THE CONTENTS OF SCD40 AND INDICATORS OF DAMAGED ENDOTHELIUM IN PATIENTS WITH CHRONIC KIDNEY DISEASE

Introduction. Impairments of endothelial structure and functions of renal vessels are regarded as important factors of progression and chronization of chronic kidney disease (CKD). It is well known that the CD40/CD40L interaction is responsible for the aggregation of blood cells and their adhesion to the vascular wall, as well as its effect on the state of immune response. We investigated whether this interaction could be altered in patients with CKD and impaired immune status. Materials and methods. We examined 48 patients with chronic glomerulonephritis (CGN), 38 patients with chronic pyelonephritis and 42 patients with essential hypertension (EH) - control group. All patients received standard therapy with an ACE inhibitor perindopril in combination with a calcium channel antagonist amlodipine. Along with standard therapy the patients intravenously administered injections of "Kardioarginine." The degree of endothelial damage was assessed by the number of CEC and VE-cadherin content in blood plasma. In order to estimate changes in the immune status we determined the content of sCD40 in serum. Results. Increase in the content of serum sCD40 was shown for the CGN patients compared with healthy subjects and EH patients. The level of sCD40 in serum correlated with the number of CEC and VE-cadherin content in plasma. The use of kardioarginine combined with standard therapy led to reduction of sCD40 and stabilized the structure of endothelium. The loss of endothelial integrity in patients with CKD is apparently due to the activation of apoptosis with subsequent accelerated desquamation under the influence of activated white blood cells and the system of cytokines. Conclusions. The increase of sCD40 in patients with CKD may be a compensatory mechanism aimed to reduce the inflammatory activity by blocking the CD40/CD40L interaction at the cellular level.

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ROLE OF HYPOXIA–INDUCED APOPTOSIS IN CHRONIC GLOMERULONEPHRITIS PROGRESSION IN CHILDREN

Ukrainian Journal of Nephrology and Dialysis ◽

10.31450/ukrjnd.4(44).2014.03 ◽

2014 ◽

pp. 41-45

Author(s):

V.G. Maidannyk ◽

E.A. Burlaka ◽

I.V. Bagdasarova ◽

S.P. Fomina ◽

V.M. Nepomnyaschiy

Keyword(s):

Chronic Kidney Disease ◽

Glomerular Filtration Rate ◽

Kidney Disease ◽

Glomerular Filtration ◽

Kidney Function ◽

Filtration Rate ◽

Control Group ◽

Chronic Glomerulonephritis ◽

Disease Course ◽

Function Impairment

Aim of the study: to study the indicators of cellular hypoxia and apoptosis in pediatric patients with nephritic type of chronic glomerulonephritis. Material and methods: 52patients with active stage of nephrotic type ofChronic glomerulonephritis were inspected. All patients were divided into groups of Chronic Kidney Disease (CKD) by the level of glomerular filtration rate (GFR). Detection of the hypoxia–induced factor (HIF) and antiapoptotic factor Bcl–xL in serum performed using Western Blotting assay and immunohistochemically on material of kidney biopsies. Imaging was done using confocal laser microscopy. Results: it has been found that the disease course is accompanied by increased levels of hypoxia–induced factor HIF–1a and decreased expression of antiapoptotic factor Bcl–xL (in plasma and on biopsies). Detected changes significantly depended on the degree of proteinuria and declining of glomerular filtration rate. Dependence between the levels of hypoxia–induced damages and level of kidney function impairment was documented. In children with Chronic Kidney Disease (SKDIst.) HIF–1a was at level 128.6±2.3% (P<0.01, compared to Control group), in children with CKD II–III st. – 141.3±1.9% (P<0.01, compared to Control group and CKD I st.). Level of antiapoptotic defense in children with nephrotic type of Chronic glomerulonephritis was related to the level of kidney function impairment as well. In group of patient with CKDIst. Bcl–xL expression was down–regulated to 75.1±2.2%, in group with CKDII–IIIst. — to 60.1+1.8% (P<0.01 and P<0.001, compared to Control group, respectively). The level of evaluated changes has a dependence on levels ofproteinuria and kidney function impairment. Conclusion. Studied parameters might be used as predictors of unfavorable disease course.

