scholarly journals The Binding of Aripiprazole to Plasma Proteins in Chronic Renal Failure Patients

Toxins ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 811
Author(s):  
Kenshiro Hirata ◽  
Tokunori Ikeda ◽  
Hiroshi Watanabe ◽  
Toru Maruyama ◽  
Motoko Tanaka ◽  
...  
Keyword(s):  
Renal Failure ◽  
Plasma Proteins ◽  
Important Determinant ◽  
Drug Binding ◽  
Uremic Toxins ◽  
Renal Diseases ◽  
Limited Data ◽  
Albumin Ratio ◽  
Binding Rate ◽  
Statistical Relationships

The binding of drugs to plasma protein is frequently altered in certain types of renal diseases. We recently reported on the effects of oxidation and uremic toxins on the binding of aripiprazole (ARP) to human serum albumin. In our continuing investigations, we examined the binding of ARP to plasma pooled from patients with chronic renal dysfunction. We examined the issue of the molecular basis for which factors affect the changes in drug binding that accompany renal failure. The study was based on the statistical relationships between ARP albumin binding and biochemical parameters such as the concentrations of oxidized albumin and uremic toxins. The binding of ARP to plasma from chronic renal patients was significantly lower than healthy volunteers. A rational relationship between the ARP binding rate and the concentration of toxins, including indoxyl sulphate (IS) and p-cresyl sulphate (PCS), was found, particularly for IS. Moreover, multiple regression analyses that involved taking other parameters such as PCS or oxidized albumin ratio to IS into account supports the above hypothesis. In conclusion, the limited data reported in this present study indicates that monitoring IS in the blood is a very important determinant in the dosage plan for the administration of site II drugs such as ARP, if the efficacy of the drug in renal disease is to be considered.

The uremic toxin indoxyl sulfate reflects cardio-renal risk and intestinal-renal relationship

2011 ◽  
Vol 152 (43) ◽  
pp. 1724-1730 ◽  
Author(s):  
István Kiss
Keyword(s):  
Renal Failure ◽  
Chronic Renal Failure ◽  
Uremic Toxins ◽  
Indoxyl Sulfate ◽  
Morbidity And Mortality ◽  
Renal Diseases ◽  
Uremic Toxin ◽  
Cardiovascular Risks ◽  
Endogenous Protein ◽  
Uremic Syndrome

Uremic syndrome and condition is primarily a result of kidney failure in which uremic toxins are accumulated. More and more attention is paid to possibilities for removal of uremic toxins, which not only means dialysis, but also takes into account special dietary considerations and treatments, which aim to absorb the toxins or reduce their production. These uremic toxins, which also increase the cardiovascular risks, play a major part in morbidity and mortality of patients suffering from chronic renal failure and those receiving renal replacement therapy. One of them is a member of the indol group, the indoxyl sulfate. This toxin is difficult to remove with dialysis and is an endogenous protein-bound uremic toxin. Today we know that indoxyl sulfate is a vascular-nephrotoxic agent, which is able to enhance progression of cardiovascular and renal diseases. It is of particular importance that because of its redox potency, this toxin causes oxidative stress and antioxidant effects at the same time and, on top of that, it is formed in the intestinal system. Its serum concentration depends on the nutrition and the tubular function and, therefore, it can also signal the progression of chronic renal failure independently of glomerular filtration rate. Successful removal of indoxyl sulfate reduces the morbidity and mortality and improves survival. Therefore, it could be a possible target or area to facilitate the reduction of uremia in chronic renal failure. The use of probiotics and prebiotics with oral adsorbents may prove to be a promising opportunity to reduce indoxyl sulfate accumulation. Orv. Hetil., 2011, 152, 1724–1730.

