EFFECT OF SODIUM GLUCOSE CO TRANSPORTER 2 INHIBITOR ON PROTEINURIA IN DIABETIC PATIENTS

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Nahla Hussein ◽  
Fatma Abdelrahman ◽  
Abdelrahman Khedr ◽  
Hayam Aref ◽  
Mohamed Reda Halawa ◽  
...  
Keyword(s):  
Body Weight ◽  
Sglt2 Inhibitor ◽  
Significant Negative Correlation ◽  
Significant Decline ◽  
P Value ◽  
Diabetic Patients ◽  
Group I ◽  
Group Ii ◽  
Stage Renal Disease ◽  
End Stage

Abstract Background Diabetic kidney disease (DKD) is considered a major cause of end stage renal disease (ESRD). It has been established that controlling microalbuminuria can delay progression to ESRD. Sodium glucose co transporter 2 inhibitor (SGLT2 i) is a newer antidiabetic drug that has a renoprotective and antiproteinuric effect. Aim of the Study to study the effect of SGLT2 inhibitor on proteinuria in diabetic patients and compare it with classic antiproteinuric drugs. Patients and Methods we conducted a randomized interventional study, involving 60 adult patients with type 2 DM divided into 2 groups: group I were prescribed the classic antiproteinuric drugs in the form of ACE inhibitors or ARBs, aspirin and statins and group II were prescribed an additional dapagliflozin 10 mg/day. Follow up as regard changes in UACR, HbA1C, Blood pressure, body weight and e GFR was done after 6 months of treatment. Results There was statistically significant decline in UACR after 6 months of treatment with dapagliflozin in group II in comparison to group I (p-value < 0.001). There was also statistically significant decline in SBP in both groups with (p-value < 0.010) in group I and (p-value <0.001) in group II and there was significant decline in DBP in both groups (p-value < 0.001). HbA1c decreased significantly in both groups, (p-value <0.023) in group I and (p-value <0.001) in group II. We also noted a significant reduction of body weight in group II (p-value <0.001). There was a statistically significant negative correlation between the change in UACR and the change in e GFR. Conclusion There was better reduction in albuminuria when adding dapagliflozin to antiproteinuric drugs, so we recommend starting dapagliflozin early in patients with DKD to delay progreesion to ESRD.

Value of Sodium Glucose co Transporter 2 Inhibitor Versus Traditional Medication In Microalbuminuric Diabetic Patients

2020 ◽  
Vol 16 ◽  
Author(s):  
Nahla Hussein ◽  
Fatma Abdelrahman ◽  
Abdelrahman Khedr ◽  
Hayam Aref ◽  
Mohamed Reda Halawa ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Kidney Disease ◽  
Sglt2 Inhibitor ◽  
Potential Effect ◽  
P Value ◽  
Diabetic Patients ◽  
Albumin Creatinine Ratio ◽  
Urine Albumin ◽  
Group I ◽  
Group Ii

Background:: Sodium glucose co transporter 2 inhibitor (SGLT2i) is a new arment in the prevention and treatment of diabetic kidney disease with a potential effect on reducing and preventing chronic kidney disease (CKD) progression. Objective:: To evaluate the effect of SGLT2 inhibitor in comparison to traditional medication in diabetic patients with microalbuminuria. Patients and Methods:: 60 diabetic patients with microalbuminuria were divided into group I: 30 patients were treated by traditional medications (RAAS blockers) and group II: 30 patients for whom Dapagliflozin was added to the traditional medications. All patients were followed up for 6 months with measuring of urine albumin/creatinine ratio (UACR) and eGFR changes. Results:: UACR significantly declined after 6 months of treatment in group II with (p-value &0.001). There was no significant eGFR changes between both groups. Systolic blood pressure decreases in both groups but the decrease was highly significant in group II (pvalue<0.001). Diastolic blood pressure decreases significantly in both groups (p-value<0.001). Also, body weight reduced significantly in group II with (p-value<0.001). Conclusion:: Dapagliflozin when added to traditional medications (RAAS Blockers) has resulted in significant reduction in microalbuminuria with no significant eGFR changes.

scholarly journals A Comparative Study between Radiocephalic and Brachiocephalic Arteriovenous Fistula in End Stage Renal Disease

2021 ◽  
Vol 14 (1) ◽  
pp. 44-49
Author(s):  
Md Nazmus Sabah ◽  
SM Parvez Ahmed ◽  
Md Saif Ullah Khan ◽  
Rakibul Hasan ◽  
Md Fidah Hossain ◽  
...  
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Color Doppler ◽  
Maturation Time ◽  
Doppler Study ◽  
Group I ◽  
Group Ii ◽  
The Difference ◽  
Stage Renal Disease ◽  
End Stage

