scholarly journals Placental Cryoextract and Renin-Angiotensin-Aldosterone System Blockade Mitigate Renal Failure in Rats

2021 ◽  
Vol 31 (3) ◽  
pp. 223-235
Author(s):  
Mykola Repin ◽  
◽  
Yuliia Chyzh ◽  
Larysa Marchenko ◽  
Tetyana Govorukha ◽  
...  
Keyword(s):  
Renal Failure ◽  
Rat Kidney ◽  
Kidney Tissue ◽  
Renal Tissue ◽  
Renin Angiotensin Aldosterone System ◽  
Renin Angiotensin ◽  
Excretory Function ◽  
Comprehensive Therapy ◽  
Inflammatory Processes ◽  
The Impact

Here, we have studied the impact of administration of rat placental cryoextract (PCE), drug blockade of the renin-angiotensin-aldosterone system (RAAS) with enalapril and spironolactone and their combination on the rat kidney tissue structure and excretory function at different stages of chronic renal failure (CRF) development using the glycerol model. In 3 weeks after glycerol introduction, the animals from all the groups showed low values of glomerular filtration rate, impaired blood flow in renal cortex, tubular epithelial dystrophy, inflammation and edema of interstitium, indicating the onset of CRF development. Tubulo-interstitial nephritis and nephrosclerosis were dominated in untreated rats 16 weeks later. The use of RAAS drug blockade, as well as a comprehensive therapy with RAAS blockers and placental cryoextract stopped the inflammatory processes in renal tissue, restored blood circulation and normalized excretory function, which persisted for up to 16 weeks of observation.

MO421THE EFFECT OF RENIN-ANGIOTENSIN-ALDOSTERONE SYSTEM BLOCKADE MEDICATIONS ON CONTRAST-INDUCED NEPHROPATHY IN PATIENTS UNDERGOING CORONARY ANGIOGRAPHY

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Emna Chaabouni ◽  
Hela Jbali ◽  
Najjar Mariem ◽  
Mzoughi Khadija ◽  
Zouaghi Mohamed karim
Keyword(s):  
Renal Failure ◽  
Chronic Renal Failure ◽  
Coronary Angiography ◽  
Low Cost ◽  
Contrast Induced Nephropathy ◽  
Renin Angiotensin Aldosterone System ◽  
Renin Angiotensin ◽  
Raas Blockade ◽  
Significant Difference ◽  
The Impact

Abstract Background and Aims Contrast-induced nephropathy (CIN) is the main complication of contrast media administration in patients undergoing coronary angiography (CAG). This complication may be accelerated by concurrent renin-angiotensin-aldosterone system (RAAS) blockers . Current literature is inconclusive. We investigated the impact of RAAS blockade on the occurrence of CIN in patients undergoing CAG. Method We prospectively enrolled 158 patients who underwent CAG with or without percutaneous coronary intervention from December 2017 to February 2018 at a cardiology department . CIN was defined as an increase in serum creatinine level >25% or 0.5 mg/dL after 48 hours postcardiac catheterization. Results Of 158 patients (females=36.1%, mean age 60.0 ± 11 years) who underwent CAG , 15 (9,5%) developed CIN . Eighty one patients (51,2%) were chronic RAAS blockade users. There was no significant difference between the two groups, RAAS blockade 'used' versus 'not-used', in the incidence of postprocedural CIN (7,5% vs 11,5%, p=0,38). However , the pre-contrast use of RASS blockers decrease the risk of CIN in patients with chronic renal failure (12,5% vs 66,6% , p=0,042) . Conclusion RAAS blockade isn’t associated with a significantly higher incidence of CIN, whereas it has the potential to mitigate the incidence of CIN in patients with chronic renal failure. This low cost intervention could be considered when referring a patient for cardiac catheterization.

scholarly journals How to potentialize the effect of renin-angiotensin-aldosterone system inhibitors?

