Alteration of glycosylation in serum proteins: a new potential indicator to distinguish non-diabetic renal diseases from diabetic nephropathy

Abstract Background Disaster-related stress can increase blood pressure and the incidence of cardiovascular diseases. However, the role of massive disasters in the development of end-stage kidney disease (ESKD) remains unknown. We investigated the incidence and different causes of dialysis initiation in patients with chronic kidney disease in a city affected by the Great East Japan Earthquake. Methods This was a single-center, retrospective observational study. All patients who initiated or were treated with dialysis at Kesennuma City Hospital between 2007 and 2020 were enrolled. The year of dialysis initiation was retrospectively determined based on the initiation date. The causative renal diseases that led to the need for dialysis initiation were divided into four groups: diabetic nephropathy, hypertensive renal disease, glomerulonephritis, and others. Results Age at dialysis initiation differed significantly among the four groups (p = 0.0262). There was a significant difference in the numbers of the four groups before and after the Great East Japan Earthquake (p = 0.0193). The age of hypertensive renal disease patients was significantly higher than those of patients with diabetic nephropathy (p = 0.0070) and glomerulonephritis (p = 0.0386) after the disaster. The increasing number of dialysis initiations after the Great East Japan Earthquake appeared to be associated with changes in hypertensive renal diseases; the number peaked after 10 years. Conclusions There was an increase in the number of dialysis initiations, especially caused by hypertensive renal diseases, for up to 10 years after the Great East Japan Earthquake. Graphic abstract

Download Full-text

Frequency of Renal Diseases in Diabetic Patients

Pakistan BioMedical Journal ◽

10.52229/pbmj.v2i1.29 ◽

2019 ◽

Vol 2 (1) ◽

Author(s):

Misbah Arshad ◽

Mamoona Ashfaq ◽

Zainab Sharmeen ◽

Zargham Mazhar ◽

Kashifa Ehsan

Keyword(s):

Diabetes Mellitus ◽

Diabetic Nephropathy ◽

Kidney Disease ◽

Renal Disease ◽

Age Groups ◽

Cross Sectional Study ◽

Renal Diseases ◽

Diabetic Patients ◽

Protein Loss ◽

Cross Sectional

Diabetic nephropathy, also known as diabetic kidney disease is the chronic loss of kidneyfunction occurring in those with diabetes mellitus. Diabetic nephropathy is one of the leading causes ofchronic kidney disease (CKD) and end-stage renal disease (ESRD) globally. Protein loss in the urine due todamage to the glomeruli may become massive, and cause a low serum albumin with resulting generalizedbody swelling (edema) and result in the nephrotic syndrome. Objective: The aim of this study was todetermine the frequency of renal disease in diabetic patients and its complications in Pakistan.Methods: A cross sectional study was conducted at Renal and Diabetic Departments of the Sir GangaRam Hospital, Lahore, over a period of 3 months, after obtaining the ethical approval from The Universityof Lahore. A total number of 100 Diabetic patients were selected through non probability convenientsampling technique. Patients of both sexes and all age groups were included. Results: In this study 60%were male and 40% were female. About 41% diabetic patients were 1-6 month of age, 42% were 1-5 yearsold and 1% of 18-23 years old who had renal diseases while 9% patients were without any renal disease.whereas the prevalence of diabetes is more in infants than others which is 35%. But there was notsignificant association between onset of renal diseases with the onset of diabetes mellitus with p-value0.24.Conclusions: Results of current study showed that diabetes mellitus effecting individuals of all agesequally but there was not significant association between diabetes and renal diseases.

Download Full-text

Plasma D Dimer: A Useful Marker of Fibrin Breakdown in Renal Failure

Thrombosis and Haemostasis ◽

10.1055/s-0038-1646627 ◽

1989 ◽

Vol 61 (03) ◽

pp. 522-525 ◽

Cited By ~ 32

Author(s):

M P Gordge ◽

R W Faint ◽

P B Rylance ◽

H Ireland ◽

D A Lane ◽

...

