furthermore, gender, malnutrition, diabetes, hyperuricemia, and phosphorus and magnesium derangements were found to be statistically significant risk factors for CKD, whereas malnutrition and magnesium derangement were associated with hyperuricemia. Conclusion It is imperative to improve dietary protein and monitor serum electrolyte concentration in renal dysfunction patients to slow the progression of CKD to end-stage renal disease (ESRD) and other serious complications.
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10
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Martinsson C, Uhlin F, Wenemark M, Eldh AC. Preference-based patient participation for most, if not all: A cross-sectional study of patient participation amongst persons with end-stage kidney disease. Health Expect 2021; 24:1833-1841. [PMID: 34337836 PMCID: PMC8483194 DOI: 10.1111/hex.13323] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 06/22/2021] [Accepted: 07/15/2021] [Indexed: 01/25/2023] Open
Abstract
Background Patient participation is considered central for good healthcare. Yet, the concept is not fully understood when it comes to patients' experiences of participation in conjunction with their preferences, particularly in long‐term healthcare. The aim of this study was to investigate the extent and variation of preference‐based patient participation in patients with end‐stage kidney disease (ESKD). Methods A cross‐sectional study was conducted with 346 patients in renal care. The main variables were patients' preferences for and experiences of patient participation, determined using the Patient Preferences for Patient Participation tool, the 4Ps. Analyses identified the degree of match between preferences and experiences, that is, the preference‐based patient participation measure. Results Overall, 57%–84% of the patients reached a sufficient level of preference‐based patient participation on the items, while 2%–12% reached an insufficient level. A mismatch indicated either less or more participation than preferred; for example, 40% had less experience than preferred for taking part in planning, and 40% had more than preferred for managing treatment. Conclusion This study shows that, although many patients reach a sufficient level of preference‐based patient participation, this is not the case for all patients and/or attributes. Further opportunities for a mutual understanding of patients' preferences are needed for healthcare professionals to support person‐centred patient participation. Patient or Public Contribution The 4Ps is manufactured in collaboration with people with experience of the patient role, and persons living with ESKD were engaged in identifying their preferences and experiences of participation in renal care.
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Affiliation(s)
- Caroline Martinsson
- Department of Health, Medicine and Caring Sciences, Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden
| | - Fredrik Uhlin
- Department of Health, Medicine and Caring Sciences, Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden.,Department of Nephrology, Region Östergötland, Linköping, Sweden.,Department of Health Technologies, Tallinn University of Technology (TalTech), Tallinn, Estonia
| | - Marika Wenemark
- Department of Health, Medicine and Caring Sciences, Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden.,Unit of Public Health and Statistics, Region Östergötland, Linköping, Sweden
| | - Ann Catrine Eldh
- Department of Health, Medicine and Caring Sciences, Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden.,Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
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11
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Yuan HC, Yu QT, Bai H, Xu HZ, Gu P, Chen LY. Alcohol intake and the risk of chronic kidney disease: results from a systematic review and dose-response meta-analysis. Eur J Clin Nutr 2021; 75:1555-1567. [PMID: 33674776 DOI: 10.1038/s41430-021-00873-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 01/15/2021] [Accepted: 01/28/2021] [Indexed: 01/11/2023]
Abstract
Many prospective cohort studies have investigated the association between the consumption of alcohol and CKD risk and have revealed inconsistent results. In the present study, we aimed to perform a meta-analysis of these studies to assess this association.We searched the PubMed and Embase databases up to 2020 and reviewed the reference lists of relevant articles to identify appropriate studies. We calculated the pooled relative risks with 95% CIs using random effects models, and then performed subgroup and meta-regression analyses. Dose-response meta-analyses were performed by sex separately. We identified 25 eligible prospective cohort studies, including 514,148 participants and 35,585 incident CKD cases. Compared with the category of minimal alcohol intake, light (RR = 0.90, I2 = 49%), moderate (RR = 0.86, I2 = 40%), and heavy (RR = 0.85, I2 = 51%) alcohol intake were associated with a lower risk of CKD. Subgroup meta-analysis by sex indicated that light (RR = 0.92, I2 = 0%), moderate (RR = 0.83, I2 = 39%) and heavy (RR = 0.76, I2 = 40%), alcohol consumption were inversely associated with CKD risk in male. Dose-response meta-analyses detected a nonlinear inverse association between alcohol consumption and the risk of CKD in all participants and linear inverse association in female participants. This meta-analysis shows that light (<12 g/day), moderate (12-24 g/day), and heavy (>24 g/day) alcohol consumption are protective against chronic kidney disease in adult participants especially in males.
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Affiliation(s)
- H C Yuan
- Department of Nutrition, Qingdao Municipal Hospital, Qingdao, China
| | - Q T Yu
- The People's Hospital of Huaiyin, Jinan, China
| | - H Bai
- The People's Hospital of Huaiyin, Jinan, China
| | - H Z Xu
- Department of Nutrition and Food Hygiene, School of Public Health, Shandong University, Jinan, China
| | - P Gu
- Department of Nutrition, Qingdao Municipal Hospital, Qingdao, China.
| | - L Y Chen
- Department of Nutrition and Food Hygiene, School of Public Health, Shandong University, Jinan, China. .,Department of Clinical Nutrition, Shandong Provincial Hospital, Jinan, China.
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12
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Sex Differences in the Renal Vascular Responses of AT 1 and Mas Receptors in Two-Kidney-One-Clip Hypertension. Int J Hypertens 2021; 2021:8820646. [PMID: 33688433 PMCID: PMC7914082 DOI: 10.1155/2021/8820646] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 01/05/2021] [Accepted: 01/20/2021] [Indexed: 01/20/2023] Open
Abstract
Background The prevalence and severity of hypertension, as well as the activity of the systemic and local renin angiotensin systems (RASs), are gender related, with more symptoms in males than in females. However, the underlying mechanisms are not well understood. In this study, we investigated sex differences in renal vascular responses to angiotensin II (Ang II) administration with and without Ang II type 1 and Mas receptor (AT1R and MasR) antagonists (losartan and A779) in the 2K1C rat model of renovascular hypertension. Methods Male and female 2K1C rats were divided into 8 experimental groups (4 of each sex) treated with vehicle, losartan, A779, or A779+losartan. Responses of mean arterial pressure (MAP), renal blood flow (RBF), and renal vascular resistance (RVR) to Ang II were determined. Results In both sexes, the basal MAP, RBF, and RVR were not significantly different between the four groups during the control period. The Ang II administration decreased RBF and increased RVR in a dose-related manner in both sexes pretreated with vehicle or A779 (Pdose < 0.0001), but in vehicle pretreated groups, RBF and RVR responses were different between male and female rats (Pgroup < 0.05). AT1R blockade increased RBF and decreased RVR responses to Ang II, and no difference between the sexes was detected. Coblockades of AT1R and MasR receptors increased RBF response to Ang II significantly in males alone but not in females (Pgroup=0.04). Conclusion The impact of Ang II on RBF and RVR responses seems to be gender related with a greater effect on males, and this sex difference abolishes by Mas receptor blockade. However, the paradoxical role of dual losartan and A779 may provide the different receptor interaction in RAS between male and female rats.
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13
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Darvishzadeh Mahani F, Khaksari M, Raji-Amirhasani A. Renoprotective effects of estrogen on acute kidney injury: the role of SIRT1. Int Urol Nephrol 2021; 53:2299-2310. [PMID: 33458788 DOI: 10.1007/s11255-020-02761-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Accepted: 12/15/2020] [Indexed: 01/23/2023]
Abstract
Acute kidney injury (AKI) is a common syndrome associated with high morbidity and mortality, despite progress in medical care. Many studies have shown that there are sex differences and different role of sex hormones particularly estrogens in kidney injury. In this regard, the incidence and rate of progression of kidney diseases are higher in men compared with women. These observations suggest that female sex hormone may be renoprotective. Silent information regulator 2 homolog 1 (SIRT1) is a histone deacetylase, which is implicated in multiple biologic processes in several organisms. In the kidneys, SIRT1 inhibits renal cell apoptosis, inflammation, and fibrosis. Studies have reported a link between SIRT1 and estrogen. In addition, SIRT1 regulates ERα expression and inhibition of SIRT1 activity suppresses ERα expression. This effect leads to inhibition of estrogen-responsive gene expression. In this text, we review the role of SIRT1 in mediating the protective effects of estrogen in the onset and progression of AKI.
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Affiliation(s)
- Fatemeh Darvishzadeh Mahani
- Physiology Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Khaksari
- Endocrinology and Metabolism Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran.
| | - Alireza Raji-Amirhasani
- Endocrinology and Metabolism Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran
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14
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Antlanger M, Noordzij M, van de Luijtgaarden M, Carrero JJ, Palsson R, Finne P, Hemmelder MH, Aresté-Fosalba N, Reisæter AV, Cases A, Traynor JP, Kramar R, Massy Z, Jager KJ, Hecking M. Sex Differences in Kidney Replacement Therapy Initiation and Maintenance. Clin J Am Soc Nephrol 2019; 14:1616-1625. [PMID: 31649071 PMCID: PMC6832047 DOI: 10.2215/cjn.04400419] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 08/11/2019] [Indexed: 12/30/2022]
Abstract
BACKGROUND AND OBJECTIVES More men than women undergo kidney replacement therapy (KRT) despite a larger number of women being affected by CKD. The aim of this multinational European study was to explore whether there might be historic and geographic trends in sex-specific incidence and prevalence of various KRT modalities. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS We assessed sex-specific differences in KRT incidence and prevalence using data from nine countries reporting to the European Renal Association-European Dialysis and Transplant Association (ERA-EDTA) Registry for at least 40 years, during the period 1965-2015. Sex distribution data were compared with the European general population (Eurostat). Statistical methodology included basic descriptive statistics, incidence and prevalence calculations per million population (pmp), as well as their male-to-female ratios. Analyses were stratified by age group and diabetic status. RESULTS We analyzed data from 230,378 patients receiving KRT (38% women). For all KRT modalities, the incidence and prevalence rates were consistently higher in men than women. For example, the KRT incidence increased from 8 pmp in 1965-1974 to 98 pmp in 2005-2015 in women, whereas it rose from 12 to 173 pmp in men during the same period. Male-to-female ratios, calculated for incident and prevalent KRT patients, increased with age (range 1.2-2.4), showing consistency over decades and for individual countries, despite marked changes in primary kidney disease (diabetes more prevalent than glomerulonephritis in recent decades). The proportion of kidney transplants decreased less with age in incident and prevalent men compared with women on KRT. Stratified analysis of patients who were diabetic versus nondiabetic revealed that the male-to-female ratio was markedly higher for kidney transplantation in patients with diabetes. CONCLUSIONS Since the beginning of KRT programs reporting to the ERA-EDTA Registry since the 1960s, fewer women than men have received KRT. The relative difference between men and women initiating and undergoing KRT has remained consistent over the last five decades and in all studied countries.
