The impact of alpha-lipoic acid on amikacin-induced nephrotoxicity

Prevention of nephrotoxicity induced by amikacin: The role of misoprostol, A prostaglandin E1 analogue

Amikacin (AK) is an aminoglycoside that is widely used to treat life-threatening Gram-negative infections, especially in intensive care units. Despite its wide clinical indications, AK causes serious side effects such as kidney toxicity. AK was found to lead to tissue damage primarily through apoptosis and oxidative stress. Therefore, it was investigated whether misoprostol (MP), which has antioxidant and antiapoptotic properties, had a beneficial effect on kidney damage caused by AK. It was observed that kidney injury molecule-1 (KIM-1) mRNA, blood urea nitrogen (BUN), creatinine (Cr), NADPH oxidase-4 (NOX-4) and Caspase-3 (CAS-3) levels increased in the AK-treated group in comparison with the control group, while uric acid, albumin, and total protein levels were decreased. In rats that were treated with AK+MP, the levels of KIM-1 mRNA, BUN, Cr, NOX-4 and CAS-3 were significantly decreased in comparison with the AK group, while uric acid, albumin and total protein levels increased. According to the obtained results, MP was found to be quite effective in the protection of kidneys from the toxic effects of AK.

Acute kidney injury in pediatrics: an overview focusing on pathophysiology

Acute kidney injury (AKI) is defined as an abrupt decline in glomerular filtration rate, with increased serum creatinine and nitrogenous waste products due to several possible etiologies. Incidence in the pediatric population is estimated to be 3.9 per 1,000 hospitalizations, and prevalence among children admitted to intensive care units is 26.9%. Despite being a condition with important incidence and morbimortality, further evidence on pathophysiology and management among the pediatric population is still lacking. This narrative review aimed to summarize and discuss current data on AKI pathophysiology in the pediatric population, considering all the physiological particularities of this age range and common etiologies. Additionally, we reported current diagnostic tools, novel biomarkers, and newly proposed medications that have been studied with the aim of early diagnosis and appropriate treatment of AKI in the future.

The protective impact of berberine against doxorubicin-induced nephrotoxicity in rats

Doxorubicin (DOX) is a well-known anti-neoplastic agent that is widely employed to treat several types of malignancies. The current study was designed to investigate the renoprotective potential of berberine (BEB) on the doxorubicin (DOX)-induced nephrotoxicity and renal fibrosis. Rats were allocated into four groups; Negative Control, DOX nephrotoxic-induced group received a single dose of DOX (20 mg/kg, i.p.), BEB-group received (50 mg/kg, p.o.) for 14 days, and co-treatment group BEB + DOX where rats were pre-treated with BEB for 10 successive days, then received a single dose of DOX on the 11th day, followed by 4 days of receiving BEB. DOX resulted in nephrotoxicity manifested by significant increments in urea, creatinine, and kidney injury molecule (KIM-1), these biochemical findings were supported with the histopathological lesions in renal tissues. Moreover, DOX provoked oxidative stress through enhancing renal malondialdehyde (MDA) and hydrogen peroxide (H2O2) contents, and decreased renal catalase (CAT) activity. DOX triggered renal fibrosis represented by increased transforming growth factor beta-1 (TGF-β1) and elevated collagen deposition. DOX stimulated apoptosis and inflammation in renal tissues as confirmed by increased immunoexpression of caspase-3 and NF-κB, respectively. These effects were alleviated by BEB co-treatment. Co-treatment with BEB markedly prohibited DOX-induced oxidative damage, inflammation, apoptosis, and fibrosis in renal tissue. Histopathological and immunohistochemical investigations showed the nephroprotective potential of BEB on renal injury, which was consistent with the biochemical findings. Accordingly, it could be concluded that the nephroprotective potential of BEB against DOX-induced kidney injury and fibrosis might be mediated by the anti-oxidant, anti-inflammatory and anti-fibrosis activities.

