scholarly journals Tibetan Medicines for the Treatment of Diabetic Nephropathy

2021 ◽  
Vol 2021 ◽  
pp. 1-15
Author(s):  
Lili Pu ◽  
Chunhong Yang ◽  
Liqiong Yu ◽  
Shiling Li ◽  
Yaqin Liu ◽  
...  
Keyword(s):  
Diabetic Nephropathy ◽  
Kidney Disease ◽  
Tibetan Medicine ◽  
Tribulus Terrestris ◽  
Potential Candidate ◽  
Terminalia Chebula ◽  
Online Database ◽  
Pharmacological Activities ◽  
Renal Lesions ◽  
Microvascular Diseases

As an important part of the traditional Chinese medicine system, Tibetan medicine has its unique treatment methods for diabetes mellitus and its complications. Diabetic nephropathy (DN) is one of the most serious diabetic microvascular diseases. Tibetan medicine believes that the occurrence of DN is closely related to renal function changes, and it can be effectively prevented and treated by improving renal lesions. In this paper, we consult ancient books of Tibetan medicine and summarize the medicines that treat kidney disease in the Tibetan medicine system. The Chinese name, English name, and Latin name of these drugs were searched as keywords in the online database. Thirty-four drugs were found for the treatment of DN. The most commonly used were Amomum kravanh, Terminalia chebula, and Tribulus terrestris, and we introduced the traditional uses and modern pharmacological activities of these drugs. The results indicate that Tibetan medicines for kidney disease could be used as potential candidate drugs for DN; they would expand the range of medications for DN and provide a new idea for the treatment of DN.

scholarly journals MicroRNA-451 as an Early Predictor of Chronic Kidney Disease in Diabetic Nephropathy

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Mostafa Abdelsalam ◽  
A. M. Wahab ◽  
Maysaa El Sayed Zaki ◽  
Mohamad Motawea
Keyword(s):  
Chronic Kidney Disease ◽  
Diabetic Nephropathy ◽  
Kidney Disease ◽  
Early Diagnosis ◽  
Serum Creatinine ◽  
High Sensitivity ◽  
Urinary Albumin ◽  
Significant Difference ◽  
Plasma Microrna ◽  
Stage Renal Disease

Background. Diabetes mellitus is the leading cause of end-stage renal disease worldwide. Microalbuminuria is the cornerstone for the diagnosis of diabetic nephropathy. However, it is an inadequate marker for early diagnosis. MicroRNAs are not only new and promising markers for early diagnosis but also, but they may also play a role in the prevention of disease progression. Methods. This study included ninety patients with type 2 DM in addition to 30 control subjects. MicroRNA-451 expression in blood and plasma using real-time PCR was evaluated in addition to the classic diabetic nephropathy markers (serum creatinine, urinary albumin, and eGFR). Results. There was a significant difference between the studied groups versus control regarding serum creatinine, eGFR, urinary, and plasma microRNA-451 with p=0.0001. Patients with eGFR 60 ml/min/1.73 m2 showed a significantly higher plasma microRNA-451 (29.6 ± 1.6) and significantly lower urinary microRNA-451 (21 ± 0.9) in comparison to patients with eGFR >60 ml/min/1.73 m2 and p=0.0001. eGFR showed a positive correlation with urinary microRNA-451 and negative correlation with both plasma microRNA-451 and urinary albumin. Both plasma and urinary microRNA-451 are highly sensitive and specific markers for chronicity in diabetic nephropathy patients with sensitivity of 90.9% and 95.5% and specificity of 67.6% and 95.6%, respectively. Conclusion. MicroRNA-451 is a promising early biomarker for chronic kidney disease in diabetic nephropathy with high sensitivity and specificity.

Histomorphometry of Feline Chronic Kidney Disease and Correlation With Markers of Renal Dysfunction

2012 ◽  
Vol 50 (1) ◽  
pp. 147-155 ◽  
Author(s):  
S. Chakrabarti ◽  
H. M. Syme ◽  
C. A. Brown ◽  
J. Elliott
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Image Analysis ◽  
Renal Function ◽  
Kidney Disease ◽  
Renal Dysfunction ◽  
Interstitial Fibrosis ◽  
Glomerular Hypertrophy ◽  
Renal Lesions ◽  
Postmortem Examinations