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Affiliation(s)
- Marlies Antlanger
- Clinical Division of Nephrology and Dialysis, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.,Department of Internal Medicine II, Kepler University Hospital, Med Campus III, Linz, Austria
| | - Marlies Noordzij
- European Renal Association-European Dialysis and Transplant Association (ERA-EDTA) Registry, Department of Medical Informatics, Amsterdam Public Health Research Institute, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Juan Jesus Carrero
- Department of Medical Epidemiology and Biostatistics, Centre for Gender Medicine, Karolinska Institute, Stockholm, Sweden
| | - Runolfur Palsson
- Division of Nephrology, Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland.,Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Patrik Finne
- Abdominal Center Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Finnish Registry for Kidney Diseases, Helsinki, Finland
| | - Marc H Hemmelder
- Dutch Renal Registry, Nefrovisie Foundation, Utrecht, The Netherlands
| | - Nuria Aresté-Fosalba
- Department of Nephrology, University Hospital Virgen Macarena and Information System of the Autonomic Transplant Coordination of Andalusia (SICATA), Seville, Spain
| | - Anna Varberg Reisæter
- Department of Transplantation Medicine, Oslo University Hospital, Rikshospitalet, Norway
| | - Aleix Cases
- Nephrology Unit, Hospital Clinic, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), University of Barcelona, Barcelona, Spain.,Catalan Registry of Renal Patients, Barcelona, Spain
| | - Jamie P Traynor
- Scottish Renal Registry, Meridian Court, Information Services Division Scotland, Glasgow, UK
| | | | - Ziad Massy
- Division of Nephrology, Ambroise Paré University Hospital, Assistance Publique - Hôpitaux de Paris (APHP), Paris, France; and.,Institut National de la Santé et de la Recherche Médicale (INSERM) Unit 1018, Team 5, Centre for Research in Epidemiology and Population Health (CESP), University of Paris Ouest-Versailles-St Quentin-en-Yveline, Villejuif, France
| | - Kitty J Jager
- European Renal Association-European Dialysis and Transplant Association (ERA-EDTA) Registry, Department of Medical Informatics, Amsterdam Public Health Research Institute, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Manfred Hecking
- Clinical Division of Nephrology and Dialysis, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria;
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15
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Sex and the kidneys: current understanding and research opportunities. Nat Rev Nephrol 2019; 15:776-783. [PMID: 31586165 DOI: 10.1038/s41581-019-0208-6] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/03/2019] [Indexed: 12/22/2022]
Abstract
Concerns regarding sex differences are increasingly pertinent in scientific and societal arenas. Although biological sex and socio-cultural gender are increasingly recognized as important modulators of renal function under physiological and pathophysiological conditions, gaps remain in our understanding of the mechanisms underlying sex differences in renal pathophysiology, disease development, progression and management. In this Perspectives article, we discuss specific opportunities for future research aimed at addressing these knowledge gaps. Such opportunities include the development of standardized core data elements and outcomes related to sex for use in clinical studies to establish a connection between sex hormones and renal disease development or progression, development of a knowledge portal to promote fundamental understanding of physiological differences between male and female kidneys in animal models and in humans, and the creation of new or the development of existing resources and datasets to make them more readily available for interrogation of sex differences. These ideas are intended to stimulate thought and interest among the renal research community as they consider sex as a biological variable in future research projects.
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16
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Wei H, Yan Y, Gong J, Dong J. Prevalence of kidney damage in Chinese elderly: a large-scale population-based study. BMC Nephrol 2019; 20:341. [PMID: 31477037 PMCID: PMC6719360 DOI: 10.1186/s12882-019-1525-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Accepted: 08/16/2019] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND In China, both population aging and kidney damage has become emerging public health challenges. Despite the number of elders is huge, data on kidney damage in this population are scarce. The present study aimed to describe the prevalence of kidney damage among older adults in Wuhan, China. METHODS To describe the prevalence of kidney damage among Chinese elderly, the health screening data of 350,881 adults older than 65 years in Wuhan, China were collected and analyzed. Kidney damage was defined as eGFR less than 60 mL/min per 1·73 m2 or the presence of proteinuria. Decreased renal function was defined as an eGFR < 60 mL/min/1.73 m2. Proteinuria was defined as urine protein ≥1+ and without urine WBC or nitrite positive. The associated risk factors of eGFR decline and kidney damage were analyzed by multivariate logistic regression. RESULTS The age-standardized prevalence of kidney damage, decreased renal function and proteinuria was 17.2, 13.5 and 5.3%. Among the patients, up to 74.4% was stage 3. The prevalence of kidney damage and eGFR decline were higher in suburbs than in urban (18.3% vs 16.0 and 14.6% vs 12.4%). Factors independently associated with kidney damage were age, female, BMI, abdominal circumference, hypertension, diabetes, stroke and coronary heart disease. CONCLUSIONS Kidney damage has become an important public health problem in Chinese elderly. More attention should be paid to elderly lived in suburbs or rural area in our further work.
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Affiliation(s)
- Honglan Wei
- Department of Nephrology, Wuhan Fourth Hospital, Puai Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430033 People’s Republic of China
| | - Yaqiong Yan
- Wuhan Center for Disease Control and Prevention, Wuhan, Hubei 430000 People’s Republic of China
| | - Jie Gong
- Wuhan Center for Disease Control and Prevention, Wuhan, Hubei 430000 People’s Republic of China
| | - Junwu Dong
- Department of Nephrology, Wuhan Fourth Hospital, Puai Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430033 People’s Republic of China
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17
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Preeclampsia and risk of end stage kidney disease: A Swedish nationwide cohort study. PLoS Med 2019; 16:e1002875. [PMID: 31361741 PMCID: PMC6667103 DOI: 10.1371/journal.pmed.1002875] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 06/28/2019] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Preeclampsia has been suggested to increase the risk of end-stage kidney disease (ESKD); however, most studies were unable to adjust for potential confounders including pre-existing comorbidities such as renal disease and cardiovascular disease (CVD). We aimed to examine the association between preeclampsia and the risk of ESKD in healthy women, while taking into account pre-existing comorbidity and potential confounders. METHODS AND FINDINGS Using data from the Swedish Medical Birth Register (MBR), women who had singleton live births in Sweden between 1982 and 2012, including those who had preeclampsia, were identified. Women with a diagnosis of chronic kidney disease (CKD), CVD, hypertension, or diabetes prior to the first pregnancy were excluded. The outcome was a diagnosis of ESKD, identified from the Swedish Renal Registry (SRR) from January 1, 1991, onwards along with the specified cause of renal disease. We conducted Cox proportional hazards regression analysis to examine the association between preeclampsia and ESKD adjusting for several potential confounders: maternal age, body mass index (BMI), education, native country, and smoking. This analysis accounts for differential follow-up among women because women had different lengths of follow-up time. We performed subgroup analyses according to preterm preeclampsia, small for gestational age (SGA), and women who had 2 pregnancies with preeclampsia in both. The cohort consisted of 1,366,441 healthy women who had 2,665,320 singleton live births in Sweden between 1982 and 2012. At the first pregnancy, women's mean (SD) age and BMI were 27.8 (5.13) and 23.4 (4.03), respectively, 15.2% were smokers, and 80.7% were native Swedish. The overall median (interquartile range [IQR]) follow-up was 7.4 years (3.2-17.4) and 16.4 years (10.3-22.0) among women with ESKD diagnosis. During the study period, 67,273 (4.9%) women having 74,648 (2.8% of all pregnancies) singleton live births had preeclampsia, and 410 women developed ESKD with an incidence rate of 1.85 per 100,000 person-years. There was an association between preeclampsia and ESKD in the unadjusted analysis (hazard ratio [HR] = 4.99, 95% confidence interval [CI] 3.93-6.33; p < 0.001), which remained in the extensively adjusted (HR = 4.96, 95% CI 3.89-6.32, p < 0.001) models. Women who had preterm preeclampsia (adjusted HR = 9.19; 95% CI 5.16-15.61, p < 0.001) and women who had preeclampsia in 2 pregnancies (adjusted HR = 7.13, 95% CI 3.12-16.31, p < 0.001) had the highest risk of ESKD compared with women with no preeclampsia. Considering this was an observational cohort study, and although we accounted for several potential confounders, residual confounding cannot be ruled out. CONCLUSIONS The present findings suggest that women with preeclampsia and no major comorbidities before their first pregnancy are at a 5-fold increased risk of ESKD compared with parous women with no preeclampsia; however, the absolute risk of ESKD among women with preeclampsia remains small. Preeclampsia should be considered as an important risk factor for subsequent ESKD. Whether screening and/or preventive strategies will reduce the risk of ESKD in women with adverse pregnancy outcomes is worthy of further investigation.
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18
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Toba H, Lindsey ML. Extracellular matrix roles in cardiorenal fibrosis: Potential therapeutic targets for CVD and CKD in the elderly. Pharmacol Ther 2019; 193:99-120. [PMID: 30149103 PMCID: PMC6309764 DOI: 10.1016/j.pharmthera.2018.08.014] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Whereas hypertension, diabetes, and dyslipidemia are age-related risk factors for cardiovascular disease (CVD) and chronic kidney disease (CKD), aging alone is an independent risk factor. With advancing age, the heart and kidney gradually but significantly undergo inflammation and subsequent fibrosis, which eventually results in an irreversible decline in organ physiology. Through cardiorenal network interactions, cardiac dysfunction leads to and responds to renal injury, and both facilitate aging effects. Thus, a comprehensive strategy is needed to evaluate the cardiorenal aging network. Common hallmarks shared across systems include extracellular matrix (ECM) accumulation, along with upregulation of matrix metalloproteinases (MMPs) including MMP-9. The wide range of MMP-9 substrates, including ECM components and inflammatory cytokines, implicates MMP-9 in a variety of pathological and age-related processes. In particular, there is strong evidence that inflammatory cell-derived MMP-9 exacerbates cardiorenal aging. This review explores the potential therapeutic targets against CVD and CKD in the elderly, focusing on ECM and MMP roles.
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Affiliation(s)
- Hiroe Toba
- Department of Clinical Pharmacology, Division of Pathological Sciences, Kyoto Pharmaceutical University, Kyoto, Japan.
| | - Merry L Lindsey
- Mississippi Center for Heart Research, Department of Physiology and Biophysics, University of Mississippi Medical Center, and Research Service, G.V. (Sonny) Montgomery Veterans Affairs Medical Center, Jackson, MS, USA.