Alpha lipoic acid supplementation improved antioxidant enzyme activities in hemodialysis patients

Background: Cardiovascular disease (CVD) is the main cause of death in hemodialysis (HD) patients and oxidative stress is an important risk factor for CVD. Superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx) are primary antioxidant enzymes in human cells acting against toxic reactive oxygen species (ROS) and their reduced activity may contribute to oxidative disorders in HD patients. Alpha lipoic acid (ALA) as a potent strong antioxidant may affect these enzymes. Objective: We examined the effects of ALA supplementation on antioxidant enzyme activities in HD patients. Method: In this double-blinded, randomized clinical trial, 63 HD patients (43 males and 20 females; age range: 22-79 years) were assigned into the ALA group (n: 31), receiving a daily dose of ALA (600 mg), or a control group (n: 32), receiving placebo for 8 weeks. Body mass index (BMI), antioxidant enzymes, albumin (Alb) and hemoglobin (Hb) were determined before and after intervention. Results: At baseline, the mean blood activities of SOD, GPx, and CAT in ALA group were 1032±366, 18.9±5.09 and 191±82.7 U/gHb which increased at the end of study to 1149±502, 19.1±7.19 and 208±86.6 U/gHb respectively. However, only the increase of SOD was statistically significant in comparison with placebo group (P = 0.04). The mean levels of Alb, Hb, weight and BMI were not significantly changed in study groups (P>0.05). Conclusion: ALA may be beneficial for HD patients by increasing the activity of antioxidant enzymes; however, further studies are needed to achieve precise results.

Preparation and renoprotective effects of carboxymethyl chitosan oligosaccharide on adriamycin nephropathy

Carboxymethyl chitosan oligosaccharide (CMCOS), the hydrolytic product of carboxymethyl chitosan, is nontoxic, easily absorbable and good antioxidant. In this study, CMCOS was prepared and its properties in adriamycin nephropathy therapy were investigated. Our results showed that CMCOS had good curative effects on renal function and parenchymal injury induced by adriamycin. CMCOS administration significantly relieved symptoms of proteinuria, hypoalbuminemia, hyperlipidemia, renal hyperplasia and histological lesions in rats (P < 0.01). Further exploration for the underlying mechanisms indicated that CMCOS treatment reduced macrophage accumulation, myofibroblast transdifferentiation and podocyte apoptosis. CMCOS treatment could regulate secretions of cytokines (IL-1β, TNF-ɑ and TGF-β1) and improve activities of antioxidative enzymes (SOD, GSH-Px) (P < 0.01). In conclusion, therapeutic effects of CMCOS on renal injury mediated by inflammation, fibrosis and oxidative stress made it a good kidney health product and a promising candidate in clinical treatment of human chronic kidney disease.

Protective effect of dexpanthenol against nephrotoxic effect of amikacin: An experimental study

BACKGROUND

Amikacin has the largest spectrum among aminoglycosides, its nephrotoxic effect limits its utilization. Our purpose in this study is to review the protective effect of dexpanthenol against the nephrotoxic effect of amikacin, accompanied with histopathological and biochemical parameters.

METHODS

32 rats were randomly separated into four groups with eight in each (amikacin (1.2mg/kg/day), amikacin (1.2mg/kg/day)+dexpanthenol (500mg/kg/day), dexpanthenol (500mg/kg/day) and control). In order to assess the oxidative balance and renal damage between groups, biochemical parameters (total antioxidant capacity (TAS), total oxidant stress (TOS), catalase (CAT), paraoxonase (PON), arylesterase (ARES), urea, and creatinin) were studied from the blood samples. At the end of the 14th day, renal tissues were reviewed blindly by a pathologist.

RESULTS

TOS and oxidative stress index (OSI) values were significantly lower in the group which was administered with dexpanthenol+amikacin compared to the group which only received amikacin (respectively, p=0.001, p=0.002). Antioxidant biochemical parameters (TAS, CAT, PON, and ARES) were significantly higher in the group which was administered with dexpanthenol+amikacin compared to the group administered only with amikacin (respectively, p=0.007, p=0.001, p=0.003, p=0.003). Urea and creatitin values were found to be significantly lower in the group which was administered with dexpanthenol+amikacin compared to the group administered only with amikacin (respectively, p=0.002, p=0.001). Histopathologic changes such as glomerular and tubular epithelium changes and interstitial edema were clearly observed in the group administered only with amikacin, such findings were insignificant in the group administered with dexpanthenol+amikacin.

CONCLUSION

It was revealed with biochemical and histopathologic data that nephrotoxic effects created by amikacin administration can be limited with dexpanthenol by using them together, and further advanced clinical studies are required.