KIDNEYS ◽  
2021 ◽  
Vol 10 (3) ◽  
pp. 156-161
Author(s):  
D.D. Ivanov
Keyword(s):  
Current Trend ◽  
Renin Angiotensin System ◽  
Significant Loss ◽  
Scientific Review ◽  
Renin Angiotensin Aldosterone System ◽  
Angiotensin System ◽  
Renin Angiotensin ◽  
Excretory Function ◽  
Ckd Stage ◽  
Lespedeza Capitata

The scientific review presents a practical analysis of the properties of Lespedeza capitata in terms of its attractiveness for nephrological practice. Lespedeza shows many effects on ectoderm derivatives, including skin and the kidneys. Thus, the results of studies showed significant stimulation of the growth of fibroblasts and keratinocytes, as well as increased collagen synthesis with a lipolytic effect on adipocytes. The researchers concluded the possibility of using herbal medicinal preparations of Lespedeza capitata to stimulate skin cells and tissue regeneration, for anti-aging therapy and induction of lipolysis due to flavonoid extract. Lespedeza capitata extract enhances diuresis, eliminates edema, reduces azotaemia and albuminuria, increases sodium excretion, and to lesser extent potassium, promotes renal filtration and excretion of nitrogenous products in the urine. The advantages of phytotherapy in normalizing the capillary permeability of the glomeruli are a mild diuretic effect, which prevents a significant loss of electrolytes in contrast to synthetic diuretics. These effects are now considered as potentiating the action of inhibitors of the renin-angiotensin system, which is the basis of renoprotection in modern nephrology. Lespedeza flavonoids improve protein-energy metabolism, which has been demonstrated in many models of acute renal failure. Correction of protein metabolism has a favourable nephroprotective effect and slows the progression of chronic kidney disease (CKD) while maintaining normal excretory function. Lespedeza extract can be considered as a substance that enhances the action of renin-angiotensin-aldosterone system inhibitors (RAASi), acting synergistically in inhibiting the activity of the renin-angiotensin system. This property of the drug becomes very relevant in patients with CKD stage 5 when the abolition of RAASi today corresponds to the current trend. Maintaining a small dose of RAASi in stage 10 CKD, or the use of RAASi with extrarenal elimination in combination with Lespedeza extract demonstrates encouraging results in clinical practice.

Analysing the impact of a guideline for the use of new potassium binders for treatment of chronic hyperkalaemia to maximise inhibition of renin–angiotensin–aldosterone system (RAAS) within the general nephrology clinic?

2020 ◽  
Author(s):  
Priyank Patel ◽  
Andrew Frankel
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Renin Angiotensin Aldosterone System ◽  
Renin Angiotensin ◽  
Ckd Stage ◽  
The Mean ◽  
Potassium Binders ◽  
The Impact ◽  
Chronic Use

Abstract Background Renin–angiotensin–aldosterone system (RAAS) inhibitors provide significant cardiorenal benefits with improved long-term outcomes for patients. This is most significant for patients receiving maximal RAAS inhibition, but some patients are unable to tolerate this therapy because of hyperkalaemia. Recently published National Institute for Health and Care Excellence (NICE) technology appraisal guidance recommended using sodium zirconium cyclosilicate (SZC) and patiromer for patients with chronic kidney disease (CKD) stage 3b to 5 or heart failure with reduced ejection fraction, who are not taking an optimised dosage of RAAS inhibitor because of hyperkalaemia. Objective Determine the impact of a locally produced guideline on effective implementation of NICE recommendation for use of SZC or patiromer to help maximise inhibition of the renin–angiotensin–aldosterone system within the general nephrology clinic. Methods A local guideline to practically support the implementation of recommendations made by NICE in the chronic use of new potassium binders was produced. One hundred sequential patients in a general nephrology clinic with non-immune chronic kidney disease (CKD 3 to 5) had their electronic records reviewed. Those with an indication for RAAS inhibition were identified. Results Of the 100 consecutive patients audited, 46 were female and 54 were male. The mean age of these patients was 64 and the mean estimated glomerular filtration rate (eGFR) was 33. Sixty-eight patients had an indication for being on RAAS inhibition with only 10 on maximal doses. Of the remaining 58 patients, 26 (45%) were limited by hyperkalaemia. Of these 26 patients, 12 of these patients (46%) had hyperkalaemia associated with an episode of acute kidney injury (AKI). Therefore, 14% of patients attending a general nephrology clinic were identified suitable for SZC and patiromer. Conclusions A significant proportion (14%) of unselected patients attending a general nephrology clinic were not on optimum RAAS inhibition due to hyperkalaemia. These patients would meet the criteria established within a working guideline for the implementation of the chronic use of SZC or patiromer and are likely to attain prognostic long-term benefit by using these new potassium binders to maximise RAAS inhibition. This analysis has implications for renal centres across the UK.

