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Sun R, Gu Q, Zhang X, Zeng R, Chen D, Yao J, Min J. Protective effect of cilostazol on vascular injury in rats with acute ischemic stroke complicated with chronic renal failure. Toxicol Res 2024; 40:189-202. [PMID: 38525134 PMCID: PMC10959867 DOI: 10.1007/s43188-023-00217-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 10/16/2023] [Accepted: 11/05/2023] [Indexed: 03/26/2024] Open
Abstract
Chronic renal failure (CRF) resulting in vascular calcification, which does damage to blood vessels and endothelium, is an independent risk factor for stroke. It has been reported that cilostazol has a protective effect on the focal cerebral ischemic infarct. However, its impact on vascular injury in CRF combined stroke and its molecular protection mechanism have not been investigated. In this study, we carried out the effect of cilostazol on CRF combined stroke rats, and the results confirmed that it improved the neurobehavior, renal function as well as pathologic changes in both the kidney and brain. In addition, the inflammation and oxidative stress factors in the kidney and brain were suppressed. Moreover, the rates of brain edema and infarction were decreased. The injured brain-blood barrier (BBB) was recovered with less Evans blue extravasation and more expressions of zonula occludens-1(ZO-1) and occludin. More cerebral blood flow (CBF) in the ipsilateral hemisphere and more expression of CD31 and vascular endothelial growth factor (VEGF) in brain and kidney were found in the cilostazol group. Furthermore, cell apoptosis and cell autophagy became less, on the contrary, proteins of vascular endothelial growth factor receptor 2 (VEGFR2) after the cilostazol treatment were increased. More importantly, this protective effect is related to the pathway of Janus Kinase (JAK)/signal transducer and activator of transcription 3 (STAT3), mammalian target of rapamycin (mTOR), and the hypoxia inducible factor-1α (HIF-1α). In conclusion, our results confirmed that cilostazol exerted a protective effect on the brain and kidney function, specifically in vascular injury, oxidative stress, cell apoptosis, cell autophagy, and inflammation response in CRF combined with stroke rats which were related to the upregulation of JAK/STAT3/mTOR signal pathway. Supplementary Information The online version contains supplementary material available at 10.1007/s43188-023-00217-w.
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Affiliation(s)
- Ru Sun
- Department of Neurology, the First People’s Hospital of Huzhou, First affiliated Hospital of Huzhou University, Huzhou, China
| | - Qun Gu
- Department of Neurology, the First People’s Hospital of Huzhou, First affiliated Hospital of Huzhou University, Huzhou, China
| | - Xufeng Zhang
- Department of Neurology, the First People’s Hospital of Huzhou, First affiliated Hospital of Huzhou University, Huzhou, China
| | - Ruiqi Zeng
- Department of Neurology, the First People’s Hospital of Huzhou, First affiliated Hospital of Huzhou University, Huzhou, China
| | - Dan Chen
- Department of Neurology, the First People’s Hospital of Huzhou, First affiliated Hospital of Huzhou University, Huzhou, China
| | - Jingjing Yao
- Department of Neurology, the First People’s Hospital of Huzhou, First affiliated Hospital of Huzhou University, Huzhou, China
| | - Jingjing Min
- Department of Neurology, the First People’s Hospital of Huzhou, First affiliated Hospital of Huzhou University, Huzhou, China
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Mei Y, Tong X, Hu Y, Liu W, Wang J, Lv K, Li X, Cao L, Wang Z, Xiao W, Gao X. Comparative pharmacokinetics of six bioactive components of Shen-Wu-Yi-Shen tablets in normal and chronic renal failure rats based on UPLC-TSQ-MS/MS. J Ethnopharmacol 2023; 317:116818. [PMID: 37348793 DOI: 10.1016/j.jep.2023.116818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 06/12/2023] [Accepted: 06/17/2023] [Indexed: 06/24/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Shen-Wu-Yi-Shen tablets (SWYST), a Chinese patent medicine consisting of 12 herbal medicines, was formulated by a famous TCM nephrologist, Zou Yunxiang. It is clinically used to improve the symptoms of nausea, vomiting, poor appetite, dry mouth and throat, and dry stool in patients with chronic renal failure (CRF) accompanied by qi and yin deficiency, dampness, and turbidity. SWYST can reduce urea nitrogen, blood creatinine, and urinary protein loss, and increase the endogenous creatinine clearance rate. However, little is known about its pharmacokinetics. AIM OF STUDY To compare the pharmacokinetics of six bioactive components after oral administration of SWYST in normal and adenine-induced CRF rats. MATERIALS AND METHODS A method based on ultra-performance liquid chromatography coupled with a triple-stage quadrupole mass spectrometer (UPLC-TSQ-MS/MS) was developed and validated to determine the six bioactive compounds (albiflorin, paeoniflorin, plantagoguanidinic acid, rhein, aloe-emodin, and emodin) in rat plasma. Rat plasma samples were prepared using protein precipitation. Chromatography was performed on an Agilent Eclipse Plus C18 column (3.0 × 50 mm, 1.8 μm) using gradient elution with a mobile phase composed of acetonitrile and water containing 0.1% (v/v) formic acid, while detection was achieved by electrospray ionization MS under the multiple selective reaction monitoring modes. After SWYST administration, rat plasma was collected at different time points, and the pharmacokinetic parameters of six analytes were calculated and analyzed based on the measured plasma concentrations. RESULTS The UPLC-TSQ-MS/MS method was fully validated for its satisfactory linearity (r ≥ 0.9913), good precisions (RSD <11.5%), and accuracy (RE: -13.4∼13.1%), as well as acceptable limits in the extraction recoveries, matrix effects, and stability (RSD <15%). In normal rats, the six analytes were rapidly absorbed (Tmax ≤ 2 h), and approximately 80% of their total exposure was eliminated within 10 h. Moreover, in normal rats, the AUC0-t and Cmax of albiflorin, plantagoguanidinic acid, and rhein exhibited linear pharmacokinetics within the dose ranges, while that of paeoniflorin is non-linear. However, in CRF rats, the six analytes exhibited reduced elimination and significantly different AUC or Cmax values. These changes may reflect a decreased renal clearance rate or inhibition of drug-metabolizing enzymes and transporters in the liver and gastrointestinal tract caused by CRF. CONCLUSIONS A sensitive UPLC-TSQ-MS/MS method was validated and used to investigate the pharmacokinetics of SWYST in normal and CRF rats. This is the first study to investigate the pharmacokinetics of SWYST, and our findings elucidate the causes of their different pharmacokinetic behaviors in CRF rats. Furthermore, the results provide useful information to guide further research on the pharmacokinetic-pharmacodynamic correlation and clinical application of SWYST.
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Affiliation(s)
- Yudan Mei
- College of Traditional Chinese Materia Medica, Shenyang Pharmaceutical University, Shenyang, 110016, People's Republic of China
| | - Xiaoyu Tong
- State Key Laboratory of New-tech for Chinese Medicine Pharmaceutical Process, Jiangsu Kanion Pharmaceutical Co., Ltd, Lianyungang, 222047, People's Republic of China; Local Joint Engineering Research Center on the Intelligent Manufacturing of TCM, Jiangsu Kanion Pharmaceutical Co., Ltd, Lianyungang, 222047, People's Republic of China
| | - Yumei Hu
- State Key Laboratory of New-tech for Chinese Medicine Pharmaceutical Process, Jiangsu Kanion Pharmaceutical Co., Ltd, Lianyungang, 222047, People's Republic of China; Local Joint Engineering Research Center on the Intelligent Manufacturing of TCM, Jiangsu Kanion Pharmaceutical Co., Ltd, Lianyungang, 222047, People's Republic of China
| | - Wenjun Liu
- State Key Laboratory of New-tech for Chinese Medicine Pharmaceutical Process, Jiangsu Kanion Pharmaceutical Co., Ltd, Lianyungang, 222047, People's Republic of China; Local Joint Engineering Research Center on the Intelligent Manufacturing of TCM, Jiangsu Kanion Pharmaceutical Co., Ltd, Lianyungang, 222047, People's Republic of China
| | - Jiajia Wang
- State Key Laboratory of New-tech for Chinese Medicine Pharmaceutical Process, Jiangsu Kanion Pharmaceutical Co., Ltd, Lianyungang, 222047, People's Republic of China; Local Joint Engineering Research Center on the Intelligent Manufacturing of TCM, Jiangsu Kanion Pharmaceutical Co., Ltd, Lianyungang, 222047, People's Republic of China
| | - Kaihong Lv
