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2.
Rev Med Suisse ; 16(683): 404-408, 2020 Feb 26.
Artículo en Francés | MEDLINE | ID: mdl-32129017

RESUMEN

Cheap and easy to access, ethylene glycol is used in the synthesis of antifreezes. Intoxication has potentially irreversible morbid consequences. Ingestion of a small amount can lead to death. Due to its ubiquitous distribution and potential complications, it is of paramount importance for the practitioner to recognize its manifestations and metabolic complications in order to implement its therapy in partnership with the nephrologist and the intensivist. A successful treatment depends on rapid and multidisciplinary management, as reviewed in this article.


Asunto(s)
Glicol de Etileno/toxicidad , Enfermedades Renales/inducido químicamente , Humanos
3.
Rev Med Suisse ; 16(683): 412-416, 2020 Feb 26.
Artículo en Francés | MEDLINE | ID: mdl-32129019

RESUMEN

Over the last decades, an increasing number of cases of chronic and end-stage kidney disease has been observed in Central America and Asia. This kidney disease mainly affects young farmers without classic renal risk factors. The clinical presentation includes a progressive decrease of the glomerular filtration rate, minimal proteinuria and the presence of tubulo-interstitial nephritis at renal biopsy. A close link with global warming is suspected for this disease, called (according to its location) meso-american nephropathy, Sri Lanka nephropathy or chronic kidney disease of unknown etiology. Others have suggested that intake of water contaminated with pesticides may be responsible. This article provides an overview of this new kidney disease. Measures to prevent acute kidney injury during heat waves in Switzerland are also discussed.


Asunto(s)
Calentamiento Global , Enfermedades Renales/epidemiología , Enfermedades Renales/etiología , Riñón/patología , Riñón/fisiopatología , América Central/epidemiología , Humanos , Enfermedades Renales/prevención & control , Fallo Renal Crónico/epidemiología , Fallo Renal Crónico/etiología , Fallo Renal Crónico/prevención & control , Sri Lanka/epidemiología , Suiza/epidemiología
5.
Autoimmun Rev ; 19(4): 102495, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-32068190

RESUMEN

OBJECTIVE: Renal involvement in anti-neutrophil cytoplasm antibody (ANCA)-associated vasculitis is associated with significant morbidity and higher mortality rates. This study examined clinical manifestations associated with renal involvement in ANCA-associated vasculitis within a large, international cross-sectional cohort. METHODS: Univariate and multivariate analyses were performed to identify clinical factors associated with renal disease, which was defined as i) a serum-creatinine >30% above normal and a fall in creatinine-clearance >25%; or ii) haematuria attributable to active vasculitis. RESULTS: The study cohort include 1230 patients from 31 countries; 723 (58.8%) presented with renal involvement: microscopic polyangiitis (82.2%), granulomatosis with polyangiitis (58.6%), and eosinophilic granulomatosis with polyangiitis (26.4%). The following clinical and laboratory factors were more common among patients with renal disease: age (OR 1.01, 95% CI 1.01-1.02), fever (OR 1.97, 95% CI 1.35-2.88), fatigue (OR 1.55, 95% CI 1.14-2.10), weight loss (OR 1.62, 95% CI 1.23-2.12), polyarthritis (OR 1.39, 95% CI 1.02-1.89), petechiae/purpura (OR 1.47, 95% CI 1.06-2.05), pulmonary haemorrhage (OR 5.23, 95% CI 1.39-19.63), gastrointestinal symptoms (OR 2.19, 95% CI 1.34-3.58), seizures (OR 3.42, 95% CI 1.26-9.30), lower serum albumin (OR 2.42, 95% CI 1.64-3.57), higher CRP (OR 2.06, 95% CI 1.04-4.06), low serum C3 at baseline (OR 3.86, 95% CI 1.30-11.53), myeloperoxidase- (OR 7.97, 95% CI 2.74-23.20) and proteinase 3-ANCA (OR 3.40, 95% CI 1.22-9.50). The following clinical factors were less common among patients with renal disease: mononeuritis multiplex (OR 0.63, 95% CI 0.41-0.98), proptosis/exophthalmos (OR 0.19, 95% CI 0.06-0.59), nasal polyps (OR 0.32, 95% CI 0.19-0.55), septal defect/perforation (OR 0.29, 95% CI 0.14-0.60), respiratory distress/pulmonary fibrosis/asthma (OR 0.08, 95% CI 0.04-0.19), and wheeze/obstructive airway disease (OR 0.29, 95% CI 0.16-0.52). CONCLUSION: In this large international study, several clinical and laboratory factors were identified as associated with renal involvement in ANCA-associated vasculitis.