Keyword(s):

Renal Failure ◽

Renal Function ◽

Acute Renal Failure ◽

Monoclonal Antibodies ◽

Diabetic Nephropathy ◽

Renal Disease ◽

Plasma Concentrations ◽

Significant Negative Correlation ◽

Healthy Controls ◽

D Dimer

SummaryD dimer and other large fragments produced during the breakdown of crosslinked fibrin may be measured by enzyme immunoassay using monoclonal antibodies. In 91 patients with renal disease and varying degrees of renal dysfunction, plasma D dimer showed no correlation with renal function, whereas FgE antigen, a fibrinogen derivative which is known to be cleared in part by the kidney, showed a significant negative correlation with creatinine clearance. Plasma concentrations of D dimer were, however, increased in patients with chronic renal failure (244 ± 3l ng/ml) (mean ± SEM) and diabetic nephropathy (308 ± 74 ng/ml), when compared with healthy controls (96 ± 13 ng/ml), and grossly elevated in patients with acute renal failure (2,451 ± 1,007 ng/ml). The results indicate an increase in fibrin formation and lysis, and not simply reduced elimination of D dimer by the kidneys, and are further evidence of activated coagulation in renal disease. D dimer appears to be a useful marker of fibrin breakdown in renal failure.

Download Full-text

PGNMID in a patient with diabetes mellitus

Journal of Onco-Nephrology ◽

10.1177/2399369320984782 ◽

2021 ◽

pp. 239936932098478

Author(s):

Joana Marques ◽

Patrícia Cotovio ◽

Mário Góis ◽

Helena Sousa ◽

Fernando Nolasco

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Diabetic Nephropathy ◽

Renal Disease ◽

Renal Involvement ◽

Organ Damage ◽

Therapeutic Implications ◽

Stage Renal Disease

Diabetic nephropathy is a well known complication of diabetes mellitus and the leader cause of end -stage renal disease worldwide. Nonetheless, other forms of renal involvement can occur in diabetic population. Since it has prognostic and therapeutic implications, differentiating non-diabetic renal disease from diabetic nephropathy is of great importance. We report an 80-year-old man with well-controlled type 2 diabetes mellitus and hypertension, who presented with rapid deterioration of renal function, nephrotic proteinuria, microscopic hematuria and leukocyturia. The atypical clinical presentation prompted us to perform a kidney biopsy. A diagnosis of proliferative glomerulonephritis with monoclonal immunoglobulin deposits (light chain only variant) was made, with however some chronic histological aspects which made us took a conservative therapeutic attitude. We emphasize that other causes of chronic proteinuric kidney disease should be considered in patients with type 2 diabetes mellitus, based on clinical suspicion, absence of other organ damage and mostly if an atypical presentation is seen. We review the spectrum of monoclonal gammopathies of renal significance, focusing on this rare and newly describe entity.

Download Full-text

Lifetime risk of cardiovascular-renal disease in type 2 diabetes: a population-based study in 473399 individuals

European Heart Journal ◽

10.1093/ehjci/ehaa946.3313 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

R Zhang ◽

J Mamza ◽

T Morris ◽

G Godfrey ◽

F Asselbergs ◽

...

Keyword(s):

Type 2 Diabetes ◽

Renal Disease ◽

Population Based ◽

Lifetime Risk ◽

Disease Stage ◽

Renal Diseases ◽

Funding Source ◽

Private Company ◽

Risk Of Death

Abstract Background Lifetime risks of cardiovascular (CV) and renal diseases are high, particularly in type 2 diabetes (T2D), but rarely studied together, and relative disease contributions are unknown. Knowledge of lifetime risk of cardiovascular-renal disease (CVRD) will better reflect disease burden in T2D. Purpose To investigate the lifetime risks (LTRs) of composite and individual components of major adverse reno-cardiovascular events, MARCE in T2D patients. Method In a population-based cohort study using national electronic health records, we studied 473399 individuals aged 45–99 years with T2D in England 2007–2018. The LTR of composite and individual components of MARCE (including CV death and CVRD: heart failure, HF; chronic kidney disease stage 3 and above, CKD; myocardial infarction, MI; stroke or peripheral artery disease, PAD) were estimated. LTRs by baseline CVRD comorbidity status were compared with individuals free from CVRD at baseline, accounting for the competing risk of death. Results Among T2D patients aged ≥45 years, the LTR of MARCE was 80% for individuals free from CVRD at baseline. LTR of MARCE was 97%, 93%, 98%, 89% and 91% for individuals with specific CVRD comorbidities for HF, CKD, MI, stroke and PAD, respectively at baseline. Within the CVRD-free cohort, LTR of CKD was highest at 54%, followed by CV death (41%), HF (29%), stroke (20%), MI (19%) and PAD (9%). Compared to CVRD-free, HF, MI and CKD at baseline were associated with the highest LTR of MARCE and its component diseases (Table). Conclusion The lifetime risk of CV disease and CKD in T2D patients is estimated to be over 60% and 50% respectively (1–3). When considered together, the LTR of MARCE is 80% in CVRD-free T2D patients, while nearly all those with T2D and HF will develop MARCE over their lifetime. Of the individual components of MARCE, LTR of CKD and HF were the highest among CVRD-free T2D patients. Preventive measures in T2D patients should be a priority in clinical practice to mitigate the burden of these complications. Funding Acknowledgement Type of funding source: Private company. Main funding source(s): AstraZeneca

