scholarly journals Clinicopathological features of fast eGFR decliners among patients with diabetic nephropathy

2020 ◽  
Vol 8 (1) ◽  
pp. e001157
Author(s):  
Kengo Furuichi ◽  
Miho Shimizu ◽  
Masayuki Yamanouchi ◽  
Junichi Hoshino ◽  
Norihiko Sakai ◽  
...  

IntroductionThe speed of declining kidney function differs among patients with diabetic nephropathy. This study was undertaken to clarify clinical and pathological features that affect the speed of declining kidney function in patients with diabetic nephropathy.Research design and methodsThis study was design as multicenter retrospective study. The subjects (377 patients with diabetic nephropathy diagnosed by kidney biopsy at 13 centers in Japan) were classified into three groups based on the estimated glomerular filtration rate (eGFR) declining speed. The eGFR increasing group, the control group, and the eGFR declining group were divided at 0 and 5 mL/min/1.73 m2/year, respectively. Characteristics of clinicopathological findings of declining kidney function were evaluated.ResultsThe mean observation period of this study was 6.9 years. The control group, the eGFR increasing group, and the eGFR declining group included 81, 66, and 230 patients, respectively. The incidences of composite kidney events represented by 100 persons/year were 25.8 in the eGFR declining group and 2.0 in the eGFR increasing group. After adjustment for age, sex, systolic blood pressure, hemoglobin, and urinary albumin levels, three clinicopathological findings (urinary albumin levels, presence of nodular lesion, and mesangiolysis) were risk factors for inclusion in the eGFR declining group (the ORs were 1.49, 2.18, and 2.08, respectively). In contrast, the presence of subendothelial space widening and polar vasculosis were characteristic findings for inclusion in the eGFR increasing group (the ORs were 0.53 and 0.41, respectively).ConclusionsAs well as urinary albumin elevation, nodular lesion and mesangiolysis were characteristic pathological features of patients with fast declining kidney function.

2019 ◽  
Vol 0 (0) ◽  
Author(s):  
Duong Thi Thuy Ngan ◽  
Nguyen Gia Binh ◽  
Le Thi Huong Lan ◽  
Cuc Thi Thu Nguyen ◽  
Phung Thanh Huong

Summary Background Albuminuria is the standard biomarker for the diagnosis of diabetic nephropathy (DN). However, some patients with persistent microalbuminuria still progress to chronic kidney disease, raising the question of finding a better biomarker. This study aimed to evaluate the correlation of urinary liver-type fatty acid-binding protein (L-FABP) levels with renal function and to compare the role of urinary albumin-to-creatinine ratio (ACR) with urinary L-FABP in early detection of DN in type 2 diabetic patients. Methods The cross-sectional study was done on 106 type 2 diabetic patients and 30 non-diabetic people. L-FABP was measured with the Latex enhanced immunoturbidimetric technique. Results There was a strong and negative correlation between the urine L-FABP levels and eGFR (r = -0.606, p<0.001). The urinary L-FABP levels were significantly higher (p<0.001) in the normoalbuminuria diabetic group than the non-diabetic control group. The ROC-curve analyses in the diabetic patients and the normoalbuminuria diabetic patients showed that the AUCL-FABP was remarkably higher (p<0.001) than the AUCACR. An optimal cutoff value of 5 mg L-FABP/g Cr (with the sensitivity of 98.1% and specificity of 90%) and of 4.3 mg L-FABP/g Cr (with the sensitivity of 100% and specificity of 86.67%) was set to detect DN in the diabetic patients and the normoalbuminuria diabetic patients, respectively. Conclusions The change in urinary L-FABP levels happened earlier than in urinary albumin during renal function impairment. Urinary L-FABP can be used as a better indicator than ACR for early detection of DN in type 2 diabetes.


