scholarly journals Undiagnosed Kidney Injury in Uninsured and Underinsured Diabetic African American Men and Putative Role of Meprin Metalloproteases in Diabetic Nephropathy

2018 ◽  
Vol 2018 ◽  
pp. 1-16 ◽  
Author(s):  
Lei Cao ◽  
Rashin Sedighi ◽  
Ava Boston ◽  
Lakmini Premadasa ◽  
Jamilla Pinder ◽  
...  
Keyword(s):  
African American ◽  
African Americans ◽  
Kidney Disease ◽  
African American Men ◽  
Significant Proportion ◽  
Kidney Injury ◽  
Diabetic Patients ◽  
Targeted Interventions ◽  
Meprin Metalloproteases ◽  
Kidney Injury Molecule 1

Diabetes is the leading cause of chronic kidney disease. African Americans are disproportionately burdened by diabetic kidney disease (DKD) and end stage renal disease (ESRD). Disparities in DKD have genetic and socioeconomic components, yet its prevalence in African Americans is not adequately studied. The current study used multiple biomarkers of DKD to evaluate undiagnosed DKD in uninsured and underinsured African American men in Greensboro, North Carolina. Participants consisted of three groups: nondiabetic controls, diabetic patients without known kidney disease, and diabetic patients with diagnosed DKD. Our data reveal undiagnosed kidney injury in a significant proportion of the diabetic patients, based on levels of both plasma and urinary biomarkers of kidney injury, namely, urinary albumin to creatinine ratio, kidney injury molecule-1, cystatin C, and neutrophil gelatinase-associated lipocalin. We also found that the urinary levels of meprin A, meprin B, and two kidney meprin targets (nidogen-1 and monocytes chemoattractant protein-1) increased with severity of kidney injury, suggesting a potential role for meprin metalloproteases in the pathophysiology of DKD in this subpopulation. The study also demonstrates a need for more aggressive tests to assess kidney injury in uninsured diabetic patients to facilitate early diagnosis and targeted interventions that could slow progression to ESRD.

scholarly journals Inflammation and Kidney Injury in Diabetic African American Men

2019 ◽  
Vol 2019 ◽  
pp. 1-12
Author(s):  
Lei Cao ◽  
Ava Boston ◽  
Olugbemiga Jegede ◽  
Heather A. Newman ◽  
Scott H. Harrison ◽  
...  
Keyword(s):  
African American ◽  
Kidney Disease ◽  
Molecular Mechanisms ◽  
African American Men ◽  
Kidney Injury ◽  
Diabetic Patients ◽  
Tnf Receptor ◽  
Urinary Levels ◽  
Signaling Axis ◽  
Multiple Biomarkers

African Americans are disproportionately burdened by diabetic kidney disease (DKD). However, little is known about the cellular and molecular mechanisms underlying the onset and progression of DKD in this population. The goal of the current study was to determine the association between specific inflammation markers and kidney injury in diabetic African American men. To this end, we recruited diabetic patients either with (n=20) or without (n=87) diagnosed kidney disease along with age-matched nondiabetic controls (n=81). Urinary albumin-to-creatinine ratios (UACRs) and estimated glomerular filtration rates (eGFR) were used for biochemical assessment of kidney function. We then measured plasma and urinary levels of seven inflammatory markers, including adiponectin, C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), TNF receptor 1 (TNFR1), TNF receptor 2 (TNFR2), interleukin-6 (IL-6), and intercellular cell adhesion molecule-1 (ICAM-1). Plasma levels of TNF-α, TNFR1, and TNFR2 were significantly higher in diabetics with macroalbuminuria compared to nondiabetic controls and diabetics with normoalbuminuria or microalbuminuria. Likewise, urinary levels of ICAM-1 were higher in diabetics with macroalbuminuria compared to the other groups. Indeed, urinary ICAM-1, plasma TNF-α, and adiponectin had moderate positive correlations with UACR while plasma TNFR1 and TNFR2 levels were strongly correlated with kidney injury, indicated by multiple biomarkers of kidney injury. In contrast, though plasma CRP was elevated in diabetic subjects relative to nondiabetic controls, its levels did not correlate with kidney injury. Together, these data suggest that inflammation, particularly that mediated by the TNF-α/NF-κB signaling axis, may play a role in the pathogenesis of DKD in African American men.

