Immunity

2015 ◽  
Author(s):  
Behdad Afzali ◽  
Claudia Kemper
Keyword(s):  
Chronic Kidney Disease ◽  
Immune System ◽  
Kidney Disease ◽  
Causes Of Death ◽  
Immune Responsiveness ◽  
Pregnancy Failure ◽  
Acquired Immunodeficiency ◽  
Underlying Mechanisms ◽  
Almost All ◽  
Fetal Antigens

Immunological health relies on a balance between immune responsiveness to foreign pathogens and tolerance to self-components, commensals, food-derived components, and semi-allogeneic fetal antigens. Disruptions of this balance are hallmarks of immunodeficiency diseases, autoimmune diseases, and pregnancy failure. Patients with chronic kidney disease are immunologically unique in demonstrating features of both chronic inflammation and acquired immunodeficiency—predisposing these individuals to the two commonest causes of death, namely cardiovascular disease and sepsis. Defects and abnormalities in almost all components of the immune system can be observed, although it is difficult to say whether the observations denote mechanism or effect. This chapter reviews, briefly, measurable immune system abnormalities in chronic kidney disease and some of the potential underlying mechanisms.

Characteris Tics and Causes of Immune Dysfunction Related to Uremia and Dialysis

2008 ◽  
Vol 28 (3_suppl) ◽  
pp. 183-187 ◽  
Author(s):  
Aline Borsato Hauser ◽  
Andréa E. M. Stinghen ◽  
Sawako Kato ◽  
Sérgio Bucharles ◽  
Carlos Aita ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Immune Response ◽  
Immune System ◽  
Kidney Disease ◽  
Adaptive Systems ◽  
Causes Of Death ◽  
Immune Dysfunction ◽  
The Other ◽  
Tissue Degeneration ◽  
Pathologic Processes

From the immunologic viewpoint, chronic kidney disease (CKD) is characterized by disorders of both the innate and adaptive systems, generating a complex and still not fully understood immune dysfunction. Markers of a chronically activated immune system are closely linked to several complications of CKD and represent powerful predictors for mortality in the CKD population. On the other hand, CKD patients respond poorly to vaccination and to challenges such as bacterial infection. Interestingly, the main causes of death in patients with CKD are cardiovascular and infectious diseases, both being pathologic processes closely linked to immune function. Therefore, accelerated tissue degeneration (as a consequence of chronic inflammation) and increased rate of sepsis (because of a poorly orchestrated immune response) represent the most important targets for interventions aiming to reduce mortality in CKD patients. Understanding the mechanisms behind the immune dysfunction that is peculiar to CKD generates a perspective to improve outcomes in this group of patients.

Does Vitamin K Intake Influence High Phosphate Induced Vascular Pseudo-ossification: An Underappreciated Therapeutic Prospect in General Population?

2019 ◽  
Vol 20 (4) ◽  
pp. 421-430
Author(s):  
Zar Chi Thent ◽  
Gabriele R.A. Froemming ◽  
Suhaila Abd Muid
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Vascular Calcification ◽  
Vitamin K ◽  
Prolonged Exposure ◽  
Vascular Complication ◽  
Key Factors ◽  
The Matrix ◽  
Underlying Mechanisms ◽  
High Phosphate

Increasing interest in vascular pseudo-ossification has alarmed the modern atherosclerotic society. High phosphate is one of the key factors in vascular pseudo ossification, also known as vascular calcification. The active process of deposition of the phosphate crystals in vascular tissues results in arterial stiffness. High phosphate condition is mainly observed in chronic kidney disease patients. However, prolonged exposure with high phosphate enriched foods such as canned drinks, dietary foods, etc. can be considered as modifiable risk factors for vascular complication in a population regardless of chronic kidney disease. High intake of vitamin K regulates the vascular calcification by exerting its anti-calcification effect. The changes in serum phosphate and vitamin K levels in a normal individual with high phosphate intake are not well investigated. This review summarised the underlying mechanisms of high phosphate induced vascular pseudo ossification such as vascular transdifferentiation, vascular apoptosis and phosphate uptake by sodium-dependent co-transporters. Pubmed, Science Direct, Scopus, ISI Web of Knowledge and Google Scholar were searched using the terms ‘vitamin K’, ‘vascular calcification, ‘phosphate’, ‘transdifferentiation’ and ‘vascular pseudoossification’. Vitamin K certainly activates the matrix GIA protein and inhibits vascular transition and apoptosis in vascular pseudo-ossification. The present view highlighted the possible therapeutic linkage between vitamin K and the disease. Understanding the role of vitamin K will be considered as potent prophylaxis agent against the vascular disease in near future.