2019 ◽  
Vol 35 (4) ◽  
Author(s):  
Fatima Abid Khan ◽  
Syeda Sadia Fatima ◽  
Ghulam Mustafa Khan ◽  
Sana Shahid

Background & Objective: Kidney Injury Molecule-1 (KIM-1) is a peptide whose release into circulation is specific to tubular injury. This study aimed to estimate levels of kidney injury molecule-1 in diabetic patients with and without kidney disease. And evaluate the role of KIM-1 as an early screening marker of progressive kidney injury. Methods: This follow-up study included n=85 subjects from the diabetic clinic of Jinnah Post Graduate Medical Center (JPMC) in collaboration with Aga Khan University from November 2016 till September 2017 They were divided as: i) Group A1 (n=30) participants with diabetes for <5 years without microalbuminuria ii) Group A2 (n= 30) subjects with diabetes for 6-10 years with microalbuminuria; iii) Group B (n=25) subjects as healthy control group. All study participants were followed for 6 months and their blood glucose, urea, creatinine, electrolytes, albuminuria and serum KIM-1 were assayed. Results: High KIM-1 at baseline was present in group A2 patients as compared to controls and group A1 (p<0.001). Higher levels were seen after six months in group A1 along with the presence of micro albuminuria (p<0.001) suggesting kidney damage. Moderate positive association were seen for KIM1 with creatinine levels (r=0.530; p<0.001), and HbA1c (r=0.576; p<0.001) in all patients. While a strong positive association was seen for blood urea nitrogen as a marker for kidney function both at baseline (r= 0.728; p=0.000) and follow up (r=0.747; p=0.001). Multiple logistic regression controlling for age showed that KIM1 was independently associated with BUN (r=0.727; p<0.001), creatinine (r=0.510; p<0.001) and HbA1c (r=0.401; p=0.008) in all groups. Conclusion: Rising KIM-1 levels with progressive kidney damage with or without derangement of kidney function is reported in this study. This finding may pave a way towards identifying KIM1 as a prognostic marker for kidney injury. doi: https://doi.org/10.12669/pjms.35.4.154 How to cite this:Khan FA, Fatima SS, Khan GM, Shahid S. Evaluation of kidney injury molecule-1 as a disease progression biomarker in diabetic nephropathy. Pak J Med Sci. 2019;35(4):---------. doi: https://doi.org/10.12669/pjms.35.4.154 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


1979 ◽  
Vol 42 (04) ◽  
pp. 1332-1339 ◽  
Author(s):  
Hiroh Yamazaki ◽  
Takeshi Motomiya ◽  
Minoru Sonoda ◽  
Noboru Miyagawa

SummaryChanges in platelets in 48 patients with uterine myoma before and after hysterectomy with and without ovariectomy were examined. Bilateral ovariectomy in 25 cases (ovariec-tomized group) and unilateral or non-ovariectomy in 23 cases (control group) were performed at the hysterectomy. Platelet count and an appearance rate of secondary aggregation decreased at one day after and increased at one week after the operation, similarly in both the ovariectomized and the control group. The appearance rate of secondary aggregation was reflected in an intensity of aggregation at 5 min after the addition of reagent to PRP. At one month after the operation, the appearance rate of secondary aggregation induced by 3 μM ADP showed a statistically significant decrease in comparison with the preoperation value (P <0.05) and the enhancement of 5-min aggregation was still observed in the control group, while ceased in the ovariectomized group. The difference between the two groups was significant (P < 0.05). There was almost no change in the speed and intensity of primary and secondary aggregation during the observation period. No significant differences in collagen-induced aggregation were noted between the two groups. The results suggest that ovarian hormones, mainly estrogen, facilitate platelet activation which is mediated by the so-called secondary aggregation.


2016 ◽  
pp. 95-100
Author(s):  
G.I. Reznichenko ◽  
◽  
N.Yu. Reznichenko ◽  
V.Yu. Potebnya ◽  
K.I. Kovalenko ◽  
...  

The objective: to determine the efficacy of medicine «Menopace» in treatment of women with natural and surgical menopause. Patients and methods. 20 women (I group) with a natural menopause were examined (basic subgroup consisted of 10 patients who used Menopace for 3 months; control subgroup consisted of 10 patients). 20 women (II group) with surgical menopause were examined (basic subgroup consisted of 10 patients who received Menopace for 3 months; control subgroup consisted of 10 patients). Results. The average score of neurovegetative and emotional manifestations of climacteric syndrome during the observation period decreased in women with natural and surgical menopause who used Menopace, compared with subgroups of patients who had not used the medicine. Conclusions. 1. The use of the medicine Menopace in women with natural menopause after 3 months showed the disappearance of clinical symptoms of climacteric syndrome in 70% of the cases, and significant improvement in general condition in 30% of cases. 2. During surgical menopause after 1 month of treatment with Menopace manifestations of sweating were observed 4.5 times less often than in control group, tides were observed 7 times less often than in control group. Neurovegetative and psychoemotional symptoms of menopause were absent in 80% of women after 3 months of treatment and in 20% of cases significant improvement was shown. 3. The obtained results give grounds to recommend wide use of Menopace in practical work for the treatment of menopausal syndrome during natural and surgical menopause. Key words: menopause, therapy, Menopace.