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Impact of prenatal and postnatal maternal environment on nephron endowment, renal function and blood pressure in the Lewis polycystic kidney rat. J Dev Orig Health Dis 2018; 10:154-163. [PMID: 30274564 DOI: 10.1017/s2040174418000673] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Maternal insufficiency during fetal development can have long-lasting effects on the offspring, most notably on nephron endowment. In polycystic kidney disease (PKD), variability in severity of disease is observed and maternal environment may be a modifying factor. In this study, we first established that in a rodent model of PKD, the Lewis polycystic kidney (LPK) rat's nephron numbers are 25% lower compared with wildtype animals. We then investigated the effects of prenatal and postnatal maternal environment on phenotype and nephron number. LPK pups born from and raised by homozygous LPK dams (control) were compared with LPK pups cross-fostered onto heterozygous LPK dams to improve postnatal environment; with LPK pups born from and raised by heterozygous LPK dams to improve both prenatal and postnatal environment and with LPK pups born from and raised by Wistar Kyoto-LPK heterozygous dams to improve both prenatal and postnatal environment on a different genetic background. Improvement in both prenatal and postnatal environment improved postnatal growth, renal function and reduced blood pressure, most notably in animals with different genetic background. Animals with improved postnatal environment only showed improved growth and blood pressure, but to a lesser extent. All intervention groups showed increased nephron number compared with control LPK. In summary, prenatal and postnatal environment had significant effect in delaying progression and reducing severity of PKD, including nephron endowment.
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20
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[Menopause: Hypertension and vascular disease]. HIPERTENSION Y RIESGO VASCULAR 2018; 35:77-83. [PMID: 29396243 DOI: 10.1016/j.hipert.2017.11.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 11/03/2017] [Accepted: 11/05/2017] [Indexed: 12/22/2022]
Abstract
Hypertension is the main cardiovascular risk factor affecting 25% of women. Hormone changes and hypertension after menopause may lead to higher target organ damage and cardiovascular disease such as increased arterial stiffness, coronary diseases, chronic heart failure and stroke. The physiopathological mechanisms involved in the development of hypertension and cardiovascular diseases in menopausal women are controversial. There are pharmacokinetic and pharmacodynamic differences in both sexes, the women have more coughing when using the converting-enzyme inhibitors, more cramps when using thiazide diuretics and more oedema in the inferior limbs when using calcium antagonists. The aim of this review is to analyse possible physiopathological mechanisms involved in hypertension after menopause and to gain a better understanding of the biological effects mediated by vascular ageing in women when the level of oestrogen protective effect decreases over the vascular system.
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21
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Evans M, Grams ME, Sang Y, Astor BC, Blankestijn PJ, Brunskill NJ, Collins JF, Kalra PA, Kovesdy CP, Levin A, Mark PB, Moranne O, Rao P, Rios PG, Schneider MP, Shalev V, Zhang H, Chang AR, Gansevoort RT, Matsushita K, Zhang L, Eckardt KU, Hemmelgarn B, Wheeler DC. Risk Factors for Prognosis in Patients With Severely Decreased GFR. Kidney Int Rep 2018; 3:625-637. [PMID: 29854970 PMCID: PMC5976849 DOI: 10.1016/j.ekir.2018.01.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 01/08/2018] [Indexed: 02/07/2023] Open
Abstract
Introduction Patients with chronic kidney disease (CKD) and estimated glomerular filtration rate (eGFR) <30 ml/min per 1.73 m2 (corresponding to CKD stage G4+) comprise a minority of the overall CKD population but have the highest risk for adverse outcomes. Many CKD G4+ patients are older with multiple comorbidities, which may distort associations between risk factors and clinical outcomes. Methods We undertook a meta-analysis of risk factors for kidney failure treated with kidney replacement therapy (KRT), cardiovascular disease (CVD) events, and death in participants with CKD G4+ from 28 cohorts (n = 185,024) across the world who were part of the CKD Prognosis Consortium. Results In the fully adjusted meta-analysis, risk factors associated with KRT were time-varying CVD, male sex, black race, diabetes, lower eGFR, and higher albuminuria and systolic blood pressure. Age was associated with a lower risk of KRT (adjusted hazard ratio: 0.74; 95% confidence interval: 0.69–0.80) overall, and also in the subgroup of individuals younger than 65 years. The risk factors for CVD events included male sex, history of CVD, diabetes, lower eGFR, higher albuminuria, and the onset of KRT. Systolic blood pressure showed a U-shaped association with CVD events. Risk factors for mortality were similar to those for CVD events but also included smoking. Most risk factors had qualitatively consistent associations across cohorts. Conclusion Traditional CVD risk factors are of prognostic value in individuals with an eGFR <30 ml/min per 1.73 m2, although the risk estimates vary for kidney and CVD outcomes. These results should encourage interventional studies on correcting risk factors in this high-risk population.
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Affiliation(s)
- Marie Evans
- Division of Renal Medicine, CLINTEC, Karolinska Institutet, Stockholm, Sweden.,Swedish Renal Registry, Jönköping, Sweden
| | - Morgan E Grams
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Yingying Sang
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Brad C Astor
- Departments of Medicine and Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Peter J Blankestijn
- Department of Nephrology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Nigel J Brunskill
- Department of Infection Immunity and Inflammation, University of Leicester, Leicester, UK
| | - John F Collins
- Department of Renal Medicine, Auckland City Hospital, Auckland, New Zealand
| | - Philip A Kalra
- Institute of Cardiovascular Sciences, University of Manchester, Manchester Academic Health Sciences Centre, Manchester, UK.,Salford Royal NHS Foundation Trust, Manchester, UK
| | - Csaba P Kovesdy
- University of Tennessee Health Science Center, Memphis, Tennessee, USA.,Memphis Veterans Affairs Medical Center, Memphis, Tennessee, USA
| | - Adeera Levin
- BC Provincial Renal Agency, Vancouver, British Columbia, Canada.,University of British Columbia, Vancouver, British Columbia, Canada
| | - Patrick B Mark
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, Scotland, UK
| | - Olivier Moranne
- Service de Néphrologie-Dialyses-Aphérèse, Hôpital Caremeau, CHU Nimes, France.,EA2415, Université Montpellier-Nimes, Nimes, France
| | - Panduranga Rao
- Department of Internal Medicine, Division of Nephrology, University of Michigan Health System, Ann Arbor, Michigan, USA
| | - Pablo G Rios
- National Renal Health Care Program, Montevideo, Uruguay
| | - Markus P Schneider
- Department of Nephrology and Hypertension, University Hospital of the Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - Varda Shalev
- Medical Division, Maccabi Healthcare Services, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Haitao Zhang
- National Clinical Research Center of Kidney Diseases, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
| | - Alex R Chang
- Division of Nephrology, Geisinger Health System, Danville, Pennsylvania, USA
| | - Ron T Gansevoort
- Department of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | | | - Luxia Zhang
- Peking University First Hospital, Beijing, China
| | - Kai-Uwe Eckardt
- Department of Nephrology and Medical Intensive Care, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Brenda Hemmelgarn
- Cumming School of Medicine, Division of Nephrology, Department of Community Health Sciences, University of Calgary, Alberta, Canada
| | - David C Wheeler
- Centre for Nephrology, University College London, London, UK
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22
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Abstract
Here we present a method for a mobile point-of-care (POC) testing of urinary albumin concentration, a biomarker of kidney damage and cardiovascular disease. The self-testing strips are meant to be interpreted by means of a smartphone application. The limits of detection range from 0.15 to 0.30 g/L urinary albumin, though results below 0.10 g/L are presented in a quantitative manner and estimates larger than this threshold are shown as categorical variables in a qualitative manner for increasing urinary albumin concentrations. Calibrated once under standard conditions, the app enables the user to capture problem samples and calculate the corresponding concentration. Negative and positive findings must be interpreted, taking into account the inherent limitations of the method, and professional health advice must be requested for diagnostic considerations. Acknowledgment of the association between early life nutrition and long-term renal health and the adoption of preventive strategies targeting high-risk groups is key for the reduction of the burden of chronic kidney disease on a global scale.
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Affiliation(s)
- P R Matías-García
- Institute of Medical Informatics, Biometry and Epidemiology (IBE), Ludwig-Maximilians-Universität München, Munich, Germany
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Hussein MH, Hashimoto T, Suzuki T, Abdel-Hamid Daoud G, Kato T, Hibi M, Tomishige H, Hara F, Ito T, Kato I, Kazuhiko K, Sobajima H, Tamura M, Togari H. Liver Transplantation from Female Donors Provokes Higher Complement Component C5a Activity. Ann Transplant 2017; 22:694-700. [PMID: 29162794 PMCID: PMC6248037 DOI: 10.12659/aot.905464] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Background Transplanted organs from female donors are associated with less favorable prognoses and outcomes. This study aimed to determine whether donor gender affects levels of serum terminal complement component C5a and oxidative stress in pediatric living related liver transplantation (LRLTx) recipients. Material/Methods The subjects were 43 patients (20 males and 23 females) who underwent LRLTx during childhood (age range 1.2 years to 14.4 years; mean age 5 years). Serum samples were taken during the patients’ regular outpatient visits after LRLTx. Serum C5a was measured using the specific human C5a ELISA kit. Serum total hydroperoxide (TH) and biological antioxidative potential (BAP) were measured using the free radical analytic system, and the oxidative stress index (OSI) was calculated as the ratio of TH to BAP. Serum glutamic pyruvic transaminase (GPT), glutamic oxaloacetic transaminase (GOT), gamma-glutamyl transpeptidase (γGTP), and lactate dehydrogenase (LDH) were also measured as part of a typical outpatient examination for such patients. Results C5a serum levels were higher in the 29 recipients who received their grafted livers from female donors than in the 14 recipients who received their grafted livers from male donors. Recipients who received their grafted livers from female donors had higher incidence of post-LTx (liver transplantation) complications. Female recipients from female donors showed the highest serum GPT and GOT levels, but this difference was only significant when compared to the female recipients from male donors (41.4±9.8 IU/L vs. 17.3±1.8 IU/L for GPT and 42.2±7.5 IU/L vs. 23.4±2.2 IU/L for GOT; P<0.05). Conclusions Pediatric LRLTx patients who receive their grafts from female donors exhibit higher levels of serum C5a that probably plays a role in the immunological response against grafted livers from female donors in LTx.