Abstract 109: Gamma-adducin Effects on Microvascular Function- a Common Link of Hypertension Induced Chronic Kidney Disease and Cognitive Impairments

Hypertension ◽  
2017 ◽  
Vol 70 (suppl_1) ◽  
Author(s):  
Fan Fan ◽  
Shaoxun Wang ◽  
Paige N Mims ◽  
Chao Zhang ◽  
Richard J Roman
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Genetic Model ◽  
Cognitive Impairments ◽  
Microvascular Dysfunction ◽  
Small Region ◽  
Glomerular Injury ◽  
Flow Pressure ◽  
Underlying Mechanisms ◽  
Stop Flow

Chronic kidney disease (CKD) and cognitive impairments are common complications of hypertension. Increasing evidence suggests that the cognitive impairments associated with CKD may be related to microvascular dysfunction, however, the underlying mechanisms remain to be elucidated. FHH is a genetic model of hypertension-induced nephropathy. We found that the myogenic response and autoregulation of the renal and cerebral circulation is impaired in FHH rats, and was restored in a FHH.1 BN congenic strain in which a small region of Chr. 1 containing 15 genes, including Add3, from BN rats was transferred into the FHH background. The present study examined whether Add3 contributes to hypertension related CKD, and is associated with the development of cognitive impairments due to microvascular dysfunction. FHH rats exhibited impaired autoregulation of RBF in comparison with FHH.1 BN rats. Pgc estimated from the stop flow pressure increased by 20 mmHg in FHH rats when RPP was increased from 100 to 140 mmHg versus only 4 mmHg in FHH.1 BN . FHH rats developed severe renal injury, and proteinuria rose from 37 ± 2 to 260 ± 32 mg/day as they aged from 12 to 21 weeks, but rose by a significant lesser extent in FHH.1 BN and FHH.Add3 rats. Glomerular injury scores were 3.31 ± 0.01, 2.54 ± 0.01 and 2.50 ± 0.03, and areas of fibrosis in renal cortex were 23.57 ± 1.04%, 8.28 ± 0.33 and 4.71 ± 0.3 in DOCA/salt induced hypertensive FHH, FHH.1 BN and FHH.Add3 rats, respectively. CBF rose by 99 ± 7%, 64 ± 5% and 42 ± 4% in FHH, FHH.1 BN and FHH.Add3 rats, respectively, when MAP was increased from 100 to 190 mmHg, demonstrating impaired autoregulation of CBF in FHH rats was partially rescued with the replacement of wildtype Add3. BBB leakage was greater in FHH rats than in FHH.1 BN and FHH.Add3 rats, and hypertensive FHH rats exhibited marked neurodegeneration and vascular remodeling of the neocortex and hippocampus. The hypertensive FHH rats took 2.5 times longer time to escape from an eight-arm water maze in comparison to FHH.1 BN rats suggesting cognitive deficit. These results indicate that Add3 may play a role in the development of hypertension related CKD and cognitive impairments in FHH rats associated with microvascular dysfunction.

scholarly journals Gambaran Anemia pada Subjek Penyakit Ginjal Kronik Stadium 4 dan 5 di Poliklinik Ginjal-Hipertensi RSUP Prof. Dr. R. D. Kandou

e-CliniC ◽  
2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Yordhan Tamsil ◽  
Emma Sy. Moeis ◽  
Frans Wantania
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Medical Records ◽  
Iron Status ◽  
Descriptive Study ◽  
Transfusion Therapy ◽  
Female Age ◽  
Stage 4 ◽  
Almost All ◽  
Age Range