- China Pharmaceutical University, Nanjing, 210009, People's Republic of China
| | - Xu Li
- State Key Laboratory of New-tech for Chinese Medicine Pharmaceutical Process, Jiangsu Kanion Pharmaceutical Co., Ltd, Lianyungang, 222047, People's Republic of China; Local Joint Engineering Research Center on the Intelligent Manufacturing of TCM, Jiangsu Kanion Pharmaceutical Co., Ltd, Lianyungang, 222047, People's Republic of China
| | - Liang Cao
- State Key Laboratory of New-tech for Chinese Medicine Pharmaceutical Process, Jiangsu Kanion Pharmaceutical Co., Ltd, Lianyungang, 222047, People's Republic of China; Local Joint Engineering Research Center on the Intelligent Manufacturing of TCM, Jiangsu Kanion Pharmaceutical Co., Ltd, Lianyungang, 222047, People's Republic of China
| | - Zhenzhong Wang
- State Key Laboratory of New-tech for Chinese Medicine Pharmaceutical Process, Jiangsu Kanion Pharmaceutical Co., Ltd, Lianyungang, 222047, People's Republic of China; Local Joint Engineering Research Center on the Intelligent Manufacturing of TCM, Jiangsu Kanion Pharmaceutical Co., Ltd, Lianyungang, 222047, People's Republic of China
| | - Wei Xiao
- College of Traditional Chinese Materia Medica, Shenyang Pharmaceutical University, Shenyang, 110016, People's Republic of China; State Key Laboratory of New-tech for Chinese Medicine Pharmaceutical Process, Jiangsu Kanion Pharmaceutical Co., Ltd, Lianyungang, 222047, People's Republic of China; Local Joint Engineering Research Center on the Intelligent Manufacturing of TCM, Jiangsu Kanion Pharmaceutical Co., Ltd, Lianyungang, 222047, People's Republic of China.
| | - Xia Gao
- State Key Laboratory of New-tech for Chinese Medicine Pharmaceutical Process, Jiangsu Kanion Pharmaceutical Co., Ltd, Lianyungang, 222047, People's Republic of China; Local Joint Engineering Research Center on the Intelligent Manufacturing of TCM, Jiangsu Kanion Pharmaceutical Co., Ltd, Lianyungang, 222047, People's Republic of China.
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Yang J, Li B, Wang J, Fan W. Puerarin alleviates chronic renal failure-induced pyroptosis in renal tubular epithelial cells by targeting miR-342-3p/TGF-β/SMAD axis. Genes Genomics 2023; 45:1563-1573. [PMID: 37747643 DOI: 10.1007/s13258-023-01448-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 08/28/2023] [Indexed: 09/26/2023]
Abstract
BACKGROUND Chronic renal failure (CRF) is the result of kidney damage. Puerarin is a flavonoid with specific nephroprotective effect, but its effect on CRF needs further research. This study explored the effect of puerarin on CRF and the potential molecular mechanism. METHODS Adenine was used to establish an in vivo CRF model in rats, and rats were intragastrically administered with puerarin at a dose of 400 mg/kg body weight once a day from day 1 to day 28. Hematoxylin and eosin (HE) and Masson staining were used to observe the morphology and fibrosis of kidney tissue. Lipopolysaccharide (LPS) (400 ng/mL)/H2O2 (200 µM) was applied to human kidney 2 (HK-2) cells to construct an in vitro CRF model. Enzyme-linked immunosorbent assay (ELISA) was performed to validate interleukin (IL)-1β and IL-18 levels. Quantitative reverse transcription polymerase chain reaction (RT-qPCR) was performed to detect microRNA (miR)-342-3p levels. Transforming growth factor beta (TGF-β)1, SMAD2, SMAD3, and pyroptosis marker proteins were detected by Western blot. The interaction between miR-342-3p and TGF-β/SMAD was determined by a dual-luciferase reporter gene assay. Cell Counting Kit-8 (CCK-8) assay was utilized to determine cell viability. RESULTS In the CRF model, puerarin alleviated renal injury and fibrosis and reduced creatinine (Cr) and blood urea nitrogen (BUN) levels. At the same time, miR-342-3p was downregulated, while the TGF-β/SMAD axis was activated and levels of IL-1β and IL-18 were increased. After treatment of CRF rats with puerarin, the expression level of miR-342-3p was increased, the TGF-β/SMAD axis was inhibited, and the secretion of IL-1β and IL-18 was decreased. MiR-342-3p directly bound to and negatively regulated the expression of TGF-β1, SMAD2, and SMAD3. In the in vitro CRF model, miR-342-3p inhibited HK-2 cell pyroptosis by inhibiting the TGF-β/SMAD axis. CONCLUSION Puerarin reduced renal injury and pyroptosis in CRF rats by targeting the miR-342-3p/TGF-β/SMAD axis.