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Structural-functional state of erythrocytes in children with chronic kidney disease

Medical alphabet ◽

10.33667/2078-5631-2019-1-7(382)-105-108 ◽

2019 ◽

Vol 1 (7) ◽

pp. 105-108

Author(s):

A. V. Sabirova ◽

D. K. Volosnikov ◽

O. V. Matyash

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Red Blood Cells ◽

Functional State ◽

Peripheral Blood ◽

Blood Cells ◽

Early Stage ◽

Control Group ◽

Healthy Children ◽

Range Analysis

During Chronic Kidney Disease (CKD) development and progression emphasis is placed on structural-functional state of red blood cells. The aim of this paper is to examine red blood values and red blood cells morphological type in peripheral blood among children with CKD. 75 children with CKD aged 5-16 years were examined. The control group consisted of 25 healthy children of the same age range. Analysis of the morphometric parameters of red peripheral blood cells - mean volume (MCV) and erythrocyte diameter, mean content (MCH) and mean hemoglobin concentration in the erythrocyte (MCHC), were performed using a Gobas Micros (Roche) hematology counter. Smears were marked according to Romanovsky-Giemsa. Morphometric studies of red blood cells were carried out using the Morphology 5.2 program and red blood cell confocal microscopy on a LSM-710 Confocal Microscope, manufactured by Carl Zeiss. The tendency to poikilocytosis in CKD was confirmed. We identified that among children with CKD the distribution of red blood cells in diameter is disturbed, the content of microcytes increases, poikilocytosis is observed with an increase in the content of irreversibly transformed elements. The revealed features may serve as an additional criterion for the diagnosis of chronic kidney insufficiency at the early stage.

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Creating an arteriovenous fistula in patients with chronic kidney disease stage 5

Kazan medical journal ◽

10.17750/kmj2015-298 ◽

2015 ◽

Vol 96 (3) ◽

pp. 298-302

Author(s):

I V Zakieva ◽

M V Timerbulatov ◽

T R Galimov ◽

S R Tuysin

Keyword(s):

Diabetes Mellitus ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Arteriovenous Fistula ◽

Main Group ◽

Disease Stage ◽

Control Group ◽

Chronic Glomerulonephritis ◽

Patients With Diabetes

Aim. Comparative assessment of microsurgical and traditional methods for creating an arteriovenous fistula for long-term hemodialysis in patients with chronic renal failure.Methods. Results of arteriovenous fistula surgeries for creating arteriovenous fistula for long-term hemodialysis in 169 patients with chronic renal failure in the period from 2008 to 2013 were analyzed. The main group included 87 patients in whom arteriovenous fistula was formed by microsurgery. For fistula thrombosis prophylaxis, 40 mg of nadroparin calcium (fraxiparine) was used in this group after surgery as a postoperative bolus, followed by 7 days subcutaneous administration. Arteriovenous fistula in patients of the main group underwent anti-thrombogenic treatment: paravasal tissues and vessel outside were irrigated by 1% sodium chloride methylthioninium (methylene blue) after the main phase of the operation, followed by lysine acetylsalicylate standard solution after 2 minutes. The control group included 82 patients in whom fistula was created conventionally without using microsurgical techniques. For arteriovenous fistula thrombosis prevention, 5000 IU of sodium heparin was used 4 times a day in patients of the control group.Results. In the main group, five cases of fistula thrombosis were observed in patients with diabetes mellitus and two in patients with chronic glomerulonephritis. In the control group, arteriovenous fistula thrombosis in the early postoperative period was recorded in 13 patients with diabetes mellitus, in four - with chronic glomerulonephritis, and in one - with polycystic kidney disease. In one (1.15%) patient of the main group and in three (3.66%) in the control group, wound infection associated with inflammatory processes development at the surgical wound was noted.Conclusion. Microsurgical formation of arteriovenous fistula in patients with terminal stage of chronic kidney disease is the method of choice (especially with concomitant diabetes mellitus), allowing to significantly reduce the risk for arteriovenous fistula thrombosis and therefore reduce the number of unsatisfactory results.