scholarly journals SUN-LB94 Impact of the Gut Microbiome and Renin-Angiotensin-Aldosterone System in Hypertensive Patients With Low-Salt Intake

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Kouki Taniguchi ◽  
Satoshi Nagase ◽  
Shigehiro Karashima ◽  
Mitsuhiro Kometani ◽  
Daisuke Aono ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Gut Microbiome ◽  
Salt Intake ◽  
High Salt ◽  
Renin Angiotensin Aldosterone System ◽  
Hypertensive Patients ◽  
Renin Angiotensin ◽  
High Salt Intake ◽  
Low Salt ◽  
The Impact

Abstract Salt intake is one of most important environmental factors responsible for triggering the onset of hypertension. Renin-angiotensin-aldosterone system (RAAS) plays a key role in adjusting sodium homeostasis and blood pressure. Recently, the potential role of the gut microbiome (GM) in altering the health of the host has drawn considerable attention. We investigated the impact of intestinal microflora and RAAS in hypertensive patients with low-salt or high-salt intake using an observational study. A total of 239 participants were enrolled and their GMs and clinical backgrounds examined, including the renin-angiotensin-aldosterone system and inflammatory cytokine levels. On the basis of enterotypes—determined by cluster analysis—and salt intake, the participants were classified into four groups, low salt/GM enterotype 1, low salt/GM enterotype 2, high salt/GM enterotype 1, and high salt/GM enterotype 2. The prevalence of hypertension was significantly lower in the low-salt intake (low salt/GM enterotype 1 = 47% vs low salt/GM enterotype 2 = 27%, p = 0.04) groups. No significant difference in the prevalence of hypertension was observed for the two GM enterotype groups with high-salt intake (GM enterotype 1 = 50%, GM enterotype 2 = 47%; p = 0.83). Plasma aldosterone concentration was significantly different among the four groups (p < 0.01). Furthermore, the relative abundance of Blautia, Bifidobacterium, Escherichia-Shigella, Lachnoclostridium, and Clostridium sensu stricto was also significantly different among these enterotypes. This suggested in certain individuals (with specific gut bacteria composition) changing dietary habits—to low salt—would be ineffective for regulating hypertension through RAAS. Our findings provide a new strategy for controlling blood pressure and preventing the development of hypertension through restoring GM homeostasis.

scholarly journals Clinical Features of COVID-19 in Patients With Essential Hypertension and the Impacts of Renin-angiotensin-aldosterone System Inhibitors on the Prognosis of COVID-19 Patients

Hypertension ◽  
2020 ◽  
Vol 76 (3) ◽  
pp. 732-741 ◽  
Author(s):  
Wei Pan ◽  
Jishou Zhang ◽  
Menglong Wang ◽  
Jing Ye ◽  
Yao Xu ◽  
...  
Keyword(s):  
Cox Regression ◽  
Medication History ◽  
Renin Angiotensin Aldosterone System ◽  
Cox Regression Analysis ◽  
Renin Angiotensin ◽  
Reactive Protein ◽  
All Cause Mortality ◽  
History Of ◽  
Raas Inhibitors ◽  
The Impact

Hypertension is one of the most common comorbidities in patients with coronavirus disease 2019 (COVID-19). This study aimed to clarify the impact of hypertension on COVID-19 and investigate whether the prior use of renin-angiotensin-aldosterone system (RAAS) inhibitors affects the prognosis of COVID-19. A total of 996 patients with COVID-19 were enrolled, including 282 patients with hypertension and 714 patients without hypertension. Propensity score-matched analysis (1:1 matching) was used to adjust the imbalanced baseline variables between the 2 groups. Patients with hypertension were further divided into the RAAS inhibitor group (n=41) and non-RAAS inhibitor group (n=241) according to their medication history. The results showed that COVID-19 patients with hypertension had more severe secondary infections, cardiac and renal dysfunction, and depletion of CD8 + cells on admission. Patients with hypertension were more likely to have comorbidities and complications and were more likely to be classified as critically ill than those without hypertension. Cox regression analysis revealed that hypertension (hazard ratio, 95% CI, unmatched cohort [1.80, 1.20–2.70]; matched cohort [2.24, 1.36–3.70]) was independently associated with all-cause mortality in patients with COVID-19. In addition, hypertensive patients with a history of RAAS inhibitor treatment had lower levels of C-reactive protein and higher levels of CD4 + cells. The mortality of patients in the RAAS inhibitor group (9.8% versus 26.1%) was significantly lower than that of patients in the non-RAAS inhibitor group. In conclusion, hypertension may be an independent risk factor for all-cause mortality in patients with COVID-19. Patients who previously used RAAS inhibitors may have a better prognosis.