Abstract: Anemia is a complication of chronic kidney disease (CKD) that often occurs. Moreover, it can occur earlier than other complications of CKD in almost all patients with late stage kidney disease. This study was aimed to obtain the profile of anemia in subjects with stage 4 and 5 of chronic kidney disease. This was a retrospective and descriptive study using medical records of patients with CKD associated with anemia for two years. The results showed that of 428 CKD patients, 131 suffered from anemia (30.60%). The majority of patients were female (54.19%), age range 60-69 years (44.27%), non-dialysis stage 5 of CKD patients (74.04%), had sufficient iron status (79.38%). However, 15,26% of the 131 patients got blood transfusion therapy. In conclusion, the majority of CKD patients were stage 5 ND, female, age range of 60-69 years, had sufficient iron status, and were not treated with blood transfusion.Keywords: chronic kidney disease, anemia Abstrak: Anemia merupakan komplikasi penyakit ginjal kronik (PGK) yang sering terjadi, bahkan dapat terjadi lebih awal dibandingkan komplikasi PGK lainnya dan hampir pada semua pasien penyakit ginjal tahap akhir. Penelitian ini bertujuan untuk mengetahui gambaran anemia pada subyek penyakit ginjal kronik stadium 4 dan 5 di Poliklinik Ginjal-Hipertensi RSUP Prof. Dr. R. D. Kandou. Jenis penelitian ialah metode deskriptif retroskpektif dengan mengunakan data rekam medik pasien PGK dengan anemia selama dua tahun. Hasil penelitian memperlihatkan dari 428 pasien PGK didapatkan 131 pasien dengan anemia pada PGK (30,60%). Mayoritas pasien ialah jenis kelamin perempuan (54,19%), usia 60-69 tahun (44,27%), dan PGK derajat 5 non-dialisis (74,04%), memiliki status besi cukup (79,38%). Terdapat 15,26% dari pasien yang mendapatkan terapi transfusi darah. Simpulan penelitian ini ialah pasien terbanyak dengan derajat 5 ND, jenis kelamin perempuan, rentang usia 60-69 tahun, dengan status besi cukup, dan tidak mendapat terapi transfusi darah.Kata kunci: penyakit ginjal kronik, anemia

Quality of Life and Stressors in Patients with Chronic Kidney Disease Depending on Treatment

2015 ◽  
Vol 18 ◽  
Author(s):  
Sonia Martínez-Sanchis ◽  
M. Consuelo Bernal ◽  
José V. Montagud ◽  
Anna Abad ◽  
Josep Crespo ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Sleep Disturbances ◽  
Well Being ◽  
Total Quality ◽  
Transplant Patients ◽  
Dialysis Vintage ◽  
Almost All

AbstractThis study evaluated health-related quality of life (HRQOL) in a Spanish sample of chronic kidney disease patients (n= 90) undergoing different renal replacement therapies, considering the influence of treatment stressors, mood, anxiety and quality of sleep. While all patients had worse physical functioning than controls (p< .01), only those undergoing haemodialysis (HD) showed worse physical well-being, occupational functioning, spiritual fulfillment and more health interference with work (p< .05). They also obtained higher depression scores than renal transplant patients (TX) (p= .005). Those TX receiving the immunosuppressor sirolimus exhibited more cardiac/renal, cognitive and physical limitations than the rest (p< .05). Dialysis vintage correlated positively with sleep disturbances and depression scores and negatively with total Quality of Life (QLI) (p< .05). HD patients experienced more psychological distress than peritoneal dialysis patients (PD) (p= .036). Regression models including sleep, anxiety and depression were estimated for subscales of HRQOL. In TX patients, low depressive scores related to an optimal QLI in almost all subscales, while in HD patients they explained part of the variability in psychological well-being, interpersonal functioning and personal fulfillment. HD condition results in a QLI more distant to the standards of controls.

scholarly journals Shedding of Klotho: Functional Implications in Chronic Kidney Disease and Associated Vascular Disease

2021 ◽  
Vol 7 ◽  
Author(s):  
Valeria Saar-Kovrov ◽  
Marjo M. P. C. Donners ◽  
Emiel P. C. van der Vorst
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Vascular Function ◽  
Transmembrane Protein ◽  
Protein A ◽  
Cardiovascular Complications ◽  
Soluble Form ◽  
Functional Implications ◽  
Membrane Bound ◽  
Underlying Mechanisms

α-Klotho (Klotho) exists in two different forms, a membrane-bound and soluble form, which are highly expressed in the kidney. Both forms play an important role in various physiological and pathophysiological processes. Recently, it has been identified that soluble Klotho arises exclusively from shedding or proteolytic cleavage. In this review, we will highlight the mechanisms underlying the shedding of Klotho and the functional effects of soluble Klotho, especially in CKD and the associated cardiovascular complications. Klotho can be cleaved by a process called shedding, releasing the ectodomain of the transmembrane protein. A disintegrin and metalloproteases ADAM10 and ADAM17 have been demonstrated to be mainly responsible for this shedding, resulting in either full-length fragments or sub-fragments called KL1 and KL2. Reduced levels of soluble Klotho have been associated with kidney disease, especially chronic kidney disease (CKD). In line with a protective effect of soluble Klotho in vascular function and calcification, CKD and the reduced levels of soluble Klotho herein are associated with cardiovascular complications. Interestingly, although it has been demonstrated that soluble Klotho has a multitude of effects its direct impact on vascular cells and the exact underlying mechanisms remain largely unknown and should therefore be a major focus of further research. Moreover, functional implications of the cleavage process resulting in KL1 and KL2 fragments remain to be elucidated.