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P0203EARLY DETECTION OF BREAST ARTERIAL CALCIFICATION IN DIFFERENT STAGES OF CHRONIC KIDNEY DISEASE PATIENTS

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa142.p0203 ◽

2020 ◽

Vol 35 (Supplement_3) ◽

Author(s):

Basma Sultan ◽

Hamdy Omar ◽

Housseini Ahmed ◽

Mahmoud Elprince ◽

Osama Anter adly ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Lipid Profile ◽

Statistical Significance ◽

University Hospital ◽

Arterial Calcification ◽

Control Group ◽

Inpatient Ward ◽

Stage 4 ◽

Ckd Stage

Abstract Background and Aims Vascular calcification (VC) plays a major role in cardiovascular disease (CVD), which is one of the main causes of mortality in patients with chronic kidney disease (CKD). The study aims at early detection of breast arterial calcification (BAC) in different stages of CKD (stage 2, 3& 4) patients as an indicator of systemic VC. Method A case control study was conducted targeting CKD women, aged 18- 60 years old. The sample was divided into 3 groups; A,B,C (representing stage 2, 3 & 4 of CKD) from women who attended nephrology and Internal medicine clinics and admitted in inpatient ward in Suez Canal University Hospital. A 4th group (D) was formed as a control group and included women with normal kidney functions (each group (A, B, C, D) include 22 women). The selected participants were subjected to history taking, mammogram to detect BAC and biochemical assessment of lipid profile, Serum creatinine (Cr), Mg, P, Ca, PTH and FGF23. Results Our study detected presence of BAC in about 81.8% of hypertensive stage 4 CKD patients compared with 50% in stage 3 CKD, also in the majority of stage 4 CKD patients who had abnormal lipid profile parameters and electrolyte disturbance. Most of the variables had statistical significance regarding the presence of BAC. Conclusion Although it is difficult to determine the definite stage at which the risk of VC begins but in our study, it began late in stage 2 CKD, gradually increased prevalence through stage 3 and became significantly higher in stage 4. These results suggest that preventive strategies may need to begin as early as stage 2 CKD.

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Oxidative Stress in Non-Dialysis-Dependent Chronic Kidney Disease Patients

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18157806 ◽

2021 ◽

Vol 18 (15) ◽

pp. 7806

Author(s):

Patricia Tomás-Simó ◽

Luis D’Marco ◽

María Romero-Parra ◽

Mari Carmen Tormos-Muñoz ◽

Guillermo Sáez ◽

...

Keyword(s):

Oxidative Stress ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Reduced Glutathione ◽

Genetic Material ◽

Future Research ◽

Control Group ◽

Dialysis Patients ◽

Early Stages ◽

Molecular Lines

Background: Cardiovascular complications are the leading cause of morbidity and mortality at any stage of chronic kidney disease (CKD). Moreover, the high rate of cardiovascular mortality observed in these patients is associated with an accelerated atherosclerosis process that likely starts at the early stages of CKD. Thus, traditional and non-traditional or uremic-related factors represent a link between CKD and cardiovascular risk. Among non-conventional risk factors, particular focus has been placed on anaemia, mineral and bone disorders, inflammation, malnutrition and oxidative stress and, in this regard, connections have been reported between oxidative stress and cardiovascular disease in dialysis patients. Methods: We evaluated the oxidation process in different molecular lines (proteins, lipids and genetic material) in 155 non-dialysis patients at different stages of CKD and 45 healthy controls. To assess oxidative stress status, we analyzed oxidized glutathione (GSSG), reduced glutathione (GSH) and the oxidized/reduced glutathione ratio (GSSG/GSH) and other oxidation indicators, including malondialdehyde (MDA) and 8-oxo-2’-deoxyguanosine (8-oxo-dG). Results: An active grade of oxidative stress was found from the early stages of CKD onwards, which affected all of the molecular lines studied. We observed a heightened oxidative state (indicated by a higher level of oxidized molecules together with decreased levels of antioxidant molecules) as kidney function declined. Furthermore, oxidative stress-related alterations were significantly greater in CKD patients than in the control group. Conclusions: CKD patients exhibit significantly higher oxidative stress than healthy individuals, and these alterations intensify as eGFR declines, showing significant differences between CKD stages. Thus, future research is warranted to provide clearer results in this area.

