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Li H, Duan J, Zhang T, Fu Y, Xu Y, Miao H, Ge X. miR-16-5p aggravates sepsis-associated acute kidney injury by inducing apoptosis. Ren Fail 2024; 46:2322688. [PMID: 38445373 PMCID: PMC10919310 DOI: 10.1080/0886022x.2024.2322688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 02/19/2024] [Indexed: 03/07/2024] Open
Abstract
Sepsis-associated acute kidney injury (S-AKI) is a common disease in pediatric intensive care units (ICU) with high morbidity and mortality. The newly discovered results indicate that microRNAs (miRNAs) play an important role in the diagnosis and treatment of S-AKI and can be used as markers for early diagnosis. In this study, the expression level of miR-16-5p was found to be significantly upregulated about 20-fold in S-AKI patients, and it also increased by 1.9 times in the renal tissue of S-AKI mice. Receiver operating characteristic (ROC) curve analysis showed that miR-16-5p had the highest predictive accuracy in the diagnosis of S-AKI (AUC = 0.9188). In vitro, the expression level of miR-16-5p in HK-2 cells treated with 10 μg/mL lipopolysaccharide (LPS) increased by more than 2 times. In addition, LPS-exposed renal tissue and HK-2 cells lead to upregulation of inflammatory cytokines IL-6, IL-1β, TNF-a, and kidney damage molecules kidney injury molecule-1 (KIM-1), neutrophil gelatinase-associated lipocalin (NGAL). However, inhibition of miR-16-5p significantly mitigated LPS expose-mediated kidney injury and inflammation. Furthermore, LPS-exposed HK-2 cells increased more than 1.7-fold the expression levels of Bax and caspase-3, decreased 3.2-fold the expression level of B-cell lymphoma-2 (Bcl-2), and significantly promoted the occurrence of apoptosis. MiR-16-5p mimic further increased LPS-induced apoptosis in HK-2 cells. Nevertheless, inhibition of miR-16-5p significantly attenuated this effect. In summary, up-regulation of miR-16-5p expression can significantly aggravate renal injury and apoptosis in S-AKI, which also proves that miR-16-5p can be used as a potential biomarker to promote early identification of S-AKI.
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Affiliation(s)
- Han Li
- Department of Emergency/Critical Medicine, Children’s Hospital of Nanjing Medical University, Nanjing, PR China
- Jiangsu Key Laboratory of Children’s Major Disease Research, Jiangsu, PR China
| | - Junyan Duan
- Department of Pediatrics, Changzhou Second Peoples Hospital Affiliated to Nanjing Medical University, Changzhou, PR China
| | - Tongtong Zhang
- Department of Emergency/Critical Medicine, Children’s Hospital of Nanjing Medical University, Nanjing, PR China
| | - Yingjie Fu
- Department of Emergency/Critical Medicine, Children’s Hospital of Nanjing Medical University, Nanjing, PR China
| | - Yue Xu
- Department of Emergency/Critical Medicine, Children’s Hospital of Nanjing Medical University, Nanjing, PR China
| | - Hongjun Miao
- Department of Emergency/Critical Medicine, Children’s Hospital of Nanjing Medical University, Nanjing, PR China
| | - Xuhua Ge
- Department of Emergency/Critical Medicine, Children’s Hospital of Nanjing Medical University, Nanjing, PR China
- Jiangsu Key Laboratory of Children’s Major Disease Research, Jiangsu, PR China
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Han T, Jiang Y, Ge W, Lu Y, Liu R, Sun Z. 2,5-Dihydroxyacetophenone attenuates acute kidney injury induced by intra-abdominal infection in rats. Nephrology (Carlton) 2024. [PMID: 39054771 DOI: 10.1111/nep.14335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 04/17/2024] [Accepted: 06/05/2024] [Indexed: 07/27/2024]
Abstract
AIMS As one of the most serious complications of sepsis, acute kidney injury (AKI) is pathologically associated with excessive inflammation. 2,5-Dihydroxyacetophenone (DHAP) is isolated from Radix rehmanniae praeparata and exhibit potent anti-inflammatory property. This research aimed at determining the role of DHAP in sepsis-associated AKI (SA-AKI) and the underlying mechanism. METHODS Plasma creatinine (Cre), blood urea nitrogen (BUN), tumour necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) levels of SA-AKI patients were detected to evaluate their clinical characteristics. SA-AKI rat models were established by using caecum ligation puncture (CLP) surgery. CLP-induced rats were administered via oral gavage with 20 or 40 mg DHAP after 2 h of CLP surgery. Subsequently, survival rates, serum indexes, histopathological changes, inflammatory factors, renal function indexes and extracellular regulated protein kinases (ERK) and nuclear factor-κB (NF-κB) signalling pathways were detected. RESULTS SA-AKI patients exhibited markedly higher levels of plasma Cre, BUN, TNF-α and IL-1β than healthy people. Compared with sham rats, CLP-induced septic rats showed significantly decreased survival rate, increased serum lactate dehydrogenase activity and serum lactate level, obvious renal histopathological injury, upregulated TNF-α, IL-1β and TGF-β1 levels, elevated serum creatinine, BUN and serum cystatin C concentrations, serum neutrophil gelatinase-associated lipocalin and kidney injury molecule-1 levels and reduced renal artery blood flow. All the above CLP-induced changes in septic rats were mitigated after DHAP administration. Additionally, CLP-induced elevation in phosphorylated-ERK1/2 and nuclear NF-κB p65 protein levels was inhibited by DHAP treatment. CONCLUSION DHAP hinders SA-AKI progression in rat models by inhibiting ERK and NF-κB signalling pathways.
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Affiliation(s)
- Tao Han
- Department of Critical Care Medicine, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, China
| | - Ye Jiang
- Department of Critical Care Medicine, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, China
| | - Weixing Ge
- Department of Critical Care Medicine, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, China
| | - Yuyu Lu
- Department of Critical Care Medicine, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, China
| | - Rongming Liu
- Department of Critical Care Medicine, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, China
| | - Zunpeng Sun
- Department of Critical Care Medicine, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, China
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Wang L, Liu C, Song H, Yuan J, Zha Y, Deng Y. Update on kidney injury caused by multiple myeloma. Ann Hematol 2024:10.1007/s00277-024-05860-3. [PMID: 38942949 DOI: 10.1007/s00277-024-05860-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Accepted: 06/20/2024] [Indexed: 06/30/2024]
Abstract
Multiple myeloma (MM) is a form of clonal plasma cell malignancy that associates with clinical manifestations such as anemia, hypercalcemia, bone pain, and renal impairment. Approximately 20-50% of MM patients at initial diagnosis experience renal injury, a vital complication that significantly influences prognosis and quality of life. This review seeks to clarify the multifaceted mechanisms of renal injury in MM, scrutinizing the pathogenic role of monoclonal proteins, the impact of hypercalcemia, and direct renal infiltration by plasma cells. Furthermore, it evaluates current diagnostic approaches, reviews management strategies, and highlights potential avenues for future research. By incorporating the latest scientific evidence and insights, this article aims to provide a comprehensive understanding of MM-associated renal impairment, offering a valuable resource for researchers and clinicians in handling this complex complication.
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Affiliation(s)
- Linhui Wang
- Department of Hematology, Guizhou Provincial People's Hospital, Guiyang, China
| | - Chen Liu
- Department of Hematology, Guizhou Provincial People's Hospital, Guiyang, China
| | - Haiyan Song
- Department of Hematology, Guizhou Provincial People's Hospital, Guiyang, China
| | - Jing Yuan
- Department of Hematology, Guizhou Provincial People's Hospital, Guiyang, China
| | - Yan Zha
- Department of Nephrology, Guizhou Provincial People's Hospital, Guiyang, China.
- NHC Key Laboratory of Pulmonary Immunological Disease, Guizhou Provincial People's Hospital, Guiyang, China.
| | - Yiyao Deng
- Department of Nephrology, Guizhou Provincial People's Hospital, Guiyang, China.
- NHC Key Laboratory of Pulmonary Immunological Disease, Guizhou Provincial People's Hospital, Guiyang, China.
- Department of Nephrology, The First Medical Centre, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Centre for Kidney Diseases, Beijing Key Laboratory of Kidney Diseases, Beijing, China.
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Niu X, Wang C, Li H, Chen W. Role of OPG/RANKL/RANK/TLR4 signaling pathway in sepsis-associated acute kidney injury. BMC Nephrol 2024; 25:205. [PMID: 38910256 PMCID: PMC11194911 DOI: 10.1186/s12882-024-03648-1] [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: 01/18/2024] [Accepted: 06/19/2024] [Indexed: 06/25/2024] Open
Abstract
BACKGROUND Sepsis-associated acute kidney injury (SA-AKI) has high mortality rates. The osteoprotegerin (OPG)/receptor activator of nuclear factor-κB ligand (RANKL)/receptor activator of nuclear factor-κB (RANK)/Toll-like receptor 4 (TLR4) pathway and its potential role in SA-AKI pathogenesis remain to be fully understood. Herein, we addressed this issue using mouse models. METHODS An SA-AKI mouse model was established using the cecal ligation and puncture method (CLP). Mice were grouped into sham, CLP model, CLP + recombinant RANKL, and CLP + anti-RANKL groups. Serum creatinine (Scr) and blood urea nitrogen (BUN) levels were measured to assess kidney function. ELISA was used to detect serum IL-1β, TNF-α, and IL-6 levels. Real-time quantitative PCR and Western blot were used to detect the mRNA and protein expression levels of OPG, RANKL, RANK, and TLR4 in kidney tissues. HE staining was performed to evaluate the pathological changes. RESULTS The CLP model group showed higher levels of Scr and BUN, indicating impaired kidney function in SA-AKI, compared to the sham group. Treatment with recombinant RANKL in the CLP + recombinant RANKL group reduced Scr and BUN levels, while anti-RANKL treatment in the CLP + anti-RANKL group elevated their levels. Moreover, the CLP model group had significantly increased IL-1β, TNF-α, and IL-6 than the sham group, indicating elevated inflammation in SA-AKI. The CLP + recombinant RANKL group demonstrated decreased cytokine levels, whereas the CLP + anti-RANKL group showed an increase. Additionally, the histopathological evaluation revealed distinct kidney tissue damage in the CLP model group. Recombinant RANKL treatment reduced this damage, while anti-RANKL treatment exacerbated it. Mechanically, the mRNA and protein expression of RANKL were significantly decreased, while those of OPG, RANK, and TLR4 were significantly increased in the CLP model group and the CLP + anti-RANKL group. Interestingly, treatment with recombinant RANKL reversed these changes, as evidenced by significantly increased RANKL but decreased OPG, RANK, and TLR4. CONCLUSION The OPG/RANKL/RANK/TLR4 pathway is involved in SA-AKI pathogenesis. Recombinant RANKL treatment attenuates the inflammatory response and kidney tissue damage in SA-AKI, possibly via regulating this pathway. This pathway shows promise as a therapeutic target for SA-AKI.
