ROS and kidney disease in the evolution from acute phase to chronic end stage disease: A commentary on “Oxidative signaling in renal epithelium: Critical role of cPLA2 and p38SAPK”

In recent decades, the main pathogenetic mechanisms for maintaining muscle mass and strength have been discovered. Most of the scientific papers on the molecular aspects of the pathogenesis of sarcopenia were focused on the Akt-signaling pathway. The subject of the study were people of elderly and senile age, immobilized patients, patients with CKD 1-4 stages, animals. However, recently more attention has been paid to the role of protein – the mammalian target of rapamycin mTOR. It seems to be a key link in the control of muscle mass and is a promising marker in understanding the mechanisms of the pathogenesis of sarcopenia. Its importance in protein metabolism in patients with end stage kidney disease is not studied and requires further research. The presented scientific review contains information on the role of mTOR and its components – mTORC1 and mTORC2 in maintaining muscle mass and strength in a healthy person and in the formation of sarcopenia in patients with CKD. The general aid of mTORC1 complex is regulation of protein production which is necessary for cell growth and differentiation. mTORC2 complex functions are not enough studied. It is established that it plays important role in such biological processes as cytoskeleton organization, intracellular homeostasis maintaining, so it provides cell resistance and cell survivability in negative external and internal impulses. mTOR protein can be considered as promising molecular marker in diagnostics of protein metabolism early disturbances in patients with CKD and also as additory factor of sarcopenia severity assessment.

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The Potential Role of Catheter-Based Renal Sympathetic Denervation in Chronic and End-Stage Kidney Disease

Journal of Cardiovascular Pharmacology and Therapeutics ◽

10.1177/1074248415624156 ◽

2016 ◽

Vol 21 (4) ◽

pp. 344-352 ◽

Cited By ~ 9

Author(s):

Yusuke Sata ◽

Markus P. Schlaich

Keyword(s):

Blood Pressure ◽

Renal Function ◽

Kidney Disease ◽

End Stage Renal Disease ◽

Renal Denervation ◽

Potential Role ◽

Stage Renal Disease ◽

End Stage ◽

Renal Sympathetic

Sympathetic activation is a hallmark of chronic and end-stage renal disease and adversely affects cardiovascular prognosis. Hypertension is present in the vast majority of these patients and plays a key role in the progressive deterioration of renal function and the high rate of cardiovascular events in this patient cohort. Augmentation of renin release, tubular sodium reabsorption, and renal vascular resistance are direct consequences of efferent renal sympathetic nerve stimulation and the major components of neural regulation of renal function. Renal afferent nerve activity directly influences sympathetic outflow to the kidneys and other highly innervated organs involved in blood pressure control via hypothalamic integration. Renal denervation of the kidney has been shown to reduce blood pressure in many experimental models of hypertension. Targeting the renal nerves directly may therefore be specifically useful in patients with chronic and end-stage renal disease. In this review, we will discuss the potential role of catheter-based renal denervation in patients with impaired kidney function and also reflect on the potential impact on other cardiovascular conditions commonly associated with chronic kidney disease such as heart failure and arrhythmias.

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The Key Role of Epithelial to Mesenchymal Transition (EMT) in Hypertensive Kidney Disease

International Journal of Molecular Sciences ◽

10.3390/ijms20143567 ◽

2019 ◽

Vol 20 (14) ◽

pp. 3567 ◽

Cited By ~ 3

Author(s):

Teresa Seccia ◽

Brasilina Caroccia ◽

Maria Piazza ◽

Gian Paolo Rossi

Keyword(s):

Kidney Disease ◽

Molecular Mechanisms ◽

Epithelial To Mesenchymal Transition ◽

Renal Diseases ◽

Hypertensive Nephropathy ◽

Mesenchymal Transition ◽

Afferent Arterioles ◽

Stage Renal Disease ◽

End Stage

Accumulating evidence indicates that epithelial-to-mesenchymal transition (EMT), originally described as a key process for organ development and metastasis budding in cancer, plays a key role in the development of renal fibrosis in several diseases, including hypertensive nephroangiosclerosis. We herein reviewed the concept of EMT and its role in renal diseases, with particular focus on hypertensive kidney disease, the second leading cause of end-stage renal disease after diabetes mellitus. After discussing the pathophysiology of hypertensive nephropathy, the ‘classic’ view of hypertensive nephrosclerosis entailing hyalinization, and sclerosis of interlobular and afferent arterioles, we examined the changes occurring in the glomerulus and tubulo-interstitium and the studies that investigated the role of EMT and its molecular mechanisms in hypertensive kidney disease. Finally, we examined the reasons why some studies failed to provide solid evidence for renal EMT in hypertension.