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Erythrogram Patterns in Dogs with Chronic Kidney Disease

Veterinary Sciences ◽

10.3390/vetsci8070123 ◽

2021 ◽

Vol 8 (7) ◽

pp. 123

Author(s):

Ilaria Lippi ◽

Francesca Perondi ◽

George Lubas ◽

Eleonora Gori ◽

Alessio Pierini ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Red Blood Cells ◽

Blood Cells ◽

Common Finding ◽

Severe Condition ◽

Regeneration Rate ◽

Morphological Abnormalities ◽

Morphological Alterations ◽

Frequent Finding

Anemia is considered a common finding in dogs with chronic kidney disease (CKD), typically as normochromic, normocytic, and non-regenerative. Although anemia can occur at any CKD IRIS (International Renal Interest Society) stage, its severity is related with the loss of kidney function. The aim of the present study was to retrospectively evaluate quantitative and morphological abnormalities of the erythrogram in dogs at different CKD IRIS stages. A total of 482 CBCs from 3648 initially screened were included in the study. Anemia was present in 302/482 (63%) dogs, in the majority of which it was normochromic, normocytic, and non-regenerative (295/302; 98%). The number of reticulocytes was <60,000/μL in the majority of dogs (248/295; 84%), with a correlation between poor regeneration rate and progression of CKD (p = 0.0001). The frequency of anemia significantly differed (p = 0.0001) among the IRIS stages: 108/231 (47%) in IRIS 2, 77/109 (71%) in IRIS 3, and 117/142 (82%) in IRIS 4. Dogs at IRIS stages 3 and 4 were more likely to have moderate to severe anemia, compared to dogs at IRIS stage 2 (p = 0.0001). Anisocytosis was the most frequent morphological abnormality (291/482; 60%), whereas the presence of poikilocytosis showed an association with progression of IRIS stages (p = 0.009). Among different morphological abnormalities, the frequency of fragmented red blood cells and Howell–Jolly bodies showed a significant association with the progression of CKD. Anemia was a frequent finding in CKD dogs, mostly associated with none to poor regeneration rate. Similar to human medicine, advanced CKD stages are more frequently characterized by morphological alterations, such as fragmented red blood cells and Howell–Jolly bodies, which may suggest a more severe condition of reduced bone marrow activity and microangiopathy.

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Role of Serum Transferrin Receptor in Diagnosing and Differentiating Iron Deficiency Anemia from Anemia of Chronic Disease in Patients with Chronic Kidney Disease

BIRDEM Medical Journal ◽

10.3329/birdem.v7i2.32451 ◽

2017 ◽

Vol 7 (2) ◽

pp. 132-137

Author(s):

Abdul Latif ◽

Muhammad Rafiqul Alam ◽

Asia Khanam ◽

Farhana Hoque ◽

Muhammad Abdur Rahim ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Chronic Disease ◽