Antithrombin III and Heparin Cofactor II in Patients with Chronic Renal Failure Undergoing Regular Hemodialysis

1987 ◽  
Vol 57 (03) ◽  
pp. 263-268 ◽  
Author(s):  
P Toulon ◽  
C Jacquot ◽  
L Capron ◽  
M -O Frydman ◽  
D Vignon ◽  
...  
Keyword(s):  
Renal Failure ◽  
Chronic Renal Failure ◽  
Plasma Proteins ◽  
Antithrombin Iii ◽  
Vascular Wall ◽  
Relative Increase ◽  
Heparin Cofactor Ii ◽  
Normal Ranges ◽  
At Iii ◽  
Regular Hemodialysis

SummaryHeparin enhances the inhibition rate of thrombin by both antithrombin III (AT III) and heparin cofactor II (HC II). We studied the activity of these two plasma proteins in patients with chronic renal failure (CRF) undergoing regular hemodialysis as their heparin requirements varied widely. In 77 normal blood donors, normal ranges (mean ± 2 SD) were 82-122% for AT III and 65-145% for HC II. When compared with these controls 82 dialyzed CRF patients had a subnormal AT III activity and a significantly (p <0.001) lower HC II activity. To evaluate the effect of hemodialysis we compared AT III, HC II and total proteins in plasma before and after dialysis in. 24 patients (12 with normal and 12 with low basal HC II activity). AT III and HC II activities significantly (p <0.001) increased in absolute value. When related to total plasma proteins, in order to suppress the influence of hemoconcentration induced by dialysis, AT III decreased significantly (p <0.01) whereas HC II increased slightly but significantly (p <0.01) in the 12 patients with low initial HC II activity. The decrease of AT III induced by heparin administrated during dialysis is likely to account for this relative decrease of AT III activity. A modification of the distribution of both HC II and heparin between the vascular wall and the circulating blood is evoked to explain the relative increase in HC II activity and the need for higher heparin dosage in patients with low HC II levels.

scholarly journals Social Integration and Depression of Older Adults in Rural China: Do Family or Friendship Ties Make a Difference?

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 580-580
Author(s):  
Dan Zhang ◽  
Zhiyong Lin ◽  
Shuzhuo Li
Keyword(s):  
Older Adults ◽  
Social Integration ◽  
Rural Areas ◽  
Important Determinant ◽  
Rural China ◽  
Later Life ◽  
Social Contexts ◽  
Limited Data ◽  
Family Ties ◽  
Relevant Evidence

Abstract Despite increasing acknowledgement that social integration/isolation is an important determinant of health in later life, relevant evidence for older adults in less developed social contexts is still limited. Data derived from 2015 and 2018 waves of a longitudinal study of 976 older adults, aged 60 and older, living in rural areas of Anhui Province, China. We analyzed how the level of social integration/isolation (measured as family and friendship ties) impacted depressive symptoms of older adults. Our results showed that more than half of older adults in our sample were either isolated from family or friends. Further analysis demonstrated that older people who were isolated from friends were more depressed in comparison with those who were closely integrated into friendship ties, while no such association was found in relation to family ties. Assessments of social integration among older adults should account for both family and friendship ties.

scholarly journals Impacts of Indoxyl Sulfate and p-Cresol Sulfate on Chronic Kidney Disease and Mitigating Effects of AST-120

Toxins ◽  
2018 ◽  
Vol 10 (9) ◽  
pp. 367 ◽  
Author(s):  
Wen-Chih Liu ◽  
Yasuhiko Tomino ◽  
Kuo-Cheng Lu
Keyword(s):  
Oxidative Stress ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Large Scale ◽  
Interstitial Fibrosis ◽  
Uremic Toxins ◽  
Indoxyl Sulfate ◽  
Renal Diseases ◽  
Glomerular Sclerosis ◽  
Inflammatory Reactions

