Kidney Function
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Sepideh Shabani ◽  
Fahimeh Kaveh Baghbahadorani ◽  
Farahnaz Jazaeri ◽  
Foruzan Ganji ◽  
Nayyereh Sadat Mortazavi ◽  

Background: Silymarin and N-acetylcysteine are antioxidant supplements with protective effects on the liver and kidneys. The aim of this study was to investigate the effect of silymarin and N-acetylcysteine on liver and kidney disorders against severe pre-eclampsia. Methods: In the present single-blind clinical trial, 60 mothers who underwent termination of pregnancy due to severe pre-eclampsia were divided into two groups. The first group received 70 mg of silymarin and the second group received 600 mg of N-acetylcysteine at 3 doses immediately, 12 and 24 hours after delivery. Patients were monitored for blood pressure, platelet and biochemical markers of liver injury and kidney function 12, 36 and 60 hours after drug administration. Results: Over time, the mean Alanine Transaminase (ALT), Aspartate Transaminase (AST), Lactate Dehydrogenase (LDH) and Alkaline Phosphatase (ALP), levels in the two groups of silymarin and N-acetylcysteine significantly decreased (p<0.001). Silymarin and N-acetylcysteine were not significantly different in reducing the increased creatinine and BUN levels. Conclusion: N-acetylcysteine and silymarin help patients with pre-eclampsia to improve kidney and hepatic dysfunction; however, silymarin was more effective in decreasing ALT, AST, ALP, and LDH levels than N-acetylcysteine. N-acetylcysteine was more effective in decreasing BUN and creatinine levels than silymarin.

2021 ◽  
pp. ASN.2020111599
Zhi Yu ◽  
Jin Jin ◽  
Adrienne Tin ◽  
Anna Köttgen ◽  
Bing Yu ◽  

Background: Genome-wide association studies (GWAS) have revealed numerous loci for kidney function (estimated glomerular filtration rate, eGFR). The relationship of polygenic predictors of eGFR, risk of incident adverse kidney outcomes, and the plasma proteome is not known. Methods: We developed a genome-wide polygenic risk score (PRS) for eGFR by applying the LDpred algorithm to summary statistics generated from a multiethnic meta-analysis of CKDGen Consortium GWAS (N=765,348) and UK Biobank GWAS (90% of the cohort; N=451,508), followed by best parameter selection using the remaining 10% of UK Biobank (N=45,158). We then tested the association of the PRS in the Atherosclerosis Risk in Communities (ARIC) study (N=8,866) with incident chronic kidney disease, kidney failure, and acute kidney injury. We also examined associations between the PRS and 4,877 plasma proteins measured at at middle age and older adulthood and evaluated mediation of PRS associations by eGFR. Results: The developed PRS showed significant associations with all outcomes with hazard ratios (95% CI) per 1 SD lower PRS ranged from 1.06 (1.01, 1.11) to 1.33 (1.28, 1.37). The PRS was significantly associated with 132 proteins at both time points. The strongest associations were with cystatin-C, collagen alpha-1(XV) chain, and desmocollin-2. Most proteins were higher at lower kidney function, except for 5 proteins including testican-2. Most correlations of the genetic PRS with proteins were mediated by eGFR. Conclusions: A PRS for eGFR is now sufficiently strong to capture risk for a spectrum of incident kidney diseases and broadly influences the plasma proteome, primarily mediated by eGFR.

2021 ◽  
Vol 22 (1) ◽  
Tomas Månsson ◽  
Sölve Elmståhl

Abstract Background Chronic kidney disease, cardiovascular disease, and cognitive dysfunction are common in the elder population. There is evidence of a connection between these conditions, possibly by a shared vascular pathogenesis. Processing speed is commonly impaired in cerebrovascular disease. Methods The data was obtained from the population based study “Good aging in Skåne” (GÅS), and included 905 individuals (mean age = 68 years). We investigated the impact of impaired kidney function at baseline on the development of dementia, MCI, and impairment in specific cognitive domains at follow up 6 years later, using logistic regression models. Impaired kidney function was defined as GFR < 60 ml/min/1,73 m2. GFR was estimated from creatinine and cystatin C, using the CKD-EPI formula. Function in the cognitive domains learning and memory, language, complex attention, executive function, perceptual-motor, as well as meta-memory, and global cognitive function, was assessed using a neuropsychological test battery consisting of 12 tests. We compared the test results from follow up, with the results obtained at baseline, using linear regression models in order to assess changes in performance in cognitive domains. Results At follow up, 14 and 158 participants had developed dementia and MCI, respectively. We did not find evidence that moderately impaired eGFR at baseline increased the odds of dementia or MCI. A decline in processing speed was associated with impaired kidney function. Conclusions The effect on processing speed could represent early vascular implications on cognition. Even at moderately impaired kidney function, overview of cardiovascular risk factors could potentially prevent further cognitive impairment.