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Affiliation(s)
- Xinrong Niu
- Department of Critical Care Medicine, Xinjiang Uyghur Autonomous Region People's Hospital, No. 91 Tianchi Road, Tianshan District, Urumqi, 830001, P.R. China.
| | - Caihong Wang
- Department of Critical Care Medicine, Xinjiang Uyghur Autonomous Region People's Hospital, No. 91 Tianchi Road, Tianshan District, Urumqi, 830001, P.R. China
| | - Hui Li
- Department of Critical Care Medicine, Xinjiang Uyghur Autonomous Region People's Hospital, No. 91 Tianchi Road, Tianshan District, Urumqi, 830001, P.R. China
| | - Weilin Chen
- Department of Critical Care Medicine, Xinjiang Uyghur Autonomous Region People's Hospital, No. 91 Tianchi Road, Tianshan District, Urumqi, 830001, P.R. China
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Fan H, Sun M, Zhu JH. Clinical role of serum microRNA-155 in early diagnosis and prognosis of septic patients with acute kidney injury. Int Urol Nephrol 2024; 56:1687-1694. [PMID: 37898565 DOI: 10.1007/s11255-023-03855-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 10/11/2023] [Indexed: 10/30/2023]
Abstract
BACKGROUND AND PURPOSE Acute kidney injury (AKI) is a common complication in patients with sepsis, and early detection and timely treatment are crucial. This article aims to explore the clinical role of microRNA-155 (miR-155) in early diagnosis and prognosis evaluation of septic patients with acute kidney injury. METHODS We collected the blood samples of septic patients and measured the relative expression of serum miR-155 by RT-qPCR, and drew the receiver operating characteristic (ROC) curves to evaluate its early diagnosis for septic AKI. RESULTS The relative expression of miR-155 in the septic AKI was significantly higher than that in the septic non-AKI, and increased with the aggravation of renal function damage. The ROC curve of miR-155 for the diagnosis of septic AKI was 1.91 (95% CI: 1.61-2.19). When the optimal cut-off value of miR-155 expression was 2.37, its sensitivity for diagnosing septic AKI was 91.12% (95% CI: 80.41-95.07%), and its specificity was 84.52% (95% CI: 71.74-89.36%). Furthermore, the severity of kidney injury, SOFA score, APACHE II score and miR-155 were the risk factors affecting the prognosis of septic patients with AKI. CONCLUSION Serum miR-155 can be used as a novel biomarker for the early diagnosis of septic AKI, and also has important clinical value in the prognosis evaluation of septic patients with AKI.
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Affiliation(s)
- Heng Fan
- Department of Intensive Care Unit, The First Affiliated Hospital of Ningbo University, No. 59 Liuting Road, Ningbo, Zhejiang Province, People's Republic of China
| | - Min Sun
- Department of Intensive Care Unit, The First Affiliated Hospital of Ningbo University, No. 59 Liuting Road, Ningbo, Zhejiang Province, People's Republic of China
| | - Jian-Hua Zhu
- Department of Intensive Care Unit, The First Affiliated Hospital of Ningbo University, No. 59 Liuting Road, Ningbo, Zhejiang Province, People's Republic of China.
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Chen J, Lin J, Weng J, Ju Y, Li Y. Association between trough serum vancomycin concentration and vancomycin-associated acute kidney injury and 30-day mortality in critically ill elderly adults. BMC Infect Dis 2024; 24:330. [PMID: 38509460 PMCID: PMC10953182 DOI: 10.1186/s12879-024-09227-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 03/14/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND Vancomycin-associated acute kidney injury (VA-AKI) is the most clinically relevant side effect of vancomycin. The objective of this study was to investigate the association between VTC and VA-AKI as well as 30-day mortality in critically ill elderly adults. METHOD Elderly patients with trough serum vancomycin concentration records(VTC) in the Medical Information Mart-IV (MIMIC-IV) and eICU databases were retrospectively studied. RESULTS A total of 3,146 critically ill elderly adults were finally enrolled. The incidence of VA-AKI in the elderly population was 76.5%. Logistic regression analysis revealed significant relationships between VA-AKI and various factors, including VTC, comorbidities, and laboratory indicators, and SOFA, and GCS score. For each mg/L increase, the OR for VA-AKI increased by 2.5%. The association between VTC and 30-day mortality was found to be statistically significant (odds ratio (OR): 1.021, 95% CI: 1.010-1.031), P < 0.001). The Restricted cubic splines (RCS) curves revealed that VTC ranged of 19.67 to 35.72 mg/l for AKI and 19.17 to 42.86 mg/l for 30-day mortality exhibit OR with 95% CI above 1, indicating statistically significant associations with an increased risk of AKI and 30-day mortality, respectively. In the subgroup analysis, VTC was identified as a risk factor for VA-AKI in specific patient groups, including white individuals, female patients, those with shock, patients with SOFA > 6, patients with baseline creatinine > 1.2 mg/dl and patients with or without exposed to other nephrotoxic medications. CONCLUSION This study found the significant association between VTC and the incidence of VA-AKI and 30-day mortality in critically ill elderly adults. The RCS curves indicated concentration ranges for AKI (19.67-35.72 mg/L) and 30-day mortality (19.17-42.86 mg/L), signifying increased risk.
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Affiliation(s)
- Jialong Chen
- Department of Pulmonary and Critical Care Medicine, Beijing Hospital, National Center of Gerontology, the Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
- Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Jing Lin
- Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
- Department of Infectious Disease, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Jianzhen Weng
- Department of Pulmonary and Critical Care Medicine, Beijing Hospital, National Center of Gerontology, the Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Yang Ju
- Department of Pulmonary and Critical Care Medicine, Beijing Hospital, National Center of Gerontology, the Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Yanming Li
- Department of Pulmonary and Critical Care Medicine, Beijing Hospital, National Center of Gerontology, the Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China.
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Aurori M, Andrei S, Dreanca AI, Morohoschi AG, Cotul M, Niculae M, Nan MI, Codea AR, Gal AF. The Nephroprotective Effect of Cornelian Cherry ( Cornus mas L.) and Rowanberry ( Sorbus aucuparia L.) in Gentamicin-Induced Nephrotoxicity on Wistar Rats with Emphasis on the Evaluation of Novel Renal Biomarkers and the Antioxidant Capacity in Correlation with Nitro-Oxidative Stress. Nutrients 2023; 15:4392. [PMID: 37892466 PMCID: PMC10609733 DOI: 10.3390/nu15204392] [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: 09/11/2023] [Revised: 10/12/2023] [Accepted: 10/13/2023] [Indexed: 10/29/2023] Open
Abstract
In spite of its well-known nephrotoxicity, gentamicin is nonetheless routinely used in humans and animals. However, no adjuvant treatments have been implemented to mitigate this harmful effect. Given this concern, medicinal plants represent a significant reservoir of natural antioxidants that could potentially reduce the renal oxidative stress induced by gentamicin. Therefore, the main objective of this research was to investigate the nephroprotective properties of Cornus mas and Sorbus aucuparia fruits in an experimental model of nephrotoxicity. The 3-week study was performed on male Wistar rats, which were randomly divided into six experimental groups, being subcutaneously treated with 50 mg/kg gentamicin and orally given Cornus mas and Sorbus aucuparia extracts, in doses of 40 mg/kg and 10 mg/kg, respectively. Antioxidant therapy significantly improved the nitro-oxidative stress parameters as well as the specific renal biomarkers KIM-1 and iNAG, demonstrating a considerable renal tubular protective impact. These outcomes were reinforced by biochemical and histopathological enhancements. Nevertheless, neither of the tested extracts succeeded in substantially diminishing BUN levels. Additionally, CysC did not significantly decline following extracts treatment, suggesting that the remedies did not effectively protect renal glomeruli against gentamicin stress. Future studies are required in order to determine the underlying mechanisms of these berries.
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Affiliation(s)
- Mara Aurori
- Department of Preclinical Sciences, Faculty of Veterinary Medicine, University of Agricultural Sciences and Veterinary Medicine, 400374 Cluj-Napoca, Romania; (M.A.); (A.I.D.); (A.G.M.); (M.C.); (M.I.N.); (A.F.G.)
| | - Sanda Andrei
- Department of Preclinical Sciences, Faculty of Veterinary Medicine, University of Agricultural Sciences and Veterinary Medicine, 400374 Cluj-Napoca, Romania; (M.A.); (A.I.D.); (A.G.M.); (M.C.); (M.I.N.); (A.F.G.)
| | - Alexandra Iulia Dreanca
- Department of Preclinical Sciences, Faculty of Veterinary Medicine, University of Agricultural Sciences and Veterinary Medicine, 400374 Cluj-Napoca, Romania; (M.A.); (A.I.D.); (A.G.M.); (M.C.); (M.I.N.); (A.F.G.)
| | - Andreea Georgiana Morohoschi
- Department of Preclinical Sciences, Faculty of Veterinary Medicine, University of Agricultural Sciences and Veterinary Medicine, 400374 Cluj-Napoca, Romania; (M.A.); (A.I.D.); (A.G.M.); (M.C.); (M.I.N.); (A.F.G.)
| | - Mihaela Cotul
- Department of Preclinical Sciences, Faculty of Veterinary Medicine, University of Agricultural Sciences and Veterinary Medicine, 400374 Cluj-Napoca, Romania; (M.A.); (A.I.D.); (A.G.M.); (M.C.); (M.I.N.); (A.F.G.)
| | - Mihaela Niculae
- Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Agricultural Sciences and Veterinary Medicine, 400374 Cluj-Napoca, Romania; (M.N.); (A.R.C.)
| | - Monica Irina Nan
- Department of Preclinical Sciences, Faculty of Veterinary Medicine, University of Agricultural Sciences and Veterinary Medicine, 400374 Cluj-Napoca, Romania; (M.A.); (A.I.D.); (A.G.M.); (M.C.); (M.I.N.); (A.F.G.)
| | - Andrei Răzvan Codea
- Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Agricultural Sciences and Veterinary Medicine, 400374 Cluj-Napoca, Romania; (M.N.); (A.R.C.)
| | - Adrian Florin Gal
- Department of Preclinical Sciences, Faculty of Veterinary Medicine, University of Agricultural Sciences and Veterinary Medicine, 400374 Cluj-Napoca, Romania; (M.A.); (A.I.D.); (A.G.M.); (M.C.); (M.I.N.); (A.F.G.)
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Kamei J, Kanamoto M, Igarashi Y, Suzuki K, Fujita K, Kuwana T, Ogura T, Mochizuki K, Banshotani Y, Ishikura H, Nakamura Y. Blood Purification in Patients with Sepsis Associated with Acute Kidney Injury: A Narrative Review. J Clin Med 2023; 12:6388. [PMID: 37835031 PMCID: PMC10573845 DOI: 10.3390/jcm12196388] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 10/01/2023] [Accepted: 10/03/2023] [Indexed: 10/15/2023] Open
Abstract
Sepsis leads to organ dysfunction. Acute kidney injury, a common type of organ dysfunction, is associated with a high mortality rate in patients with sepsis. Kidney replacement therapy can correct the metabolic, electrolyte, and fluid imbalances caused by acute kidney injury. While this therapy can improve outcomes, evidence of its beneficial effects is lacking. Herein, we review the indications for blood purification therapy, including kidney replacement therapy, and the current knowledge regarding acute kidney injury in terms of renal and non-renal indications. While renal indications have been well-documented, indications for blood purification therapy in sepsis (non-renal indications) remain controversial. Excessive inflammation is an important factor in the development of sepsis; blood purification therapy has been shown to reduce inflammatory mediators and improve hemodynamic instability. Given the pathophysiology of sepsis, blood purification therapy may decrease mortality rates in these patients. Further trials are needed in order to establish the effectiveness of blood purification therapy for sepsis.