Kidney Disease ◽

Iron Deficiency ◽

Iron Deficiency Anemia ◽

Transferrin Receptor ◽

Deficiency Anemia ◽

Control Group ◽

Anemia Of Chronic Disease ◽

Female Ratio

Background: Anemia is common in patients with chronic kidney disease (CKD) and this is generally anemia of chronic disease, but iron deficiency anemia (IDA) is also common. Soluble transferrin receptor (sTfR) is a useful marker for IDA. Present study was undertaken to assess the utility of sTfR as a marker of IDA in selected group of Bangladeshi patients with CKD.Methods: This cross-sectional study was conducted in the Department of Nephrology, BSMMU, Dhaka, Bangladesh from January 2013 to December 2014. Patients with anemia admitted in nephrology department whether on hemodialysis or not and medicine department of BSMMU were taken for study. The study population was further divided into two groups; Group A, patients who are having IDA and Group B, patients with ACD and a control group was also selected. Data were collected by face to face interview and laboratory investigations with a self-administered questionnaire.Results: The mean age of the patients in two study groups were 38.40±13.23 and 34.85±10.52 years respectively and male-female ratio were 0.5:1 and 1:0.5. Mean sTfR level was higher (4.81± 1.64 ?g/ml) in patients with IDA than (2.89±1.40 ?g/ml) in patients with ACD (p <0.0001). In our study mean ferritin level was 599.59± 449.15?g/L in ACD patients whereas 101.23±119.42 in IDA patients (p<0.0001). Total iron binding capacity (TIBC) was more in ACD patients with sTfRe3?g/ml as compared to ACD patients with sTfR<3?g/ml. Transferrin saturation (TSAT) level was significantly decreased in ACD patients with sTfR ?3?g/ml as compared to ACD patients with sTfR<3?g/ml.Conclusion: sTfR has a comparable ability to S. ferritin in diagnosing IDA and ACD. However, sTfR and serum ferritin alone cannot definitely exclude co-existing iron deficiency in ACD. As sTfR is not affected by infection and/or inflammation, thus providing a non-invasive alternative to bone marrow study.Birdem Med J 2017; 7(2): 132-137

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Abstract 17220: Effects of the Oral Adsorbent of AST-120 in Patients with both Chronic Heart Failure and Chronic Kidney Disease

Circulation ◽

10.1161/circ.130.suppl_2.17220 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Miki Imazu ◽

Masanori Asakura ◽

Takuya Hasegawa ◽

Hiroshi Asanuma ◽

Shin Ito ◽

...

Keyword(s):

Heart Failure ◽

Chronic Kidney Disease ◽

Chronic Heart Failure ◽

Kidney Disease ◽

Diastolic Dysfunction ◽

Uremic Toxins ◽

Control Group ◽

Blood Levels ◽

Uremic Toxin ◽

Oral Adsorbent

Background: One of uremic toxins, indoxyl sulfate (IS) is related to the progression of chronic kidney disease (CKD) and the worse cardiovascular outcomes. We have previously reported the relationship between IS levels and the severity of chronic heart failure (CHF), but the question arises as to whether the treatment of uremic toxin is beneficial in patients with CHF. This study aimed to elucidate whether the treatment with the oral adsorbent which reduces uremic toxin improved the cardiac function of the patients with CHF. Methods: First of all, we retrospectively enrolled 49 patients with both CHF and stage ≤3 CKD in our institute compared with the healthy subjects without CHF or CKD in the resident cohort study of Arita. Secondly, we retrospectively enrolled 16 CHF outpatients with stage 3-5 CKD. They were treated with and without the oral adsorbent of AST-120 for one year termed as the treatment and control groups, respectively. We underwent both blood test and echocardiography before and after the treatment. Results: First of all, among 49 patients in CHF patients, plasma IS levels increased to 1.38 ± 0.84 μg/ml from the value of 0.08 ± 0.06 μg/ml in Arita-cho as a community-living matched with gender and eGFR of CHF patients. We found both fractional shortening (FS) and E/e’, an index of diastolic function were decreased (25.0 ± 12.7%) and increased (13.7 ± 7.5), respectively in CHF patients compared with the value of FS and E/e’ in Arita-cho (FS: 41.8 ± 8.3%, E/e’: 8.8 ± 2.1). Secondly, in the treatment group, the plasma IS levels and the serum creatinine and brain natriuretic peptide levels decreased (1.40 ± 0.17 to 0.92 ± 0.15 μg/ml; p<0.05, 1.91 ± 0.16 to 1.67 ± 0.12 mg/dl; p<0.05, 352 ± 57 to 244 ± 49 pg/ml; p<0.05, respectively) and both FS and E/e’ were improved following the treatment with AST-120 (28.8 ± 2.8 to 32.9 ± 2.6%; p<0.05, 18.0 ± 2.0 to 11.8 ± 1.0; p<0.05). However, these parameters did not change in the control group. Conclusions: The treatment to decrease the blood levels of uremic toxins improved not only renal dysfunction but cardiac systolic and diastolic dysfunction in patients with chronic heart failure. Oral adsorbents might be a new treatment of heart failure especially with diastolic dysfunction.