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Affiliation(s)
- Jing Yang
- Department of Nephrology, The First Affiliated Hospital of Kunming Medical University, 295 Xichang Road, Wuhua District, Kunming, 650032, China
| | - Baochao Li
- Department of Nephrology, The First Affiliated Hospital of Kunming Medical University, 295 Xichang Road, Wuhua District, Kunming, 650032, China
| | - Jiangming Wang
- Department of Nephrology, The First Affiliated Hospital of Kunming Medical University, 295 Xichang Road, Wuhua District, Kunming, 650032, China
| | - Wenxing Fan
- Department of Nephrology, The First Affiliated Hospital of Kunming Medical University, 295 Xichang Road, Wuhua District, Kunming, 650032, China.
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Zhang W, Li P, Zhou H. Mid-short-term risk factors for chronic renal failure in children with posterior urethral valve. Pediatr Surg Int 2022; 38:1321-1326. [PMID: 35779105 DOI: 10.1007/s00383-022-05154-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/06/2022] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To analyze the mid-short-term risk factors for chronic renal failure (CRF) in children with posterior urethral valve (PUV) after valve ablation. MATERIALS AND METHODS A retrospective study of 143 patients with PUV who underwent operation was performed. Patients were divided into CRF group (n = 39) and non-CRF group (n = 104). Clinical data of both groups such as the first resection age, last resection age, number of operations, the maximal detrusor pressure (Pdetmax), and vesicoureteral reflux (VUR) were collected and analyzed. RESULTS The first resection age, last resection age, and the Pdetmax of patients in the CRF group were higher than those of patients in the non-CRF group (P < 0.05). Multiple regression analysis showed that the indicators related to chronic renal failure were last resection age (β = 1.034, P < 0.05) and Pdetmax (β = 1.068, P < 0.05). The cut-off value of last resection age was 35.5 months, Pdetmax was 41.65 cmH2O. There was positive correlation of final blood creatinine with last resection age and Pdetmax. CONCLUSION The last resection age and Pdetmax are the risk factors of chronic renal failure in children with PUV. A Pdetmax of lower than 41.65 cmH2O indicates a good prognosis of renal function in patients with PUV.
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Affiliation(s)
- Wei Zhang
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, 510515, China.,Department of Urology, Quanzhou First Hospital Affiliated to Fujian Medical University, Quanzhou, 362000, China
| | - Pin Li
- Department of Urology, Bayi Children's Hospital, Affiliated to The Seventh Medical Center of Chinese PLA General Hospital, Beijing, 100700, China
| | - Huixia Zhou
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, 510515, China. .,Department of Urology, Bayi Children's Hospital, Affiliated to The Seventh Medical Center of Chinese PLA General Hospital, Beijing, 100700, China.
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Yang X, Wan JX, Yuan J, Dong R, Da JJ, Sun ZL, Zha Y. Effects of calcitriol on peripheral endothelial progenitor cells and renal renovation in rats with chronic renal failure. J Steroid Biochem Mol Biol 2021; 214:105956. [PMID: 34348182 DOI: 10.1016/j.jsbmb.2021.105956] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 06/20/2021] [Accepted: 07/21/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND The role of calcitriol (1,25-dihydroxyvitamin D3 or 1,25-(OH)2D3) in physiological processes, such as anti-fibrosis, anti-inflammation, and immunoregulation is known; however, its role in the remodeling of the glomerular capillary endothelium in rats with chronic renal failure (CRF) remains unclear. METHODS Here, we analyzed the role/number of endothelial progenitor cells (EPCs), renal function, and pathological alterations in rats with CRF, and compared the results before and after supplementation with calcitriol in vivo. RESULTS Amongst the three experimental groups (sham group, CRF group, and calcitriol-treated group (0.03 μg/kg/d), we observed substantially elevated cell adhesion and vasculogenesis in vivo in the calcitriol-treated group. Additionally, lower levels of serum creatinine (Scr) and blood urea nitrogen (BUN) was recorded in the calcitriol-treated group than the CRF group (p > 0.05). Calcitriol treatment also resulted in an improvement in renal pathological injury. CONCLUSIONS Thus, calcitriol could ameliorate the damage of glomerular arterial structural and renal tubules vascular network integrity, maybe through regulating the number and function of EPCs in the peripheral blood of CRF rats. Treatment with it may improve outcomes in patients with renal insufficiency or combined cardiac insufficiency. Calcitriol could ameliorate CRF-induced renal pathological injury and renal dysfunction by remodeling of the glomerular capillary endothelium, thus, improving the function of glomerular endothelial cells.