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Affiliation(s)
- Jun Kamei
- Department of Primary Care and Emergency Medicine, Graduate School of Medicine, Kyoto University, Kyoto 606-8501, Japan;
| | - Masafumi Kanamoto
- Department of Anesthesiology, Gunma Prefectural Cardiovascular Center, 3-12, Kameizumi, Gunma 371-0004, Japan;
| | - Yutaka Igarashi
- Department of Emergency and Critical Care Medicine, Nippon Medical School, Tokyo 1138603, Japan;
| | - Kodai Suzuki
- Department of Emergency and Disaster Medicine, Gifu University Graduate School of Medicine, Gifu 501-1194, Japan;
| | - Kensuke Fujita
- Department of Emergency Medicine and Critical Care Medicine, Saiseikai Utsunomiya Hospital, Tochigi 321-0974, Japan; (K.F.); (T.O.)
| | - Tsukasa Kuwana
- Division of Emergency and Critical Care Medicine, Department of Acute Medicine, Nihon University School of Medicine, Tokyo 173-8610, Japan;
| | - Takayuki Ogura
- Department of Emergency Medicine and Critical Care Medicine, Saiseikai Utsunomiya Hospital, Tochigi 321-0974, Japan; (K.F.); (T.O.)
| | - Katsunori Mochizuki
- Department of Emergency and Critical Care Medicine, Osaka Medical and Pharmaceutical University, Osaka 569-8686, Japan;
| | - Yuki Banshotani
- Tajima Emergency & Critical Care Medical Center, Toyooka Hospital, Hyogo 668-8501, Japan;
| | - Hiroyasu Ishikura
- Department of Emergency and Critical Care Medicine, Fukuoka University Hospital, Fukuoka 814-0180, Japan;
| | - Yoshihiko Nakamura
- Department of Emergency and Critical Care Medicine, Fukuoka University Hospital, Fukuoka 814-0180, Japan;
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Balkrishna A, Sinha S, Kumar A, Arya V, Gautam AK, Valis M, Kuca K, Kumar D, Amarowicz R. Sepsis-mediated renal dysfunction: Pathophysiology, biomarkers and role of phytoconstituents in its management. Biomed Pharmacother 2023; 165:115183. [PMID: 37487442 DOI: 10.1016/j.biopha.2023.115183] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 07/08/2023] [Accepted: 07/18/2023] [Indexed: 07/26/2023] Open
Abstract
Sepsis has evolved as an enormous health issue amongst critically ill patients. It is a major risk factor that results in multiple organ failure and shock. Acute kidney injury (AKI) is one of the most frequent complications underlying sepsis, which portends a heavy burden of mortality and morbidity. Thus, the present review is aimed to provide an insight into the recent progression in the molecular mechanisms targeting dysregulated immune response and cellular dysfunction involved in the development of sepsis-associated AKI, accentuating the phytoconstituents as eligible candidates for attenuating the onset and progression of sepsis-associated AKI. The pathogenesis of sepsis-mediated AKI entails a complicated mechanism and is likely to involve a distinct constellation of hemodynamic, inflammatory, and immune mechanisms. Novel biomarkers like neutrophil gelatinase-associated lipocalin, soluble triggering receptor expressed on myeloid cells 1, procalcitonin, alpha-1-microglobulin, and presepsin can help in a more sensitive diagnosis of sepsis-associated AKI. Many bioactive compounds like curcumin, resveratrol, baicalin, quercetin, and polydatin are reported to play an important role in the prevention and management of sepsis-associated AKI by decreasing serum creatinine, blood urea nitrogen, cystatin C, lipid peroxidation, oxidative stress, IL-1β, TNF-α, NF-κB, and increasing the activity of antioxidant enzymes and level of PPARγ. The plant bioactive compounds could be developed into a drug-developing candidate in managing sepsis-mediated acute kidney injury after detailed follow-up studies. Lastly, the gut-kidney axis may be a more promising therapeutic target against the onset of septic AKI, but a deeper understanding of the molecular pathways is still required.
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Affiliation(s)
- Acharya Balkrishna
- Patanjali Herbal Research Department, Patanjali Research Institute, Haridwar, India
| | - Sugandh Sinha
- Patanjali Herbal Research Department, Patanjali Research Institute, Haridwar, India
| | - Ashwani Kumar
- Patanjali Herbal Research Department, Patanjali Research Institute, Haridwar, India.
| | - Vedpriya Arya
- Patanjali Herbal Research Department, Patanjali Research Institute, Haridwar, India
| | - Ajay Kumar Gautam
- Patanjali Herbal Research Department, Patanjali Research Institute, Haridwar, India
| | - Martin Valis
- Department of Neurology, Charles University in Prague, Faculty of Medicine in Hradec Králové and University Hospital, Hradec Králové, Czech Republic
| | - Kamil Kuca
- Department of Chemistry, Faculty of Science, University of Hradec Kralove, Hradec Kralove, Czech Republic; Biomedical Research Center, University Hospital in Hradec Kralove, Sokolska 581, Hradec Kralove, Czech Republic.
| | - Dinesh Kumar
- School of Bioengineering and Food Technology, Shoolini University of Biotechnology and Management Sciences, Solan, India
| | - Ryszard Amarowicz
- Institute of Animal Reproduction and Food Research, Polish Academy of Sciences, Olsztyn, Poland
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Wong CS, Chen TT, Akhmetzhanov AR, Hu PJ, Wu MS, Wu MY. A National Case-Crossover Study on the Risk of Kidney Injury Requiring Dialysis after Sepsis. J Clin Med 2023; 12:4950. [PMID: 37568351 PMCID: PMC10419702 DOI: 10.3390/jcm12154950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 07/02/2023] [Accepted: 07/25/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND Patients with sepsis-associated acute kidney injury (AKI) are at risk of kidney damage, potentially necessitating acute temporary or chronic dialysis. Our study aims to estimate the odds ratio (OR) of preceding sepsis among patients requiring their first dialysis. METHODS A nationwide population-based case-only study was conducted using claims records from the National Health insurance database of Taiwan. All patients over 20 years of age who underwent their first dialysis between 2004 and 2016 were included in the study. The six months prior to their first dialysis served as a self-control period. RESULTS The study included 147,201 patients who required acute temporary and 75,031 patients who required chronic dialysis. The odds ratios for patients needing acute temporary dialysis after 1, 2, 3, and 4 weeks of exposure periods were 15.8, 10.7, 9.2, and 8.4, respectively. The ORs for patients requiring chronic dialysis were 7.0, 4.1, 4.2, and 3.7, respectively. CONCLUSIONS Our findings indicate that sepsis was substantially associated with an increased risk of renal failure. The risk was highest during the first week following sepsis for both acute temporary and chronic dialysis cases.
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Affiliation(s)
- Chung-Shun Wong
- Department of Emergency Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan
- Department of Emergency Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
| | - Tzu-Ting Chen
- Center for Neuropsychiatric Research, National Health Research Institutes, Miaoli County 35053, Taiwan
| | - Andrei R. Akhmetzhanov
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei 106, Taiwan
- Global Health Program, College of Public Health, National Taiwan University, Taipei 106, Taiwan
| | - Ping-Jen Hu
- Division of Gastroenterology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan
| | - Mai-Szu Wu
- Division of Nephrology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan
- Division of Nephrology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
- TMU Research Center of Urology and Kidney, Taipei Medical University, Taipei 110, Taiwan
| | - Mei-Yi Wu
- Division of Nephrology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan
- Division of Nephrology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
- TMU Research Center of Urology and Kidney, Taipei Medical University, Taipei 110, Taiwan
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11
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Zhai Y, Liu X, Li Y, Hu Q, Zhang Z, Hu T. Role of platelet to albumin ratio for predicting persistent acute kidney injury in patients admitted to the intensive care unit. BMC Anesthesiol 2023; 23:242. [PMID: 37468887 PMCID: PMC10354882 DOI: 10.1186/s12871-023-02137-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 05/12/2023] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND The aim of this study was to investigate the prognostic role of platelet to albumin ratio (PAR) and in persistent acute kidney injury (pAKI) of patients admitted to the intensive care unit (ICU). METHODS We involved pAKI patients from the Medical Information Mart for Intensive Care-IV (MIMIC-IV) database and eICU Collaborative Research Database (eICU-CRD). Receiver operating curve (ROC) analysis was performed to evaluate the optimal cut-off PAR. RESULTS A total of 7,646 patients were finally included in the present study. The optimal cut-off value of PAR was 7.2. The high-PAR group was associated with pAKI (hazard ratio [HR]: 3.25, 95% CI: 2.85-3.72, P < 0.001). We also performed this in the validation cohort, the results further confirmed that the high-PAR group was associated with pAKI (HR: 2.24, 95% CI: 1.86-2.71, P < 0.001). The PAR exhibited good pAKI predictive abilities in the original cohort (C-index: 0.726, 95%CI: 0.714-0.739) and in the validation cohort (C-index: 0.744, 95%CI:0.722-0.766) Moreover, as a systemic inflammatory indicator, PAR depicted better predictive ability compared to other systemic inflammatory indicators. CONCLUSION The present study manifested that elevated PAR could predicts pAKI in patients admitted to ICU. PAR may be an easily obtained and useful biomarker to clinicians for the early identification of pAKI.
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Affiliation(s)
- Yuanwei Zhai
- Department of Medical Imaging, the First People's Hospital of Ziyang, Ziyang, Sichuan, China
| | - Xiaoqiang Liu
- Department of Orthopedic Surgery, Anyue County People's Hospital, Ziyang, Sichuan, China
| | - Yu Li
- Department of Nephrology, Bishan Hospital Affiliated to Chongqing Medical University, Chongqing, China
| | - Qionghua Hu
- Department of Critical Care Medicine, Chengdu Second People's Hospital, 10 Qingyunnan Street, Jinjiang District, Chengdu, 610017, Sichuan, China
| | - Zhengwei Zhang
- Department of Critical Care Medicine, Chengdu Second People's Hospital, 10 Qingyunnan Street, Jinjiang District, Chengdu, 610017, Sichuan, China.
| | - Tianyang Hu
- Precision Medicine Center, the Second Affiliated Hospital, Chongqing Medical University, 74 Linjiang Road, Yuzhong District, Chongqing, 400010, China.