scholarly journals JC Viruria Is Associated With Reduced Risk of Diabetic Kidney Disease

2019 ◽  
Vol 104 (6) ◽  
pp. 2286-2294 ◽  
Author(s):  
Etty Kruzel-Davila ◽  
Jasmin Divers ◽  
Gregory B Russell ◽  
Zipi Kra-Oz ◽  
Moran Szwarcwort Cohen ◽  
...  
Keyword(s):  
African American ◽  
African Americans ◽  
Kidney Disease ◽  
Diabetic Kidney Disease ◽  
Kidney Injury ◽  
Joint Analysis ◽  
Inverse Association ◽  
Diabetic Kidney ◽  
Heart Study ◽  
Diabetes Heart Study

Abstract Purpose African Americans who shed JC polyomavirus (JCV) in their urine have reduced rates of nondiabetic chronic kidney disease (CKD). We assessed the associations between urinary JCV and urine BK polyomavirus (BKV) with CKD in African Americans with diabetes mellitus. Methods African Americans with diabetic kidney disease (DKD) and controls lacking nephropathy from the Family Investigation of Nephropathy and Diabetes Consortium (FIND) and African American-Diabetes Heart Study (AA-DHS) had urine tested for JCV and BKV using quantitative PCR. Of the 335 individuals tested, 148 had DKD and 187 were controls. Results JCV viruria was detected more often in the controls than in the patients with DKD (FIND: 46.6% vs 32.2%; OR, 0.52; 95% CI, 0.29 to 0.93; P = 0.03; AA-DHS: 30.4% vs 26.2%; OR, 0.63; 95% CI, 0.27 to 1.48; P = 0.29). A joint analysis adjusted for age, sex, and study revealed that JC viruria was inversely associated with DKD (OR, 0.56; 95% CI, 0.35 to 0.91; P = 0.02). Statistically significant relationships between BKV and DKD were not observed. Main Conclusions The results from the present study extend the inverse association between urine JCV and nondiabetic nephropathy in African Americans to DKD. These results imply that common pathways likely involving the innate immune system mediate coincident chronic kidney injury and restriction of JCV replication. Future studies are needed to explore causative pathways and characterize whether the absence of JC viruria can serve as a biomarker for DKD in the African American population.

African American men who become mental health advocates

2021 ◽  
pp. 002076402110127
Author(s):  
Sandra Yaklin ◽  
Miyong Kim ◽  
Jacklyn Hecht
Keyword(s):  
Mental Health ◽  
African American ◽  
African Americans ◽  
Intervention Program ◽  
African American Men ◽  
Working Relationships ◽  
Major Theme ◽  
Community Based ◽  
Tailored Messages ◽  
Promote Mental Health

Using a narrative approach, this study explored how African American men became mental health advocates. This ancillary study is part of a formative within an ongoing community based intervention program that was designed to promote mental health of African Americans (AMEN) project within an ongoing community based intervention program that was designed to promote mental health of African Americans (AMEN) project. Narrative research techniques were used to analyze and synthesize the data. Analysis generated one major theme (interdependence) with four supporting sub-themes (credibility, social depression, stigma, and calling). These findings and insights through this qualitative study guided the AMEN project team to formulate effective communication strategies in establishing working relationships with community partners and wider stakeholders as well as crafting culturally tailored messages for African American participants.