Uremic toxins, such as indoxyl sulfate (IS) and p-cresol, or p-cresyl sulfate (PCS), are markedly accumulated in the organs of chronic kidney disease (CKD) patients. These toxins can induce inflammatory reactions and enhance oxidative stress, prompting glomerular sclerosis and interstitial fibrosis, to aggravate the decline of renal function. Consequently, uremic toxins play an important role in the worsening of renal and cardiovascular functions. Furthermore, they destroy the quantity and quality of bone. Oral sorbent AST-120 reduces serum levels of uremic toxins in CKD patients by adsorbing the precursors of IS and PCS generated by amino acid metabolism in the intestine. Accordingly, AST-120 decreases the serum IS levels and reduces the production of reactive oxygen species by endothelial cells, to impede the subsequent oxidative stress. This slows the progression of cardiovascular and renal diseases and improves bone metabolism in CKD patients. Although large-scale studies showed no obvious benefits from adding AST-120 to the standard therapy for CKD patients, subsequent sporadic studies may support its use. This article summarizes the mechanisms of the uremic toxins, IS, and PCS, and discusses the multiple effects of AST-120 in CKD patients.

Autopsy Findings in Patients Treated by Continuous Ambulatory Peritoneal Dialysis (CAPD)

1986 ◽  
Vol 6 (3) ◽  
pp. 130-135 ◽  
Author(s):  
Kostas Sombolos ◽  
Peter McNamee ◽  
Ahmed Mitwalli ◽  
Sol Rabinovich ◽  
Dimitrios G. Oreopoulos
Keyword(s):  
Renal Failure ◽  
Chronic Renal Failure ◽  
Causes Of Death ◽  
Coronary Artery Stenosis ◽  
Renal Diseases ◽  
Chronic Glomerulonephritis ◽  
Insulin Dependent ◽  
The Mean ◽  
Organ Changes ◽  
Acquired Cystic Disease

From October 1977 to October 1985, our pathology department did autopsies on 19 patients (14 men, five women) treated by CAPD for four to 55 (mean 29.3) months. Their mean age was 60.2 (range 28–79) years and the primary renal diseases were diabetes mellitus (eight), nephrosclerosis (five), polycystic kidneys (three), chronic glomerulonephritis (one) and chronic renal failure associated with sarcoidosis and congestive cardiomyopathy in two. During the same period, the authors selected as controls 18 autopsied patients (14 men, four women), who had not had chronic renal failure, and these were matched with the CAPD patients for age, sex, longstanding hypertension and insulin-dependent diabetes. Direct causes of death for CAPD patients were cardiovascular incidents (12) infection (5), pancreatitis (1) and lung cancer (1); in controls, the causes were cardiovascular in 11 and infection in two. Thirteen of the CAPD and 12 autopsied controls had coronary artery stenosis equal to or greater than 70%, and affecting one or more arteries. The mean weight of organs in CAPD patients and controls were similar except for kidneys and the spleen; we found the latter weighed more in those on CAPD (p = 0.002). In CAPD patients the most important organ changes were: evidence of myocardial infarction, old or acute, in nine, acquired cystic disease of the kidney in five, and thickening and adhesions of peritoneum in nine and five respectively.

An Overview of Renal Diseases in Children in Pokhara

1970 ◽  
Vol 27 (2) ◽  
pp. 75-78 ◽  
Author(s):  
T Malla ◽  
KK Malla ◽  
A Thapalial ◽  
MS Sharma
Keyword(s):  
Renal Failure ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Renal Stone ◽  
Laboratory Evaluation ◽  
Renal Diseases ◽  
Adequate Treatment ◽  
Stage Renal Disease ◽  
End Stage