2021 ◽  
Vol 8 ◽  
Wei Ling Lau ◽  
Mark Fisher ◽  
Evan Fletcher ◽  
Charles DeCarli ◽  
Hayden Troutt ◽  

Cognitive decline is common in chronic kidney disease (CKD). While the evidence of vascular cognitive impairment in this population is robust, the role of Alzheimer's pathology is unknown. We evaluated serum cystatin C-estimated glomerular filtration rate (eGFR), brain amyloid-β positron emission tomography (PET) imaging, and cognitive function in 166 participants from The 90+ Study. Mean age was 93 years (range 90-107) and 101 (61%) were women; 107 participants had normal cognitive status while 59 participants had cognitive impairment no dementia (CIND) or dementia. Mean ± standard deviation cystatin C was 1.59 ± 0.54 mg/L with eGFR 40.7 ± 18.7 ml/min/1.73m2. Higher amyloid-β burden was associated with dementia, but not with age, diabetes, hypertension, or cardiovascular disease. We found no association between brain amyloid-β burden and cystatin C eGFR. We previously reported that kidney function was associated with cognition and cerebral microbleeds in the same cohort of oldest-old adults (90+ years old). Collectively, these findings suggest that microvascular rather than Alzheimer's pathology drives CKD-associated cognitive dysfunction in this population.

2021 ◽  
Vol 21 (1) ◽  
Martin Müller ◽  
Michaela Traschitzger ◽  
Michael Nagler ◽  
Spyridon Arampatzis ◽  
Aristomenis K. Exadaktylos ◽  

Abstract Background Up to a fourth of patients at emergency department (ED) presentation suffer from acute deterioration of renal function, which is an important risk factor for bleeding events in patients on oral anticoagulation therapy. We hypothesized that outcomes of patients, bleeding characteristics, therapy, and outcome differ between direct oral anticoagulants (DOACs) and vitamin-K antagonists (VKAs). Methods All anticoagulated patients older than 17 years with an impaired kidney function treated for an acute haemorrhage in a large Swiss university ED from 01.06.2012 to 01.07.2017 were included in this retrospective cohort study. Patient, treatment, and bleeding characteristics as well as outcomes (length of stay ED, intensive care unit and in-hospital admission, ED resource consumption, in-hospital mortality) were compared between patients on DOAC or VKA anticoagulant. Results In total, 158 patients on DOAC and 419 patients on VKA with acute bleeding and impaired renal function were included. The renal function in patients on VKA was significantly worse compared to patients on DOAC (VKA: median 141 μmol/L vs. DOAC 132 μmol/L, p = 0.002). Patients on DOAC presented with a smaller number of intracranial bleeding compared to VKA (14.6% DOAC vs. 22.4% VKA, p = 0.036). DOAC patients needed more emergency endoscopies (15.8% DOAC vs, 9.1% VKA, p = 0.020) but less interventional emergency therapies to stop the bleeding (13.9% DOAC vs. 22.2% VKA, p = 0.027). Investigated outcomes did not differ significantly between the two groups. Conclusions DOAC patients were found to have a smaller proportional incidence of intracranial bleedings, needed more emergency endoscopies but less often interventional therapy compared to patients on VKA. Adapted treatment algorithms are a potential target to improve care in patients with DOAC.

2021 ◽  
Vol 12 ◽  
Josipa Kuleš ◽  
Ivana Rubić ◽  
Blanka Beer Ljubić ◽  
Petra Bilić ◽  
Renata Barić Rafaj ◽  

Canine babesiosis is a tick-borne disease with a worldwide distribution, caused by the haemoprotozoan parasites of the genus Babesia. One of the most prevalent complication is acute kidney injury, and an early diagnosis of altered kidney function remains a challenge for veterinary practice. The aim of this study was to assess the urine metabolic profile from dogs with babesiosis and different degree of kidney function using untargeted and targeted MS-based metabolomics approaches. In this study, 22 dogs naturally infected with Babesia canis and 12 healthy dogs were included. Untargeted metabolomics approach identified 601 features with a differential abundance between the healthy group and groups of dogs with babesiosis and different level of kidney function, with 27 of them identified as a match to known standards; while targeted approach identified 17 metabolites with significantly different concentrations between the groups. A pattern of significantly altered metabolites referring to the inflammatory host response, oxidative stress, and energy metabolism modulation in babesiosis was presented. Our findings have demonstrated that kidney dysfunction accompanying canine babesiosis was associated with changes in amino acid metabolism, energy metabolism, fatty acid metabolism, and biochemical pathways such as urea cycle and ammonia detoxication. These findings will enable the inclusion of urinary markers for the detection and monitoring of renal damage in babesiosis, as well as in other similar diseases.