Chronic kidney disease is common in geriatric cats, but most cases have nonspecific renal lesions, and few studies have correlated these lesions with clinicopathological markers of renal dysfunction. The aim of this study was to identify the lesions best correlated with renal function and likely mediators of disease progression in cats with chronic kidney disease. Cats were recruited through 2 first-opinion practices between 1992 and 2010. When postmortem examinations were authorized, renal tissues were preserved in formalin. Sections were evaluated by a pathologist masked to all clinicopathological data. They were scored semiquantitatively for the severity of glomerulosclerosis, interstitial inflammation, and fibrosis. Glomerular volume was measured using image analysis; the percentage of glomeruli that were obsolescent was recorded. Sections were assessed for hyperplastic arteriolosclerosis and tubular mineralization. Kidneys from 80 cats with plasma biochemical data from the last 2 months of life were included in the study. Multivariable linear regression ( P < .05) was used to assess the association of lesions with clinicopathological data obtained close to death. Interstitial fibrosis was the lesion best correlated with the severity of azotemia, hyperphosphatemia, and anemia. Proteinuria was associated with interstitial fibrosis and glomerular hypertrophy, whereas higher time-averaged systolic blood pressure was associated with glomerulosclerosis and hyperplastic arteriolosclerosis.

Diabetic kidney disease in thedb/dbmouse

2003 ◽  
Vol 284 (6) ◽  
pp. F1138-F1144 ◽  
Author(s):  
Kumar Sharma ◽  
Peter McCue ◽  
Stephen R. Dunn
Keyword(s):  
Diabetic Nephropathy ◽  
Kidney Disease ◽  
Mouse Model ◽  
Renal Disease ◽  
Mouse Models ◽  
Diabetic Kidney Disease ◽  
Diabetic Kidney ◽  
Matrix Expansion ◽  
Stage Renal Disease ◽  
End Stage

Diabetic nephropathy is increasing in incidence and is now the number one cause of end-stage renal disease in the industrialized world. To gain insight into the genetic susceptibility and pathophysiology of diabetic nephropathy, an appropriate mouse model of diabetic nephropathy would be critical. A large number of mouse models of diabetes have been identified and their kidney disease characterized to various degrees. Perhaps the best characterized and most intensively investigated model is the db/ db mouse. Because this model appears to exhibit the most consistent and robust increase in albuminuria and mesangial matrix expansion, it has been used as a model of progressive diabetic renal disease. In this review, we present the findings from various studies on the renal pathology of the db/ db mouse model of diabetes in the context of human diabetic nephropathy. Furthermore, we discuss shortfalls of assessing functional renal disease in mouse models of diabetic kidney disease.

scholarly journals TERMINALIA CHEBULA: SUCCESS FROM BOTANY TO ALLOPATHIC AND AYURVEDIC PHARMACY

2016 ◽  
Vol 9 (5) ◽  
pp. 21
Author(s):  
Varun Garg ◽  
Barinder Kaur ◽  
Sachin Kumar Singh ◽  
Bimlesh Kumar
Keyword(s):  
Chemical Constituents ◽  
Present Review ◽  
Terminalia Chebula ◽  
Pharmacological Activities ◽  
Therapeutic Uses ◽  
Anti Cancer ◽  
Anti Oxidant ◽  
Anti Inflammatory

ABSTRACTTerminalia chebula (TC) is a unique herb having various therapeutic potentials as anti-inflammatory, antioxidant, anticancer, and digestant. It belongsto family Combretaceae. In the present review, an attempt has been made to decipher classification, chemical constituents, therapeutic uses, andpatents that have been reported for TC. Various pharmacological activities of TC that make it as potential medicine and its Ayurvedic formulationsare highlighted.Keywords: Terminalia chebula, Anti-oxidant, Anti-cancer, Ayurvedic formulations, Anti-oxidant.

scholarly journals MO638ANEMIA IN DIABETIC PATIENTS REFLECTS SEVERE TUBULOINTERSTITIAL INJURY AND ASSISTS CLINICALLY IN PREDICTING DIAGNOSIS OF DIABETIC NEPHROPATHY

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Soichiro Yokota ◽  
Kenji Ito ◽  
Maho Watanabe ◽  
Koji Takahashi ◽  
Naoko Himuro ◽  
...  
Keyword(s):  
Renal Function ◽  
Regression Analysis ◽  
Diabetic Nephropathy ◽  
Kidney Disease ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Kidney Biopsy ◽  
Renal Pathology ◽  
Diabetic Patients ◽  
Pathological Findings