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12
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Li Y, Cai C, Liu Z, Tang X, Qu L, Wu Y, Wu P, Duan Y, She P. Inhibitory effects of simeprevir on Staphylococcusepidermidis and itsbiofilm in vitro. ZHONG NAN DA XUE XUE BAO. YI XUE BAN = JOURNAL OF CENTRAL SOUTH UNIVERSITY. MEDICAL SCIENCES 2023; 48:868-876. [PMID: 37587072 PMCID: PMC10930433 DOI: 10.11817/j.issn.1672-7347.2023.220644] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Indexed: 08/18/2023]
Abstract
OBJECTIVES Staphylococcus epidermidis (S. epidermidis) is a Gram-positive opportunistic pathogen that often causes hospital infections. With the abuse of antibiotics, the resistance of S. epidermidis gradually increases, and drug repurposing has become a research hotspot in the treating of refractory drug-resistant bacterial infections. This study aims to study the antimicrobial and antibiofilm effects of simeprevir, an antiviral hepatitis drug, on S. epidermidis in vitro. METHODS The micro-dilution assay was used to determine the minimal inhibitory concentration (MIC) and minimal bactericidal concentration (MBC) of simeprevir against S. epidermidis. Crystal violet staining assay was used to detect the biofilm inhibitory effect of simeprevir. The antimicrobial activity of simeprevir against S. epidermidis and its biofilm were explored by SYTO9/PI fluorescent staining. The combined effect between simeprevir and gentamycin was assessed by checkerboard assay and was confirmed by time-inhibition assay. RESULTS Simeprevir showed significant antimicrobial effects against S. epidermidis type strains and clinical isolates with the MIC and MBC at 2-16 μg/mL and 4-32 μg/mL, respectively. The antimicrobial effects of simeprevir were confirmed by SYTO9/PI staining. Simeprevir at MIC could significantly inhibit and break the biofilm on cover slides. Similarly, simeprevir also significantly inhibit the biofilm formation on the surface of urine catheters either in TSB [from (0.700±0.020) to (0.050±0.004)] (t=54.03, P<0.001), or horse serum [from (1.00±0.02) to (0.13±0.01)] (t=82.78, P<0.001). Synergistic antimicrobial effect was found between simeprevir and gentamycin against S. epidermidis with the fractional inhibitory concentration index of 0.5. CONCLUSIONS Simeprevir shows antimicrobial effect and anti-biofilm activities against S. epidermidis.
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Affiliation(s)
- Yingjia Li
- Department of Laboratory Medicine, Third Xiangya Hospital, Central South University, Changsha 410013.
| | - Chaoni Cai
- Department of Laboratory Medicine, Third Xiangya Hospital, Central South University, Changsha 410013
- School of Medicine, Hunan Normal University, Changsha 410205
| | - Zixin Liu
- Department of Laboratory Medicine, Third Xiangya Hospital, Central South University, Changsha 410013
- Department of Medicine, Shaoyang University, Shaoyang Hunan 422000, China
| | - Xichang Tang
- Department of Laboratory Medicine, Third Xiangya Hospital, Central South University, Changsha 410013
| | - Lin Qu
- Department of Laboratory Medicine, Third Xiangya Hospital, Central South University, Changsha 410013
| | - Yuan Wu
- Department of Laboratory Medicine, Third Xiangya Hospital, Central South University, Changsha 410013
| | - Pingyun Wu
- Department of Laboratory Medicine, Third Xiangya Hospital, Central South University, Changsha 410013
| | - Yao Duan
- Department of Laboratory Medicine, Third Xiangya Hospital, Central South University, Changsha 410013
| | - Pengfei She
- Department of Laboratory Medicine, Third Xiangya Hospital, Central South University, Changsha 410013.
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Li Q, Zheng H, Chen B. Identification of macrophage-related genes in sepsis-induced ARDS using bioinformatics and machine learning. Sci Rep 2023; 13:9876. [PMID: 37336980 DOI: 10.1038/s41598-023-37162-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 06/16/2023] [Indexed: 06/21/2023] Open
Abstract
Sepsis-induced acute respiratory distress syndrome (ARDS) is one of the leading causes of death in critically ill patients, and macrophages play very important roles in the pathogenesis and treatment of sepsis-induced ARDS. The aim of this study was to screen macrophage-related biomarkers for the diagnosis and treatment of sepsis-induced ARDS by bioinformatics and machine learning algorithms. A dataset including gene expression profiles of sepsis-induced ARDS patients and healthy controls was downloaded from the gene expression omnibus database. The limma package was used to screen 325 differentially expressed genes, and enrichment analysis suggested enrichment mainly in immune-related pathways and reactive oxygen metabolism pathways. The level of immune cell infiltration was analysed using the ssGSEA method, and then 506 macrophage-related genes were screened using WGCNA; 48 showed differential expression. PPI analysis was also performed. SVM-RFE and random forest map analysis were used to screen 10 genes. Three key genes, SGK1, DYSF and MSRB1, were obtained after validation with external datasets. ROC curves suggested that all three genes had good diagnostic efficacy. The nomogram model consisting of the three genes also had good diagnostic efficacy. This study provides new targets for the early diagnosis of sepsis-induced ARDS.
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Affiliation(s)
- Qiuyue Li
- Department of Emergency Medicine, The Second Hospital of Tianjin Medical University, No. 23, Pingjiang Road, Hexi District, Tianjin, 300211, China
| | - Hongyu Zheng
- Department of Maxillofacial Surgery, The First Affiliated Hospital of Chongqing Medical University, No. 1, Youyi Road, Yuzhong District, Chongqing, 400016, China
| | - Bing Chen
- Department of Emergency Medicine, The Second Hospital of Tianjin Medical University, No. 23, Pingjiang Road, Hexi District, Tianjin, 300211, China.
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14
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Bakken K, Klopp A, Shehan M, Jacob L, Tell D. Analyzing Apparent Causes of 30-Day Readmissions to Acute Care From Skilled Nursing Facilities. J Nurs Adm 2023; 53:344-352. [PMID: 37172009 DOI: 10.1097/nna.0000000000001297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
This quality improvement project implemented a bidirectional apparent cause analysis of patients readmitted to 1 hospital from 8 skilled nursing facilities (SNFs). The purpose of the project was to receive input from both hospital and SNF nursing staff to critically examine the apparent causes of SNF readmissions from both settings and identify opportunities for improvement. Nurse-led measures to prevent readmissions can be found in 5 domains: improved collaboration, communication, coordination, clarification, and cause analysis.
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Affiliation(s)
- Keith Bakken
- Author Affiliations: Associate Professors of Nursing and Health Sciences (Drs Bakken and Shehan), North Park University, Chicago; and Assistant Professor of Nursing (Dr Klopp); Clinical Associate Professor (Dr Tell), Loyola University Chicago, Illinois; and Nurse Care Coordinator (Ms Jacob), Thresholds, Chicago, Illinois
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15
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Hemha P, Chomphoo S, Polsan Y, Goto K, Watanabe M, Kondo H, Hipkaeo W. Discrete localization of phospholipase Cβ3 and diacylglycerol kinase ι along the renal proximal tubules of normal rat kidney and gentamicin-induced changes in their expression. Histochem Cell Biol 2023; 159:293-307. [PMID: 36478081 DOI: 10.1007/s00418-022-02166-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/11/2022] [Indexed: 12/12/2022]
Abstract
Many signaling enzymes have multiple isozymes that are localized discretely at varying molecular levels in different compartments of cells where they play specific roles. In this study, among the various isozymes of phospholipase C (PLC) and diacylglycerol kinase (DGK), which work sequentially in the phosphoinositide cycle, both PLCβ3 and DGKι were found in renal brush-border microvilli, but found to replace each other along the proximal tubules: PLCβ3 in the proximal straight tubules (PST) of the outer stripe of the outer medulla (OSOM) and the medullary ray (MR), and DGKι in the proximal convoluted tubules (PCT) in the cortex and partially in the PST of the MR. Following daily injection of gentamicin for 1 week, the expression of PLCβ3 and DGKι was transiently enhanced, as demonstrated by western blot, and the increases were found to most likely occur in their original sites, that is, in the brush borders of the PST for PLCβ3 and in the PCT for DGKι. These findings showing differences in expression along the tubules suggest that the exertion of reabsorption and secretion through various ion channels and transporters in the microvillus membranes and the maintenance of microvillus turnover are regulated by a PLC-mediated signal with the balance shifted toward relative augmentation of the DAG function in the PST, and by a DGK-mediated signal with the balance shifted to relative augmentation of the phosphatidic acid function in the PCT. Our results also suggest the possibility that these isozymes are potential diagnostic signs for the early detection of acute kidney injury caused by gentamicin.
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Affiliation(s)
- Premrudee Hemha
- Electron Microscopy Laboratory, Division of Anatomy, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand
| | - Surang Chomphoo
- Electron Microscopy Laboratory, Division of Anatomy, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand
| | - Yada Polsan
- Electron Microscopy Laboratory, Division of Anatomy, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand
| | - Kaoru Goto
- Department of Anatomy, School of Medicine, Yamagata University, Yamagata, Japan
| | - Masahiko Watanabe
- Department of Anatomy, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Hisatake Kondo
- Electron Microscopy Laboratory, Division of Anatomy, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand
| | - Wiphawi Hipkaeo
- Electron Microscopy Laboratory, Division of Anatomy, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand.
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16
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Fan H, Sun M, Le JW, Zhu JH. S-Nitrosoglutathione protects acute kidney injury in septic rats by inhibiting the activation of NLRP3 inflammasome. IRANIAN JOURNAL OF BASIC MEDICAL SCIENCES 2023; 26:830-835. [PMID: 37396949 PMCID: PMC10311978 DOI: 10.22038/ijbms.2023.69651.15169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 04/19/2023] [Indexed: 07/04/2023]
Abstract
Objectives We aimed to study the effect of S-nitroso glutathione (SNG) on acute kidney injury (AKI) in septic rats by regulating nucleotide oligomerization domain-like receptor protein 3 (NLRP3). Materials and Methods Sprague Dawley rats were used to construct the AKI model, and biochemical methods were used to detect the levels of inflammatory factors and anti-oxidant enzymes in renal tissue. We observed the ultrastructural changes of renal tissue by transmission electron microscopy and detected the protein and mRNA levels of NLRP3, apoptosis-associated speck-like protein containing a caspase recruitment domain foci (ASC) and caspase-1 by western-blotting and RT-qPCR. Results Cecal ligation and puncture induced renal tubular epithelial tissue damage in septic rats, resulting in decreased renal function, increased levels of inflammation and decreased levels of anti-oxidant enzymes in renal tissue, and aggravated mitochondrial damage, significantly decreased mitochondrial density and enzyme complex I/II/III/IV levels (all P<0.001), and increased the protein and mRNA expression of NLRP3, ASC, and caspase-1 (all P<0.001). However, after pretreatment with SNG, the pathological damage of renal tubular epithelial tissue was reduced, the renal function was improved, the level of inflammation in renal tissue decreased and the level of anti-oxidant enzymes increased, the density of mitochondria and the level of enzyme complex I/II/III/IV were significantly increased (all P<0.001), meanwhile the protein and mRNA levels of NLRP3, ASC, and caspase-1 were all decreased significantly (all P<0.05). Conclusion SNG protects AKI in septic rats by inhibiting NLRP3 inflammasome activation.