Background: Chronic Kidney Disease (CKD) is a major health issue all over the world. Patients with deteriorating renal function and end-stage renal disease require vascular access for hemodialysis. Studies suggest that Arterio-Venous fistula (AVF) constructed judiciously using autologous conduit give the best outcome in this regard. Objective of the study was to compare the outcomes of Radiocephalic and Brachiocephalic AVF in end stage renal disease (ESRD). Methods: It was a quasi-experimental study carried out at the Department of Vascular Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka. The study was conducted from June 2019 to May 2020. Patients suffering from ESRD underwent AVF creation surgery for hemodialysis access. A total of 60 (Sixty) patients were included in this study. The patients were divided into two groups; Group I included 30 patients who underwent Radiocephalic AVF operation and Group II included 30 patients who had Brachiocephalic AVF operation. Results: In Group I, (Radiocephalic AVF) 60% were male and 40% were female. On the other hand, in Group II (Brachiocephalic AVF) 73.3% were male and 26.7% were female. Calculated volume flow (Q max) was significantly higher in Group II compared with Group I (769.11±101.54 ml/min vs 626.37±55.81) ml/min) with the difference being statistically significant (P=0.001). Maturation time was significantly less in Group II compared with Group I )37.78±1.93 vs 43.33±2.12 days) with the difference between the two group being statistically significant (P=0.001). Complication was more in Group I than Group II (16.7% vs 3.3%). Conclusion: The present study shows that Brachiocephalic AVF gives significantly better outcome in terms of shorter maturation time and less complications compared with Radio-Cephalic AVF. Color Doppler study is an essential tool for preoperative vessel evaluation which guides the selection of suitable AVF construction site. Cardiovasc j 2021; 14(1): 44-49

scholarly journals Cytokine Signature in End-Stage Renal Disease Patients on Hemodialysis

2017 ◽  
Vol 2017 ◽  
pp. 1-9 ◽  
Author(s):  
Danyelle Romana Alves Rios ◽  
Melina Barros Pinheiro ◽  
Wander Valadares de Oliveira Junior ◽  
Karina Braga Gomes ◽  
Andréa Teixeira Carvalho ◽  
...  
Keyword(s):  
Renal Disease ◽  
Vascular Access ◽  
The Body ◽  
T Helper ◽  
T Helper 1 ◽  
Group I ◽  
Group Ii ◽  
Inflammatory Profile ◽  
Stage Renal Disease ◽  
End Stage

Hemodialysis is a modality of blood filtration in which accumulated toxins and water are removed from the body. This treatment is indicated for patients at the end stage of renal disease. Vascular access complications are responsible for 20–25% of all hospitalizations in dialyzed patients. The occurrence of thrombosis in the vascular access is a serious problem that may severely compromise or even make the hemodialysis impossible, which is vital for the patient. The aim of this study was to investigate inflammatory profile in patients undergoing hemodialysis as well as the association between these alterations and vascular access thrombosis. A total of 195 patients undergoing hemodialysis have been evaluated; of which, 149 patients had not experienced vascular access thrombosis (group I) and 46 patients had previously presented this complication (group II). Plasma levels of cytokines including interleukin (IL-) 2, IL-4, IL-5, IL-10, TNF-α, and IFN-γwere measured by cytometric bead array. Our results showed that patients with previous thrombotic events (group II) had higher levels of the IL-2, IL-4, IL-5, and IFN-γwhen compared to those in group I. Furthermore, a different cytokine signature was detected in dialyzed patients according to previous occurrences or not of thrombotic events, suggesting that elevated levels of T-helper 1 and T-helper 2 cytokines might, at least in part, contribute to this complication.

scholarly journals Right Ventricular Function Assessment in patients with chronic stable angina with Type II DM Versus Non Diabetic Patients by TAPSE and TDI Echocardiography

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
M Kamal ◽  
A Shabana ◽  
S Thabet ◽  
B Wadie
Keyword(s):  
Stable Angina ◽  
Chronic Stable Angina ◽  
P Value ◽  
Diabetic Patients ◽  
Type Ii ◽  
Group I ◽  
Significant Difference ◽  
Group Ii ◽  
Rv Function ◽  
I 32