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Affiliation(s)
- Mohamed Hamed Hussein
- Division of Neonatology, Center of Maternal, Fetal and Neonatal Medicine, Saitama Medical Center, Saitama Medical University, Kamoda, Kawagoe, Saitama, Japan.,Department of Pediatric Surgery, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Takashi Hashimoto
- Department of General and Pediatric Surgery, Masuko Memorial Hospital, Nakamura, Nagoya, Japan.,Department of Virology and Liver Unit, Nagoya City University Graduate School of Medical Sciences, Kawasumi, Mizuho, Nagoya, Japan
| | - Tatsuya Suzuki
- Department of Pediatric Surgery, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | | | - Takazumi Kato
- Department of Pediatric Surgery, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Masahito Hibi
- Department of Pediatric Surgery, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Hirokazu Tomishige
- Department of Pediatric Surgery, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Fujio Hara
- Department of Pediatric Surgery, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Tetsuya Ito
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Ineko Kato
- Department of Perinatal Development and Preventive Medicine, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | - Kabe Kazuhiko
- Division of Neonatology, Center of Maternal, Fetal and Neonatal Medicine, Saitama Medical Center, Saitama Medical University, Kamoda, Kawagoe, Saitama, Japan
| | - Hisanori Sobajima
- Division of Neonatology, Center of Maternal, Fetal and Neonatal Medicine, Saitama Medical Center, Saitama Medical University, Kamoda, Kawagoe, Saitama, Japan
| | - Masanori Tamura
- Division of Neonatology, Center of Maternal, Fetal and Neonatal Medicine, Saitama Medical Center, Saitama Medical University, Kamoda, Kawagoe, Saitama, Japan
| | - Hajime Togari
- , Kinjogakuin University, Moriyama-ku, Nagoya, Aichi, Japan
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Gala-Błądzińska A, Dumnicka P, Kuśnierz-Cabala B, Rybak K, Drożdż R, Żyłka A, Kuźniewski M. Urinary Neutrophil Gelatinase-Associated Lipocalin Is Complementary to Albuminuria in Diagnosis of Early-Stage Diabetic Kidney Disease in Type 2 Diabetes. BIOMED RESEARCH INTERNATIONAL 2017; 2017:4691389. [PMID: 28845433 PMCID: PMC5563398 DOI: 10.1155/2017/4691389] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Revised: 03/19/2017] [Accepted: 07/06/2017] [Indexed: 12/31/2022]
Abstract
BACKGROUND Two clinical phenotypes of diabetic kidney disease (DKD) have been reported, that is, with or without increased albuminuria. The aim of study was to assess the usefulness of urinary neutrophil gelatinase-associated lipocalin (uNGAL) for the early diagnosis of DKD in the type 2 diabetes mellitus (T2DM). METHODS The study group consisted of 123 patients with T2DM (mean age 62 ± 14 years), with urine albumin/creatinine ratio (uACR) < 300 mg/g and eGFR ≥ 60 ml/min/1.73 m2. The control group included 22 nondiabetic patients with comparable age, sex, and comorbidities. uNGAL, albumin, and creatinine were measured in the first morning urine samples. uACR and uNGAL/creatinine ratios (uNCR) were calculated. RESULTS In the control group, maximum uNCR was 39.64 µg/g. In T2DM group, 24 patients (20%) had higher results, with the maximum value of 378.6 µg/g. Among patients with uNCR > 39.64 µg/g, 13 (54%) did not have markedly increased albuminuria. Women with T2DM had higher uNCR than men (p < 0.001), without difference in uACR (p = 0.09). uNCR in T2DM patients correlated significantly with HbA1c. Sex, total cholesterol, and uACR were independent predictors of uNCR above 39.64 µg/g. CONCLUSIONS Increased uNGAL and uNCR may indicate early tubular damage, associated with dyslipidemia and worse diabetes control, especially in females with T2DM.
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Affiliation(s)
- Agnieszka Gala-Błądzińska
- Department of Dialysis and Nephrology, St. Queen Jadwiga Clinical District Hospital No. 2 in Rzeszów, Lwowska 60 Street, 35-301 Rzeszów, Poland
| | - Paulina Dumnicka
- Department of Medical Diagnostics, Jagiellonian University Medical College, Medyczna 9, 30-688 Kraków, Poland
| | - Beata Kuśnierz-Cabala
- Department of Diagnostics, Chair of Clinical Biochemistry, Jagiellonian University Medical College, 15A Kopernika Street, 31-501 Krakow, Poland
| | - Katarzyna Rybak
- Department of Internal Medicine, Nephrology & Endocrinology, St. Queen Jadwiga Clinical District Hospital No. 2 in Rzeszów, Lwowska 60 Street, 35-301 Rzeszów, Poland
| | - Ryszard Drożdż
- Department of Medical Diagnostics, Jagiellonian University Medical College, Medyczna 9, 30-688 Kraków, Poland
| | - Agnieszka Żyłka
- St. Queen Jadwiga Clinical District Hospital No. 2 in Rzeszów, Lwowska 60 Street, 35-301 Rzeszów, Poland
| | - Marek Kuźniewski
- Department of Nephrology, Jagiellonian University Medical College, 15 Kopernika Street, 31-501 Krakow, Poland
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25
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Angiotensin II type 2 receptor (AT2R) in renal and cardiovascular disease. Clin Sci (Lond) 2017; 130:1307-26. [PMID: 27358027 DOI: 10.1042/cs20160243] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 05/06/2016] [Indexed: 12/14/2022]
Abstract
Angiotensin II (Ang II) is well-considered to be the principal effector of the renin-angiotensin system (RAS), which binds with strong affinity to the angiotensin II type 1 (AT1R) and type 2 (AT2R) receptor subtype. However, activation of both receptors is likely to stimulate different signalling mechanisms/pathways and produce distinct biological responses. The haemodynamic and non-haemodynamic effects of Ang II, including its ability to regulate blood pressure, maintain water-electrolyte balance and promote vasoconstriction and cellular growth are well-documented to be mediated primarily by the AT1R. However, its biological and functional effects mediated through the AT2R subtype are still poorly understood. Recent studies have emphasized that activation of the AT2R regulates tissue and organ development and provides in certain context a potential counter-regulatory mechanism against AT1R-mediated actions. Thus, this review will focus on providing insights into the biological role of the AT2R, in particular its actions within the renal and cardiovascular system.
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26
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Safari T, Miri S, Ghofran O, Fereidooni F, Niazi AA, Bagheri H, Nematbakhsh M. Gender differences in response to vitamin E and C in gentamicin induced nephrotoxicity in Wistar rats. J Nephropathol 2017. [DOI: 10.15171/jnp.2017.54] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
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Wang Y, Zhong B, Li Y, Qin X, Wang B, Xu X, Hou F, Huo Y, Xu X. Relationship of diabetes with renal dysfunction in hypertensive adults. Medicine (Baltimore) 2017; 96:e7169. [PMID: 28614254 PMCID: PMC5478339 DOI: 10.1097/md.0000000000007169] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
We aimed to examine the relationship of diabetes with the estimated glomerular filtration rate (eGFR)-based renal function in the Chinese hypertensive adults.This cross-sectional analysis included a total of 18,641 hypertensive adults aged 45 to 75 years. The relationship of diabetes (a fasting glucose ≥7.0 mmol/L or self-reported use of hypoglycemic agents or physician diagnosed diabetes) with glomerular hyperfiltration (an absolute eGFR >90th percentile after adjusting for sex, age), hypofiltration (an eGFR <10th percentile and ≥60 mL/min/1.73 m), and reduced eGFR (an eGFR <60 mL/min/1.73 m) were estimated by multiple logistic regressions.Both the cut-points for hyperfiltration and hypofiltration decreased with age increased, ranging from 115 to 91 mL/min/1.73 m and 91 to 67 mL/min/1.73 m, respectively. In the multiple logistic models, diabetes was positively associated with glomerular hyperfiltration (odds ratio [OR]: 2.19, 95% confidence interval [CI]: 1.93-2.47), hypofiltration (1.24, 1.05-1.46), and reduced eGFR (2.88, 2.21-3.76). Furthermore, the stronger association between diabetes and hyperfiltration was found in those with younger age (P for interaction <.001), or higher total cholesterol (TC) levels (P for interaction = .008). Consistently, significant association between diabetes and hypofiltration was only observed in participants with younger age (P for interaction = .043). And detrimentally interaction between diabetes and higher TC levels was also found (P for interaction <.001) on the risk of reduced eGFR.Diabetes was significantly associated with the impairment of renal function, particularly in those with younger age or with higher TC levels. Fasting glucose should be monitored as a marker to identify those with early renal dysfunction.
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Affiliation(s)
- Yuejuan Wang
- Department of Emergency, Shenzhen Maternal and Child Healthcare Hospital and The Affiliated Hospital of Southern Medical University
- National Clinical Research Center of Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou
| | - Biyan Zhong
- National Clinical Research Center of Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou
| | - Youbao Li
- National Clinical Research Center of Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou
| | - Xianhui Qin
- National Clinical Research Center of Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou
| | - Binyan Wang
- National Clinical Research Center of Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou
| | - Xin Xu
- National Clinical Research Center of Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou
| | - Fanfan Hou
- National Clinical Research Center of Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou
| | - Yong Huo
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Xiping Xu
- National Clinical Research Center of Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou
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28
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Gigante A, Di Mario F, Pierucci A, Amoroso A, Pignataro FS, Napoleone L, Basili S, Raparelli V. Kidney disease and venous thromboembolism: Does being woman make the difference? Eur J Intern Med 2017; 39:18-23. [PMID: 28258791 DOI: 10.1016/j.ejim.2017.02.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Revised: 12/20/2016] [Accepted: 02/16/2017] [Indexed: 01/05/2023]
Abstract
The risk of venous thromboembolism (VTE) is increased across the spectrum of chronic kidney disease (CKD), from mild to more advanced CKD, and typically characterizes nephrotic syndrome (NS). VTE risk in patients with kidney disease may be due to underlying hemostatic abnormalities, including activation of pro-thrombotic factors, inhibition of endogenous anticoagulation systems, enhanced platelet activation and aggregation, and decreased fibrinolytic activity. The mechanisms involved differ depending on the cause of the kidney impairment (i.e. presence of NS or CKD stage). Sex and gender differences, as well as, environmental factors or comorbidities may play a modulating role; however, specific sex and gender data on this topic are still rare. The aim of the present review is to discuss the VTE risk associated with impairment of kidney function, the potential mechanism accounting for it and the impact of sex differences in this clinical setting.