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Affiliation(s)
- Heng Fan
- Department of Intensive Care Unit, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang Province, P.R China
| | - Min Sun
- Department of Intensive Care Unit, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang Province, P.R China
| | - Jian-wei Le
- Department of Intensive Care Unit, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang Province, P.R China
| | - Jian-hua Zhu
- Department of Intensive Care Unit, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang Province, P.R China
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17
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Wang B, Xu J, Fu P, Ma L. MicroRNAs in septic acute kidney injury. BURNS & TRAUMA 2023; 11:tkad008. [PMID: 36959845 PMCID: PMC10027606 DOI: 10.1093/burnst/tkad008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 11/18/2022] [Accepted: 01/29/2023] [Indexed: 03/25/2023]
Abstract
Sepsis is a potentially fatal complication of burns and trauma that can cause acute kidney injury (AKI) with substantial morbidity and mortality, but this disease is poorly understood. Despite medical advances, effective therapeutic regimens for septic AKI remain uncommon. MicroRNAs (miRNAs) are endogenous non-coding RNAs that influence the translation of target messenger RNAs in a variety of biological processes. Emerging evidence has shown that miRNAs are intimately associated with septic AKI. The goal of this review was to summarize recent advances in the profound understanding of the functional role of miRNAs in septic AKI, as well as to provide new insights into miRNAs as feasible biomarkers and therapeutic targets for septic AKI.
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Affiliation(s)
| | | | - Ping Fu
- Correspondence, Ping Fu, ; Liang Ma,
| | - Liang Ma
- Correspondence, Ping Fu, ; Liang Ma,
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18
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Polat EC, Koc A, Demirkan K. The role of the clinical pharmacist in the prevention of drug-induced acute kidney injury in the intensive care unit. J Clin Pharm Ther 2022; 47:2287-2294. [PMID: 36394173 DOI: 10.1111/jcpt.13811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 10/18/2022] [Accepted: 10/29/2022] [Indexed: 11/18/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE Acute kidney injury (AKI) is a disorder that is commonly seen in patients in the intensive care unit (ICU) and has a detrimental impact on the patients' clinical prognosis. Although a variety of factors contribute to the development of AKI in patients, drug-induced AKI is a common occurrence in the ICU. With the widespread availability of clinical pharmacy services, the clinical pharmacist's consultation service to the healthcare team aids in the resolution of drug-related issues and the enhancement of therapeutic outcomes. The involvement of a clinical pharmacist in the ICU team is expected to minimize the incidence of drug-induced AKI and enhance therapeutic results. Therefore, the goal of our study was to demonstrate the impact of having a clinical pharmacist on the occurrence, stages, and treatment of AKI. METHODS The study included two patient groups: intervention (n = 75) (IG) and control (n = 75) (CG) groups. The clinical pharmacist has made recommendations to the ICU team regarding the treatment of IG patients on drug selection, drug administration routes, drug dose adjustment, drug-drug interactions, drug-food or nutritional solution interactions, drug side effect management, and drug incompatibility. No interventions were provided by the clinical pharmacist in the CG patients. The clinical pharmacist visited patients regularly and noted the laboratory findings and pharmacological treatments of patients in the study groups on the patient follow-up forms. The obtained data of IG and CG were compared and statistical methods were used to assess them. RESULTS AND DISCUSSION According to our findings, AKI was found to be more common in CG than in IG (p < 0.05). Stage 1 was shown to be the most common AKI stage in the patients (p > 0.05). The gap between the patients' highest Cr and basal sCr values was less in IG (p < 0.05). When the association between reasons for ICU admission and AKI was investigated, pulmonary edema and acute respiratory failure were found to have a significant and positive relationship with AKI (p < 0.05). Furthermore, it was shown that patients with diabetes and cancer comorbidities were the most vulnerable to developing AKI (p < 0.05). Antibiotics, anaesthetics, and cardiovascular system medication categories were found to have a significant and positive correlation with AKI in patients (p < 0.05). Also, it was revealed that the usage of vancomycin, colistin, ampicillin-sulbactam, clarithromycin, ceftriaxone, midazolam, and dexketoprofen caused AKI (p < 0.05). WHAT IS NEW AND CONCLUSION Our findings demonstrate that if a clinical pharmacist is included in the ICU team and provides consultation services to the ICU team regarding patient treatment by performing regular patient follow-up, the incidence of AKI in patients can be minimized and therapeutic outcomes can be improved.
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Affiliation(s)
- Eyup Can Polat
- Department of Clinical Pharmacy, Faculty of Pharmacy, Hacettepe University, Ankara, Turkey.,Department of Clinical Pharmacy, Faculty of Pharmacy, Erzincan Binali Yildirim University, Erzincan, Turkey
| | - Alparslan Koc
- Department of Anesthesiology and Reanimation, Erzincan Binali Yildirim University Mengucek Gazi Training and Research Hospital, Erzincan, Turkey
| | - Kutay Demirkan
- Department of Clinical Pharmacy, Faculty of Pharmacy, Hacettepe University, Ankara, Turkey
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Wang JL, Xiang BX, Song XL, Que RM, Zuo XC, Xie YL. Prevalence of polymyxin-induced nephrotoxicity and its predictors in critically ill adult patients: A meta-analysis. World J Clin Cases 2022; 10:11466-11485. [PMID: 36387815 PMCID: PMC9649555 DOI: 10.12998/wjcc.v10.i31.11466] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 09/15/2022] [Accepted: 09/23/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Polymyxin-induced nephrotoxicity is a major safety concern in clinical practice due to long-term adverse outcomes and high mortality.
AIM To conducted a systematic review and meta-analysis of the prevalence and potential predictors of polymyxin-induced nephrotoxicity in adult intensive care unit (ICU) patients.
METHODS PubMed, EMBASE, the Cochrane Library and Reference Citation Analysis database were searched for relevant studies from inception through May 30, 2022. The pooled prevalence of polymyxin-induced nephrotoxicity and pooled risk ratios of associated factors were analysed using a random-effects or fixed-effects model by Stata SE ver. 12.1. Additionally, subgroup analyses and meta-regression were conducted to assess heterogeneity.
RESULTS A total of 89 studies involving 12234 critically ill adult patients were included in the meta-analysis. The overall pooled incidence of polymyxin-induced nephrotoxicity was 34.8%. The pooled prevalence of colistin-induced nephrotoxicity was not higher than that of polymyxin B (PMB)-induced nephrotoxicity. The subgroup analyses showed that nephrotoxicity was significantly associated with dosing interval, nephrotoxicity criteria, age, publication year, study quality and sample size, which were confirmed in the univariable meta-regression analysis. Nephrotoxicity was significantly increased when the total daily dose was divided into 2 doses but not 3 or 4 doses. Furthermore, older age, the presence of sepsis or septic shock, hypoalbuminemia, and concomitant vancomycin or vasopressor use were independent risk factors for polymyxin-induced nephrotoxicity, while an elevated baseline glomerular filtration rate was a protective factor against colistin-induced nephrotoxicity.
CONCLUSION Our findings indicated that the incidence of polymyxin-induced nephrotoxicity among ICU patients was high. It emphasizes the importance of additional efforts to manage ICU patients receiving polymyxins to decrease the risk of adverse outcomes.
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Affiliation(s)
- Jiang-Lin Wang
- Department of Pharmacy, The Third Xiangya Hospital of Central South University, Changsha 410013, Hunan Province, China
| | - Bi-Xiao Xiang
- Department of Pharmacy, The Third Xiangya Hospital of Central South University, Changsha 410013, Hunan Province, China
| | - Xiao-Li Song
- Department of Pharmacy, Sanya Central Hospital, Sanya 572000, Hainan Province, China
| | - Rui-Man Que
- Department of Pharmacy, The Third Xiangya Hospital of Central South University, Changsha 410013, Hunan Province, China
| | - Xiao-Cong Zuo
- Department of Pharmacy, The Third Xiangya Hospital of Central South University, Changsha 410013, Hunan Province, China
| | - Yue-Liang Xie
- Department of Pharmacy, The Third Xiangya Hospital of Central South University, Changsha 410013, Hunan Province, China
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Wang M, Jiang F, Zhang L, Zhang J, Xie H. Knockdown of P2Y4 ameliorates sepsis-induced acute kidney injury in mice via inhibiting the activation of the NF-κB/MMP8 axis. Front Physiol 2022; 13:953977. [PMID: 36105291 PMCID: PMC9467379 DOI: 10.3389/fphys.2022.953977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 07/21/2022] [Indexed: 11/16/2022] Open
Abstract
Sepsis-induced acute kidney injury (S-AKI) has emerged as a frequent and life-threatening complication in critically ill patients, which is characterized by a systematic inflammatory response and a rapid decline in kidney function. P2Y4, a member of G protein–coupled P2Y nucleotide receptor family, has been reported to serve as a crucial player in inflammatory responses during the development of neurocognitive disorder and myocardial infarction. Nonetheless, the biological role of P2Y4 in S-AKI remains largely unclear. This study aimed to decipher the biological role of P2Y4 in S-AKI and illuminate the potential mechanisms. In this study, S-AKI models were successfully established in mice via cecal ligation and puncture. Results showed that the kidney tissues from S-AKI mouse models exhibited a higher P2Y4 expression level than from the sham-operated group. Knockdown of P2Y4 was found to remarkably alleviate kidney damage and reduce inflammatory response in mice of S-AKI models. Moreover, P2Y4 ablation inhibited the activation of the NF-κB/MMP-8 signaling axis. Additionally, mechanistic studies revealed that rescuing MMP-8 reversed the alleviating effects of P2Y4 knockdown against renal cell damage. Collectively, our findings indicate that P2Y4 knockdown ameliorated S-AKI in mice via inhibiting the activation of the NF-κB/MMP-8 axis and that P2Y4 may represent a novel therapeutic target for S-AKI patients.
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Expression of MicroRNAs in Sepsis-Related Organ Dysfunction: A Systematic Review. Int J Mol Sci 2022; 23:ijms23169354. [PMID: 36012630 PMCID: PMC9409129 DOI: 10.3390/ijms23169354] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 08/10/2022] [Accepted: 08/17/2022] [Indexed: 02/06/2023] Open
Abstract
Sepsis is a critical condition characterized by increased levels of pro-inflammatory cytokines and proliferating cells such as neutrophils and macrophages in response to microbial pathogens. Such processes lead to an abnormal inflammatory response and multi-organ failure. MicroRNAs (miRNA) are single-stranded non-coding RNAs with the function of gene regulation. This means that miRNAs are involved in multiple intracellular pathways and thus contribute to or inhibit inflammation. As a result, their variable expression in different tissues and organs may play a key role in regulating the pathophysiological events of sepsis. Thanks to this property, miRNAs may serve as potential diagnostic and prognostic biomarkers in such life-threatening events. In this narrative review, we collect the results of recent studies on the expression of miRNAs in heart, blood, lung, liver, brain, and kidney during sepsis and the molecular processes in which they are involved. In reviewing the literature, we find at least 122 miRNAs and signaling pathways involved in sepsis-related organ dysfunction. This may help clinicians to detect, prevent, and treat sepsis-related organ failures early, although further studies are needed to deepen the knowledge of their potential contribution.