2016 ◽  
pp. 191-108
Author(s):  
A.A. Sukhanova ◽  
◽  
Yu.M. Melnik ◽  
O.O. Karlova ◽  
◽  
...  

The aim of the study: to study the efficacy and safety of use Mastofemin in the treatment of various forms of mastitis in women of reproductive age. Materials and methods. The study included 62 women of reproductive age (mean age of 33.5±2.3 years) who were screened in the Kiev city center reproductive and perinatal medicine. Women were divided into 2 groups. The first (main) group consisted of 32 patients who received the proposed treatment using herbal remedies Mastofemin 1 capsule 2 times per day for 3 months; 30 patients of the second (control) group were under observation and received no treatment. These groups were representative and homogeneous on age, clinical symptoms and sonographic characteristics. The clinical method included evaluation of complaints of patients, anamnesis, presence of concomitant gynecologic pathology, inspection, palpation of the lymph nodes and the breast and obtaining a discharge from the nipples to conduct cytological examination, which allowed excluding from the study women with suspected malignancy of the process. All the patients were performed ultrasound examination of the breast. The review was supplemented with vaginal gynecological examination and ultrasound examination of small pelvis organs to assess the condition of the uterus and its appendages, the diagnosis of gynecological diseases. Results. Summarizing obtained in this study results one should stress the positive long-term effect of applying Mastofemin for the treatment of proliferative changes of the breast in women of reproductive age. This is manifested by a decrease in the intensity of clinical signs of mastitis, consistent with the results of sonographic control. Established positive dynamics in the treatment of cystic mastitis, dectective and when combined cystic mastopathy with dectective. In the control group of patients for a given observation period (6 months) no significant changes in clinical signs of mastitis and sonographic characteristics. Regression of disease has not occurred in any of the patients, in 2 patients increased sensitivity of the breast after 6 months moved to the soreness. Sonographic characteristics of mastitis during the observation period did not change. Thus, the use of Mastofemin aimed at pathogenetic treatment of mastitis and prevention of breast cancer. Conclusion. Application of Mastofemin during the treatment of mastitis in women of reproductive age significantly improves the clinical condition of patients; reduce the subjective and objective symptoms of the disease. The positive effect of the treatment with Mastofemin proved in the case of the treatment of sonographic following forms of mastitis: cystic mastopathy, cystic mastopathy with dectectasy. Mastofemin may be the drug of choice for complex conservative monotherapy in women of reproductive age with proliferative changes in the breast, and can also be used as part of complex treatment in patients with diffuse changes of the breast when combined with hyperplastic processes of the myometrium and endometrium. Keywords: mastopathy, breast gland, herbal medicine, herbal remedies, Mastofemin.


Diabetes ◽  
1994 ◽  
Vol 43 (9) ◽  
pp. 1108-1113 ◽  
Author(s):  
F. S. Nielsen ◽  
P. Rossing ◽  
M. A. Gall ◽  
P. Skott ◽  
U. M. Smidt ◽  
...  

2019 ◽  
Vol 24 (2) ◽  
pp. 121-126 ◽  
Author(s):  
V. G. Atrushkevich ◽  
L. Yu. Orekhova ◽  
O. O. Yanushevich ◽  
E. Yu. Sokolova ◽  
E. S. Loboda

Relevance: to indentify if periodontal treatment which is presented by photoactivated disinfection (PAD) adjunctively to scaling and root planing (SRP) yield better outcomes than ozone therapy as an adjunct to SRP in periodontitis.Materials and methods: we examined 57 (mean age 49,3 ± 1,02) patients with chronic periodontitis, divided into groups, SRP + PAD, SRP + ozone therapy and SRP alone. Subgingival plaque samples were subjected to DNA extraction and real time PCR amplifcation for detection Porphyromonas gingivalis (Pg), Prevotella intermedia (Pi), Tannerella forsythensis (Tf), Treponema denticola (Td), Aggregatibacter actinomycetemcomitans (Aa). The amount of periodontopathogens and clinical parameters including plaque index, clinical attachment loss, pocket depth, bleeding on probing were measured at baseline, after 40, 90 and 180 days.Results: the results in groups of PAD+SRP and ozone therapy+SRP showed an improvement in all clinical parameters PI, BOP, PD, CAL and the quantity of Pg, Td and Tf compared to the control group during an observation period.Conclusion: the results showed additional benefts from PAD and ozone therapy as an adjunctive treatment to SRP for patients of chronic periodontitis.