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Affiliation(s)
- A Gigante
- Department of Clinical Medicine, Sapienza University of Rome, Rome, Italy.
| | - F Di Mario
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - A Pierucci
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - A Amoroso
- Department of Clinical Medicine, Sapienza University of Rome, Rome, Italy
| | - F S Pignataro
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - L Napoleone
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - S Basili
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy; Research Center on Gender and Evaluation and Promotion of Quality in Medicine, (CEQUAM), Sapienza University of Rome, Rome, Italy
| | - V Raparelli
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
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29
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Elmarakby AA, Bhatia K, Crislip R, Sullivan JC. Hemodynamic responses to acute angiotensin II infusion are exacerbated in male versus female spontaneously hypertensive rats. Physiol Rep 2016; 4:4/1/e12677. [PMID: 26755738 PMCID: PMC4760407 DOI: 10.14814/phy2.12677] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
We previously reported that male spontaneously hypertensive rats (SHRs) are more sensitive to chronic angiotensin (Ang) II‐induced hypertension compared with female rats. This study was designed to test the hypothesis that anesthetized male SHRs are also more responsive to acute Ang II‐induced increases in blood pressure and renal hemodynamic changes when compared with female SHRs. Baseline mean arterial pressure (MAP) was higher in male SHRs than in female SHRs (135 ± 2 vs. 124 ± 4 mmHg, P < 0.05). Acute intravenous infusion of Ang II (5 ng/kg/min) for 60 minutes significantly increased MAP to 148 ± 2 mmHg in male SHRs (P < 0.05) without a significant change in MAP in female SHRs. Baseline glomerular filtration rate (GFR) was also higher in male SHRs than in female SHRs (2.6 ± 0.3 vs. 1.3 ± 0.1 mL/min, P < 0.05). Ang II infusion for 60 min significantly decreased GFR in male SHRs (2.0 ± 0.2 mL/min; P < 0.05) without significant changes in urine flow rate, sodium, or chloride excretion. In contrast, Ang II infusion increased GFR in female SHRs (1.9 ± 0.2 mL/min; P < 0.05). The increase in GFR upon Ang II infusion in female SHRs was associated with increases in urine flow rate (4.3 ± 0.3 to 7.1 ± 0.9 μL/min), sodium excretion (0.16 ± 0.04 to 0.4 ± 0.1 μmol/min), and chloride excretion (0.7 ± 0.08 to 1.1 ± 0.1 μmol/min; for all P < 0.05). These findings support the hypothesis that there is sex difference in response to acute Ang II infusion in SHRs with females being less responsive to Ang II‐induced elevations in blood pressure and decreases in GFR relative to male SHRs.
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Affiliation(s)
- Ahmed A Elmarakby
- Departments of Oral Biology, Augusta University, Augusta, Georgia Departments of Pharmacology & Toxicology, Augusta University, Augusta, Georgia
| | - Kanchan Bhatia
- Departments of Physiology, Augusta University, Augusta, Georgia
| | - Ryan Crislip
- Departments of Physiology, Augusta University, Augusta, Georgia
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30
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Physiological and pathophysiological factors affecting the expression and activity of the drug transporter MRP2 in intestine. Impact on its function as membrane barrier. Pharmacol Res 2016; 109:32-44. [DOI: 10.1016/j.phrs.2016.04.014] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 04/15/2016] [Accepted: 04/17/2016] [Indexed: 12/15/2022]
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31
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Hewitson TD, Boon WC, Simpson ER, Smith ER, Samuel CS. Estrogens do not protect, but androgens exacerbate, collagen accumulation in the female mouse kidney after ureteric obstruction. Life Sci 2016; 158:130-6. [PMID: 27373424 DOI: 10.1016/j.lfs.2016.06.022] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Accepted: 06/24/2016] [Indexed: 11/18/2022]
Abstract
AIMS Controversy surrounds the gender basis of progression in chronic kidney disease. Unfortunately, most experimental studies addressing this question do not distinguish between direct effects of estrogen and indirect activation of estrogen receptors through conversion of testosterone to 17β-estradiol by aromatase. We examined the pathogenesis of renal fibrosis in female aromatase knockout (ArKO) mice, which lack circulating and stored estrogens, while having normal levels of testosterone. MAIN METHODS ArKO mice and their wild-type (ArWT) counterparts were subjected to unilateral ureteric obstruction (UUO), with kidney tissue collected at day(D) 0, 3 and 9 post-UUO. Effects of 5α-dihydrotestosterone (DHT) administration on each genotype were also studied. Tissue was assessed biochemically and histochemically for fibrosis. Western blot analysis was used to measure α-smooth muscle actin (α-SMA) expression and TGF-β1 signalling. Matrix metalloproteinase-2 (MMP-2) activity was measured by zymography. KEY FINDINGS UUO increased collagen content over time (p<0.05 (D3) and p<0.01 (D9) vs day 0), with no difference between genotypes in qualitative (collagen IV staining) and quantitative (hydroxyproline concentration) analyses. Systemic administration of non-aromatizable DHT increased collagen content after 3days of UUO in both genotypes. This was not paralleled by any change in α-SMA (myofibroblast burden) or TGF-β1 signalling but was commensurate with DHT reducing MMP2 activity in both genotypes (p<0.05 vs genotype controls). SIGNIFICANCE Physiological concentrations of estrogens do not protect the injured kidney from fibrosis progression. Androgens rather than estrogens are the relevant factor involved in regulating disease-related renal scarring in this model.
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Affiliation(s)
- Tim D Hewitson
- Department of Nephrology, Royal Melbourne Hospital, Parkville, Victoria, Australia; Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Carlton, Victoria, Australia
| | - Wah Chin Boon
- Florey Institute of Neuroscience and Mental Health, Parkville, Victoria, Australia; Prince Henry's Institute of Medical Research, Monash University, Clayton, Victoria, Australia.
| | - Evan R Simpson
- Prince Henry's Institute of Medical Research, Monash University, Clayton, Victoria, Australia
| | - Edward R Smith
- Department of Nephrology, Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Chrishan S Samuel
- Florey Institute of Neuroscience and Mental Health, Parkville, Victoria, Australia; Cardiovascular Disease Program, Biomedicine Discovery Institute and Department of Pharmacology, Monash University, Clayton, Victoria, Australia.
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Dehghani A, Saberi S, Nematbakhsh M. Cisplatin-induced nephrotoxicity alters blood pressure response to angiotensin II administration in rats. Adv Biomed Res 2016; 5:53. [PMID: 27110550 PMCID: PMC4817397 DOI: 10.4103/2277-9175.178797] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Accepted: 01/17/2015] [Indexed: 11/30/2022] Open
Abstract
Background: Cisplatin (CP) is an effective chemotherapeutic drug used in the clinic, which is accompanied with nephrotoxicity. CP may also disturb hemodynamics of the circulation system. We have tested the role of CP in mean arterial pressure (MAP) response to graded angiotensin (Ang) II infusion in rats. Materials and Methods: Male and female rats were treated with CP (2.5 mg/kg/day) for a period of 1-week and compared with the vehicle-treated animals. The blood pressure response to Ang II (100–1000 ng/kg/min) was determined under the anesthesia condition. Endothelial permeability of aorta was measured according to the Evans blue uptake. The kidney tissue was also subjected to histological investigation. Results: Significant increase in serum levels of blood urea nitrogen and creatinine and pathological findings in CP-treated rats verified CP-induced nephrotoxicity. Significant difference in percentage of change in MAP response to Ang II between male and female rats was detected in vehicle-treated groups (P < 0.05) while in CP-treated animals this response difference was not observed. The groups were not significantly different with regard to the endothelial permeability of aorta while the serum level of nitrite in male rats increased significantly following administration of CP (P < 0.05). Conclusion: It seems the different response in percentage of change of MAP to graded Ang II infusion between male and female indicates the effect of CP on renin Ang system parameters.
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Affiliation(s)
- Aghdas Dehghani
- Water and Electrolytes Research Center, Isfahan University of Medical Sciences, Isfahan, Iran; Department of Physiology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shadan Saberi
- Water and Electrolytes Research Center, Isfahan University of Medical Sciences, Isfahan, Iran; Department of Physiology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mehdi Nematbakhsh
- Water and Electrolytes Research Center, Isfahan University of Medical Sciences, Isfahan, Iran; Department of Physiology, Isfahan University of Medical Sciences, Isfahan, Iran; Isfahan Institute of Basic and Applied Sciences Research, Isfahan, Iran
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33
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Regensteiner JG, Golden S, Huebschmann AG, Barrett-Connor E, Chang AY, Chyun D, Fox CS, Kim C, Mehta N, Reckelhoff JF, Reusch JEB, Rexrode KM, Sumner AE, Welty FK, Wenger NK, Anton B. Sex Differences in the Cardiovascular Consequences of Diabetes Mellitus: A Scientific Statement From the American Heart Association. Circulation 2015; 132:2424-47. [PMID: 26644329 DOI: 10.1161/cir.0000000000000343] [Citation(s) in RCA: 211] [Impact Index Per Article: 23.4] [Reference Citation Analysis] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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34
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Chen K, Bi J, Su Y, Chappell MC, Rose JC. Sex-Specific Changes in Renal Angiotensin-Converting Enzyme and Angiotensin-Converting Enzyme 2 Gene Expression and Enzyme Activity at Birth and Over the First Year of Life. Reprod Sci 2015; 23:200-10. [PMID: 26243544 DOI: 10.1177/1933719115597760] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVE Angiotensin-converting enzyme (ACE) and angiotensin-converting enzyme 2 (ACE2) are key enzymes of the renin-angiotensin system. We investigated developmental changes in renal ACE and ACE2 gene expression and activity in both male and female sheep. METHODS Three groups of sheep (fetus, newborn, and adult) were used. Renal ACE and ACE2 activities, messenger RNA (mRNA), and protein expression were studied. RESULTS Renal ACE and ACE2 activities increased at 1 year in males, while there were no changes throughout development in females. Renal ACE and ACE2 mRNA and protein showed no sex differences but increased by 1 year of age. CONCLUSION There are sex-related differences in the development of renal-converting enzyme activities that may have functional implications in terms of the regulation of blood pressure and renal function in men and women. The difference in the patterns of gene expression and enzyme activity indicates that changes in gene expression may not accurately reflect changes in activity.
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Affiliation(s)
- Kai Chen
- Department of Obstetrics and Gynecology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Jianli Bi
- Department of Obstetrics and Gynecology, Wake Forest School of Medicine, Winston-Salem, NC, USA Center of Research for Obstetrics and Gynecology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Yixin Su
- Department of Obstetrics and Gynecology, Wake Forest School of Medicine, Winston-Salem, NC, USA Center of Research for Obstetrics and Gynecology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Mark C Chappell
- Hypertension and Vascular Research Center, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - James C Rose
- Department of Obstetrics and Gynecology, Wake Forest School of Medicine, Winston-Salem, NC, USA Center of Research for Obstetrics and Gynecology, Wake Forest School of Medicine, Winston-Salem, NC, USA
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35
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Vafapour M, Nematbakhsh M, Monajemi R, Mazaheri S, Talebi A, Talebi N, Shirdavani S. Effect of Γ-aminobutyric acid on kidney injury induced by renal ischemia-reperfusion in male and female rats: Gender-related difference. Adv Biomed Res 2015; 4:158. [PMID: 26380243 PMCID: PMC4550949 DOI: 10.4103/2277-9175.161585] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Accepted: 01/17/2015] [Indexed: 11/25/2022] Open
Abstract
Background: The most important cause of kidney injury is renal ischemia/reperfusion injury (IRI), which is gender-related. This study was designed to investigate the protective role of Γ-aminobutyric acid (GABA (against IRI in male and female rats. Materials and Methods: Thirty-six female and male wistar rats were assigned to six experimental groups. The IRI was induced by clamping renal vessels for 45 min then was performed reperfusion for 24 h. The group sex posed to IRI were pretreated with GABA and were compared with the control groups. Results: Serum levels of creatinine and blood urea nitrogen, kidney weight, and kidney tissue damage score increased in the IRI alone groups, (P < 0.05), while GABA decreased these parameters in female significantly (P < 0.05), but not in male rats. Uterus weight decreased significantly in female rats treated with GABA. Testis weight did not alter in male rats. Serum level of nitrite and kidney level of malondialdehyde (MDA) had no significant change in both female and male rats. Kidney level of nitrite increased significantly in female rats experienced IRI and serum level of MDA increased significantly in males that were exposed to IRI (P < 0.05). Conclusion: GABA could ameliorate kidney injury induced by renal IRI in a gender dependent manner.