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Romaní L, León-Figueroa DA, Rafael-Navarro D, Barboza JJ, Rodriguez-Morales AJ. Association between the Use of Antibiotics and the Development of Acute Renal Injury in Patients Hospitalized for COVID-19 in a Hospital in the Peruvian Amazon. J Clin Med 2022; 11:jcm11154493. [PMID: 35956109 PMCID: PMC9369744 DOI: 10.3390/jcm11154493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 07/21/2022] [Accepted: 07/26/2022] [Indexed: 02/04/2023] Open
Abstract
Introduction: A significant antibiotic prescribing pattern associated with the COVID-19 pandemic has been described. Multiple protocols included empirical antimicrobials, leading to a substantial increase in antimicrobial consumption in medical care. A higher mortality rate is described among patients diagnosed with COVID-19 who received antibiotics. Objectives: To determine the association between the use of antibiotics and the development of acute renal injury in patients infected with SARS-CoV-2 in patients treated at the Hospital II EsSalud de Ucayali, 2021. Methods: A cross-sectional-analytical study was conducted, evaluating the medical records of patients admitted to the intensive care unit between July 2020 and July 2021. For the statistical analysis, measures of central tendency and dispersion, statistical hypothesis contrast tests were used in relation to acute kidney injury (AKI), antibiotic use and associated factors, derived from linear regression models. Results: The factors that were positively associated with the development of AKI were sepsis (aPR: 2.86; 95% CI: 1.26–6.43), shock (aPR:2.49; 95% CI: 1.28–4.86), mechanical ventilation (aPR:9.11; 95% CI: 1.23–67.57), and use of vancomycin (aPR: 3.15; 95% CI: 1.19–8.27). Conclusions: In the Peruvian Amazon, there is a high consumption and inadequate prescription of antibiotics. The drugs most commonly used for the treatment of COVID-19 were: aminoglycosides, vancomycin, ivermectin, azithromycin, tocilizumab, and corticosteroids. The development of AKI among hospitalized patients was found to be related to vancomycin administration. In addition, an association was found with the use of mechanical ventilation, a high body mass index, and the presence of complications such as sepsis or shock. Therefore, inappropriate antibiotic use for COVID-19 has been associated with multiple negative outcomes and consequences.
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Affiliation(s)
- Luccio Romaní
- Facultad de Medicina Humana, Universidad San Martín de Porres, Chiclayo 15011, Peru; (L.R.); (D.A.L.-F.)
- Emerge, Unidad de Investigación en Enfermedades Emergentes y Cambio Climático, Facultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia, Lima 15102, Peru
| | - Darwin A. León-Figueroa
- Facultad de Medicina Humana, Universidad San Martín de Porres, Chiclayo 15011, Peru; (L.R.); (D.A.L.-F.)
- Emerge, Unidad de Investigación en Enfermedades Emergentes y Cambio Climático, Facultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia, Lima 15102, Peru
| | - David Rafael-Navarro
- Facultad de Medicina Humana, Universidad Nacional de Ucayali, Pucallpa 25004, Peru;
| | - Joshuan J. Barboza
- Vicerrectorado de Investigación, Universidad Norbert Wiener, Lima 15046, Peru
- Correspondence: ; Tel.: +51-992-108-520
| | - Alfonso J. Rodriguez-Morales
- Grupo de Investigación Biomedicina, Faculty of Medicine, Fundación Universitaria Autónoma de las Américas, Pereira 660003, Risaralda, Colombia; or
- Institución Universitaria Visión de las Américas, Pereira 660003, Risaralda, Colombia
- Master of Clinical Epidemiology and Biostatistics, Universidad Científica del Sur, Lima 15067, Peru
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Zhou P, Li D, Luo F, Wan X. NCOA2 coordinates with the transcriptional KAT2B-NF-κB partner to trigger inflammation response in acute kidney injury. Gene X 2022; 832:146583. [PMID: 35597525 DOI: 10.1016/j.gene.2022.146583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 04/15/2022] [Accepted: 05/16/2022] [Indexed: 11/04/2022] Open
Abstract
Dysregulation of multiple genes is an important risk factor for acute kidney injury (AKI). Numerous genes, such as proinflammatory cytokines, intracellular cell adhesion molecules (ICAMs), and nitric oxide synthases (NOSs), are implicated in AKI pathogenesis. However, the molecular mechanisms involved in the dysregulation of these genes are still obscure. Herein, we discovered that two subunits of NF-κB (p50 and p65) couple with lysine acetyltransferase 2B (KAT2B) and nuclear receptor coactivator 2 (NOCA2) to assemble a transcriptional complex in a LPS-induced mouse model of AKI. The NCOA2-KAT2B-NF-κB complex bound to the promoters of some NF-κB target genes, such as interleukin 1 beta (IL-1B), IL-6, tumor necrosis factor alpha (TNFA), ICAM1, vascular cell adhesion molecule 1 (VCAM1), cluster of differentiation 38 (CD38), CD40, CD80, and NOS2, and transactivated their expression. In vitro knockdown of components of the NCOA2-KAT2B-NF-κB complex or blockage of KAT2B by its inhibitors (5-chloro-2-(4-nitrophenyl)-3(2H)-isothiazolone [CNIT] and garcinol) significantly decreased the expression of these NF-κB target genes following LPS treatment. The administration of CNIT and garcinol significantly improved the in vivo outcomes of the AKI mice. Our findings reveal the underlying mechanism of NF-κB target upregulation in the pathogenesis of LPS-induced AKI and identify a new therapeutic strategy for AKI that involves targeting the NCOA2-KAT2B-NF-κB complex.
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Affiliation(s)
- Ping Zhou
- Department of Nephrology, Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang 330006, Jiangxi, China
| | - Dongdong Li
- Department of Respiratory Medicine, Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang 330006, Jiangxi, China
| | - Fuli Luo
- Department of Diagnosis and Treatment of Chronic Kidney Diseases, Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang 330096, Jiangxi, China
| | - Xiaoxiao Wan
- Department of Nephrology, Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang 330006, Jiangxi, China.
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Pan W, Zhang J, Hu L, Huang Z. Evaluation Value of Serum miR-4299 and miR-16-5p in Risk Stratification of Sepsis-Induced Acute Kidney Injury. BIOMED RESEARCH INTERNATIONAL 2022; 2022:5165892. [PMID: 35845963 PMCID: PMC9286879 DOI: 10.1155/2022/5165892] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 05/31/2022] [Accepted: 06/03/2022] [Indexed: 11/17/2022]
Abstract
Objective This study was designed to determine the evaluation value of serum miR-4299 and miR-16-5p in risk stratification of sepsis-induced acute kidney injury (SI-AKI). Methods A total of 115 sepsis patients were enrolled and assigned to the SI-AKI group (n = 64) or the sepsis-non-AKI group (n = 51) based on the occurrence of AKI, and 72 healthy individuals were enrolled. Fasting venous blood was sampled from every patient before admission, before therapy, and after therapy, followed by quantification of miR-4299 and miR-16-5p by fluorescence quantitative PCR. Receiver operating characteristic (ROC) curves were drawn to evaluate the value of serum miR-16-5p and miR-4299 expression in predicting SI-AKI, and Pearson's correlation analysis was performed to explore the associations of the two with Scr, Cys-C, and KIM-1. Results Cases with sepsis, especially SI-AKI, presented significantly downregulated serum miR-4299 and miR-16-5p. After therapy, the expression in them increased. The area under curve (AUC) of serum miR-4299 and miR-16-5p in the prediction value for early diagnosis of SI-AKI was 0.895 (95% CI: 0.839-0.951, cutoff value: 0.780) and 0.838 (95% CI: 0.767-0.909, cutoff value: 0.775), respectively, and the AUC of them in the prediction value for clinical efficacy on the disease were 0.733 (95% CI: 0.645-0.820, cutoff value: 1.115) and 0.776 (95% CI: 0.698-0.855, cutoff value: 1.125), respectively. Serum miR-16-5p and mIR-4299 were negatively correlated with Scr, Cys-C, and KIM-1, separately. Conclusion Both miR-16-5p and mIR-4299 are promising factors for early diagnosis of SI-AKI and dynamic evaluation of the efficacy on it.
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Affiliation(s)
- Weiwei Pan
- Intensive Care Unit, Beilun People's Hospital, No. 1288 Lushan East Road, Beilun District, Ningbo, Zhejiang, China
| | - Junfeng Zhang
- Intensive Care Unit, Beilun People's Hospital, No. 1288 Lushan East Road, Beilun District, Ningbo, Zhejiang, China
| | - Luqi Hu
- Intensive Care Unit, Beilun People's Hospital, No. 1288 Lushan East Road, Beilun District, Ningbo, Zhejiang, China
| | - Zhiping Huang
- Intensive Care Unit, Beilun People's Hospital, No. 1288 Lushan East Road, Beilun District, Ningbo, Zhejiang, China
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Abstract
Sepsis-associated AKI is a life-threatening complication that is associated with high morbidity and mortality in patients who are critically ill. Although it is clear early supportive interventions in sepsis reduce mortality, it is less clear that they prevent or ameliorate sepsis-associated AKI. This is likely because specific mechanisms underlying AKI attributable to sepsis are not fully understood. Understanding these mechanisms will form the foundation for the development of strategies for early diagnosis and treatment of sepsis-associated AKI. Here, we summarize recent laboratory and clinical studies, focusing on critical factors in the pathophysiology of sepsis-associated AKI: microcirculatory dysfunction, inflammation, NOD-like receptor protein 3 inflammasome, microRNAs, extracellular vesicles, autophagy and efferocytosis, inflammatory reflex pathway, vitamin D, and metabolic reprogramming. Lastly, identifying these molecular targets and defining clinical subphenotypes will permit precision approaches in the prevention and treatment of sepsis-associated AKI.
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Affiliation(s)
- Shuhei Kuwabara
- Division of Nephrology and Center for Immunity, Inflammation, and Regenerative Medicine, University of Virginia, Charlottesville, Virginia
| | - Eibhlin Goggins
- Division of Nephrology and Center for Immunity, Inflammation, and Regenerative Medicine, University of Virginia, Charlottesville, Virginia
| | - Mark D Okusa
- Division of Nephrology and Center for Immunity, Inflammation, and Regenerative Medicine, University of Virginia, Charlottesville, Virginia
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26
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Li B, Lin F, Xia Y, Ye Z, Yan X, Song B, Yuan T, Li L, Zhou X, Yu W, Cheng F. The Intersection of Acute Kidney Injury and Non-Coding RNAs: Inflammation. Front Physiol 2022; 13:923239. [PMID: 35755446 PMCID: PMC9218900 DOI: 10.3389/fphys.2022.923239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 05/16/2022] [Indexed: 12/02/2022] Open
Abstract
Acute renal injury (AKI) is a complex clinical syndrome, involving a series of pathophysiological processes, in which inflammation plays a key role. Identification and verification of gene signatures associated with inflammatory onset and progression are imperative for understanding the molecular mechanisms involved in AKI pathogenesis. Non-coding RNAs (ncRNAs), involved in epigenetic modifications of inflammatory responses, are associated with the aberrant expression of inflammation-related genes in AKI. However, its regulatory role in gene expression involves precise transcriptional regulation mechanisms which have not been fully elucidated in the complex and volatile inflammatory response of AKI. In this study, we systematically review current research on the intrinsic molecular mechanisms of ncRNAs that regulate the inflammatory response in AKI. We aim to provide potential research directions and strategies for developing ncRNA-targeted gene therapies as an intervention for the inflammatory damage in AKI.