Abstract Background In patients with documented right coronary artery (RCA) lesions, right ventricular function could be affected. In addition, the presence of diabetes mellitus is found to be a risk factor for cardiomyopathy. Objective The aim of the study is to assess the effect of type II DM on RV function in patients with chronic stable angina who have significant RCA lesion, using TAPSE and TDI by echocardiography Patients and Methods One hundred patients who underwent elective coronary angiography for suspected coronary artery disease and were found to have significant RCA lesion were divided into two groups according to presence of Type II DM. Echocardiography was done for all patients and RV function assessment by TAPSE and TDI was done. Results In our study 100 patients were included; 73 of patients were males and 27 were females with mean age of 56.70 ± 8.51 years. almost one fourth of the candidates were smokers, 23% were ex-smokers and about half of the candidates were non-smokers (51%).About half of the patients were known hypertensive (48%) while the rest were not. As regarding LVEF it ranged between 35-73% with a Mean ± SD of 54.10 ± 8.94, TAPSE ranged between 17-30 mm with a mean ± SD of 22.81 ± 3.08 and S ‘was ranged between 9-19cm/s with a mean ± SD of 13.50 ± 2.24. Comparison between both groups showed that control group (Group I) had a mean age of (57.34 ± 8.74) and 86% were males . All Diabetic patients (Group II) had a mean age of (56.06 ± 8.30) years, (60%) were males. There was no significant difference between the two groups with respect to age and gender. As regarding smoking status in Group II (20%) were smokers and for Group I (32%) . As regarding hypertension, in Group II (72%) were hypertensive and for the Group I (32%) were hypertensive which was significantly different in both groups.The presence of associated significant LAD lesions was found in 52% of Group II and only 32% in Group I, which was significantly differenct between 2 groups. (p = 0.043).As regarding Echocardiographic data, there was no significant difference in both groups regarding TAPSE (P value .629) and S’(P value .247). Conclusions The results of this study shows that TAPSE and S’ showed normal values in patients with chronic stable angina and there was no additional effect for type II D.M.

scholarly journals Bilateral Nephrectomy in Patients with Autosomal Dominant Polycystic Kidney Disease and End-Stage Chronic Renal Failure

Nephron ◽  
2021 ◽  
pp. 1-7
Author(s):  
Alexander E. Lubennikov ◽  
Nicolay V. Petrovskii ◽  
German E. Krupinov ◽  
Evgeniy M. Shilov ◽  
Roman N. Trushkin ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Large Bowel ◽  
Elective Surgery ◽  
Length Of Hospital Stay ◽  
Bowel Injury ◽  
Polycystic Kidney ◽  
Group I ◽  
Group Ii ◽  
Autosomal Dominant Polycystic Kidney ◽  
End Stage

<b><i>Background:</i></b> In patients with autosomal dominant polycystic kidney disease (ADPKD) and end-stage kidney disease, bilateral nephrectomy (BN) is currently performed predominantly via the laparoscopic approach. We analysed the results of BN depending on the approach and preoperative and perioperative factors. <b><i>Patients and Methods:</i></b> This was a single-centre retrospective study carried out from April 2010 to March 2020, including a total of 142 patients presenting with ADPKD who were treated by BN. Of these, 108 patients meeting the inclusion criteria were selected to analyse the results. We compared therapeutic outcomes depending on the surgical approach (laparotomy or laparoscopy) and the type of the operation (emergent or elective). <b><i>Results:</i></b> Of the 108 eligible patients, 36 (group I) underwent laparoscopic BN and the remaining 72 patients (group II) were subjected to midline laparotomy. Sixty-nine patients underwent elective surgery and 39 endured emergent operations. The most frequent indications (87 patients, 80.6%) for surgical treatment were urinary tract infection and infected cysts. The median length of hospital stay for group I and group II patients amounted to 8 days (IQR: 7.5–9) and 12.5 days (IQR: 9–16.5), respectively (<i>p</i> &#x3c; 0.001). However, comparing the patients operated on electively, the actual difference in the length of hospital stay was inconsiderable: median 8 days (IQR: 7–9) in group I and 9 days (IQR: 9–11.5) in group II. The median duration of the operation was significantly (<i>p</i> &#x3c; 0.001) longer in group I amounting to 217.5 min (IQR: 197.5–305) than in group II equalling 115 min (IQR: 107.5–145). The frequency of postoperative complications, lethal outcomes, and blood loss volume did not statistically significantly differ depending on the surgical approach. Only patients operated on emergency underwent releparotomy due to intraoperative large bowel injury. Lethal outcomes (<i>n</i> = 18, 16.7%) after surgery were observed only in emergent patients. Sepsis prior to surgery, systemic inflammation response syndrome (SIRS) with the CRP level above 173 mg/mL, prolonged preoperative antibacterial therapy, and undiagnosed large bowel injury were associated with a lethal outcome after BN. <b><i>Conclusion:</i></b> The results of open and laparoscopic BN in elective surgery were comparable. Emergency operations for infected renal cysts and SIRS were associated with increased incidence of large bowel injury and lethal outcomes.

scholarly journals Identification of Novel Biomarker for Early Detection of Diabetic Nephropathy