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Affiliation(s)
- Marzieh Vafapour
- Water and Electrolytes Research Center, Isfahan University of Medical Sciences, Isfahan, Iran ; Department of Biology, Falavarjan Branch, Islamic Azad University, Isfahan, Iran
| | - Mehdi Nematbakhsh
- Water and Electrolytes Research Center, Isfahan University of Medical Sciences, Isfahan, Iran ; Department of Physiology, Isfahan University of Medical Sciences, Isfahan, Iran ; Isfahan-MN Institute of Basic and Applied Sciences Research, Isfahan, Iran
| | - Ramesh Monajemi
- Department of Biology, Falavarjan Branch, Islamic Azad University, Isfahan, Iran
| | - Safoora Mazaheri
- Water and Electrolytes Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ardeshir Talebi
- Water and Electrolytes Research Center, Isfahan University of Medical Sciences, Isfahan, Iran ; Department of Clinical Pathology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nahid Talebi
- Water and Electrolytes Research Center, Isfahan University of Medical Sciences, Isfahan, Iran ; Department of Biology, Falavarjan Branch, Islamic Azad University, Isfahan, Iran
| | - Soheyla Shirdavani
- Water and Electrolytes Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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The Effects of Survival Predictors Before Hemodialysis Initiation is Different in Adults and the Elderly. INT J GERONTOL 2015. [DOI: 10.1016/j.ijge.2014.12.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Ballotari P, Ranieri SC, Luberto F, Caroli S, Greci M, Giorgi Rossi P, Manicardi V. Sex differences in cardiovascular mortality in diabetics and nondiabetic subjects: a population-based study (Italy). Int J Endocrinol 2015; 2015:914057. [PMID: 25873959 PMCID: PMC4385659 DOI: 10.1155/2015/914057] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Revised: 10/03/2014] [Accepted: 10/05/2014] [Indexed: 01/14/2023] Open
Abstract
The objective of this study is to assess the impact of diabetes on cardiovascular mortality, focusing on sex differences. The inhabitants of Reggio Emilia province on December 31, 2009, aged 20-84 were followed up for three years for mortality. The exposure was determined using Reggio Emilia diabetes register. The age-adjusted death rates were estimated as well as the incidence rate ratios using Poisson regression model. Interaction terms for diabetes and sex were tested by the Wald test. People with diabetes had an excess of mortality, compared with nondiabetic subjects (all cause: IRR = 1.68; 95%CI 1.60-1.78; CVD: IRR = 1.61; 95%CI 1.47-1.76; AMI: IRR = 1.59; 95%CI 1.27-1.99; renal causes: IRR = 1.71; 95%CI 1.22-2.38). The impact of diabetes is greater in females than males for all causes (P = 0.0321) and for CVD, IMA, and renal causes. Further studies are needed to investigate whether the difference in cardiovascular risk profile or in the quality of care delivered justifies the higher excess of mortality in females with diabetes compared to males.
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Affiliation(s)
- Paola Ballotari
- Servizio Interaziendale di Epidemiologia, Azienda Unità Sanitaria Locale, Via Amendola 2, 42122 Reggio Emilia, Italy
- IRCCS Arcispedale Santa Maria Nuova, Viale Umberto I 50, 42123 Reggio Emilia, Italy
| | - Sofia Chiatamone Ranieri
- Laboratorio Analisi Chimico Cliniche ed Endocrinologia, IRCCS Arcispedale Santa Maria Nuova, Viale Risorgimento 80, 42123 Reggio Emilia, Italy
| | - Ferdinando Luberto
- Servizio Interaziendale di Epidemiologia, Azienda Unità Sanitaria Locale, Via Amendola 2, 42122 Reggio Emilia, Italy
- IRCCS Arcispedale Santa Maria Nuova, Viale Umberto I 50, 42123 Reggio Emilia, Italy
| | - Stefania Caroli
- Servizio Interaziendale di Epidemiologia, Azienda Unità Sanitaria Locale, Via Amendola 2, 42122 Reggio Emilia, Italy
- IRCCS Arcispedale Santa Maria Nuova, Viale Umberto I 50, 42123 Reggio Emilia, Italy
| | - Marina Greci
- Dipartimento Cure Primarie, Azienda Unità Sanitaria Locale, Via Amendola 2, 42122 Reggio Emilia, Italy
| | - Paolo Giorgi Rossi
- Servizio Interaziendale di Epidemiologia, Azienda Unità Sanitaria Locale, Via Amendola 2, 42122 Reggio Emilia, Italy
- IRCCS Arcispedale Santa Maria Nuova, Viale Umberto I 50, 42123 Reggio Emilia, Italy
| | - Valeria Manicardi
- Dipartimento di Medicina Interna, Ospedale di Montecchio, Azienda Unità Sanitaria Locale, Via Barilla 16, 42027 Montecchio, Italy
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Qin X, Wang Y, Li Y, Xie D, Tang G, Wang B, Wang X, Xu X, Xu X, Hou F. Risk factors for renal function decline in adults with normal kidney function: a 7-year cohort study. J Epidemiol Community Health 2015; 69:782-8. [DOI: 10.1136/jech-2014-204962] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Accepted: 02/09/2015] [Indexed: 12/14/2022]
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Szczubial M, Kankofer M, Bochniarz M, Dąbrowski R. Effects of ovariohysterectomy on oxidative stress markers in female dogs. Reprod Domest Anim 2015; 50:393-9. [PMID: 25704084 DOI: 10.1111/rda.12501] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Accepted: 01/17/2015] [Indexed: 11/28/2022]
Abstract
Numerous studies reported an increase of oxidative stress increases in both women and female laboratory animals after ovariectomy. However, there is little information about the evaluation of antioxidative/oxidative status in ovariectomized dogs. The purpose of this study was to examine the changes in oxidative stress markers after ovariohysterectomy (OHE) in female dogs. The study included eighteen healthy mongrel female dogs. Blood samples were collected immediately before surgery and 14 and 30 days after surgery. Following parameters of oxidative stress intensity were determined: the erythrocyte activity of glutathione peroxidase (GSH-Px) and superoxide dismutase (SOD) as well as the plasma concentrations of thiobarbituric acid reactive substances (TBARS), radical cations of N,N, diethylpara-phenylene diamine (RC-DEPPD), sulfhydryl groups (SH groups), bityrosine and formylkynurenine. The activity of GSH-Px increased markedly, although not significantly, 14 days after OHE and then significantly decreased at 30 days after OHE. A significant increase in plasma TBARS, bityrosine and formylkynurenine concentrations and a decrease in SH group content were concurrently noted at 30 days after surgery. Acquired results suggested that a loss of control over ROS production occurred in female dogs after OHE, which could lead to oxidative stress in the late post-operative period. In conclusion, our findings indicated that OHE is related with the risk of oxidative stress in the late period after operations. Given that oxidative stress contributes to the pathogenesis of various diseases, this may suggest an increased risk of disorders in ovariectomized female dogs; however, further studies are necessary to confirm this hypothesis.
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Affiliation(s)
- M Szczubial
- Department and Clinic of Animal Reproduction, Faculty of Veterinary Medicine, University of Life Sciences, Lublin, Poland
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Kwekel JC, Vijay V, Desai VG, Moland CL, Fuscoe JC. Age and sex differences in kidney microRNA expression during the life span of F344 rats. Biol Sex Differ 2015; 6:1. [PMID: 25653823 PMCID: PMC4316605 DOI: 10.1186/s13293-014-0019-1] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Accepted: 12/29/2014] [Indexed: 02/08/2023] Open
Abstract
Background Growing evidence suggests that epigenetic mechanisms of gene regulation may play a role in susceptibilities to specific toxicities and adverse drug reactions. MiRNAs in particular have been shown to be important regulators in cancer and other diseases and show promise as predictive biomarkers for diagnosis and prognosis. In this study, we characterized the global kidney miRNA expression profile in untreated male and female F344 rats throughout the life span. These findings were correlated with sex-specific susceptibilities to adverse renal events, such as male-biased renal fibrosis and inflammation in old age. Methods Kidney miRNA expression was examined in F344 rats at 2, 5, 6, 8, 15, 21, 78, and 104 weeks of age in both sexes using Agilent miRNA microarrays. Differential expression was determined using filtering criteria of ≥1.5 fold change and ANOVA or pairwise t-test (FDR <5%) to determine significant age and sex effects, respectively. Pathway analysis software was used to investigate the possible roles of these target genes in age- and sex-specific differences. Results Three hundred eleven miRNAs were found to be expressed in at least one age and sex. Filtering criteria revealed 174 differentially expressed miRNAs in the kidney; 173 and 34 miRNAs exhibiting age and sex effects, respectively. Principal component analysis revealed age effects predominated over sex effects, with 2-week miRNA expression being much different from other ages. No significant sexually dimorphic miRNA expression was observed from 5 to 8 weeks, while the most differential expression (13 miRNAs) was observed at 21 weeks. Potential target genes of these differentially expressed miRNAs were identified. Conclusions The expression of 56% of detected renal miRNAs was found to vary significantly with age and/or sex during the life span of F344 rats. Pathway analysis suggested that 2-week-expressed miRNAs may be related to organ and cellular development and proliferation pathways. Male-biased miRNA expression at older ages correlated with male-biased renal fibrosis and mononuclear cell infiltration. These miRNAs showed high representation in renal inflammation and nephritis pathways, and included miR-214, miR-130b, miR-150, miR-223, miR-142-5p, miR-185, and miR-296*. Analysis of kidney miRNA expression throughout the rat life span will improve the use of current and future renal biomarkers and inform our assessments of kidney injury and disease. Electronic supplementary material The online version of this article (doi:10.1186/s13293-014-0019-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Joshua C Kwekel
- Division of Systems Biology, Personalized Medicine Branch, National Center for Toxicological Research, US Food and Drug Administration, 3900 NCTR Road, Jefferson, AR 72079 USA
| | - Vikrant Vijay
- Division of Systems Biology, Personalized Medicine Branch, National Center for Toxicological Research, US Food and Drug Administration, 3900 NCTR Road, Jefferson, AR 72079 USA
| | - Varsha G Desai
- Division of Systems Biology, Personalized Medicine Branch, National Center for Toxicological Research, US Food and Drug Administration, 3900 NCTR Road, Jefferson, AR 72079 USA
| | - Carrie L Moland
- Division of Systems Biology, Personalized Medicine Branch, National Center for Toxicological Research, US Food and Drug Administration, 3900 NCTR Road, Jefferson, AR 72079 USA
| | - James C Fuscoe
- Division of Systems Biology, Personalized Medicine Branch, National Center for Toxicological Research, US Food and Drug Administration, 3900 NCTR Road, Jefferson, AR 72079 USA
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Puelles VG, Douglas-Denton RN, Zimanyi MA, Armitage JA, Hughson MD, Kerr PG, Bertram JF. Glomerular hypertrophy in subjects with low nephron number: contributions of sex, body size and race. Nephrol Dial Transplant 2014; 29:1686-95. [PMID: 24792374 DOI: 10.1093/ndt/gfu088] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND We have shown that low nephron number (Nglom) is a strong determinant of individual glomerular volume (IGV) in male Americans. However, whether the same pattern is present in female Americans remains unclear. The contributions of body surface area (BSA) and race to IGV in the context of Nglom also require further evaluation. METHODS Kidneys without overt renal disease were collected at autopsy in Mississippi, USA. The extremes of female Nglom were used to define high and low Nglom for both sexes. Nglom and IGV were estimated by design-based stereology. A total of 24 African and Caucasian American females (n = 12 per race; 6 per Nglom extreme) were included. These subjects were subsequently matched to 24 comparable males by age and Nglom and to 18 additional males by age, Nglom and BSA. RESULTS IGV average and variance were very similar in female African and Caucasian Americans with high and low Nglom. Males with low Nglom from both races showed greater IGV average and variance than comparable females matched by age and Nglom. These differences in IGV between sexes were not observed in Caucasian Americans with low Nglom that were matched by age, Nglom and BSA. In contrast, glomeruli from African Americans were larger than those from Caucasian Americans, especially in subjects with high Nglom. CONCLUSIONS While female Americans with low Nglom did not show glomerular hypertrophy, comparable males with low Nglom showed marked glomerular hypertrophy that was closely associated with high BSA. Glomerular size in African Americans may be confounded by multiple additional factors.