Abstract Background and Aims Diabetic nephropathy (DN) is currently a leading cause of end-stage kidney disease worldwide. Kidney biopsy is generally performed in diabetic patients to discriminate between DN and non-diabetic kidney disease (NDKD), and to provide more specific treatments. In addition to conventional predicting factors of DN, recent studies suggested the predictive value of anemia in the diagnosis of DN, however detailed pathophysiology and the significance of anemia in renal pathology are not fully understood. This study aimed to investigate the impact of anemia on renal pathology and clinical course in patients who underwent kidney biopsy. Method We reviewed 81 patients (60.4 ± 13.7 years, 54 men and 27 women) with type 2 diabetes who underwent percutaneous kidney biopsy in Fukuoka University Hospital from January 2001 through March 2020. DN was diagnosed by mesangial expansion or nodular glomerulosclerosis observed under a light microscope, and immunofluorescence assisted in differentiating NDKD from DN. Anemia was defined as hemoglobin level &lt;13 g/dL in males and &lt;12 g/dL in females in accordance with the World Health Organization standards. Laboratory and pathological findings, and clinical courses were investigated. Results According to their pathological findings, patients were classified into two groups: isolated DN (DN group, n=30) and NDKD alone or concurrent DN (NDKD group, n=51). There were 11 types of NDKD. Of these, membranous nephropathy was the most common (23.5%), followed by IgA nephropathy (17.6%), and crescentic glomerulonephritis (13.7%). In multiple logistic regression analysis, absence of severe hematuria (odds ratio (OR) 11.66, 95% confidence interval (CI) 1.68 - 89.9) and presence of anemia (OR 11.38, 95% CI 2.51 - 51.52) were significantly related with the diagnosis of DN. Akaike’s information criterion (AIC) and net reclassification improvement (NRI) analyses revealed improved predictive performance by adding anemia to the conventional factors (AIC 100.152 to 91.844; NRI 27.0%). The tissues of patients in the DN group demonstrated more severe interstitial fibrosis and tubular atrophy (IF/TA) than the NDKD group (p&lt;0.05) regardless of the rate of global glomerulosclerosis (figure), and IF/TA was related to the prevalence of anemia (odds ratio: 7.31, 95% confidence interval: 2.33 - 23.00) in multivariate regression analysis. These results suggest DM-associated severe IF/TA (compared with NDKD) impaired erythropoietin production, resulting in earlier anemia, independent of glomerular injuries and renal function. Furthermore, the renal prognosis was significantly better in the NDKD group than in the DN group using Log-rank test (p&lt;0.05). Conclusion DN is associated with anemia because of severe IF/TA regardless of renal function, and anemia helps clinician discriminate clinically between isolated DN and NDKD.

scholarly journals Perubahan Kadar Protein dalam Urin terhadap Penggunaan Obat Antihipertensi (Valsartan) pada Pasien Nefropati

2019 ◽  
Vol 4 (1) ◽  
pp. 1-6
Author(s):  
Selly Septi Fandinata
Keyword(s):  
Blood Pressure ◽  
Diabetic Nephropathy ◽  
Kidney Disease ◽  
Metabolic Disorder ◽  
Meta Analysis ◽  
Normal Blood ◽  
Normal Blood Pressure ◽  
Central Hospital ◽  
Inclusion Criteria ◽  
Chronic Complication

ABSTRAKDiabetes mellitus (DM) adalah suatu sindroma gangguan metabolisme yang dicirikan dengan hiperglikemia abnormal sebagai akibat dari suatu defisiensi sekresi insulin, berkurangnya efektivitas aktivitas biologis insulin atau adanya resistensi insulin. Komplikasi kronik mikrovaskular, salah satunya yaitu Penyakit Ginjal Diabetik. Penyakit Ginjal Diabetik didefinisikan secara klinik yaitu penyakit DM dengan proteinuria yang menetap dalam urin. Meta analisis melaporkan bahwa proteinuria merupakan marker terjadinya kerusakan ginjal. Beberapa penelitian membuktikan bahwa terapi ARB dapat menurunkan derajat proteinuria pada pasien ginjal-diabetik. Terapi ARB yang paling banyak digunakan di RSUD Dr. Sutomo adalah valsartan. Tujuan dari penelitian ini adalah untuk mengetahui perubahan kadar protein dalam urin terhadap penggunaan antihipertensi (valsartan) pada pasien penyakit Nefropati. Penelitian dilakukan di Instalasi Rawat Jalan Penyakit Dalam RSUD Dr. Sutomo. Kriteria Inklusi yaitu penderita penyakit ginjal diabetik di Instalasi rawat jalan dengan proteinuria dan tekanan darah terkontrol (≤130/80mmHg), yang menggunakan terapi antihipertensi tunggal valsartan. Kriteria Eksklusi yaitu hiperkalemia, ISK, menggunakan obat-obatan yang mempengaruhi proteinuria (NSAID, vit B6, B12) dan kontraindikasi terhadap valsartan. Dari penelitian ini disimpulkan bahwa pada pemberian valsartan tidak terjadi perubahan distribusi derajat proteinuria, dari 27 penderita 29,6% mengalami penurunan, 59,26% tetap dan 11,11% mengalami peningkatan derajat proteinuria. Kesimpulan pada penelitian ini bahwa valsartan tidak mengalami perubahan dalam menurunkan deraajat proteinuria.Kata kunci: nefropati, proteinuria, ARB, valsartan. ABSTRACTDiabetes Mellitus (DM) is a syndrome of metabolic disorder characterized by abnormal hyperglicemia. One of the chronic complication DM is renal microangiopathy called Diabetic Nephropathy (DN). In addition, clinical DN is defined as DM with proteinuria. Meta analysis reported proteinuria as a marker of kidney damage as predictor of progressive kidney disease is robust. Moreover several trials concluded ARBs treatment could reduce the level of proteinuria in DN patients. ARBs treatment used in RSUD Dr. Soetomo Central Hospital Surabaya is valsartan. The purpose of this study was to determine the effect of valsartan treatments on the proteinuria level in DN patients. This study was done at the outpatients clinic departement RSUD Dr. Soetomo Central Hospital Surabaya. The inclusion criteria were DN patients with normal blood pressure (≤130/80mmHg). Twenty seven patients were enrolled in this study. The result showed valsartan antiproteinuria, there was no change in proteinuria level distribution. From twenty seven patients 29,6% decreased, 59,26% did not change and 11,11% increased proteinuria level. As a conclusion, valsartan treatment no change in proteinuria level distribution.Keywords: diabetic nephropathy, proteinuria, ARBs, valsartan.