Biomedicines ◽  
2021 ◽  
Vol 9 (5) ◽  
pp. 457
Author(s):  
Kyeong-Seok Kim ◽  
Jin-Sol Lee ◽  
Jae-Hyeon Park ◽  
Eun-Young Lee ◽  
Jong-Seok Moon ◽  
...  
Keyword(s):  
Diabetic Nephropathy ◽  
Early Stage ◽  
Kidney Injury ◽  
Diabetic Patients ◽  
High Morbidity ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Zucker Diabetic Fatty Rats ◽  
Kidney Injury Molecule 1 ◽  
Stage Renal Disease ◽  
End Stage

Diabetic nephropathy (DN) is one of the most common complications of diabetes mellitus. After development of DN, patients will progress to end-stage renal disease, which is associated with high morbidity and mortality. Here, we developed early-stage diagnostic biomarkers to detect DN as a strategy for DN intervention. For the DN model, Zucker diabetic fatty rats were used for DN phenotyping. The results revealed that DN rats showed significantly increased blood glucose, blood urea nitrogen (BUN), and serum creatinine levels, accompanied by severe kidney injury, fibrosis and microstructural changes. In addition, DN rats showed significantly increased urinary excretion of kidney injury molecule-1 (KIM-1) and neutrophil gelatinase-associated lipocalin (NGAL). Transcriptome analysis revealed that new DN biomarkers, such as complementary component 4b (C4b), complementary factor D (CFD), C-X-C motif chemokine receptor 6 (CXCR6), and leukemia inhibitory factor (LIF) were identified. Furthermore, they were found in the urine of patients with DN. Since these biomarkers were detected in the urine and kidney of DN rats and urine of diabetic patients, the selected markers could be used as early diagnosis biomarkers for chronic diabetic nephropathy.

scholarly journals Renoprotective Effects of the Dipeptidyl Peptidase-4 Inhibitor Sitagliptin: A Review in Type 2 Diabetes

2017 ◽  
Vol 2017 ◽  
pp. 1-14 ◽  
Author(s):  
Cristina Mega ◽  
Edite Teixeira-de-Lemos ◽  
Rosa Fernandes ◽  
Flávio Reis
Keyword(s):  
Type 2 Diabetes ◽  
Current Knowledge ◽  
Diabetic Patients ◽  
Dipeptidyl Peptidase 4 ◽  
Dipeptidyl Peptidase 4 Inhibitor ◽  
Increased Risk ◽  
Long Time ◽  
Stage Renal Disease ◽  
End Stage

Diabetic nephropathy (DN) is now the single commonest cause of end-stage renal disease (ESRD) worldwide and one of the main causes of death in diabetic patients. It is also acknowledged as an independent risk factor for cardiovascular disease (CVD). Since sitagliptin was approved, many studies have been carried out revealing its ability to not only improve metabolic control but also ameliorate dysfunction in various diabetes-targeted organs, especially the kidney, due to putative underlying cytoprotective properties, namely, its antiapoptotic, antioxidant, anti-inflammatory, and antifibrotic properties. Despite overall recommendations, many patients spend a long time well outside the recommended glycaemic range and, therefore, have an increased risk for developing micro- and macrovascular complications. Currently, it is becoming clearer that type 2 diabetes mellitus (T2DM) management must envision not only the improvement in glycaemic control but also, and particularly, the prevention of pancreatic deterioration and the evolution of complications, such as DN. This review aims to provide an overview of the current knowledge in the field of renoprotective actions of sitagliptin, namely, improvement in diabetic dysmetabolism, hemodynamic factors, renal function, diabetic kidney lesions, and cytoprotective properties.

Seasonal variations in wool growth and heat tolerance of sheep. I. Wool growth

1960 ◽  
Vol 11 (1) ◽  
pp. 75 ◽  
Author(s):  
M Wodzicka
Keyword(s):  
Body Weight ◽  
Day Treatment ◽  
The Other ◽  
Seasonal Rhythm ◽  
Group Iii ◽  
Wool Growth ◽  
Group I ◽  
The Mean ◽  
Group Ii ◽  
The Difference

The monthly wool growth of three groups of rams was studied at Beltsville, Maryland. Group I received natural daylight (at 38° 53' N.) and was shorn monthly. Group II had a 7:17 hours of daylight to hours of darkness rhythm and was shorn every 6 months, once in winter and once in summer. Group III received natural daylight and was likewise shorn every 6 months. The rams of all groups produced more wool in summer than in winter. This difference was significant (P<0.001). The mean body weight and food intake were both greater in the winter months, which indicated that the seasonal rhythm of wool growth was not a consequence of poorer feeding in winter. The rams which were shorn monthly (group I) grew considerably more wool than the other two groups, but the difference was not statistically significant. The short-day treatment of group II did not increase the annual wool production nor decrease the seasonal rhythm of wool growth. The balance of evidence from this and other experiments indicates that temperature rather than light controls the seasonal rhythm of wool growth.

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