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Affiliation(s)
- Bojun Li
- Department of Urology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Fangyou Lin
- Department of Urology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Yuqi Xia
- Department of Urology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Zehua Ye
- Department of Urology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Xinzhou Yan
- Department of Urology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Baofeng Song
- Department of Urology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Tianhui Yuan
- Department of Urology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Lei Li
- Department of Urology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Xiangjun Zhou
- Department of Urology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Weimin Yu
- Department of Urology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Fan Cheng
- Department of Urology, Renmin Hospital of Wuhan University, Wuhan, China
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Hof S, Marcus C, Kuebart A, Schulz J, Truse R, Raupach A, Bauer I, Flögel U, Picker O, Herminghaus A, Temme S. A Toolbox to Investigate the Impact of Impaired Oxygen Delivery in Experimental Disease Models. Front Med (Lausanne) 2022; 9:869372. [PMID: 35652064 PMCID: PMC9149176 DOI: 10.3389/fmed.2022.869372] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 04/25/2022] [Indexed: 12/29/2022] Open
Abstract
Impaired oxygen utilization is the underlying pathophysiological process in different shock states. Clinically most important are septic and hemorrhagic shock, which comprise more than 75% of all clinical cases of shock. Both forms lead to severe dysfunction of the microcirculation and the mitochondria that can cause or further aggravate tissue damage and inflammation. However, the detailed mechanisms of acute and long-term effects of impaired oxygen utilization are still elusive. Importantly, a defective oxygen exploitation can impact multiple organs simultaneously and organ damage can be aggravated due to intense organ cross-talk or the presence of a systemic inflammatory response. Complexity is further increased through a large heterogeneity in the human population, differences in genetics, age and gender, comorbidities or disease history. To gain a deeper understanding of the principles, mechanisms, interconnections and consequences of impaired oxygen delivery and utilization, interdisciplinary preclinical as well as clinical research is required. In this review, we provide a "tool-box" that covers widely used animal disease models for septic and hemorrhagic shock and methods to determine the structure and function of the microcirculation as well as mitochondrial function. Furthermore, we suggest magnetic resonance imaging as a multimodal imaging platform to noninvasively assess the consequences of impaired oxygen delivery on organ function, cell metabolism, alterations in tissue textures or inflammation. Combining structural and functional analyses of oxygen delivery and utilization in animal models with additional data obtained by multiparametric MRI-based techniques can help to unravel mechanisms underlying immediate effects as well as long-term consequences of impaired oxygen delivery on multiple organs and may narrow the gap between experimental preclinical research and the human patient.
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Affiliation(s)
- Stefan Hof
- Department of Anaesthesiology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Carsten Marcus
- Department of Anaesthesiology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Anne Kuebart
- Department of Anaesthesiology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Jan Schulz
- Department of Anaesthesiology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Richard Truse
- Department of Anaesthesiology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Annika Raupach
- Department of Anaesthesiology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Inge Bauer
- Department of Anaesthesiology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Ulrich Flögel
- Experimental Cardiovascular Imaging, Department of Molecular Cardiology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Olaf Picker
- Department of Anaesthesiology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Anna Herminghaus
- Department of Anaesthesiology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Sebastian Temme
- Department of Anaesthesiology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
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Gao Q, Zheng Y, Wang H, Hou L, Hu X. circSTRN3 aggravates sepsis-induced acute kidney injury by regulating miR-578/ toll like receptor 4 axis. Bioengineered 2022; 13:11388-11401. [PMID: 35510365 PMCID: PMC9275965 DOI: 10.1080/21655979.2022.2061293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Sepsis is a systemic inflammatory response caused by infection, and severe sepsis is commonly associated with the development of acute kidney injury (AKI). Accumulating evidence has revealed the implication of circular RNAs in AKI. In this study, we explored the potential engagement and the underlying mechanism of hsa_circ_010157 (circSTRN3) in sepsis-induced AKI. CircSTRN3 levels in HK2 cells and serum samples of patients were determined by RT-PCR. The protein levels of TLR4 (Toll Like Receptor 4), bax (Bcl-2-associated X protein), cleaved caspase 3 and bcl-2 (B-cell lymphoma-2) were detected by Western blotting (WB), and the levels of proinflammatory cytokines were detected by ELISA. The molecular interactions between mir-578/TLR4 and circSTRN3/miR-578 were analyzed by dual luciferase reporter assay as well as RNA pull-down experiment. Lipopolysaccharide (LPS) treated HK2 cells were used as an in vitro model to investigate the functional interaction of circSTRN3/miR-578/TLR4 axis. We found that the expression level of circSTRN3 in patients with sepsis-induced AKI and LPS-induced HK2 cells was higher. Silencing cicrSTRN3 alleviated LPS-induced cell proliferation, and suppressed the inflammatory response and apoptosis in LPS-treated HK2 cells. In contrast, the overexpression of circSTRN3 aggravated the cellular damages induced by LPS treatment. CircSTRN3 targeted miR-578/TLR4 axis to influence the damage effect induced by LPS. miR-578 inhibitor or TLR4 overexpression impaired the rescue effect of circSTRN3 knockdown. These results indicate that circSTRN3 upregulation in sepsis-induced AKI modulates miR-578/TLR4 axis to promote the pathogenesis of AKI, which could serve as future therapeutic targets for AKI treatment.
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Affiliation(s)
- Qiuying Gao
- Department of Hematology, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China
| | - Yan Zheng
- Department of Hematology, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China
| | - Hui Wang
- Department of Hematology, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China
| | - Limin Hou
- Department of Hematology, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China
| | - Xingxing Hu
- Department of Hematology, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China
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29
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Analysis of microRNA Expression after Glutamine Intervention in Acute Renal Ischemia-Reperfusion Injury. JOURNAL OF HEALTHCARE ENGINEERING 2022; 2022:2401152. [PMID: 35035815 PMCID: PMC8754598 DOI: 10.1155/2022/2401152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 12/27/2021] [Indexed: 11/17/2022]
Abstract
Background Ischemia-reperfusion acute kidney injury (I/R AKI) is a severe kidney disease with high mortality and morbidity. This study aimed to explore the protective mechanism of glutamine (GLN) against I/R AKI. Methods The I/R AKI rat model was established, and HE staining of kidney tissue and serum creatinine (SCr) and blood urea nitrogen (BUN) detection were performed. The miRNAs were sequenced by high throughput in rat kidney tissue samples. Differentially expressed miRNAs (DEmiRs) between the I/R group and I/R + GLN group were screened, and enrichment analysis for target genes of DEmiRs was performed. Meanwhile, human HK-2 cells were cultured, and an I/R model was established to verify the expression of DEmiRs. Results Compared with the I/R group, the SCr and BUN levels at each time point were lower in the I/R + GLN group. Vacuolar degeneration of renal tubules in the I/R + GLN group was significantly reduced. In the 104 DEmiRs, we selected miR-132-5p, miR-205, and miR-615 as key miRNAs. KEGG analysis showed that the Notch signaling pathway, PI3K-Akt signaling pathway, and cGMP signaling pathway were mainly related to the GLN against I/R. qRT-PCR verified the downregulation of miR-205 in the I/R group, compared to the sham and I/R + GLN group. The I/R model was established with HK-2 cells, and the expression of miR-132-5p and miR-205 was decreased. Conclusion GLN reduced I/R-induced AKI. There were significant differences between miRNAs expression in I/R after GLN treatment. The process of GLN against I/R-induced AKI may be related to the Notch and PI3K-Akt signaling pathway.
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Fan H, Su BJ, Le JW, Zhu JH. Salidroside Protects Acute Kidney Injury in Septic Rats by Inhibiting Inflammation and Apoptosis. Drug Des Devel Ther 2022; 16:899-907. [PMID: 35386851 PMCID: PMC8978577 DOI: 10.2147/dddt.s361972] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 03/17/2022] [Indexed: 12/27/2022] Open
Abstract
Purpose To clarify the protective effect and mechanism of salidroside (SLDS) on acute kidney injury (AKI) in septic rats. Methods We pretreated rats with different doses of SLDS and analyzed the impact of SLDS on the survival of septic rats. We evaluated the levels of inflammatory factors in rats, the expression of NF-ƙB p65 in the kidney, and the apoptosis of kidney tubular epithelial cells (KTECs). Results SLDS significantly decreased the mortality of septic rats, and it reduced the levels of TNF-α, IL-1β, and IL-17A in plasma and kidneys and decreased the levels of serum creatinine, plasma renal injury molecule-1 and plasma neutrophil gelatin-associated lipocalin. Moreover, SLDS could significantly decrease the expression of NF-ƙB p65 in kidney tissues and the apoptotic number of KETCs, while reducing the mRNA levels of Caspase-3 and Bax mRNA, and increasing the level of Bcl-2 mRNA. Conclusion SLDS pretreatment protects against AKI in septic rats by inhibiting the inflammation of kidney and the apoptosis of KTECs.
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Affiliation(s)
- Heng Fan
- Department of Intensive Care Unit, Ningbo First Hospital, Ningbo, Zhejiang Province, People's Republic of China
| | - Bin-Jie Su
- Department of Intensive Care Unit, Ningbo First Hospital Haishu Branch, Ningbo, Zhejiang Province, People's Republic of China
| | - Jian-Wei Le
- Department of Intensive Care Unit, Ningbo First Hospital, Ningbo, Zhejiang Province, People's Republic of China
| | - Jian-Hua Zhu
- Department of Intensive Care Unit, Ningbo First Hospital, Ningbo, Zhejiang Province, People's Republic of China
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31
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Huang HJ, Lee YH, Chou CL, Zheng CM, Chiu HW. Investigation of potential descriptors of chemical compounds on prevention of nephrotoxicity via QSAR approach. Comput Struct Biotechnol J 2022; 20:1876-1884. [PMID: 35521549 PMCID: PMC9052077 DOI: 10.1016/j.csbj.2022.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 04/02/2022] [Accepted: 04/11/2022] [Indexed: 11/15/2022] Open
Abstract
Drug-induced nephrotoxicity remains a common problem after exposure to medications and diagnostic agents, which may be heightened in the kidney microenvironment and deteriorate kidney function. In this study, the toxic effects of fourteen marked drugs with the individual chemical structure were evaluated in kidney cells. The quantitative structure–activity relationship (QSAR) approach was employed to investigate the potential structural descriptors of each drug-related to their toxic effects. The most reasonable equation of the QSAR model displayed that the estimated regression coefficients such as the number of ring assemblies, three-membered rings, and six-membered rings were strongly related to toxic effects on renal cells. Meanwhile, the chemical properties of the tested compounds including carbon atoms, bridge bonds, H-bond donors, negative atoms, and rotatable bonds were favored properties and promote the toxic effects on renal cells. Particularly, more numbers of rotatable bonds were positively correlated with strong toxic effects that displayed on the most toxic compound. The useful information discovered from our regression QSAR models may help to identify potential hazardous moiety to avoid nephrotoxicity in renal preventive medicine.
