Alteration of connexin expression is an early signal for chronic kidney disease

2011 ◽  
Vol 301 (1) ◽  
pp. F24-F32 ◽  
Author(s):  
Julie Toubas ◽  
Samantha Beck ◽  
Anne-Laure Pageaud ◽  
Anne-Cecile Huby ◽  
Mouna Mael-Ainin ◽  
...  

Chronic kidney disease is promoted by a variety of factors that induce chronic inflammation and fibrosis. Inflammation and excessive scaring have been recently associated with disruptions of the gap junction-mediated intercellular communication. Nevertheless, little is known about alterations of the expression of gap junction proteins such as connexin (Cx) 43 and 37 in chronic renal disease. In this study, we investigated the expression of these two Cxs in the hypertensive RenTg mice, the anti-glomerular basement membrane glomerulonephritis, and the unilateral ureteral obstruction models, all leading to the development of chronic kidney disease in mice. Expression of Cx43 was almost negligible in the renal cortex of control mice. In contrast, Cx43 was markedly increased in the endothelium of peritubular and glomerular capillaries of the 3-mo-old RenTg mice, in the glomeruli of mice suffering from glomerulonephritis, and in the tubules after obstructive nephropathy. The Cx43 expression pattern was paralleled closely by that of the adhesion markers such as vascular cell adhesion molecule-1 and intercellular adhesion molecule-1 as well as the inflammatory biomarker monocyte chemoattractant protein-1. In contrast, Cx37 that was abundantly expressed in the renal cortex of healthy mice was markedly decreased in the three experimental models. Interestingly, Cx43+/− mice showed restricted expression of VCAM-1 after 2 wk of obstructive nephropathy. These findings suggest the importance of Cxs as markers of chronic renal disease and indicate that these proteins may participate in the inflammatory process during the development of this pathology.

2008 ◽  
Vol 149 (15) ◽  
pp. 691-696
Author(s):  
Dániel Bereczki

Chronic kidney diseases and cardiovascular diseases have several common risk factors like hypertension and diabetes. In chronic renal disease stroke risk is several times higher than in the average population. The combination of classical risk factors and those characteristic of chronic kidney disease might explain this increased risk. Among acute cerebrovascular diseases intracerebral hemorrhages are more frequent than in those with normal kidney function. The outcome of stroke is worse in chronic kidney disease. The treatment of stroke (thrombolysis, antiplatelet and anticoagulant treatment, statins, etc.) is an area of clinical research in this patient group. There are no reliable data on the application of thrombolysis in acute stroke in patients with chronic renal disease. Aspirin might be administered. Carefulness, individual considerations and lower doses might be appropriate when using other treatments. The condition of the kidney as well as other associated diseases should be considered during administration of antihypertensive and lipid lowering medications.


Hypertension ◽  
2012 ◽  
Vol 60 (suppl_1) ◽  
Author(s):  
Anne-Cecile Huby ◽  
Ahmed Abed ◽  
Panos Kavvadas ◽  
Carlo Alfieri ◽  
Maria-Pia Rastaldi ◽  
...  

Background: Hypertension-induced chronic kidney disease in mouse models is quite fast and consequently away from the human pathology. There is an increasing need for a mouse model that can be used to delineate the pathogenic process leading to progressive renal disease. Aim: Our objective was dual: to investigate whether mice overexpressing renin ectopically at constant and high levels by genetic clamping (RenTg) could mimic kinetics and the physiopathological characteristics of hypertension-induced CKD and to identify cellular and/or molecular events characterizing the different steps of the progression of CKD. Results: We found that RenTg mice are hypertensive (123±7 vs to 90±2 mm Hg for the wt age-matched animals, p<0.05) and slightly albuminuric (22.1±5.3 vs. 5.2±0.4 g/mol, p<0.01) as early as 3 month old. At this age, the expressions of adhesion markers such as vascular cell adhesion molecule-1 and platelet endothelial cell adhesion molecule-1 are 4-5 fold increased in the renal cortical vasculature indicating the beginning of endothelial dysfunction. Five month-old RenTg mice show perivascular and periglomerular infiltrations of macrophages and their GFR is starting to decrease(-10%). At 8 months, the renal cortex of RenTg mice is altered by leukocyte invasion, decreased expression of nephrin (a protein controlling filtration barrier), increased expression of KIM-1 (a protein typical of tubular cell stress) and of several pro-fibrotic agents of the TGFbeta family, and establishment of fibrotic lesions. At the age of 12 months, RenTg mice display several lesions of renal structure typical of hypertensive renal disease (such as glomerular ischemia, glomerulo- and nephroangio-sclerosis, mesangial expansion, tubular dilation), important proteinuria (138±20 g/mol) and a 55% fall of GFR. Conclusions: The RenTg strain develops progressively with age CKD. In this model, endothelial dysfunction is an early event preceding the structural and fibrotic alterations which ultimately lead to the development of CKD. This model can provide a useful tool allowing to gain new insights into the mechanisms of chronic renal failure and to identify new targets for arresting and/or reversing the development of CKD