Children ◽  
2021 ◽  
Vol 8 (9) ◽  
pp. 810
Jesus Alejandro Estevez-Garcia ◽  
Marcela Tamayo-Ortiz ◽  
Alison P. Sanders

Increased exposure to maternal psychosocial stress during gestation and adverse neonatal environments has been linked to alterations in developmental programming and health consequences in offspring. A programmed low nephron endowment, among other altered pathways of susceptibility, likely increases the vulnerability to develop chronic kidney disease in later life. Our aim in this scoping review was to identify gaps in the literature by focusing on understanding the association between life-course exposure to psychosocial stress, and the risk of reduced kidney function. A systematic search in four databases (PubMed, ProQuest, Wed of Science, and Scopus) was performed, yielding 609 articles. Following abstract and full-text review, we identified 19 articles meeting our inclusion criteria, reporting associations between different psychosocial stressors and an increase in the prevalence of kidney disease or decline in kidney function, mainly in adulthood. There are a lack of studies that specifically evaluated the association between gestational exposure to psychosocial stress and measures of kidney function or disease in early life, despite the overall evidence consistent with the independent effects of prenatal stress on other perinatal and postnatal outcomes. Further research will establish epidemiological studies with clear and more comparable psychosocial stressors to solve this critical research gap.

2021 ◽  
Vol 4 (9) ◽  
pp. e2123365
Cedric Edwards ◽  
Gregory L. Hundemer ◽  
William Petrcich ◽  
Mark Canney ◽  
Greg Knoll ◽  

2021 ◽  
Bende Liu ◽  
Xiaoling Liu ◽  
Ze Zhang ◽  
Yan Qin ◽  
Fang Zou ◽  

Abstract Objective: To investigate the effects of tea blend composed of Enshi selenium-rich tea, gynostemma pentaphyllum and apenma on blood lipid and lipid metabolism in mice with hyperlipidemia and prevention of hyperlipidemia in mice on the high-fat diet.Methods: Mice were randomized into 7 groups, among which 6 groups were fed with high-fat diet to establish a hyperlipidemia mouse model, and the other group was fed with normal diet as the normal control. After the hyperlipidemia model was established, mice were fed with normal diet while receiving different regimens. The normal diet group, the high-fat control group and the positive control group were given physiological saline solution, physiological saline solution and atorvastatin daily by gavage, respectively. The initial intervention group was given medium dose tea blend solution by gavage, and the other three groups were given low, medium and high dose of tea solution daily by gavage, respectively. After 4 weeks of treatment, mice were sacrificed, blood samples were taken for monitoring of lipid metabolism, -liver and tissue tissues were removed for examination of morphology and gene expression.Results: The tea blend not only significantly reduced the level of blood lipid in hyperlipidemia mice, but also effectively protected the liver and kidney function (P < 0.05). Observation under the light microscope reveled that, high-fat diet led to the accumulation of fat in hepatocytes and disorder of hepatic cordage, while the tea blend alleviated the hepatocyte steatosis. In addition, the tea blend promoted the expression of HL and HSL genes, and increased the levels of LAXR and PPARA, which regulated lipid metabolism at the genetic level (P < 0.05).Conclusion: This study confirmed that drinking tea blend composed of Enshi selenium-enriched tea, Gynostemma pentaphyllum and Apocynum venetum could lower blood lipids in mice with hyperlipidemia. In addition, various doses of tea blend could be used for hyperlipidemia with good liver and kidney function, and medium or high dose of tea blend was relatively safe for hyperlipidemia with poor liver and kidney function.

2021 ◽  
pp. 1-20
Diene S. Schlickmann ◽  
Patrícia Molz ◽  
Caroline Brand ◽  
Caroline dos Santos ◽  
Thalia G. da Silva ◽  

Abstract Dietary supplements have been increasingly used by gym users and are often consumed without the guidance of a health professional. Moreover, the indiscriminate supplements use can have adverse health effects, such as changes in liver and kidney function. The aim of this study was to verify the association between dietary supplements intake with alterations in the liver and kidney function among gym users. A cross-sectional study with 594 gym users (mean age 37±14 years, 55.2% women) from a city in southern Brazil. A questionnaire was used to evaluate the use of dietary supplements. The markers of the liver (alanine aminotransferase; ALT, aspartate aminotransferase; AST, alkaline phosphatase; AKP, gamma-glutamyltransferase; Gama-GT) and renal (creatinine and urea) function were also evaluated on a subsample of the study population. Data were analyzed by Binary Logistic Regression, adjusted for sex, age and education. The prevalence of dietary supplement intake was 36.0%. Individuals who intake dietary supplements showed a higher prevalence to present slight alterations in the AST enzyme and in the urea after adjustments for potential confounders. In conclusion, the use of dietary supplement was associated with slight alterations in AST enzyme and in the urea among gym users. These findings show the importance of using supplements correctly, especially with guidance from professionals trained to avoid possible risks to health.

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