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Affiliation(s)
- Xia Yang
- School of Medical, Guizhou University, Guiyang, China; Renal Divisihttp://10.10.23.106:8080/TDXPSLIVEGANG/gateway/elsevierjournal/index.jsp#on, Department of Medicine, Guizhou Provincial People's Hospital, Guiyang, China; NHC Key Laboratory of Pulmonary Immunological People's Hospital, Guiyang, China
| | - Jian-Xin Wan
- The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Jing Yuan
- Renal Divisihttp://10.10.23.106:8080/TDXPSLIVEGANG/gateway/elsevierjournal/index.jsp#on, Department of Medicine, Guizhou Provincial People's Hospital, Guiyang, China; NHC Key Laboratory of Pulmonary Immunological People's Hospital, Guiyang, China
| | - Rong Dong
- School of Medical, Guizhou University, Guiyang, China; NHC Key Laboratory of Pulmonary Immunological People's Hospital, Guiyang, China
| | - Jing-Jing Da
- School of Medical, Guizhou University, Guiyang, China; NHC Key Laboratory of Pulmonary Immunological People's Hospital, Guiyang, China
| | - Zhao-Lin Sun
- School of Medical, Guizhou University, Guiyang, China
| | - Yan Zha
- School of Medical, Guizhou University, Guiyang, China; Renal Divisihttp://10.10.23.106:8080/TDXPSLIVEGANG/gateway/elsevierjournal/index.jsp#on, Department of Medicine, Guizhou Provincial People's Hospital, Guiyang, China; NHC Key Laboratory of Pulmonary Immunological People's Hospital, Guiyang, China.
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Aghamir SMK. Successful retrograde intrarenal surgery (RIRS) for a 2-centimeter stone in a chronic renal failure (CRF) patient. Int J Surg Case Rep 2021; 87:106375. [PMID: 34534812 DOI: 10.1016/j.ijscr.2021.106375] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 08/22/2021] [Accepted: 09/02/2021] [Indexed: 12/23/2022] Open
Abstract
Introduction and importance Retrograde intrarenal surgery (RIRS) is the best complementary method to Flexible Ureterorenoscopy (URF). In the case of renal insufficiency in patients with urolithiasis, the stone treatment strategy can be different because it should have the least injury to the kidney and be minimally invasive. There was no previous evidence of RIRS in stone-breaking in a chronic renal failure (CRF) patient. For the first time, we presented a successful RIRS in the monokidney CRF case with >2 cm stone. Case presentation We have done the RIRS over a 55-year-old monokidney woman. She already has lymphoma, chemotherapy, lithotripsy, right renal nephrostomy, and a left kidney stone removal. She had hydronephrosis with a >2 cm stone in her left kidney. The patient underwent RIRS surgery and Holmium lithotripsy (strength 8 and impact strength 13,000) on pinking layers of stone. Clinical discussion During the RIRS surgery, we put a ureteric stent (the patient already had a double J before), and we fixed the ureteral catheter with the Foley catheter and removed the ureteral catheter 4 days after the surgery. The result of the surgery was satisfying and after three days the patient goes into a stable condition. Conclusion Regarding the least injury to the kidney during RIRS surgery, it can be the best treatment option for urolithiasis in CRF patients. RIRS is the best complementary method to Flexible Ureterorenoscopy (URF). We presented a successful RIRS in the monokidney woman CRF case with >2 cm stone. RIRS surgery can be the best treatment option for urolithiasis in CRF patients.