Download Full-text

Diabetic kidney disease in thedb/dbmouse

AJP Renal Physiology ◽

10.1152/ajprenal.00315.2002 ◽

2003 ◽

Vol 284 (6) ◽

pp. F1138-F1144 ◽

Cited By ~ 267

Author(s):

Kumar Sharma ◽

Peter McCue ◽

Stephen R. Dunn

Keyword(s):

Diabetic Nephropathy ◽

Kidney Disease ◽

Mouse Model ◽

Renal Disease ◽

Mouse Models ◽

Diabetic Kidney Disease ◽

Diabetic Kidney ◽

Matrix Expansion ◽

Stage Renal Disease ◽

End Stage

Diabetic nephropathy is increasing in incidence and is now the number one cause of end-stage renal disease in the industrialized world. To gain insight into the genetic susceptibility and pathophysiology of diabetic nephropathy, an appropriate mouse model of diabetic nephropathy would be critical. A large number of mouse models of diabetes have been identified and their kidney disease characterized to various degrees. Perhaps the best characterized and most intensively investigated model is the db/ db mouse. Because this model appears to exhibit the most consistent and robust increase in albuminuria and mesangial matrix expansion, it has been used as a model of progressive diabetic renal disease. In this review, we present the findings from various studies on the renal pathology of the db/ db mouse model of diabetes in the context of human diabetic nephropathy. Furthermore, we discuss shortfalls of assessing functional renal disease in mouse models of diabetic kidney disease.

Download Full-text

Obstructive nephropathy and renal fibrosis

AJP Renal Physiology ◽

10.1152/ajprenal.00362.2001 ◽

2002 ◽

Vol 283 (5) ◽

pp. F861-F875 ◽

Cited By ~ 367

Author(s):

Saulo Klahr ◽

Jeremiah Morrissey

Keyword(s):

Renal Disease ◽

Renal Fibrosis ◽

Interstitial Fibrosis ◽

Rodent Model ◽

Renal Diseases ◽

Obstructive Nephropathy ◽

Therapeutic Approaches ◽

Cellular Events ◽

The Impact ◽

Made In

Interstitial fibrosis has a major role in the progression of renal diseases. Several animal models are available for the study of renal fibrosis. The models of aminonucleoside-induced nephrotic syndrome, cyclosporin nephrotoxicity, and passive Heyman nephritis are characterized by molecular and cellular events similar to those that occur in obstructive nephropathy. Additionally, inhibition of angiotensin-converting enzyme exerts salutary effects on the progression of renal fibrosis in obstructive nephropathy. Unilateral ureteral obstruction (UUO) has emerged as an important model for the study of the mechanisms of renal fibrosis and also for the evaluation of the impact of potential therapeutic approaches to ameliorate renal disease. Many quantifiable pathophysiological events occur over the span of 1 wk of UUO, making this an attractive model for study. This paper reviews some of the ongoing studies that utilized a rodent model of UUO. Some of the findings of the animal model have been compared with observations made in patients with obstructive nephropathy. Most of the evidence suggests that the rodent model of UUO is reflective of human renal disease processes.

Download Full-text

PERCUTANEOUS RENAL BIOPSY IN CHILDREN

PEDIATRICS ◽

10.1542/peds.30.2.287 ◽

1962 ◽

Vol 30 (2) ◽

pp. 287-296

Author(s):

W. F. Dodge ◽

C. W. Daeschner ◽

J. C. Brennan ◽

H. S. Rosenberg ◽

L. B. Travis ◽

...

Keyword(s):

