Flavonoids in Kidney Health and Disease.

This review summarizes the latest advances in knowledge on the effects of flavonoids on renal function in health and disease. Flavonoids have antihypertensive, antidiabetic, and antiinflammatory effects, among other therapeutic activities. Many of them also exert renoprotective actions that may be of interest in diseases such as glomerulonephritis, diabetic nephropathy, and chemically-induced kidney insufficiency. They affect several renal factors that promote diuresis and natriuresis, which may contribute to their well-known antihypertensive effect. Flavonoids prevent or attenuate the renal injury associated with arterial hypertension, both by decreasing blood pressure and by acting directly on the renal parenchyma. These outcomes derive from their interference with multiple signaling pathways known to produce renal injury and are independent of their blood pressure-lowering effects. Oral administration of flavonoids prevents or ameliorates adverse effects on the kidney of elevated fructose consumption, high fat diet, and types I and 2 diabetes. These compounds attenuate the hyperglycemia-disrupted renal endothelial barrier function, urinary microalbumin excretion, and glomerular hyperfiltration that results from a reduction of podocyte injury, a determinant factor for albuminuria in diabetic nephropathy. Several flavonoids have shown renal protective effects against many nephrotoxic agents that frequently cause acute kidney injury (AKI) or chronic kidney disease (CKD), such as LPS, gentamycin, alcohol, nicotine, lead or cadmium. Flavonoids also improve cisplatin- or methotrexate-induced renal damage, demonstrating important actions in chemotherapy, anticancer and renoprotective effects. A beneficial prophylactic effect of flavonoids has been also observed against AKI induced by surgical procedures such as ischemia/reperfusion (I/R) or cardiopulmonary bypass. In several murine models of CKD, impaired kidney function was significantly improved by the administration of flavonoids from different sources, alone or in combination with stem cells. In humans, cocoa flavanols were found to have vasculoprotective effects in patients on hemodialysis. Moreover, flavonoids develop antitumor activity against renal carcinoma cells with no toxic effects on normal cells, suggesting a potential therapeutic role in patients with renal carcinoma.

Beneficial Effects of Different Flavonoids on Vascular and Renal Function in L-NAME Hypertensive Rats.

BACKGROUND: we have evaluated the antihypertensive effect of several flavonoid extracts in a rat model of arterial hypertension caused by chronic administration (6 weeks) of the nitric oxide synthesis inhibitor, L-NAME. METHODS: Sprague Dawley rats received L-NAME alone or L-NAME plus flavonoid-rich vegetal extracts (Lemon, Grapefruit + Bitter Orange, and Cocoa) or purified flavonoids (Apigenin and Diosmin) for 6 weeks. RESULTS: L-NAME treatment resulted in a marked elevation of blood pressure, and treatment with Apigenin, Lemon Extract, and Grapefruit + Bitter Orange extracts significantly reduced the elevated blood pressure of these animals. Apigenin and some of these flavonoids also ameliorated nitric oxide-dependent and -independent aortic vasodilation and elevated nitrite urinary excretion. End-organ abnormalities such as cardiac infarcts, hyaline arteriopathy and fibrinoid necrosis in coronary arteries and aorta were improved by these treatments, reducing the end-organ vascular damage. CONCLUSIONS: the flavonoids included in this study, specially apigenin, may be used as functional food ingredients with potential therapeutic benefit in arterial hypertension.

El secreto profesional en Enfermería: un caso práctico / The professional secret in nursing: a practical case

En su quehacer diario, los profesionales de la Enfermería se enfrentan continuamente a numerosassituaciones en las que siempre están presentes los principios éticos. El secreto profesionalconstituye hoy en día un derecho del usuario y una obligación del profesional frente a la cualdebe adoptarse una actitud responsable y acorde con los mínimos exigibles tanto legislativa comodeontológicamente. Con el fin de identificar las aportaciones de la Bioética a la práctica diariade la Enfermería, en el presente artículo se lleva a cabo el análisis y la fundamentación de uncaso práctico en el que se plantean diversos dilemas éticos en el marco del secreto profesional yla confidencialidad de datos del paciente. La Enfermería, en tanto que labor de cuidado, tieneque ver con la realidad frágil y vulnerable del ser humano y, por tanto, la convicción actual esque las tareas del profesional enfermero incluyen algo más que la mera ejecución competentede labores de cuidado; implica no sólo la competencia y habilidad técnica, sino también la virtudmoral. Es en este contexto en el que el secreto profesional y el respeto a los datos obtenidos enla relación con el paciente adquieren toda su trascendencia. La formación en el campo de la Bioéticay la puesta en práctica de sus principios básicos permite al profesional adoptar una actitudresponsable, respetuosa e individualizada, acorde con las necesidades de las personas en cadamomento

In their daily activity, nursing professionals are constantly being faced with numerous situationsin which ethical issues are always present. Professional secret is today a right of the user and anobligation for the professional that requires a responsible attitude. Such responsible attitudemust be in accordance with the minimum required both from a legislative point of view as wellas from a deontological point of view. With the aim of identifying the contributions of Bioethicsto the daily, practice of Nursing, this article intents to analyse and to support a practical case inwhich several ethical dilemmas are looked upon within the framework of professional secretand confidentiality of patient data. Nursing, apart from having direct care as its priority, also hasto do with the fragility of reality and the vulnerability of human beings. Thus, current convictionis that the duties of the nursing professional include far more than the simple performance ofcare duties. Such duties include competition and technical ability and most importantly, a moralvirtue. It is within this framework that professional secret and respect for the data obtained inrelation to the patient becomes transcendent. Training in the field of bioethics and the set up ofits basic principles permits the professional to adopt a responsible attitude that is both respectfuland individualised, in accordance with the needs of each patient at each moment