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 Pleiotropic Effects of Sodium-Glucose Cotransporter-2 Inhibitors: Renoprotective Mechanisms beyond Glycemic Control

2021 ◽  
Vol 22 (9) ◽  
pp. 4374
Author(s):  
Tomoaki Takata ◽  
Hajime Isomoto
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Glycemic Control ◽  
Kidney Injury ◽  
Sglt2 Inhibitors ◽  
Pleiotropic Effects ◽  
Future Research ◽  
Diabetic Patients ◽  
Sodium Glucose Cotransporter ◽  
Stage Renal Disease

Diabetes mellitus is a major cause of chronic kidney disease and end-stage renal disease. However, the management of chronic kidney disease, particularly diabetes, requires vast improvements. Recently, sodium-glucose cotransporter-2 (SGLT2) inhibitors, originally developed for the treatment of diabetes, have been shown to protect against kidney injury via glycemic control, as well as various other mechanisms, including blood pressure and hemodynamic regulation, protection from lipotoxicity, and uric acid control. As such, regulation of these mechanisms is recommended as an effective multidisciplinary approach for the treatment of diabetic patients with kidney disease. Thus, SGLT2 inhibitors are expected to become key drugs for treating diabetic kidney disease. This review summarizes the recent clinical evidence pertaining to SGLT2 inhibitors as well as the mechanisms underlying their renoprotective effects. Hence, the information contained herein will advance the current understanding regarding the pleiotropic effects of SGLT2 inhibitors, while promoting future research in the field.

scholarly journals Circulating Biomarker Levels in Patients With Stage 5 Chronic Kidney Disease With Respect to Neurovascular Diseases

2018 ◽  
Vol 24 (9_suppl) ◽  
pp. 314S-322S
Author(s):  
Justin Lee ◽  
Ryan McMillan ◽  
Leonidas Skiadopoulos ◽  
Vinod Bansal ◽  
José Biller ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Carotid Artery Disease ◽  
Kidney Injury ◽  
Assay Method ◽  
Neurocognitive Deficits ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Intracranial Atherosclerotic Disease ◽  
Artery Disease ◽  
Kidney Injury Molecule 1

The prevalence of neurocognitive deficits remains high in patients with stage 5 chronic kidney disease (CKD5D). Major contributors to such deficits include stroke, cervical carotid artery disease (CCAD), and intracranial atherosclerotic disease (ICAD). The risk of developing these dysfunctional vascular processes is facilitated by the chronic inflammation associated with renal failure. Plasma levels of 10 circulating biomarkers in patients with CKD5D (n = 78-90) were quantified using the sandwich enzyme linked immune sorbent assay method. Biomarkers for this study included kidney injury molecule-1, N-terminal prohormone of brain natriuretic peptide (NT-proBNP), neutrophil gelatinase-associated lipocalin, interleukin-18, endothelin 1, calcifediol, parathyroid hormone, platelet-derived growth factor, microparticles-expressing tissue factor, and lipoprotein(a) (Lp(a)). Of the 90 patients with CKD5D, 30 had CCAD, 24 had ICAD, and 22 had stroke. Lp(a) level was significantly elevated in patients with CKD5D with comorbid ICAD compared to those without (125.70 ± 10.03 ng/mL vs 97.16 ± 5.97 ng/mL; P = .0065). NT-proBNP level was also significantly elevated in patients with CKD5D with comorbid stroke diagnosis compared to those without stroke history, once patients with a diagnosis of heart failure (HF) were excluded (14.84 ± 2.80 ng/mL vs 9.06 ± 1.27 ng/mL; P = .0283). Profiling levels of Lp(a) and NT-ProBNP could thus be useful in the risk stratification of ICAD and stroke, respectively, in the CKD5D population.

JOB AUTHORITY AND EMERGING RACIAL INCOME INEQUALITIES IN THE PUBLIC SECTOR

2016 ◽  
Vol 14 (1) ◽  
pp. 349-373
Author(s):  
George Wilson ◽  
Vincent J. Roscigno
Keyword(s):  
African American ◽  
Public Sector ◽  
African Americans ◽  
African American Men ◽  
Work Organization ◽  
General Social Survey ◽  
Negative Consequences ◽  
New Governance ◽  
Social Survey ◽  
The Public