Renal Disease ◽

Renal Biopsy ◽

Clinical Importance ◽

Renal Diseases ◽

Renal Lesion ◽

Bleeding Tendency ◽

Percutaneous Renal Biopsy ◽

The One ◽

Selection Of

Since 1951, when the percutaneous renal biopsy was introduced as an adjunctive method for study of patients with renal disease, reports of some 4,000 kidney biopsies have appeared in the literature. Only about 250 of these, however, have been performed in children. A biopsy specimen containing 5 to 10 glomeruli has been reported to be adequate for interpretation and to be representative of the total renal parenchyma in 84% of the cases with diffuse renal disease. Using a biopsy technique similar to that described by Kark, we have obtained an adequate specimen in 92% of 205 kidney biopsies performed in 168 children with diffuse renal diseases. Seven deaths have been previously reported in the literature. The circumstances surrounding the death of these seven patients and of the one death that occurred in our series are described. Perirenal hematoma has had a reported incidence of 0.4%. It has been our experience, as well as that of the other investigators, that if blood boss is replaced, the patient has an otherwise uneventful course and the mass subsequently disappears. Gross hematuria has had a reported incidence of 5.2%. Microscopic hematuria, lasting for 6 to 12 hours after biopsy, has been found to be the rule rather than the exception. The complications which have occurred have been associated with bleeding, and therefore a careful history concerning bleeding tendency and a study of the clotting mechanism is essential if the risk of needle renal biopsy is to be minimized. In addition to a bleeding tendency or defect in clotting mechanism, most investigators are agreed that the presence of only one kidney or an uncooperative patient are absolute contraindications to renal biopsy. The renal biopsy is primarily, at present, an additional and most useful investigative tool in the elucidation of the pathogenesis, natural history (by serial studies) and effectiveness of specific therapy upon the various renal diseases. It is of practical clinical importance in the selection of those patients with the nephrotic syndrome in whom glucocorticoid therapy is likely to be beneficial or the patient with anuria whose renal lesion is probably reversible with time; and, as a guide to the effectiveness of therapy in patients with pyelonephritis or lupus nephritis. It is not a technique that can be recommended for general or casual use. A classification of the pathohistobogic findings of diffuse glomerulonephritis, patterned after Ellis, is presented and discussed. This classification will be used in the description and discussion of various renal diseases and systemic diseases with associated nephritis in the three subsequent papers.

Download Full-text

Diabetic Nephropathy: Mechanisms of Renal Disease Progression

Experimental Biology and Medicine ◽

10.3181/0705-mr-134 ◽

2008 ◽

Vol 233 (1) ◽

pp. 4-11 ◽

Cited By ~ 377

Author(s):

Yashpal S. Kanwar ◽

Jun Wada ◽

Lin Sun ◽

Ping Xie ◽

Elisabeth I. Wallner ◽

...

Keyword(s):

Diabetic Nephropathy ◽

Renal Disease ◽

Disease Progression ◽

Renal Disease Progression

Download Full-text

The Complexity and Heterogeneity of Monoclonal Immunoglobulin–Associated Renal Diseases

Journal of the American Society of Nephrology ◽

10.1681/asn.2017121319 ◽

2018 ◽

Vol 29 (7) ◽

pp. 1810-1823 ◽

Cited By ~ 45

Author(s):

Sanjeev Sethi ◽

S. Vincent Rajkumar ◽

Vivette D. D’Agati

Keyword(s):

Renal Disease ◽

B Cell ◽

B Lymphocytes ◽

Plasma Cells ◽

Hematologic Malignancy ◽

Organ Damage ◽

Renal Tissue ◽

Renal Diseases ◽

Malignant Neoplasms ◽

Cast Nephropathy

Monoclonal gammopathies are characterized by the overproduction of monoclonal Ig (MIg) detectable in the serum or urine resulting from a clonal proliferation of plasma cells or B lymphocytes. The underlying hematologic conditions range from malignant neoplasms of plasma cells or B lymphocytes, including multiple myeloma and B-cell lymphoproliferative disorders, to nonmalignant small clonal proliferations. The term MGUS implies presence of an MIg in the setting of a “benign” hematologic condition without renal or other end organ damage. The term MGRS was recently introduced to indicate monoclonal gammopathy with MIg-associated renal disease in the absence of hematologic malignancy. Most MIg-associated renal diseases result from the direct deposition of nephrotoxic MIg or its light- or heavy-chain fragments in various renal tissue compartments. Immunofluorescence microscopy is essential to identify the offending MIg and define its tissue distribution. Mass spectrometry is helpful in difficult cases. Conditions caused by direct tissue deposition of MIg include common disorders, such as cast nephropathy, amyloidosis, and MIg deposition diseases, as well as uncommon disorders, such as immunotactoid glomerulopathy, proliferative GN with MIg deposits, light-chain proximal tubulopathy, and the rare entities of crystal-storing histiocytosis and crystalglobulinemia. Indirect mechanisms of MIg-induced renal disease can cause C3 glomerulopathy or thrombotic microangiopathy without tissue MIg deposits. Treatment of MIg-associated renal disease is aimed at eliminating the clonal plasma cell or B-cell population as appropriate. Both the renal and the underlying hematologic disorders influence the management and prognosis of MIg-associated renal diseases.

Download Full-text