Ligusticum chuanxiong Effects on Oxidative Stress and Nrf2/HO-1 Signaling Using Nano-Magnetic Beads in Bleomycin-Induced Renal Fibrosis Rats

2020 ◽  
Vol 12 (10) ◽  
pp. 1185-1191
Author(s):  
Haixia Liu ◽  
Wenwen Huang ◽  
Xinli Han ◽  
Qihang Ma
Keyword(s):  
Renal Fibrosis ◽  
Magnetic Beads ◽  
Rat Kidney ◽  
Smooth Muscle Actin ◽  
Kidney Tissue ◽  
Renal Tissue ◽  
High Dose ◽  
Early Administration ◽  
Ligusticum Chuanxiong ◽  
Hematoxylin Eosin

Ligusticum chuanxiong can relieve the degree of renal fibrosis. However, the specific mechanism of Ligusticum chuanxiong to improve renal fibrosis is not yet clear. A unilateral ureteral obstruction was used to construct a rat renal fibrosis model. The rats were treated with 20 mg/kg and 40 mg/kg of Ligusticum chuanxiong. Four weeks after treatment, blood was collected from the rats, and the rats were sacrificed. Blood urea nitrogen (BUN), serum creatinine (Scr), kidney tissue malondialdehyde (MDA), and superoxide dismutase (SOD) levels were detected. Hematoxylin–eosin staining was used to observe the pathological rat kidney changes. The renal tissue smooth muscle actin (α-SMA) was detected by immunohistochemistry. Nrf2 and HO-1 levels were determined by PCR using nano-magnetic beads. The results showed BUN, Scr, and MDA levels reduced, while SOD levels were elevated in Ligusticum chuanxiong-treated rats, compared to model rats (P < 0.05). These effects were more dramatic in Ligusticum chuanxiong high dose (HD) rats compared to Ligusticum chuanxiong low dose (LD) rats. Additionally, Nrf2 and HO-1 levels were elevated in Ligusticum chuanxiong-treated rats (P < 0.05). These effects were also more dramatic in HD rats compared to LD rats. These findings indicated that Ligusticum chuanxiong early administration can reduce renal fibrosis in rats by stimulating the Nrf2/HO-1 pathway.

RENIN-ANGIOTENSIN-ALDOSTERONE SYSTEM INHIBITORS AND COVID-19 COMPLICATIONS

2021 ◽  
Author(s):  
ARTHUR FIOROTTO DE MATTOS ◽  
NATHALIA SILVEIRA BARSOTTI ◽  
RAFAEL RIBEIRO ALMEIDA
Keyword(s):  
Rna Virus ◽  
Host Cells ◽  
Converting Enzyme ◽  
Respiratory Complications ◽  
Renin Angiotensin Aldosterone System ◽  
Renin Angiotensin ◽  
The World ◽  
Raas Inhibitors ◽  
The Impact ◽  
Different Tissues

The world faces today a pandemic of unquestionable importance, caused by an infection with a new enveloped RNA virus that belongs to the Coronaviridae family. The new coronavirus (SARS-CoV 2) uses a glycoprotein present on its surface to bind to and infect host cells that express the angiotensin converting enzyme II (ACE-2). Although different tissues may be targeted by the virus, respiratory complications remain as the main cause of death. It has been demonstrated that Renin-Angiotensin-Aldosterone System (RAAS) inhibitors increase ACE-2 expression in animal models, raising the concern that patients under treatment with these drugs could become more susceptible to COVID-19 complications. Here, we discuss the impact of RAAS inhibitors on COVID-19 outcomes and show that no evidence so far supports that the use of these drugs could pose a risk to SARS-CoV 2-infected patients. In fact, clinical data suggest that RAAS inhibitors may even act in a protective way against COVID-19 complications and should not be discontinued.,

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