Objective: To determine the current pattern and prevalence of renal diseases in childhood in this region of Nepal. Material and Methods: A retrospective study of the renal diseases in children attending the Pediatric OPD and those hospitalised in Manipal Teaching Hospital, Pokhara was done over a period of 6 years (September 2000- September 2006). A detailed clinical and laboratory evaluation was performed at baseline. The children were managed according to disease diagnosed. These cases are under follow up and some have undergone surgical treatment. Results: 228 children (123 boys & 105girls) were diagnosed to have renal disease. Among them 39.5% had urinary tract infection (UTI), 30.7 % were suffering from acute glomerulonephritis (AGN), 17.5% were cases of nephrotic syndrome (NS) and 12 % had some other problems for example, 6.14% had genetic defects, 2.63% had renal Stone, 2.2% had pre-renal acute renal failure, unexplained recurrent hematuria in 1.3%. All the cases of UTI underwent through investigation and were treated accordingly. All cases of AGN are planned for follow up for 1½ yrs and among them 3 required biopsy till date. All cases of NS are under regular follow-ups and 2 have undergone biopsy. Renal stone was operated successfully. All cases of acute and chronic renal failures had required dialysis. Out of 5 (2.5%) chronic renal failures, 2 with end stage renal disease expired after repeated hemodialysis and three are still requiring dialysis. Among the obstructive uropathies, 43 % had renal stone, 36 % had posterior urethral valve and 21% VUR. Conclusion: It can be concluded that renal disease is not uncommon in children. It can be completely cured with proper and adequate treatment. Sometimes it has a bad prognosis when it reaches end stage renal disease. Early recognition, timely treatment and regular follow up are mandatory in management of children with renal diseases. Key words: Renal disease pattern, UTI, AGN, NS, Obstructive Uropathy, Renal failure   doi:10.3126/jnps.v27i2.1414 J. Nepal Paediatr. Soc. Vol.27(2) p.75-78

scholarly journals The Spectrum of Biopsy-Proved Kidney Disease: A Retrospective Single Center Study in Erbil-Iraq

2019 ◽  
Vol 10 (2) ◽  
pp. 46-51
Author(s):  
Ahmed Al-Imam ◽  
Mudhafar Abdullah Ali ◽  
Safa Ezzaddin Al-Mukhtar
Keyword(s):  
Renal Failure ◽  
Renal Biopsy ◽  
Immunofluorescence Microscopy ◽  
Histopathological Examination ◽  
Glomerular Disease ◽  
Clinical Indication ◽  
Renal Diseases ◽  
Glomerular Diseases ◽  
Nephritic Syndrome ◽  
Management Protocol

BACKGROUND Renal biopsy is crucial to determine the pattern of the different types of renal diseases. It represents the gold standard of diagnostics for renal pathologies, including glomerular diseases, and it has an important value for the prognosis, monitoring disease progression, and planning the management protocol. AIMS AND OBJECTIVE To report the frequency of different pathological lesions affecting the kidney in patients who were admitted to our medical centre. MATERIALS AND METHODS This is a retrospective study of all patients with renal diseases who underwent percutaneous renal biopsy at the Erbil Kidney Centre for eight years  (1st of January 2010  to 31st of December 2017). A total of 893 cases were biopsied and subsequently studied via histopathological examination and immunofluorescence microscopy. The study is ethically permitted by the Kurdistan Board for Medical Specialization. RESULTS The average age of the patients was 30.9 years. The most common clinical indication for biopsy included nephrotic syndrome (46.47%), acute renal failure (19.04%), chronic renal failure (15.34%), nephritic syndrome (7.39%), proteinuria alone (7.28%), and hematuria alone (4.48%). In patients with a primary glomerular disease, focal segmental glomerulosclerosis and minimal change disease were the most frequent (27.44% and 16.01%) in the younger patients (18.61±13.47 years), while membranous glomerulonephritis was more common in older patients (38.94±13.69 years). Patients with a secondary glomerular disease were mainly diagnosed with lupus nephritis, amyloidosis, and diabetic nephropathy. CONCLUSION The epitome of our study signifies that the spectrum of glomerular diseases varies based on age, sex, ethnicity, and geographical distribution. The implementation of renal biopsy proved to be a cornerstone in reaching the correct diagnosis. Future studies should implement the use of electron microscopy in conjunction with classical techniques of histopathology and immunofluorescence microscopy to diagnose equivocal cases of interest.

Inhibition of Imatinib Transport by Uremic Toxins During Renal Failure

2008 ◽  
Vol 26 (25) ◽  
pp. 4226-4227 ◽  
Author(s):  
Ryan M. Franke ◽  
Alex Sparreboom
Keyword(s):  
Renal Failure ◽  
Uremic Toxins
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