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FEATURES OF CHRONIC KIDNEY DISEASE IN ELDERLY PATIENTS

Успехи геронтологии ◽

10.34922/ae.2020.33.1.015 ◽

2020 ◽

pp. 113-120

Author(s):

О. Н. Курочкина

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Elderly Patients ◽

Clinical Situation ◽

Chronic Glomerulonephritis ◽

Hypertensive Nephropathy ◽

Number Of Patients ◽

Rate Of Decline ◽

People Group ◽

Group 1

Изучены особенности течения хронической болезни почек (ХБП) у пожилых пациентов на основании анализа регистра ХБП за 2015-2018 гг. В регистре 484 пациента, из них 231 (47,7%) мужчина, 253 (52,3%) женщины, средний возраст - 58,8±15,8 года. Пациенты были разделены на три группы: 1-я - 218 человек до 59 лет; 2-я - 207 человек 60-74 лет; 3-я - 59 человек 75 лет и старше. В 1-й группе ведущей причиной ХБП явился хронический гломерулонефрит -27,1%, во 2-й - хронический тубулоинтерстициальный нефрит (ТИН) - 21,7%, диабетическая нефропатия (ДН) - 20,8% и гипертоническая нефропатия - 15,9%; в 3-й - ТИН (27,1%), хронический пиелонефрит (ПН) - 15,9% и ДН (13,6%). С возрастом увеличивалась частота встречаемости ТИН ( р <0,1), ПН ( р <0,05), ишемической болезни почек ( р <0,05), подагрической нефропатии ( р <0,1). Среднее снижение СКФ - 3,99 мл/мин на 1,73 мза год наблюдения. Темп снижения СКФ в 1-й группе - 3,36±1,8 мл/мин на 1,73 мза год, во 2-й - 2,43±1,2 ( р <0,001 между 1-йи 2-й группой), в 3-й - 1,82±1,1 мл/мин на 1,73 мза год. Наблюдали отрицательную корреляцию с возрастом ( р <0,05). Формирование регистра больных с ХБП позволяет знать количество больных и причины ХБП у пациентов пожилого и старческого возраста, оценивать клиническую ситуацию, темпы снижения СКФ и выбирать лечебную тактику у этих пациентов. The purpose of the work is to study the characteristics of the course of chronic kidney disease in elderly patients based on the analysis of the register of chronic kidney disease (CKD) for 2015-2018. in the Department of Nephrology, the Komi Republican Clinical Hospital. There are 484 patients in the register, of whom 231 are men (47,7%), 253 women (52,3%). The average age is 58,8±15,8 years old. The patients were divided into 3 groups: persons under the age of 59 years old - 218 people (group 1); from 60 to 74 years old - 207 people (group 2); and over 75 years old - 59 people (group 3). Most patients are between the ages of 60 and 69 years old. In the 1 group, the chronic glomerulonephritis is the leading cause of CKD - 27,1%; in the 2 group - the chronic tubulo-interstitial nephritis (TIN) - 21,7%, the diabetic nephropathy (DN) - 20,8% and the hypertensive nephropathy - 15,9%; in the 3 group - TIN (27,1%), the chronic pyelonephritis (PN) (15,9%) and DN (13,6%). With increasing age, the incidence of TIN ( p <0,1), MO ( p <0,05), coronary kidney disease (IBP) ( p <0,05), gouty nephropathy ( p <0,1) were raised. The average reduction in GFR is 3,99 ml/min/1,73 m per year of observation. The rate of decline in GFR in the 1st group is 3,36±1,8 ml/min/1,73 m per year, in the 2 - 2,43±1,2 ( p <0,001 between group 1 and 2), in the 3 group - 1,82±1,1; with aging the negative correlation was observed ( p <0,05). 39 patients received hemodialysis, including: in the 1 group - 20 people (9%), in the 2 group - 18 (8,7%), in the 3 group - 1 patient (1,7%). Making the register of the patients with CKD allows us to know the number of patients and the causes of CKD among the patients of elderly and senile ages, to assess the clinical situation, the rate of decline in GFR and treatment tactics in these patients.