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Yin S, Zhang J, Hua X, Huang G, Jia B, Liu Y, Ma Y, Su L. Analysis of factors associated with vision after cataract surgery in chronic renal failure patients on dialysis. BMC Ophthalmol 2020; 20:211. [PMID: 32487044 PMCID: PMC7268610 DOI: 10.1186/s12886-020-01479-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Accepted: 05/22/2020] [Indexed: 11/17/2022] Open
Abstract
Background To analyze the related factors of visual acuity after phacoemulsification and intraocular lens implantation in chronic renal failure (CRF) patients. Methods We retrospectively analyzed 42 patients (51 eyes) with CRF (failure, uremia) on hemodialysis or peritoneal dialysis and 40 patients (50 eyes) without CRF as a control group. Each individual underwent physical and laboratory examinations including best corrected visual acuity (BCVA), slit lamp examination, intraocular pressure, corneal endothelial cell count, fundus examination and optical coherence tomography (OCT) for macular examination. The patients with abnormal platelet, liver and kidney function, coagulation function received treatment accordingly to reduce the perioperative risk. All patients underwent phacoemulsification with IOL implantation. Follow-up examinations were performed at 1 week, 1 month and 3 months after surgery and included BCVA, slit lamp examination, noncontact IOP, dilated fundus examination and OCT of the macula. Results In control group the preoperative RBC, HB, Cr, and urea values were not associated with the pre- or postoperative BCVA. The RBC, HB, Cr, urea, SBP, DBP, preoperative BCVA and postoperative BCVA values were all significantly different between CRF and control group(P < 0.05). Conclusion In CRF patients, the RBC, HB, Cr and Urea indexes should be monitored before the cataract operation for guarded visual outcome. The pre-existing ocular comorbidities could significantly compromise the vision. The CRF patients could achieve relatively good visual outcome after cataract surgery when the underlaying diseases are effectively managed.
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Affiliation(s)
- Songtao Yin
- Department of Ophthalmology, The Second Hospital of Tianjin Medical University, 23 Pingjiang street, Tianjin, 300221, China
| | - Jie Zhang
- Department of Ophthalmology, The Second Hospital of Tianjin Medical University, 23 Pingjiang street, Tianjin, 300221, China
| | - Xia Hua
- Department of Ophthalmology, The Second Hospital of Tianjin Medical University, 23 Pingjiang street, Tianjin, 300221, China
| | - Guannan Huang
- Department of Ophthalmology, The Second Hospital of Tianjin Medical University, 23 Pingjiang street, Tianjin, 300221, China
| | - Biyun Jia
- Department of Ophthalmology, The Second Hospital of Tianjin Medical University, 23 Pingjiang street, Tianjin, 300221, China
| | - Yang Liu
- Department of Ophthalmology, The Second Hospital of Tianjin Medical University, 23 Pingjiang street, Tianjin, 300221, China
| | - Yao Ma
- Department of Ophthalmology, The Second Hospital of Tianjin Medical University, 23 Pingjiang street, Tianjin, 300221, China
| | - Long Su
- Department of Ophthalmology, The Second Hospital of Tianjin Medical University, 23 Pingjiang street, Tianjin, 300221, China.
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Ma Z, Yu T, Wu Y, Liu D, Zhang X, Miao X, Xing H, Li G. Nano-lanthanum hydroxide, a novel phosphate binder, for treating hyperphosphatemia: A preclinical study. Biomed Pharmacother 2019; 111:909-916. [PMID: 30841470 DOI: 10.1016/j.biopha.2018.12.107] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 12/14/2018] [Accepted: 12/23/2018] [Indexed: 11/25/2022] Open
Abstract
This study is to determine the pharmacological effects of nano-lanthanum hydroxide (nano-LH) in the treatment of hyperphosphatemia, in comparison with other phosphate binders. Rat models of chronic renal failure and hyperphosphatemia were induced by adenine, which were treated with nano-LH (0.15, 0.10, and 0.05 g/Kg/d), lanthanum carbonate (0.30 g/Kg/d), and normal-size lanthanum hydroxide (0.10 g/Kg/d), respectively. To investigate the therapeutic effects, the serum levels of phosphorus, Scr, Ucr, BUN, UUN, PTH, and other hyperphosphatemia-related biochemical indicators were determined. A novel phosphorus-binding agent, nano-LH, was synthesized herein, which was rod-like particle with the length of 30-50 nm, width of 10-20 nm, and diameter of 5-10 nm. In vitro phosphorus binding experiments showed that nano-LH had better binding rate. Pharmacodynamic experiments confirmed that the therapeutic effects of lanthanum-hydroxide (0.10 g/kg/d) were superior to other existing phosphate binders in rat models of hyperphosphatemia, in lowering the blood phosphate level and improving the renal function. In the term of drug safety, our preliminary results showed that the nano-LH at appropriate dose did not cause death cases in mice, and the serum levels of alkaline phosphatase and lactate dehydrogenase were not significantly changed, indicating good oral safety. Nano-LH has high potency compared with several phosphate binders, which might be a promising therapeutic agent for the treatment of hyperphosphatemia in clinic.