2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Fabrizio Fabrizi ◽  
Piergiorgio Messa ◽  
Paul Martin

The 2011 report of the World Health Organization General Assembly on noncommunicable diseases identified chronic kidney disease as a worldwide health issue posing a heavy economic burden. Hepatitis C virus infection, which is responsible for over 1 million deaths resulting from cirrhosis and liver cancer, is linked to chronic kidney disease in several ways; some forms of renal disease are precipitated by hepatitis C and patients with end-stage chronic renal disease are at increased risk for acquiring HCV. The aim of this review is to update the evidence on the relationship between hepatitis C infection and chronic kidney disease. Information has been accumulated in the last decade indicating that HCV plays an adverse effect on the incidence and progression of chronic kidney disease; a novel meta-analysis of observational studies (seven longitudinal studies; 890,560 unique individuals) found a relationship between hepatitis C seropositivity and incidence of reduced estimated glomerular filtration rate (adjusted relative risk, 1.70; 95% CI, 1.20; 2.39; P=0.002) in the adult general population. In addition to conventional risk factors, hepatitis C may be an additional factor for the development of chronic kidney disease, and an atheromasic activity of hepatitis C virus has been mentioned. The link between hepatitis C and atherosclerosis could also explain the excess risk of cardiovascular mortality that has been observed among hepatitis C virus seropositive patients undergoing maintenance dialysis. A number of biologically plausible mechanisms related to hepatitis C virus have been hypothesized to contribute to atherosclerosis. Implementation of effective treatment intervention towards hepatitis C is required to decrease the healthcare burden of hepatitis C and to prevent the progression of chronic renal disease.


Author(s):  
Dr Bakul Gupta

Background: Various studies have shown the association between dyslipidemia and cardio-vascular risk among patients of chronic renal disease but the association non-significant than patients with normal renal function. There was lack of evidence exists because patients with chronic renal disease were excluded from the major clinical studies where the association with that target dyslipidemia treatment was being evaluated Material & Methods: The present prospective study was conducted among the patients of Chronic Kidney Disease above 18 years of age and diagnosed on the basis of history, detailed clinical examination, and biochemical and sonological examination based upon National Kidney Foundation (NKF) criteria were enrolled into the study. Clearance from hospital ethics committee was taken before start of study. Written informed consent was taken from each study participant. Results:  In the present study out of total study participants of chronic kidney disease 46% were in the 3rd stage of CKD, 38% were in the 4th stage of CKD and 16% were in the 5th stage of CKD. Out of total study participants of chronic kidney disease, 82% were managed by conservative treatment and 18% were being managed by hemodialysis. Out of total study participants of chronic kidney disease, 38% had normal lipid profile while 62% patients had dyslipidemia. We found statistically significant (p value < 0.05) association between dyslipidemia and hemodialysis and association between dyslipidemia and stages of chronic kidney disease was statistically non- significant (p value > 0.05). Conclusion:  We concluded from the present study that dyslipidemia is significantly associated as an additional risk factor in patients of Chronic Kidney Disease. We found significant association of hemodialysis with abnormal lipid profile. Key words: Chronic kidney disease, dyslipidemia, hemodialysis.


2018 ◽  
Author(s):  
Raghu V Durvasula ◽  
Jonathan Himmelfarb

Chronic kidney disease (CKD) is a clinical syndrome arising from progressive kidney injury, formerly known as chronic renal failure, chronic renal disease, and chronic renal insufficiency. It is classified into five stages based primarily on glomerular filtration rate (GFR). This article discusses the epidemiology of CKD and end-stage renal disease (ESRD), as well as etiology and genetics, pathophysiology, and pathogenesis. The section on diagnosis looks at clinical manifestations and physical findings, laboratory (and other) tests, imaging studies, and biopsy. A short section on differential diagnosis is followed by a discussion of treatment, including hemodialysis and peritoneal dialysis. Long-term complications of patients on dialysis include cardiovascular disease, renal osteodystrophy, dialysis-related amyloidosis, and acquired cystic disease (renal cell carcinoma). The final section addresses prognosis and socioeconomic burden. Figures include the classification system for CKD, prevalence of CKD in the United States, rising prevalence, risk of, and leading causes of ESRD in the United States, plus the changing prevalence of ESRD over time, clinical manifestations of uremia, and an overview of hemodialysis circuit. Tables look at the burden of CKD relative to other chronic disorders, the specific hereditary causes of kidney disease, and situations when serum creatinine does not accurately predict GFR. Other tables list equations for estimating GFR, the causes of CKD without shrunken kidneys, and clinical features distinguishing chronic kidney disease from acute kidney injury. ESRD and indications for initiation of dialysis are presented, as well as typical composition of dialysate and reasons for failure of peritoneal dialysis. This chapter contains 71 references.