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Affiliation(s)
- Victor G Puelles
- Department of Anatomy and Developmental Biology, Monash University, Melbourne, Australia
| | | | - Monika A Zimanyi
- Department of Anatomy and Developmental Biology, Monash University, Melbourne, Australia Department of Anatomy and Pathology, James Cook University, Townsville, Australia
| | - James A Armitage
- Department of Anatomy and Developmental Biology, Monash University, Melbourne, Australia School of Medicine (Optometry), Deakin University, Geelong, Australia
| | - Michael D Hughson
- Department of Pathology, University of Mississippi Medical Center, Jackson, USA
| | - Peter G Kerr
- Department of Nephrology, Monash Health, Melbourne, Australia Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - John F Bertram
- Department of Anatomy and Developmental Biology, Monash University, Melbourne, Australia
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Alam A, Amanullah F, Baig-Ansari N, Lotia-Farrukh I, Khan FS. Prevalence and risk factors of kidney disease in urban Karachi: baseline findings from a community cohort study. BMC Res Notes 2014; 7:179. [PMID: 24670059 PMCID: PMC3972995 DOI: 10.1186/1756-0500-7-179] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Accepted: 03/20/2014] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Chronic kidney disease (CKD) is being increasingly recognized as a leading public health problem. However, there are limited data available with respect to prevalence of CKD in Pakistan, a developing South Asian country. The study presents the baseline findings of prevalence and risk factors for adult kidney disease in a Pakistani community cohort. METHODS A total of 667 households were enrolled between March 2010 and August 2011 including 461 adults, aged 15 and older. Mild kidney disease was defined as estimated Glomerular Filtration Rate (eGFR) ≥60 ml/min with microalbuminuria ≥ 30 mg/dl and moderate kidney disease was defined as eGFR <60 ml/min (with or without microalbuminuria). RESULTS The overall prevalence of kidney disease was 16.6% with 8.6% participants having mild kidney disease and 8% having moderate kidney disease. Age was significantly associated with kidney disease (p < 0.0001). The frequency of diabetes, hypertension and smoking differed significantly among the three groups, i.e., no kidney disease, mild kidney disease and moderate kidney disease. CONCLUSION Our study results suggest that the burden of kidney disease in this population is found considerable and comparable to neighboring developing countries. We believe that these results have critical implications on health and economics of these countries and due to the epidemic of diabetes, hypertension, cardiovascular disease, smoking and association with worsening poverty, further rapid growth is expected. There is an urgent need for early recognition and prevention strategies based on risk factors and disease trends determined through longitudinal research.
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Affiliation(s)
- Ashar Alam
- Department of Nephrology, The Indus Hospital, Korangi Crossing, Karachi 75190, Pakistan
| | - Farhana Amanullah
- Department of Nephrology, The Indus Hospital, Korangi Crossing, Karachi 75190, Pakistan
- Interactive Research & Development, Suite 508, Ibrahim Trade Tower, Main Shahrah-e-Faisal, Karachi 75350, Pakistan
| | - Naila Baig-Ansari
- Indus Hospital Research Center, The Indus Hospital, Korangi Crossing, Karachi 75190, Pakistan
- Interactive Research & Development, Suite 508, Ibrahim Trade Tower, Main Shahrah-e-Faisal, Karachi 75350, Pakistan
| | - Ismat Lotia-Farrukh
- Interactive Research & Development, Suite 508, Ibrahim Trade Tower, Main Shahrah-e-Faisal, Karachi 75350, Pakistan
| | - Faisal S Khan
- Interactive Research & Development, Suite 508, Ibrahim Trade Tower, Main Shahrah-e-Faisal, Karachi 75350, Pakistan
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Maric-Bilkan C, Gilbert EL, Ryan MJ. Impact of ovarian function on cardiovascular health in women: focus on hypertension. Int J Womens Health 2014; 6:131-9. [PMID: 24493934 PMCID: PMC3908909 DOI: 10.2147/ijwh.s38084] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Arterial blood pressure levels and the prevalence of hypertension are generally lower in premenopausal women compared with age-matched men. The lower blood pressure levels in premenopausal women are associated with a lower risk of the development and progression of cardiovascular disease. In contrast, menopause, a state characterized by a physiologic reduction in ovarian hormone levels, is associated with progressive increases in blood pressure and an overall increase in the risk of cardiovascular disease. These observations suggest an association between blood pressure regulation and changes in ovarian hormone levels, estrogens in particular. In addition to menopause, the risk of hypertension and cardiovascular disease is also dramatically increased in premenopausal women with chronic diseases such as diabetes and systemic lupus erythematosus. Studies suggest that these chronic diseases may be associated with an imbalance in ovarian hormones, which may explain the increased risk of hypertension and cardiovascular disease in these women. However, the use of hormone therapy to manage the risk and prevent the development of hypertension and cardiovascular diseases in women remains controversial. The precise mechanisms by which estrogens contribute to the regulation of blood pressure are still not completely understood. However, accumulating evidence suggests that modulating the activity of locally active hormone systems is one of the major mechanisms by which estrogens exert their effects on target organs, including the vasculature, kidneys, and immune system. In particular, the interaction between estrogens and the renin-angiotensin system has been implicated in the regulation of blood pressure and cardiovascular function in both humans and experimental models. This review summarizes our current understanding of the mechanisms by which estrogens regulate blood pressure and the potential use of hormone therapy in prevention of hypertension and consequent cardiovascular risk.
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Affiliation(s)
- Christine Maric-Bilkan
- Division of Cardiovascular Sciences, National Heart, Lung and Blood Institute, Bethesda, MD
| | - Emily L Gilbert
- Department of Physiology and Biophysics, University of Mississippi Medical Center, Jackson, MS, USA
| | - Michael J Ryan
- Department of Physiology and Biophysics, University of Mississippi Medical Center, Jackson, MS, USA
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Maditz KH, Gigliotti JC, Tou JC. Evidence for a role of proteins, lipids, and phytochemicals in the prevention of polycystic kidney disease progression and severity. Nutr Rev 2013; 71:802-14. [PMID: 24246056 DOI: 10.1111/nure.12085] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Polycystic kidney disease (PKD) is a heritable disease characterized by renal cysts and is a leading cause of end-stage renal disease. Dietary intervention offers a potentially efficacious, cost-effective, and safe therapeutic option for PKD. The aim of this article was to review studies investigating the effect of dietary components on PKD and potential mechanisms of action. Low-protein diets are commonly recommended for PKD patients, but inconsistent findings in human and animal PKD studies suggest that the type rather the amount of protein may be of greater importance. Dietary soy protein has been shown to have renal protective effects in various animal models of PKD. Other than dietary proteins, studies investigating the role of the amount and type of dietary lipids on PKD progression are increasing. The omega-3 polyunsaturated fatty acids can alter multiple steps in PKD pathogenesis. Phytoestrogens and phytochemicals are other dietary compounds shown to attenuate cyst pathogenesis in animal studies. A better understanding of the role of nutrition in PKD can contribute to the development of dietary recommendations and diet-based therapies to reduce PKD progression and severity.
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Affiliation(s)
- Kaitlin H Maditz
- Human Nutrition and Foods, Division of Animal and Nutritional Sciences, West Virginia University, Morgantown, West Virginia, USA
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Inhibition of Nitric Oxide Synthase by L-NAME Promotes Cisplatin-Induced Nephrotoxicity in Male Rats. ISRN TOXICOLOGY 2013; 2013:242345. [PMID: 24167747 PMCID: PMC3791574 DOI: 10.1155/2013/242345] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/26/2013] [Accepted: 07/28/2013] [Indexed: 11/17/2022]
Abstract
Objective. Nitric oxide (NO) has numerous important functions in the kidney. The role of NO in cisplatin (CP)-induced nephrotoxicity is not completely understood. This study was designed to determine the role of NO synthase inhibitor (L-NAME) on the severity of CP-induced nephrotoxicity in rats. Methods. Sixty four male (M) and female (F) Wistar rats were randomly divided into eight groups. The sham groups (group 1, male, n = 6 and group 2, female, n = 6) received saline. Groups 3 (male, n = 8) and 4 (female, n = 8) were treated with L-NAME (4 mg/kg, i.p.), and groups 5 (male, n = 8) and 6 (female, n = 8) received CP (3 mg/kg) for 7 days. Groups 7 (male, n = 8) and 8 (female, n = 8) were treated with L-NAME and CP for 7 days. Results. The CP-alone treated rats showed weight loss and increase in serum levels of blood urea nitrogen (BUN) and creatinine (Cr). Coadministration of L-NAME and CP did not improve weight loss, and it increased the levels of BUN and Cr in male but not in female rats (P < 0.05). CP alone increased kidney damage significantly (P < 0.05
), however, the damage induced by combination of CP and L-NAME was gender-related. Conclusion. NOS inhibition by L-NAME increased CP-induced nephrotoxicity, which was gender-related.
