COVID-19 Modulates Inflammatory and Renal Markers That May Predict Hospital Outcomes among African American Males

Background and Objectives: African Americans and males have elevated risks of infection, hospitalization, and death from SARS-CoV-2 in comparison with other populations. We report immune responses and renal injury markers in African American male patients hospitalized for COVID-19. Methods: This was a single-center, retrospective study of 56 COVID-19 infected hospitalized African American males 50+ years of age selected from among non-intensive care unit (ICU) and ICU status patients. Demographics, hospitalization-related variables, and medical history were collected from electronic medical records. Plasma samples collected close to admission (≤2 days) were evaluated for cytokines and renal markers; results were compared to a control group (n = 31) and related to COVID-19 in-hospital mortality. Results: Among COVID-19 patients, eight (14.2%) suffered in-hospital mortality; seven (23.3%) in the ICU and one (3.8%) among non-ICU patients. Interleukin (IL)-18 and IL-33 were elevated at admission in COVID-19 patients in comparison with controls. IL-6, IL-18, MCP-1/CCL2, MIP-1α/CCL3, IL-33, GST, and osteopontin were upregulated at admission in ICU patients in comparison with controls. In addition to clinical factors, MCP-1 and GST may provide incremental value for risk prediction of COVID-19 in-hospital mortality. Conclusions: Qualitatively similar inflammatory responses were observed in comparison to other populations reported in the literature, suggesting non-immunologic factors may account for outcome differences. Further, we provide initial evidence for cytokine and renal toxicity markers as prognostic factors for COVID-19 in-hospital mortality among African American males.

The Study of Biochemical Markers in Chronic Renal Failure Patients in Pre- and Post-Haemodialysis

Background: The current research is designed to investigate alterations in lipid peroxidation (malondialdehyde - MDA) and renal markers (urea and creatinine) in patients of chronic renal failure (CRF) as compared to the control group. Method: The study included 55 subjects, who were separated into two groups: control group, which included 15 healthy members with no history of systematic illness; and patients group, which included 40 patients with CRF divided into four groups “Non: CRF patients without any accompanied disease, DM: CRF patients with diabetes mellitus, HT: CRF patients with hypertension, and HT + DM: CRF patients with diabetes mellitus and hypertension”. Results: The findings reveal that there is a notable increase in serum concentration of MDA, urea, and creatinine, in patients group as compared to the control group. Conclusion: In all chronic renal failure patients with or without any accompanying disease, lipid peroxidation is present in pre- and post-haemodialysis patients as well as patients with CRF have high levels of urea and creatinine compared with healthy groups.

Bone outcomes in virally suppressed youth with HIV switching to tenofovir disoproxil fumarate

Background: Tenofovir disoproxil fumarate (TDF) is included in first-line antiretroviral treatment (ART) for adolescents living with HIV (ALWH). Associated toxicities remain a concern.Objective: We evaluated bone and renal safety outcomes in virologically suppressed South African ALWH after switching to TDF.Method: We recruited virally suppressed ( 100 copies/mL) adolescents, aged 15–20 years, who switched from an abacavir (ABC)-based to a TDF-based efavirenz regimen. Bone mass and renal function were assessed at Week 0 and at Week 24 after the switch to TDF using dual-energy X-ray absorptiometry (DXA) and serum renal markers. A change in the lumbar spine (LS) and the whole-body less head (WBLH) bone mineral density (BMD) Z-scores and the estimated glomerular filtration rate (eGFR) between the two measures were compared (paired t-tests) and stratified by sex.Results: Fifty participants (48% male), with a median duration of prior ART of 11.4 years, were enrolled. Among 47 participants with 24-week DXA results, 15 (32%) had either no change or a decreased LS-BMD after the switch, with a mean change of –1.6%. Overall, more female participants experienced this outcome: 58% versus 4%, P 0.0001. The mean change (standard deviation) in the LS-Z-score was –0.03 (0.25) and in the WBLH-Z-score was 0.02 (0.24). A decrease in the eGFR from 132.2 to 120.4 was observed (P = 0.0003); however, the levels remained clinically acceptable.Conclusion: South African ALWH switching from abacavir to TDF-based ART experienced statistically significant decreases in eGFR but not in LS and WBLH BMD. Female ALWH were more likely to experience a decrease in LS-BMD and may require closer monitoring.

Aqueous extract of Pterocarpus santalinoides DC stem bark prevents L-NAME-induced hypertension in rat

Background: Pterocarpus santalinoides stem bark is commonly used in Cameroonian medicine to treat many diseases including hypertension. Thus, this study was aimed to evaluate preventive effects of aqueous extract of Pterocarpus santalinoides (AEPS) stem bark on NG-Nitro-L-arginine-methyl ester (LNAME)-induced hypertension in rat. Methods: Normotensive rats received L-NAME (25 mg/kg intraperitoneally) concomitantly with AEPS (50, 100 and 200 mg/kg) or captopril (20 mg/kg) orally during 3 weeks. At the end of experimental period, arterial pressure and heart rate were recorded by invasive method. After sacrifice, blood, aorta and heart were harvested for biochemical analysis on homogenate. Results: Intraperitoneal injection of L-NAME induced in rat a significant increase (p < 0.001; p < 0.01; p < 0.05) of blood pressure, heart rate, malondialdehyde, total cholesterol, triglycerides, LDL-cholesterol, hepatic and renal markers functions. L-NAME also decreased significantly (p < 0.001; p < 0.01; p < 0.05) the levels of HDL-cholesterol, nitrites, glutathione, superoxide dismutase and catalase activities as compared to control rats. The AEPS prevented significantly the increase (p < 0.001) of hemodynamic parameters induced by L-NAME and various modifications of biochemical parameters (lipid profile, hepatic and renal markers functions) and oxidative stress markers evaluated. Conclusion: This study shows that the aqueous extract of Pterocarpus santalinoides prevents hypertension, dyslipidemia and oxidative stress induced by L-NAME in rat by attenuating endothelial dysfunction, liver and kidney’s damages