2020 ◽  
Vol 5 (2) ◽  
pp. 319-327
Author(s):  
Pelastri Rahayu ◽  
◽  
Retno Hestiningsih ◽  
Martini Martini ◽  
Dwi Sutiningsih ◽  
...  

The prevalence of DM in Riskesdas in 2018 according to the Perkeni consensus in 2015 is higher than according to the Perkeni consensus in 2011, the prevalence was10.9%. The disease can develop into diabetes nephropathy, Increased prevalence of diabetic nephropathy directly proportional with an increase in diabetes prevalence. Diabetic nephropathy is a microvascular complication in diabetics that develops around 30% in patients with type I DM and about 40% in patients with type II DM. Turmeric extract has antioxidant and anti-inflammatory effects to prevent the bad development of diabetes nephropathy. This study looked at the effect of giving a combination of noni and turmeric extract on histopathology of alloxan-induced renal rats. A total of 25 mice were divided into 5 treatment groups, namely the PI group (250 mg / kgBB extract dose), PII group (500 mg / kgBB extract dose), PIII group (750 mg / kgBB extract dose), positive control group (glibenklamid) and negative control group (without extract and glibenklamid). The study used Post Test Only Group. The highest percentage decrease in blood glucose in the PI group was 56.11% and the lowest decrease in the PIII group was 24.12% with p = 0.012. The results of the study were not based on the number of extract doses. The measurement results of rat body weight and glomerular diameter were not affected by blood glucose level with p = 0.700 for body weight and p = 0.187 for glomerular measurement results.


2020 ◽  
Vol 13 ◽  
Author(s):  
Kun Xiao ◽  
Fei Zhao ◽  
WenJie Xie ◽  
Jian Ding ◽  
XiaoAn Gong ◽  
...  

Objective: To explore and investigate the molecular mechanism of TLR4 mediated T cell immune effect in transfusion-induced acute injury based on SLIT2/ROBO4 signaling pathway. Methods: Sixty C57/BL6 male mice (Wild type, WT) aged 8 to 10 weeks were randomly divided into 5 groups: 1) normal type WT, 2) LPS control group of WT type lipopolysaccharide, 3) WT type TRALI group (LPS + MHC-I mAb), 4) (TLR4 antibody) lipopolysaccharide LPS control group, 5) (TLR4 antibody) TRALI group (LPS + MHC-I mAb). Mice were dosed with LPS (0.1 mg / kg), and MHC-I mAb (2 mg / kg) was injected into the tail vein 24 hours later for modeling. After 2 hours, mice were sacrificed and experimental samples were collected. HE staining was performed to detect pathological features. The myeloperoxidase (MPO) activity and the level of IL-2, IL-6, TNF, IFN-γ, IL-17A as well as IL-10 were measured in the lung tissue homogenate supernatant. Blood, spleen single cell suspension and bronchoalveolar lavage fluid (BALF) were collected to detect the ratio of Treg and Th17 cells by flow cytometry, respectively. RT-PCR and WB indicated the mRNA or protein expression of CDH5 (Cadherin-5), SLIT2 and ROBO4 in mouse lung tissue and pulmonary vascular tissue respectively. Results: TLR4 mAb treatment decreases the pathological features of LPS induced ALI model in vivo. And so does the MPO activity as well as the level of proinflammatory factors in the lung tissue. TLR4 exerts its function through the changes of Treg/Th17 ratio via SLIT2/ROBO4 signaling pathway and downregulating CDH5 and SETSIP in ALI model. Conclusion: TLR4 mediates immune response in LPS induced ALI model through SLIT2/ROBO4 signaling pathway.


Sign in / Sign up

Export Citation Format

Share Document