scholarly journals Urinary Markers of Glomerular Injury in Diabetic Nephropathy

2012 ◽  
Vol 2012 ◽  
pp. 1-11 ◽  
Author(s):  
Abraham Cohen-Bucay ◽  
Gautham Viswanathan
Keyword(s):  
Renal Failure ◽  
Diabetic Nephropathy ◽  
Kidney Disease ◽  
Current Literature ◽  
Cardiovascular Events ◽  
Diabetic Kidney Disease ◽  
Glomerular Injury ◽  
Diabetic Kidney ◽  
Urinary Markers

Diabetic nephropathy, the leading cause of renal failure worldwide, affects approximately one-third of all people with diabetes. Microalbuminuria is considered the first sign and the best predictor of progression to renal failure and cardiovascular events. However, albuminuria has several limitations. Therefore, earlier, more sensitive and specific biomarkers with greater predictability are needed. The aim of this paper is to discuss the current literature on biomarkers of glomerular injury that have been implicated in diabetic kidney disease.

scholarly journals The role of renal dipeptidyl peptidase-4 in kidney disease: renal effects of dipeptidyl peptidase-4 inhibitors with a focus on linagliptin

2018 ◽  
Vol 132 (4) ◽  
pp. 489-507 ◽  
Author(s):  
Keizo Kanasaki
Keyword(s):  
Type 2 Diabetes ◽  
Diabetic Nephropathy ◽  
Growth Factor ◽  
Kidney Disease ◽  
Dipeptidyl Peptidase ◽  
Renal Effects ◽  
Dipeptidyl Peptidase 4 ◽  
Dipeptidyl Peptidase 4 Inhibitors ◽  
Membrane Bound

Emerging evidence suggests that dipeptidyl peptidase-4 (DPP-4) inhibitors used to treat type 2 diabetes may have nephroprotective effects beyond the reduced renal risk conferred by glycemic control. DPP-4 is a ubiquitous protein with exopeptidase activity that exists in cell membrane-bound and soluble forms. The kidneys contain the highest levels of DPP-4, which is increased in diabetic nephropathy. DPP-4 inhibitors are a chemically heterogeneous class of drugs with important pharmacological differences. Of the globally marketed DPP-4 inhibitors, linagliptin is of particular interest for diabetic nephropathy as it is the only compound that is not predominantly excreted in the urine. Linagliptin is also the most potent DPP-4 inhibitor, has the highest affinity for this protein, and has the largest volume of distribution; these properties allow linagliptin to penetrate kidney tissue and tightly bind resident DPP-4. In animal models of kidney disease, linagliptin elicited multiple renoprotective effects, including reducing albuminuria, glomerulosclerosis, and tubulointerstitial fibrosis, independent of changes in glucagon-like peptide-1 (GLP-1) and glucose levels. At the molecular level, linagliptin prevented the pro-fibrotic endothelial-to-mesenchymal transition by disrupting the interaction between membrane-bound DPP-4 and integrin β1 that enhances signaling by transforming growth factor-β1 and vascular endothelial growth factor receptor-1. Linagliptin also increased stromal cell derived factor-1 levels, ameliorated endothelial dysfunction, and displayed unique antioxidant effects. Although the nephroprotective effects of linagliptin are yet to be translated to the clinical setting, the ongoing Cardiovascular and Renal Microvascular Outcome Study with Linagliptin in Patients with Type 2 Diabetes Mellitus (CARMELINA®) study will definitively assess the renal effects of this DPP-4 inhibitor. CARMELINA® is the only clinical trial of a DPP-4 inhibitor powered to evaluate kidney outcomes.

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