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Advocacy for renal replacement therapy: the role of renal registries

Clinical Kidney Journal ◽

10.1093/ckj/sfaa067 ◽

2020 ◽

Vol 13 (5) ◽

pp. 742-744

Author(s):

Cecile Couchoud ◽

Mohamed Benghanem Gharbi

Keyword(s):

Renal Replacement Therapy ◽

Kidney Disease ◽

Replacement Therapy ◽

South African ◽

Limited Resource ◽

Service Planning ◽

End Stage Kidney Disease ◽

End Stage ◽

Resource Environment

Abstract The paper by Jardine et al. reporting results from the South African Renal Registry describes a 2-fold success. First, even in a limited-resource environment, survival of patients on renal replacement therapy (RRT) is favourable. Secondly, this information is available because a few years ago, South African nephrologists started a renal registry. These successes cannot conceal, however, that numerous patients are not offered RRT. Robust health information systems make it possible to define chronic kidney disease and end-stage kidney disease (ESKD) burdens, guide resource allocation, inform service planning and enable policy. Registries can highlight inequitable RRT access and help support advocacy in favour of additional resources for ESKD care.

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Critical Role of Pharmacist in the Management of End-Stage Heart Failure with Mechanical Circulatory Support and Post-Heart Transplant Patients

Journal of Cardiac Failure ◽

10.1016/j.cardfail.2006.08.066 ◽

2006 ◽

Vol 12 (8) ◽

pp. S156

Author(s):

Wada Kyoichi ◽

Komamura Kazuo ◽

Ochi Hiroyuki ◽

Horibe Akemi ◽

Kotake Takesi ◽

...

Keyword(s):

Heart Failure ◽

Heart Transplant ◽

Mechanical Circulatory Support ◽

Critical Role ◽

Circulatory Support ◽

Transplant Patients ◽

End Stage Heart Failure ◽

End Stage

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The Quality of Palliative Sedation in End-Stage Disease: Audit From a Department of Oncology and Haematology

10.21203/rs.3.rs-1047987/v1 ◽

2021 ◽

Author(s):

Saviola Alessia ◽

Schipilliti Francesca Matilde ◽

Isca Chrystel ◽

Massimiliano Salati ◽

Daniele Dini ◽

...

Keyword(s):

Karnofsky Performance Status ◽

Performance Status ◽

Critical Role ◽

Palliative Sedation ◽

University Hospital ◽

Refractory Symptoms ◽

Stage Disease ◽

End Stage ◽

The Impact

Abstract PurposePalliative sedation (PS) plays a critical role to give suffering relief from refractory symptoms at the end of life. Our audit aimed to assess and improve quality of PS at the Department of Oncology and Hematology of University Hospital of Modena, to verify the adherence to international guidelines, the cooperation among members of care team, focusing with attention on family’s perception of this delicate situation. MethodsFrom December 2016 to June 2019, data of patients undergoing PS in the Department were collected by an electronic folder tool, “Sedation Tool” (ST), that recorded clinical and PS informations, D-PaP, Rudkin Score and family’s perception. Results245 patients were enrolled. 82% had a Karnofsky Performance Status 10-20%. The most common cancer types were lung and gastro-intestinal carcinomas (27% and 21% respectively). Refractory symptoms observed were confusion and agitation (76%), dyspnea (39%), pain (15%), delirium (10%), psychological distress (5%). Midazolam was the drug of choice for PS. Most of patients had Rudkin score 5 after 24 hours and 33% had terminal event within a period of 24 hours from the beginning of PS. During PS most of Patient’s relatives reported peacefulness (65%), agitation/impatience in 6% of cases, concern for suffering (16%). ConclusionPS is used in case of worsening general conditions at the end-stage disease to relieve refractory symptoms with dignity. The ST can become a simple instrument to evaluate and improve PS quality, providing more attention on the impact of PS on relatives to then possibly develop new supportive procedures for patients and their families.

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