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Sex differences in kidney gene expression during the life cycle of F344 rats. Biol Sex Differ 2013; 4:14. [PMID: 23902594 PMCID: PMC3844475 DOI: 10.1186/2042-6410-4-14] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2013] [Accepted: 07/06/2013] [Indexed: 02/03/2023] Open
Abstract
Background The kidney functions in key physiological processes to filter blood and regulate blood pressure via key molecular transporters and ion channels. Sex-specific differences have been observed in renal disease incidence and progression, as well as acute kidney injury in response to certain drugs. Although advances have been made in characterizing the molecular components involved in various kidney functions, the molecular mechanisms responsible for sex differences are not well understood. We hypothesized that the basal expression levels of genes involved in various kidney functions throughout the life cycle will influence sex-specific susceptibilities to adverse renal events. Methods Whole genome microarray gene expression analysis was performed on kidney samples collected from untreated male and female Fischer 344 (F344) rats at eight age groups between 2 and 104 weeks of age. Results A combined filtering approach using statistical (ANOVA or pairwise t test, FDR 0.05) and fold-change criteria (>1.5 relative fold change) was used to identify 7,447 unique differentially expressed genes (DEGs). Principal component analysis (PCA) of the 7,447 DEGs revealed sex-related differences in mRNA expression at early (2 weeks), middle (8, 15, and 21 weeks), and late (104 weeks) ages in the rat life cycle. Functional analysis (Ingenuity Pathway Analysis) of these sex-different genes indicated over-representation of specific pathways and networks including renal tubule injury, drug metabolism, and immune cell and inflammatory responses. The mRNAs that code for the qualified urinary protein kidney biomarkers KIM-1, Clu, Tff3, and Lcn2 were also observed to show sex differences. Conclusions These data represent one of the most comprehensive in-life time course studies to be published, assessing sex differences in global gene expression in the F344 rat kidney. PCA and Venn analyses reveal specific periods of sexually dimorphic gene expression which are associated with functional categories (xenobiotic metabolism and immune cell and inflammatory responses) of key relevance to acute kidney injury and chronic kidney disease, which may underlie sex-specific susceptibility. Analysis of the basal gene expression patterns of renal genes throughout the life cycle of the rat will improve the use of current and future renal biomarkers and inform our assessments of kidney injury and disease.
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Chronic kidney disease and dialysis access in women. J Vasc Surg 2013; 57:49S-53S.e1. [PMID: 23522719 DOI: 10.1016/j.jvs.2012.10.117] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2012] [Revised: 09/10/2012] [Accepted: 10/26/2012] [Indexed: 01/19/2023]
Abstract
Chronic kidney disease currently affects one in nine Americans and over 500,000 have progressed to failure requiring kidney replacement therapy, with nearly 45% being women. Clinical Practice Guidelines have been developed in an effort to synthesize the latest literature, particularly randomized controlled trials, to assist clinical decision making. Women have different levels of kidney function than men at the same level of serum creatinine and may also lose kidney function over time more slowly than men. Although the arteriovenous fistulae have long been recognized as the preferred access for hemodialysis, women are less likely to initiate dialysis with an arteriovenous fistula in place. In addition, the female sex is regarded as a risk factor for access failure as well for complications such as steal. This article reviews treatment of women with chronic kidney disease, focusing on the difficulties they are perceived to have with dialysis access.
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48
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Matsha TE, Yako YY, Rensburg MA, Hassan MS, Kengne AP, Erasmus RT. Chronic kidney diseases in mixed ancestry south African populations: prevalence, determinants and concordance between kidney function estimators. BMC Nephrol 2013; 14:75. [PMID: 23547953 PMCID: PMC3637389 DOI: 10.1186/1471-2369-14-75] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2012] [Accepted: 03/18/2013] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Population-based data on the burden of chronic kidney disease (CKD) in sub-Saharan Africa is still very limited. We assessed the prevalence and determinants of CKD, and evaluated the concordance of commonly advocated estimators of glomerular filtration rate (eGFR) in a mixed ancestry population from South Africa. METHODS Participants were a population-based sample of adults selected from the Bellville-South community in the metropolitan city of Cape Town. eGFR was based on the Cockroft-Gault (CG), Modification of Diet in Kidney Disease (MDRD) and CKD Epidemiology Collaboration (CKD-EPI) equations (with and without adjustment for ethnicity). Kidney function staging used the Kidney Disease Outcome Quality Initiative (KDOQI) classification. Logistic regressions and kappa statistic were used to investigate determinants of CKD and assess the agreement between different estimators. RESULTS The crude prevalence of CKD stage 3-5 was 14.8% for Cockcroft-Gault, 7.6% and 23.9% respectively for the MDRD with and without ethnicity correction, and 7.4% and 17.3% for the CKD-EPI equations with and without ethnicity correction. The highest agreement between GFR estimators was between MDRD and CKD-EPI equations, both with ethnicity correction, Kappa 0.91 (95% CI: 0.86-0.95), correlation coefficient 0.95 (95% CI: 0.94-0.96). In multivariable logistic regression models, sex, age and known hypertension were consistently associated with CKD stage 3-5 across the 5 estimators. CONCLUSIONS The prevalence of CKD stages greater than 3 is the highest reported in Africa. This study provides evidence for support of the CKD-EPI equation for eGFR reporting and CKD classification.
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Affiliation(s)
- Tandi E Matsha
- Department of Biomedical Sciences, Faculty of Health and Wellness Science, Cape Peninsula University of Technology, Cape Town, South Africa
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Malekmakan L, Khajehdehi P, Pakfetrat M, Malekmakan A, Mahdaviazad H, Roozbeh J. Prevalence of chronic kidney disease and its related risk factors in elderly of southern iran: a population-based study. ISRN NEPHROLOGY 2013; 2013:427230. [PMID: 24967234 PMCID: PMC4045432 DOI: 10.5402/2013/427230] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/22/2013] [Accepted: 06/03/2013] [Indexed: 11/23/2022]
Abstract
Aim. The prevalence of chronic kidney disease (CKD) as a serious public health problem is growing in the elderly. This study aimed to assess CKD prevalence and its related risk factors in elderly population of Fars province. Methods. In this cross sectional study a total of 1190 elderly people are enrolled, and demographic and medical data were obtained. Data were analyzed by SPSS, and P of less than 0.05 was considered as statistically significant. Results. Prevalence of CKD stages III–V was 27.5% in the 60–69 years age group, 36.5% in the 70–79 years age group, and 40% in the ≥80 years age group. The prevalence of CKD increased with ageing in both men and women. Female gender was the strongest risk factor for CKD. Conclusions. Prevalence of CKD in elderly is high in Southern Iran, which has become an important health problem while it can be prevented or delayed in progression.
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Affiliation(s)
- Leila Malekmakan
- Shiraz Nephro-Urology Research Center, Shiraz University of Medical Sciences, Shiraz 7193636154, Iran
| | - Parviz Khajehdehi
- Internal Medicine, Shiraz Nephro-Urology Research Center, Shiraz University of Medical Sciences, Shiraz 7193636154, Iran
| | - Maryam Pakfetrat
- Internal Medicine, Shiraz Nephro-Urology Research Center, Shiraz University of Medical Sciences, Shiraz 7193636154, Iran
| | | | - Hamideh Mahdaviazad
- Social Determinat of Health Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Jamshid Roozbeh
- Internal Medicine, Shiraz Nephro-Urology Research Center, Shiraz University of Medical Sciences, Shiraz 7193636154, Iran
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Pezeshki Z, Nematbakhsh M, Nasri H, Talebi A, Pilehvarian AA, Safari T, Eshraghi-Jazi F, Haghighi M, Ashrafi F. Evidence against protective role of sex hormone estrogen in Cisplatin-induced nephrotoxicity in ovarectomized rat model. Toxicol Int 2013; 20:43-7. [PMID: 23833437 PMCID: PMC3702126 DOI: 10.4103/0971-6580.111568] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Cisplatin (CP) is an effective drug in cancer therapy to treat the solid tumors, but it is accompanied with nephrotoxicity. The protective effect of estrogen in cardiovascular diseases is well-documented; but its nephron-protective effect against CP-induced nephrotoxicity is not completely understood. MATERIALS AND METHODS Thirty ovarectomized Wistar rats were divided in to five groups. Groups 1-3 received different doses of estradiol valerate (0.5, 2.5 and 10 mg/kg/week) in sesame oil for 4 weeks, and at the end of week 3, a single dose of CP (7 mg/kg, intraperitoneal [IP]) was administrated. Group 4 (positive control) received the same regimen as group 1-3 without estradiol without vehicle. The negative control group (Group 5) received sesame oil during the study. The animals were sacrificed 1 week after CP injection for histopathological studies. RESULTS The serum level of blood urea nitrogen and creatinine, kidney tissue damage score (KTDS), kidney weight and percentage of body weight change in CP-treated groups significantly increased (P < 0.05), however, there were no significant differences detected between the estrogen-treated groups (Groups 1-3) and the positive control group (Group 4). Although, estradiol administration enhanced the serum level of nitrite, it was not affected by CP. Finally, significant correlation between KTDS and kidney weight was detected (r (2) = 0.63, P < 0.01). CONCLUSION Estrogen is not nephron-protective against CP-induced nephrotoxicity. Moreover, it seems that the mechanism may be related to estrogen-induced oxidative stress in the kidney, which may promote the nephrotoxicity.
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Affiliation(s)
- Zahra Pezeshki
- Water and Electrolytes Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Basic Sciences Isfahan University of Payam Noor, Isfahan, Iran
| | - Mehdi Nematbakhsh
- Water and Electrolytes Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Physiology, Isfahan University of Medical Sciences, Isfahan, Iran
- Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamid Nasri
- Water and Electrolytes Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ardeshir Talebi
- Water and Electrolytes Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Clinical Pathology, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Tahereh Safari
- Water and Electrolytes Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Physiology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fatemeh Eshraghi-Jazi
- Water and Electrolytes Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Maryam Haghighi
- Water and Electrolytes Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Farzaneh Ashrafi
- Water and Electrolytes Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Internal Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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