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Affiliation(s)
- Zixing Ma
- Department of Pharmacology, College of Pharmacy, Inner Mongolian Medical University, Jinshan Street, Hohhot 010110, Inner Mongolia Autonomous Region, China
| | - Tengfei Yu
- Department of Pharmacology, College of Pharmacy, Inner Mongolian Medical University, Jinshan Street, Hohhot 010110, Inner Mongolia Autonomous Region, China
| | - Yan Wu
- Department of Pharmacology, College of Pharmacy, Inner Mongolian Medical University, Jinshan Street, Hohhot 010110, Inner Mongolia Autonomous Region, China
| | - Dandan Liu
- Department of Pharmacology, College of Pharmacy, Inner Mongolian Medical University, Jinshan Street, Hohhot 010110, Inner Mongolia Autonomous Region, China
| | - Xiaofei Zhang
- Department of Pharmacology, College of Pharmacy, Inner Mongolian Medical University, Jinshan Street, Hohhot 010110, Inner Mongolia Autonomous Region, China
| | - Xin Miao
- Department of Pharmacology, College of Pharmacy, Inner Mongolian Medical University, Jinshan Street, Hohhot 010110, Inner Mongolia Autonomous Region, China
| | - Haiyan Xing
- Department of Pharmacology, College of Pharmacy, Inner Mongolian Medical University, Jinshan Street, Hohhot 010110, Inner Mongolia Autonomous Region, China
| | - Gang Li
- Department of Pharmacology, College of Pharmacy, Inner Mongolian Medical University, Jinshan Street, Hohhot 010110, Inner Mongolia Autonomous Region, China.
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Kato K, Onodera K, Iwasaki Y, Matsuda M, Kawakami T, Higuchi M, Kato K, Kato Y, Taniguchi M, Furukawa H. Pravastatin-induced rhabdomyolysis and purpura fulminans in a patient with chronic renal failure. Int J Surg Case Rep 2015; 8C:84-7. [PMID: 25644555 PMCID: PMC4353943 DOI: 10.1016/j.ijscr.2015.01.042] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Revised: 01/22/2015] [Accepted: 01/23/2015] [Indexed: 11/28/2022] Open
Abstract
Pravastatin monotherapy is associated with the potentially fatal side effect of rhabdomyolysis in a patient with chronic renal failure. The pathogenesis of purpura fulminans with digital gangrene is unclear and thought to be related to the development of DIC. We report an extremely rare case of pravastatin-induced rhabdomyolysis and purpura fulminans with DIC in a patient with CRF. This is the first report of pravastatin monotherapy resulting in rhabdomyolysis of the multifidus muscle and purpura fulminans with DIC.
Introduction Rhabdomyolysis associated with the use of pravastatin has been demonstrated to be a rare but potentially life-threatening adverse effect of statins. Here, we report a rare case of rhabdomyolysis and purpura fulminans in a patient who had used pravastatin and developed chronic renal failure (CRF) necessitating the initiation of dialysis. Presentation of case We present the case of an 86-year-old man with chronic kidney disease (CKD) treated with dialysis who was admitted with back pain. He was prescribed and took pravastatin for almost 3 years to treat hyperlipidemia. He received hemodialysis therapy 7 times prior to presentation. Laboratory values included a serum creatine concentration of 6.6 mg/dl and a creatinine phosphokinase (CPK) concentration of 2350 IU/L. An abdominal computed tomography scan showed swollen muscles with reduced muscle density and air density in the multifidus muscle. Two days after admission, he had large, tender ecchymotic lesions and purpuric progressive skin necrosis over the back, abdomen, and upper and lower extremities. The patient died 6 days after the initial admission due to disseminated intravascular coagulation (DIC). Based on these findings and the clinical history, a diagnosis of pravastatin-induced rhabdomyolysis and purpura fulminans was made. Discussion The long-term use of statin therapy and the initiation of dialysis therapy due to ESRD, followed by a rapid onset of rhabdomyolysis within 6 days, is indicative of an elevated statin concentration. Conclusion We report an extremely rare case of pravastatin-induced rhabdomyolysis and purpura fulminans with DIC in a patient with CRF.