2017 ◽  
Author(s):  
Raghu V Durvasula ◽  
Jonathan Himmelfarb

Chronic kidney disease (CKD) is a clinical syndrome arising from progressive kidney injury, formerly known as chronic renal failure, chronic renal disease, and chronic renal insufficiency. It is classified into five stages based primarily on glomerular filtration rate (GFR). This article discusses the epidemiology of CKD and end-stage renal disease (ESRD), as well as etiology and genetics, pathophysiology, and pathogenesis. The section on diagnosis looks at clinical manifestations and physical findings, laboratory (and other) tests, imaging studies, and biopsy. A short section on differential diagnosis is followed by a discussion of treatment, including hemodialysis and peritoneal dialysis. Long-term complications of patients on dialysis include cardiovascular disease, renal osteodystrophy, dialysis-related amyloidosis, and acquired cystic disease (renal cell carcinoma). The final section addresses prognosis and socioeconomic burden. Figures include the classification system for CKD, prevalence of CKD in the United States, rising prevalence, risk of, and leading causes of ESRD in the United States, plus the changing prevalence of ESRD over time, clinical manifestations of uremia, and an overview of hemodialysis circuit. Tables look at the burden of CKD relative to other chronic disorders, the specific hereditary causes of kidney disease, and situations when serum creatinine does not accurately predict GFR. Other tables list equations for estimating GFR, the causes of CKD without shrunken kidneys, and clinical features distinguishing chronic kidney disease from acute kidney injury. ESRD and indications for initiation of dialysis are presented, as well as typical composition of dialysate and reasons for failure of peritoneal dialysis. This chapter contains 71 references.


2016 ◽  
Vol 6 (2) ◽  
pp. 53-62
Author(s):  
Jeta Ajasllari

The aim of this study was to evaluate the effectiveness of an intervention with CBT in patients with chronic renal disease. The study findings are in the context of previous researches and existing theories. Searches were done in the professional literature related to different chronic diseases and respectively with Chronic Kidney Disease in children and adolescents. Many paediatric chronic diseases are difficult to be managed because of the limitations caused by the disease itself; consequently, some of them need to be subjected to painful and difficult medical procedures as well. Respectively, for children diagnosed with CKD life changes completely because of limitations, mainly physical ones, due to the characteristics of the disease which require constant adaption as well as development of strategies to face the disease. Their behaviours must change accordingly as part of a new life of self-care. Cognitive-Behavioural Therapy is a psychological therapy, which has been investigated extensively and has been found as very effective to reduce psychological symptoms caused by the disease. This therapy integrates the modification of behaviour with the cognitive restructuring, the aim of which is to change the patient’s unhealthy behaviours through cognitive and behaviour techniques. Keywords: children; chronic kidney disease; cognitive behavioural therapy


2015 ◽  
Vol 33 (1) ◽  
pp. 57-60 ◽  
Author(s):  
Sarah L Stevens ◽  
Richard J Stevens ◽  
FD Richard Hobbs ◽  
Daniel S Lasserson

2021 ◽  
Author(s):  
Adam Oliver Michel ◽  
Taryn Donovan ◽  
Ben Roediger ◽  
Quintin Lee ◽  
Christopher J Jolly ◽  
...  

Mouse Kidney Parvovirus (MKPV) was recently recognized as the cause of murine inclusion body nephropathy, a disease reported for over 40 years in laboratory mice. Immunodeficient mice are persistently infected with MKPV, leading to chronic renal disease, morbidity and mortality whereas immunocompetent mice seroconvert with mild renal pathology. Given the high incidence of MKPV infection in wild mice in the New York City area, the first goal of this study was to evaluate the possibility of MKPV involvement in feline chronic kidney disease (CKD) from the same geographic region. As MKPV and related parvoviruses recently described in other animal species appear to have a tropism for kidney tissue, the second goal was to investigate the possible role of a virus of this group, other than MKPV, in the development of feline CKD, Presence of MKPV and related viruses was investigated in feline renal samples using PCR, RNA in situ hybridization (ISH) and immunohistochemistry (IHC). Cats were divided into three groups: normal (N=25), CKD (N=25) and immune suppressed (N=25). None of the kidney tissues from any of the 75 cats revealed the presence of MKPV DNA, RNA or antigen expression. Nor was "fechavirus" detected using PCR in renal tissue from cats with chronic kidney disease. We conclude that MKPV is an unlikely cause or contributor to feline CKD.


2019 ◽  
Vol 70 (3) ◽  
pp. 993-995
Author(s):  
Adina Mandita ◽  
Delia Timofte ◽  
Andra-Elena Balcangiu-Stroescu ◽  
Daniela Balan ◽  
Laura Raducu ◽  
...  

The treatment of HTA plays a central part in the management of Chronic Kidney Disease (CKD) in all its stages, especially in patients following a substitute treatment of renal functions. HBP can be both the cause and the consequence of CKD. The HBP control in CKD patients represents one of the most important concerns of clinicians. HBP treatment is non pharmacological as well as pharmacological.


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