scholarly journals Gambaran Anemia pada Subjek Penyakit Ginjal Kronik Stadium 4 dan 5 di Poliklinik Ginjal-Hipertensi RSUP Prof. Dr. R. D. Kandou

e-CliniC ◽  
2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Yordhan Tamsil ◽  
Emma Sy. Moeis ◽  
Frans Wantania
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Medical Records ◽  
Iron Status ◽  
Descriptive Study ◽  
Transfusion Therapy ◽  
Female Age ◽  
Stage 4 ◽  
Almost All ◽  
Age Range

Abstract: Anemia is a complication of chronic kidney disease (CKD) that often occurs. Moreover, it can occur earlier than other complications of CKD in almost all patients with late stage kidney disease. This study was aimed to obtain the profile of anemia in subjects with stage 4 and 5 of chronic kidney disease. This was a retrospective and descriptive study using medical records of patients with CKD associated with anemia for two years. The results showed that of 428 CKD patients, 131 suffered from anemia (30.60%). The majority of patients were female (54.19%), age range 60-69 years (44.27%), non-dialysis stage 5 of CKD patients (74.04%), had sufficient iron status (79.38%). However, 15,26% of the 131 patients got blood transfusion therapy. In conclusion, the majority of CKD patients were stage 5 ND, female, age range of 60-69 years, had sufficient iron status, and were not treated with blood transfusion.Keywords: chronic kidney disease, anemia Abstrak: Anemia merupakan komplikasi penyakit ginjal kronik (PGK) yang sering terjadi, bahkan dapat terjadi lebih awal dibandingkan komplikasi PGK lainnya dan hampir pada semua pasien penyakit ginjal tahap akhir. Penelitian ini bertujuan untuk mengetahui gambaran anemia pada subyek penyakit ginjal kronik stadium 4 dan 5 di Poliklinik Ginjal-Hipertensi RSUP Prof. Dr. R. D. Kandou. Jenis penelitian ialah metode deskriptif retroskpektif dengan mengunakan data rekam medik pasien PGK dengan anemia selama dua tahun. Hasil penelitian memperlihatkan dari 428 pasien PGK didapatkan 131 pasien dengan anemia pada PGK (30,60%). Mayoritas pasien ialah jenis kelamin perempuan (54,19%), usia 60-69 tahun (44,27%), dan PGK derajat 5 non-dialisis (74,04%), memiliki status besi cukup (79,38%). Terdapat 15,26% dari pasien yang mendapatkan terapi transfusi darah. Simpulan penelitian ini ialah pasien terbanyak dengan derajat 5 ND, jenis kelamin perempuan, rentang usia 60-69 tahun, dengan status besi cukup, dan tidak mendapat terapi transfusi darah.Kata kunci: penyakit ginjal kronik, anemia

scholarly journals Overview of Ureum and Creatinine Levels in Hemodialysis Patients with Chronic Kidney Disease

2020 ◽  
Vol 2 (1) ◽  
pp. 6-11
Author(s):  
Roni Roni Afriansya ◽  
Eko Naning Sofyanita ◽  
Suwarsi Suwarsi
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Secondary Data ◽  
Inclusion Criteria ◽  
Electrolyte Disorders ◽  
Organ Systems ◽  
Male Sex ◽  
Almost All ◽  
Blood Urea Level ◽  
Very High

Chronic Kidney Disease is evident if the blood urea level is more than 200 mg/dl. Uremia causes a malfunction in almost all organ systems such as; fluid and electrolyte disorders, metabolic endocrine, neuromuscular, cardiovascular and pulmonary, skin, gastrointestinal, hematological, and immunological. Hemodialysis is an attempt to reduce the symptoms of uremia so that the patient's clinical condition can also improve. The purpose of this study was to determine the description of Ureum and Creatinine in CKD Patients undergoing Hemodialysis. This type of research is observational descriptive. The sample included all CKD patients undergoing hemodialysis at the Ir Sukarno Sukoharjo Regional Hospital in 2019 who met the inclusion criteria, so as many as 83 samples were obtained. The type of data is secondary data obtained from medical records. The results showed that most patients were in the 40-60 years age group of 72% and the majority of the male sex were 51 patients (61%). Urea and creatinine appearance in patients undergoing hemodialysis has increased very high. In 83 patients with CKD increased serum creatinine levels ( 100%) with a mean creatinine level in men of 11.80 mg / dL and women of 9.73 mg / dL and an increase in ureum levels with a mean of 167 men, 09 mg / dL and women of 164.39 mg / dL. This study concludes that all patients with CKD have increased levels of urea and creatinine by more than 100%.

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