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Affiliation(s)
- Kazuya Kato
- Department of Surgery, Pippu Clinic, 2-10, 1 cyome Nakamachi, Pippu Town Kamikawa-Gun, Hokkaido, 078-0343, Japan.
| | - Kazuhiko Onodera
- Department of Surgery, Sapporo Hokuyu Hospital, 5-1, 6-6 Higashi-Sappro, Shiroishi-Ku, Sapporo City 003-0006, Japan
| | - Yoshiaki Iwasaki
- Department of Gastroenterology and Hepatology, Okayama University, 2-5-1 Shikata Town, Okayama 700-8558, Japan
| | - Minoru Matsuda
- Department of Surgery, Nihon University, 1-8-13 Surugadai Kanda, Chiyoda-Ku, Tokyo 010-8309, Japan
| | - Takako Kawakami
- Department of Surgery, Pippu Clinic, 2-10, 1 cyome Nakamachi, Pippu Town Kamikawa-Gun, Hokkaido, 078-0343, Japan
| | - Mineko Higuchi
- Department of Surgery, Pippu Clinic, 2-10, 1 cyome Nakamachi, Pippu Town Kamikawa-Gun, Hokkaido, 078-0343, Japan
| | - Kimitaka Kato
- Department of Surgery, Pippu Clinic, 2-10, 1 cyome Nakamachi, Pippu Town Kamikawa-Gun, Hokkaido, 078-0343, Japan
| | - Yurina Kato
- Department of Surgery, Pippu Clinic, 2-10, 1 cyome Nakamachi, Pippu Town Kamikawa-Gun, Hokkaido, 078-0343, Japan
| | - Masahiko Taniguchi
- Department of Surgery, Asahikawa Medical University, 1-1, 2-1 Midorigaoka, Asahikawa City 078-8510, Japan
| | - Hiroyuki Furukawa
- Department of Surgery, Asahikawa Medical University, 1-1, 2-1 Midorigaoka, Asahikawa City 078-8510, Japan
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Abstract
The study was planned as a case-control study to examine the effects of music on some of the complications experienced by chronic renal failure (CRF) patients during hemodialysis. A total of 60 patients (30 intervention and 30 control) diagnosed with end-stage renal failure undergoing hemodialysis treatment participated in this study. The study was conducted in Manisa Merkez Efendi State Hospital Hemodialysis Unit and Manisa Özel Anemon Hemodialysis between April 2012 and July 2012. The intervention group listened 30 minutes in each session (12 total sessions) Turkish art music at the beginning of the third hour of their hemodialysis sessions. Patient Information Form and visual analog scale to assess pain, nausea, vomiting, and cramps during hemodialysis session were used. For the analysis of data, the number, percentage, chi-square test, and significance test of independent group differences between two averages were conducted. According to the findings of the study, the average of the intervention and control group ages, respectively, was 50.86 ± 11.3 and 55.13 ± 9.68. The primary duration of hemodialysis treatment for both intervention and control groups was "1 year and above" (70.0%). The intervention group's pain and nausea scores were lower than the control group for all 12 sessions. The difference between the intervention and the control group's pain scores was significant (P < 0.05). However, in pain scores from the first session to 12th session, continuous decreasing trend was not observed. According to the results, music can be used as an independent nursing practice for reduction of complications for CRF patients receiving hemodialysis treatment.
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Meena RS, Aseri Y, Singh BK, Verma PC. Hearing loss in patients of chronic renal failure: a study of 100 cases. Indian J Otolaryngol Head Neck Surg 2011; 64:356-9. [PMID: 24294578 DOI: 10.1007/s12070-011-0405-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2011] [Accepted: 11/24/2011] [Indexed: 12/01/2022] Open
Abstract
The purpose of our study was to determine the incidence of hearing loss and to describe the hearing impairment and the possible contributing factors, responsible for sensori neural hearing loss in chronic renal failure (CRF) patients. This was a prospective study carried out on 50 cases of CRF attending otorhinolaryngological services for hearing disturbance and on 50 healthy volunteers for control study, having the same inclusion criteria except (does not suffering with CRF) having normal renal function tests. These volunteers attended the ENT OPD, for oto-rhino-laryngological services but not for hearing problems. 14 (28%) out of 50 cases of CRF had sensori neural hearing loss of moderate to severe degree in the high frequency range which was bilateral and symmetrical, while in control group the incidence of sensorineural hearing loss was only 6%.
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Affiliation(s)
- Rakesh Singh Meena
- Jawahar Lal Nehru MedicalCollege, B 534, Panchsheel Nagar, Makadwali Road, Ajmer, Rajasthan India ; A.G. Hospitals, Ajmer, Rajasthan India
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