Animal models of chronic kidney disease: Screening tool to investigate nephroprotective effects of natural products

Abstract Background and Aims Stabilizers of hypoxia-inducible factor (HIF) have been shown to be effective on treatment of anemia in patients with chronic kidney disease (CKD). Increased erythropoietin (EPO) production and enhanced erythropoiesis are known to be the major mechanisms responsible for the treatment effects. However, the effect of HIF stabilization on renal fibrosis is controversial. We created animal models characterized by CKD and pericyte-specific stabilization of HIF to examine the effects of HIF on renal fibrosis and erythropoiesis. Method Gli1CreERT2/+;Egln1F/F, Gli1CreERT2/+;VhlF/F, and Gli1CreERT2/+;Hif1aF/F;Hif2aF/F mice were generated to study the effects of pericyte-specific overexpression or knockout of Hif. Unilateral ureteral obstruction (UUO) was used to induce CKD. The severity of fibrosis was determined by Picrosirius red stain and Col1a1 mRNA level in the kidney. Results Pericyte-specific stabilization of HIF resulted in increased serum EPO level, augmented splenic erythropoiesis, and polycythemia, while the severity of renal fibrosis was not affected. In line with these findings, pericyte-specific knockout of Hif1a or Hif2a did not result in significant change of renal fibrosis. Conclusion Our study endorses the neutral effects of pericyte-specific HIF stabilization on renal fibrosis.

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Texture branch network for chronic kidney disease screening based on ultrasound images

Frontiers of Information Technology & Electronic Engineering ◽

10.1631/fitee.1900210 ◽

2019 ◽

Vol 21 (8) ◽

pp. 1161-1170 ◽

Cited By ~ 1

Author(s):

Peng-yi Hao ◽

Zhen-yu Xu ◽

Shu-yuan Tian ◽

Fu-li Wu ◽

Wei Chen ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Disease Screening ◽

Ultrasound Images

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Medical Neighborhood Model for the Care of Chronic Kidney Disease Patients

American Journal of Nephrology ◽

10.1159/000448294 ◽

2016 ◽

Vol 44 (4) ◽

pp. 308-315 ◽

Cited By ~ 4

Author(s):

Zoe G. Smith ◽

Lynn McNicoll ◽

Timothy L. Clark ◽

Andrew J. Cohen ◽

Antonia L. Ross ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Screening Tool ◽

Interdisciplinary Team ◽

Patient Centered Medical Home ◽

Model Of Care ◽

Patient Centered ◽

Ckd Stage ◽

Baseline Characteristics ◽

Blue Shield

Background: The patient-centered medical home is a popular model of care, but the patient-centered medical neighborhood (PCMN) is rarely described. We developed a PCMN in an academic practice to improve care for patients with chronic kidney disease (CKD). The purpose of this study is to identify the prevalence of CKD in this practice and describe baseline characteristics, develop an interdisciplinary team-based approach to care and determine cost associated with CKD patients. Methods: Patients with CKD stage 3a with comorbidities through stage 5 were identified. Data collected include demographics, comorbidities and whether patients had a nephrologist. Using a screening tool based on the 2012 Kidney Disease Improving Global Outcomes guidelines, a nurse care manager (NCM) made recommendations about management including indications for referral. A pharmacist reviewed patients' charts and made medication-related recommendations. Blue Cross Blue Shield (BCBS) insurance provided cost data for a subset of patients. Results: A total of 1,255 patients were identified. Half did not have a formal diagnosis of CKD and three-quarters had never seen a nephrologist. Based on the results of the screening tool, the NCM recommended nephrology E-consult or full consult for 85 patients. The subset of BCBS patients had a mean healthcare cost of $1,528.69 per member per month. Conclusions: We implemented a PCMN that allowed for easy identification of a high-risk, high-cost population of CKD patients and optimized their care to reflect guideline-based standards.

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