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32
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Tienda-Vázquez MA, Morreeuw ZP, Sosa-Hernández JE, Cardador-Martínez A, Sabath E, Melchor-Martínez EM, Iqbal HMN, Parra-Saldívar R. Nephroprotective Plants: A Review on the Use in Pre-Renal and Post-Renal Diseases. PLANTS (BASEL, SWITZERLAND) 2022; 11:plants11060818. [PMID: 35336700 PMCID: PMC8955229 DOI: 10.3390/plants11060818] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 03/14/2022] [Accepted: 03/16/2022] [Indexed: 02/05/2023]
Abstract
Kidney diseases are expected to become the fifth leading cause of death by 2040. Several physiological failures classified as pre-, intra-, and post-renal factors induce kidney damage. Diabetes, liver pathologies, rhabdomyolysis, and intestinal microbiota have been identified as pre-renal factors, and lithiasis or blood clots in the ureters, prostate cancer, urethral obstructions, prostate elongation, and urinary tract infections are post-renal factors. Additionally, the nephrotoxicity of drugs has been highlighted as a crucial factor inducing kidney injuries. Due to the adverse effects of drugs, it is necessary to point to other alternatives to complement the treatment of these diseases, such as nephroprotective agents. Plants are a wide source of nephroprotective substances and can have beneficial effects in different levels of the physiological pathways which lead to kidney damage. In traditional medicines, plants are used as antioxidants, anti-inflammatories, diuretics, and anticancer agents, among other benefits. However, the mechanism of action of some plants empirically used remains unknown and scientific data are required to support their nephroprotective effects. The present work reviewed the plants with a beneficial effect on kidney diseases. The classification of nephroprotective plants according to the clinical definition of pre-renal, intrinsic, and post-renal factors is proposed to orient their use as complementary treatments.
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Affiliation(s)
- Mario Adrián Tienda-Vázquez
- Tecnologico de Monterrey, School of Engineering and Sciences, Monterrey 64849, Mexico; (M.A.T.-V.); (Z.P.M.); (J.E.S.-H.); (A.C.-M.)
| | - Zoé P. Morreeuw
- Tecnologico de Monterrey, School of Engineering and Sciences, Monterrey 64849, Mexico; (M.A.T.-V.); (Z.P.M.); (J.E.S.-H.); (A.C.-M.)
| | - Juan Eduardo Sosa-Hernández
- Tecnologico de Monterrey, School of Engineering and Sciences, Monterrey 64849, Mexico; (M.A.T.-V.); (Z.P.M.); (J.E.S.-H.); (A.C.-M.)
| | - Anaberta Cardador-Martínez
- Tecnologico de Monterrey, School of Engineering and Sciences, Monterrey 64849, Mexico; (M.A.T.-V.); (Z.P.M.); (J.E.S.-H.); (A.C.-M.)
| | - Ernesto Sabath
- Departamento de Nefrología, Hospital General de Querétaro, Queretaro 76175, Mexico;
- Facultad de Ciencias Naturales, Universidad Autónoma de Querétaro, Juriquilla 76230, Mexico
| | - Elda M. Melchor-Martínez
- Tecnologico de Monterrey, School of Engineering and Sciences, Monterrey 64849, Mexico; (M.A.T.-V.); (Z.P.M.); (J.E.S.-H.); (A.C.-M.)
- Correspondence: (E.M.M.-M.); (H.M.N.I.); (R.P.-S.)
| | - Hafiz M. N. Iqbal
- Tecnologico de Monterrey, School of Engineering and Sciences, Monterrey 64849, Mexico; (M.A.T.-V.); (Z.P.M.); (J.E.S.-H.); (A.C.-M.)
- Correspondence: (E.M.M.-M.); (H.M.N.I.); (R.P.-S.)
| | - Roberto Parra-Saldívar
- Tecnologico de Monterrey, School of Engineering and Sciences, Monterrey 64849, Mexico; (M.A.T.-V.); (Z.P.M.); (J.E.S.-H.); (A.C.-M.)
- Correspondence: (E.M.M.-M.); (H.M.N.I.); (R.P.-S.)
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Lin F, Han S, Yu W, Rao T, Ruan Y, Yuan R, Li H, Ning J, Xia Y, Xie J, Qi Y, Zhou X, Cheng F. microRNA‐486‐5p is implicated in the cisplatin‐induced apoptosis and acute inflammation response of renal tubular epithelial cells by targeting HAT1. J Biochem Mol Toxicol 2022; 36:e23039. [PMID: 35279909 DOI: 10.1002/jbt.23039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 01/19/2022] [Accepted: 03/02/2022] [Indexed: 01/01/2023]
Affiliation(s)
- Fang‐You Lin
- Department of Urology Renmin Hospital of Wuhan University Wuhan Hubei China
| | - Shang‐Ting Han
- Department of Urology Renmin Hospital of Wuhan University Wuhan Hubei China
| | - Wei‐Min Yu
- Department of Urology Renmin Hospital of Wuhan University Wuhan Hubei China
| | - Ting Rao
- Department of Urology Renmin Hospital of Wuhan University Wuhan Hubei China
| | - Yuan Ruan
- Department of Urology Renmin Hospital of Wuhan University Wuhan Hubei China
| | - Run Yuan
- Department of Urology Renmin Hospital of Wuhan University Wuhan Hubei China
| | - Hao‐Yong Li
- Department of Urology Renmin Hospital of Wuhan University Wuhan Hubei China
| | - Jin‐Zhuo Ning
- Department of Urology Renmin Hospital of Wuhan University Wuhan Hubei China
| | - Yu‐Qi Xia
- Department of Urology Renmin Hospital of Wuhan University Wuhan Hubei China
| | - Jin‐Na Xie
- Department of Urology Renmin Hospital of Wuhan University Wuhan Hubei China
| | - Yu‐Cheng Qi
- Department of Urology Renmin Hospital of Wuhan University Wuhan Hubei China
| | - Xiang‐Jun Zhou
- Department of Urology Renmin Hospital of Wuhan University Wuhan Hubei China
| | - Fan Cheng
- Department of Urology Renmin Hospital of Wuhan University Wuhan Hubei China
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Vancomycin-Associated Acute Kidney Injury: A Narrative Review from Pathophysiology to Clinical Application. Int J Mol Sci 2022; 23:ijms23042052. [PMID: 35216167 PMCID: PMC8877514 DOI: 10.3390/ijms23042052] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 02/10/2022] [Accepted: 02/11/2022] [Indexed: 12/12/2022] Open
Abstract
Vancomycin is the most frequently used antibiotic, accounting for up to 35% of hospitalized patients with infection, because of its optimal bactericidal effectiveness and relatively low price. Vancomycin-associated AKI (VA-AKI) is a clinically relevant but not yet clearly understood entity in critically ill patients. The current review comprehensively summarizes the pathophysiological mechanisms of, biomarkers for, preventive strategies for, and some crucial issues with VA-AKI. The pathological manifestations of VA-AKI include acute tubular necrosis, acute tubulointerstitial nephritis (ATIN), and intratubular crystal obstruction. The proposed pathological mechanisms of VA-AKI include oxidative stress and allergic reactions induced by vancomycin and vancomycin-associated tubular casts. Concomitant administration with other nephrotoxic antibiotics, such as piperacillin–tazobactam, high vancomycin doses, and intermittent infusion strategies compared to the continuous infusion are associated with a higher risk of VA-AKI. Several biomarkers could be applied to predict and diagnose VA-AKI. To date, no promising therapy is available. Oral steroids could be considered for patients with ATIN, whereas hemodialysis might be applied to remove vancomycin from the patient. In the future, disclosing more promising biomarkers that could precisely identify populations susceptible to VA-AKI and detect VA-AKI occurrence early on, and developing pharmacological agents that could prevent or treat VA-AKI, are the keys to improve the prognoses of patients with severe infection who probably need vancomycin therapy.
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Tan D, Zhao L, Peng W, Wu FH, Zhang GB, Yang B, Huo WQ. Value of urine IL-8, NGAL and KIM-1 for the early diagnosis of acute kidney injury in patients with ureteroscopic lithotripsy related urosepsis. Chin J Traumatol 2022; 25:27-31. [PMID: 34702632 PMCID: PMC8787229 DOI: 10.1016/j.cjtee.2021.10.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 08/31/2021] [Accepted: 09/10/2021] [Indexed: 02/04/2023] Open
Abstract
PURPOSE To investigate the clinical value of urine interleukin-18 (IL-8), neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule-1 (KIM-1) for the early diagnosis of acute kidney injury (AKI) in patients with ureteroscopic lithotripsy (URL) related urosepsis. METHODS A retrospective study was carried out in 157 patients with urosepsis after URL. The patients were divided into AKI group and non-AKI group according to the Kidigo guideline and urine IL-8, NGAL and KIM-1 levels were detected by enzyme-linked immunosorbent assay at 0, 4, 12, 24 and 48 h after the surgery. Receiver operating characteristic curve (ROC) was used to evaluate the diagnostic value of these three biomarkers for postoperative AKI. RESULTS The level of urine IL-8, NGAL and KIM-1 in AKI group was significantly higher than that in non-AKI group at 4, 12, 24 and 48 h (p < 0.01). The ROC analysis showed the combined detection of urine IL-8, NGAL and KIM-1 at 12 h had a larger area under curve (AUC) than a single marker (0.997, 95% CI: 0.991-0.998), and the sensitivity and specificity were 98.2% and 96.7%, respectively. Pearson correlation analysis showed that the levels of urine NGAL at 4, 12, 24 and 48 h in AKI patients were positively correlated with the levels of urine KIM-1 and IL-18 (p < 0.01). CONCLUSION AKI could be quickly recognized by the elevated level of urine IL-8, NGAL and KIM-1 in patients with URL-related urosepsis. Combined detection of the three urine biomarkers at 12 h after surgery had a better diagnostic performance, which may be an important reference for the early diagnosis of AKI.
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García-Estañ J, Vargas F. Editorial for Special Issue-Biomarkers of Renal Disease. Int J Mol Sci 2020; 21:ijms21218077. [PMID: 33138007 PMCID: PMC7662859 DOI: 10.3390/ijms21218077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 10/27/2020] [Indexed: 11/30/2022] Open
Affiliation(s)
- Joaquín García-Estañ
- Departamento de Fisiologia, Facultad de Medicina, IMIB, Universidad de Murcia, 30120 Murcia, Spain
- Correspondence: (J.G.-E.); (F.V.)
| | - Felix Vargas
- Departamento de Fisiologia, Facultad de Medicina, Universidad de Granada, 18071 Granada, Spain
- Correspondence: (J.G.-E.); (F.V.)
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