AbstractHas the adoption of “new governance” reforms over the last two decades eroded the public sector as a long-standing occupational niche for African Americans? Utilizing data from the General Social Survey, we address this issue in the context of earnings “returns” to three levels of job authority for African American men and women relative to their White counterparts. Findings, derived from analyses of three waves of the General Social Survey, indicate that the acceleration of this “business model” of work organization in the public sector has had relatively profound and negative consequences for African American income. Specifically, racial parity in earnings returns at all levels of authority in the “pre-reform” period (1992–1994) progressively eroded during “early reform” (2000–2002) and then even more so during the “late reform” (2010–2012) period. Much of this growing public sector disadvantage—a disadvantage that is approaching that seen in the private sector—is driven largely by income gaps between White and African American men, although a similar (though smaller) racial gap is witnessed among women. We conclude by discussing the occupational niche status of public sector work for African Americans, calling for further analyses of the growing inequality patterns identified in our analyses, and drawing attention to the implications for contemporary racial disadvantages.

Age Differences in Knowledge about HIV Transmission among African-American Men and Women

2007 ◽  
Vol 101 (3_suppl) ◽  
pp. 1133-1140 ◽  
Author(s):  
Ann Kathleen Burlew
Keyword(s):  
African American ◽  
African Americans ◽  
African American Women ◽  
Hiv Transmission ◽  
African American Men ◽  
Hiv And Aids ◽  
Men And Women ◽  
Younger Women ◽  
Older African Americans ◽  
The Difference

To test whether knowledge about HIV transmission may be one contributing factor to the disproportionately high rates of HIV and AIDS cases among older African Americans, this study examined data from 448 African-American men and women, who completed the AIDS Knowledge and Awareness Scale. Overall the findings supported the hypothesis that older African Americans were not as knowledgeable as their younger counterparts. However, the analyses also indicated older (age 61+) African-American women were significantly less knowledgeable about HIV transmission than the younger women. However, the difference between older and younger men was not significant. One implication is that older African Americans, especially women, should be targets of educational efforts.

scholarly journals Associations of psychosocial factors with fruit and vegetable intake among African-Americans

2007 ◽  
Vol 10 (7) ◽  
pp. 701-711 ◽  
Author(s):  
Joanne L Watters ◽  
Jessie A Satia ◽  
Joseph A Galanko
Keyword(s):  
African American ◽  
African Americans ◽  
Psychosocial Factors ◽  
Self Efficacy ◽  
Vegetable Intake ◽  
African American Men ◽  
Predisposing Factors ◽  
Fruit And Vegetable Intake ◽  
Fruit And Vegetable ◽  
Enabling Factors

AbstractObjectiveTo examine associations of various psychosocial factors with fruit and vegetable intake in African-American adults.MethodsA cross-sectional survey of a population-based sample of 658 African-Americans, aged 18–70 years, in North Carolina. Information was collected on diet-related psychosocial (predisposing, reinforcing and enabling) factors based on the PRECEDE (Predisposing, Reinforcing, and Enabling Constructs in Educational Diagnosis and Evaluation) planning framework; demographic, lifestyle and behavioural characteristics, and fruit and vegetable intake.ResultsThe mean participant age was 43.9 years (standard deviation 11.6), 57% were female and 76% were overweight/obese. Participants expressed healthy beliefs regarding many of, but not all, the psychosocial factors. For example, although half of the respondents believed it is important to eat a diet high in fruits/vegetables, only 26% knew that ≥ 5 daily servings are recommended. The strongest associations of the psychosocial factors with fruit/vegetable intake were for predisposing factors (e.g. belief in the importance of a high fruit/vegetable diet and knowledge of fruit/vegetable recommendations) and one reinforcing factor (social support), with differences between the healthiest and least healthy responses of 0.5–1.0 servings per day. There was evidence of effect modification by gender in associations between psychosocial factors and fruit/vegetable consumption (e.g. self-efficacy was only significant in women), with higher intakes and generally healthier responses to the psychosocial variables in women than men.ConclusionsInterventions to increase fruit/vegetable intake in African-Americans may be more effective if they focus primarily on predisposing factors, such as knowledge, self-efficacy and attitudes, but not to the exclusion of reinforcing and enabling factors. The psychosocial factors that are targeted may also need to be somewhat different for African-American men and women.

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