Amelioration of Diabetes-Induced Nephropathy by Loranthus regularis: Implication of Oxidative Stress, Inflammation and Hyperlipidaemia

In traditional Yemeni medicine, various preparations of Loranthus regularis (L. regularis), such as powder, decoctions and infusions are commonly used to treat diabetes, kidney stone formations and inflammation. In the present study, we evaluated the antinephrotoxic effects of L. regularis extract in experimentally-induced diabetes in male Wistar rats. A single dose (60 mg/kg/day) of Streptozotocin (STZ) was used to induce type 1 diabetes. Animals were then treated for four weeks with L. regularis extract (150 or 300 mg/kg/day) by oral gavage. Renal and blood samples were subsequently harvested. Several biochemical indices, oxidative stress and inflammatory markers were assessed. Additionally, histological alterations in the renal tissue were examined. Serum glucose levels were significantly (p < 0.01) lowered while insulin levels were enhanced in L. regularis-treated diabetic animals. The increased renal markers in diabetic rats were decreased by L. regularis treatment. Serum elevated lipid profiles were markedly decreased by the plant extract. The serum and renal cytokines that were significantly increased (p < 0.001) by STZ were diminished by L. regularis treatment. Finally, renal tissue antioxidant enzymatic activity was enhanced with L. regularis treatment. Taken together, the data here indicate that L. regularis possesses therapeutic ability to reduce the development of diabetic nephropathy (DN) by minimizing oxidative injury and inflammation.

Quantification Series of Procalcitonin Decides the Conceivable Bacterial Infection among Vital Organs

Sepsis is the occurrence of infection in association with the systemic inflammatory response syndrome (SIRS). Bacterial sepsis is one of the major illnesses that shows severe symptoms which leads to organ dysfunction. Procalcitonin (PCT) the precursor of the hormone calcitonin shows a huge impact on the diagnosis of sepsis caused by the bacterial infection. Many studies have also insisted the importance of PCT as a biomarker for sepsis. As early diagnosis is the key factor to overcome the difficulties of the sepsis, PCT acts a prominent diagnostic tool to acquire the desired results. This study focused on the role of PCT in correlation with supporting parameters of the vital organs such as renal markers, liver enzymes and pancreatic enzymes to reduce the organ dysfunction and its complications. Keywords: Sepsis, procalcitonin, renal markers, liver enzymes, pancreatic enzymes.

Remdesivir and Favipiravir Changes Hepato-Renal Profile in COVID-19 patients: A Cross Sectional Observation in Bangladesh

Background: Coronavirus disease (COVID-19) is the current global public health concern. Till date no specific, effective, and approved treatment available. With the rapid increase in rate of infection, repurposing use of anti- viral like remdesivir and favipiravir were considered as an option to find the promising anti-COVID therapeutics. In this study, we aim to observe hepato-renal safety concerns related to these drugs. Method: A retrospective study done from May 17 to September 9, 2020 on total 1348 hospital records. 182 patients were included in the study, devided into two groups who recieved remdesivir only (RO) and favipiravir only (FO). Result: Mean age of respective groups are 59.42 (RO) and 54.64 (FO). Average duration of hospital stay was 11 to 12 days. Mortality rate (28.39%) was higher in RO group. Mean± SD of both ALT (70.65± 50.25) and AST (62.25± 25.46) level was increased in RO group than FO group. On the other hand, Blood urea (56.67± 38.40) and serum creatinine (01.70± 02.41) level was higher in FO group. Hematuria was absent in both group, proteinuria was also unremarkable. Conclusion: In patients with Covid-19 receive remdesivir and favipiravir, showed elevation in the level of hepato- renal markers.

Nephroprotective Effects of L-Arginine against Chemotherapy Induced Acute Kidney Injury in Wistar Rats

Objective To evaluate the protective role of L-Arginine in cisplatin induced acute renal injury through assessment of renal, oxidative stress and inflammatory markers in albino wistar rats. Methods: Quasi-experimental study was conducted at the department of physiology and postgraduate research laboratory at Isra University, Hyderabad, Sindh from April 2019 to September 2019. Thirty male Albino wistar rats were selected through non-random purposive sampling and divided equally into three different groups: Group-A (Control group), Group-B (experimental group) received Cisplatin alone and Group-C (experimental group) received Cisplatin along with arginine. After sacrificing the animals, blood samples were collected through cardiac puncture while renal histopathological analysis was under the light microscope. The changes in severity were observed using a graded scale. Data was analysed using SPSS v23.0. Results: There was a statistically significant (p-value <0.05) decline in the bodyweight and rise in absolute kidney weight of group B in comparison with other two group. Moreover, significant rise (p-value <0.05) in serum renal markers was observed in group B while significant decline (p-value <0.05) in these serum renal markers in group C compared with group B. Furthermore, prominent demage in normal renal histology in group B rats while restoration of renal histology was demonstrated in group C rats. Conclusion: The present study concludes that L-Arginine exerts an anti-oxidative, anti-inflammatory and nephro-protective effect for renal tissue damage caused by Cisplatin. Keywords: Acute Kidney Injury, Antioxidant, Cisplatin, L-Arginine, Oxidative stress