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Effect of Experimentally Induced Chronic Kidney disease on Skeletal, Cardiac and Smooth Muscle fibers of albino rat

QJM ◽

10.1093/qjmed/hcab099.006 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Ghada Lotfy ◽

Amel Soliman ◽

Nevine Bahaa ◽

Mohammed Hegazi

Keyword(s):

Skeletal Muscle ◽

Chronic Kidney Disease ◽

Smooth Muscle ◽

Kidney Disease ◽

Intramuscular Injection ◽

Muscle Fibers ◽

Lateral Wall ◽

Control Group ◽

Once Daily ◽

Group Ii

Abstract Background Chronic kidney disease (CKD), or chronic renal failure (CRF) as it was historically termed, includes all degrees of decreased renal function, starting from mild, and moderate, to severe chronic kidney failure. Skeletal muscle atrophy frequently complicates the course of CKD and is associated with excess morbidity and mortality. Cardiovascular diseases have been reported to be the leading causes of death in CKD patients. Chronic Kidney Disease was also reported to be associated with an increased incidence of acid-related gastrointestinal disorders. Aim of the work The aim of this study was to investigate the effect of chronic kidney disease experimentally induced by gentamicin intramuscular injection on the histological structure of gastrocnemius skeletal muscle, left ventricular cardiac muscle and smooth muscle fibers of lower esophagus. Materials and methods Twenty male adult Wistar albino rats were randomly and equally divided into two groups. Group I (control group) received physiological saline intramuscular injection, once daily for 28 consecutive days, in a dose equivalent to that taken in group II. Group II (Gentamicin-treated group) were given Gentamicin intramuscular injection for induction of CKD. Gentamicin was given as Gentamycin sulfate, 40 mg/ml (Sandoz, Switzerland), once daily, in a dose of 80 mg/kg/day for 28 days to induce CKD. After 28 days of the first injection of gentamicin, rats were anaesthetized and blood samples were collected to measure the level of serum urea and creatinine. The left kidneys, the middle third of left gastrocnemius muscle, the lateral wall of left ventricle (LV) and the gastroesophageal junction of all rats of both groups (I and II) were processed for light microscopic study. The middle third of left gastrocnemius muscle, the lateral wall of left ventricle (LV) were further processed for transmission electron microscopic study. Histomorphometrical and statistical analysis were also done. Results The LM examination revealed moderate obliteration of glomeruli, dilatation in some renal tubules and collapse in others, mainly in distal convoluted tubules, with significant fibrosis of renal parenchyma. Serum urea and creatinine levels were increased significantly. The skeletal muscle fibers of the rats in group II (CKD) showed focal areas of myofibers degeneration with siginificant fibrosis. The cardiac muscle fibers of the rats in the group II (CKD) showed focal areas of cardiomyocytes degeneration and other areas of significantly hypertrophied fibers. The smooth muscle fibers of the lower esophageal sphincter of the rats in group II (CKD) showed no significant structural changes compared with the control group, however, the myenetric plexus showed multiple pyknotic and karyolitic nuclei with vacuolated cytoplasm. In addition, insignificant increase in the amount of collagen fibers was observed in almost all layers. Conclusion CKD produced moderate atrophy of skeletal muscle fibers, significant increase in the cardiomyocyte size and no significant structural effect of smooth muscle fibers of the lower esophageal sphincter.

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