Asunto(s)
Vasculitis Asociada a Anticuerpos Citoplasmáticos Antineutrófilos/complicaciones , Enfermedades Renales/complicaciones , Síndrome de Churg-Strauss , Estudios Transversales , Granulomatosis con Poliangitis , Humanos
6.
Zhonghua Nei Ke Za Zhi ; 59(2): 161-164, 2020 Feb 01.
Artículo en Chino | MEDLINE | ID: mdl-32074693

RESUMEN

A 49-year-old woman was admitted to hospital with intermittent dizziness and fatigue for 7 years. The symptoms were aggravated and accompanied by bone pain for more than 4 months. She was referred to our hospital. Laboratory tests and imaging findings suggested that acquired Fanconi Syndrome (FS) was associated with smoldering multiple myeloma (MM). Renal biopsy and electron microscopy confirmed the diagnosis of proximal light chain tubular disease (LCPT). LCPT causes proximal tubular dysfunction, which is characterized by the cytoplasmic crystal deposition usually kappa monoclonal light chain in the proximal tubule. MM with FS and LCPT is less common in clinical practice because it is difficult to diagnose. This is a typical case focusing on the differential diagnosis of monoclonal gammopathy of renal significance(MGRS) such as LCPT and plasma cells diseases.


Asunto(s)
Anemia , Mareo/etiología , Síndrome de Fanconi/etiología , Fatiga/etiología , Enfermedades Renales/complicaciones , Mieloma Múltiple , Paraproteinemias/complicaciones , Proteinuria , Síndrome de Fanconi/diagnóstico , Femenino , Humanos , Cadenas kappa de Inmunoglobulina , Enfermedades Renales/diagnóstico , Persona de Mediana Edad , Paraproteinemias/diagnóstico
7.
J Agric Food Chem ; 68(9): 2765-2772, 2020 Mar 04.
Artículo en Inglés | MEDLINE | ID: mdl-32045244

RESUMEN

Fatty acid esters of 3-monochloropropane 1,2-diol (3-MCPD esters) are processing-induced food toxicants, with the kidney as their major target organ. For the first time, this study treated Sprague Dawley (SD) rats with 3-MCPD 1-monooleate at 10 and 100 mg/kg BW/day and 1-monostearate at 15 and 150 mg/kg BW/day for 90 days and examined for their potential semi-long-term nephrotoxicity and the associated molecular mechanisms. No bodyweight difference was observed between groups during the study. Both 3-MCPD 1-monooleate and 1-monostearate resulted in a dose-dependent increase of serum urea creatinine, uric acid and urea nitrogen levels, and histological renal impairment. The proteomic analysis of the kidney samples showed that the 3-MCPD esters deregulated proteins involved in the pathways for ion transportation, apoptosis, the metabolism of xenobiotics, and enzymes related to endogenous biological metabolisms of carbohydrates, amino acids, nitrogen, lipids, fatty acids, and the tricarboxylic acid (TCA) cycle, providing partial explanation for the nephrotoxicity of 3-MCPD esters.


Asunto(s)
Enfermedades Renales/metabolismo , Riñón/efectos de los fármacos , Estearatos/toxicidad , alfa-Clorhidrina/toxicidad , Animales , Creatinina/orina , Ésteres/metabolismo , Ésteres/toxicidad , Humanos , Riñón/metabolismo , Enfermedades Renales/etiología , Enfermedades Renales/genética , Enfermedades Renales/orina , Masculino , Proteómica , Ratas , Ratas Sprague-Dawley , Estearatos/química , Estearatos/metabolismo , Ácido Úrico/orina , alfa-Clorhidrina/metabolismo
8.
Chem Biol Interact ; 317: 108975, 2020 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-32032593

RESUMEN

In patients with acute kidney injury progressively converting into chronic kidney disease (CKD), proteinuria and high blood pressure predict progression to end-stage renal disease (ESRD). Although, Renin-angiotensin-aldosterone system (RAAS) regulates blood pressure and kidney disease through both direct and indirect mechanisms. RAAS blockers that act at the level of angiotensin or lower in the cascade can cause compensatory increases in the plasma renin and angiotensin II level. Here, in this review article, we are exploring the evidence-based on RAAS blockade action releases of aldosterone and hypothesizing the molecular mechanism for converting the acute kidney injury into chronic kidney disease to end-stage renal disease.


Asunto(s)
Aldosterona/metabolismo , Enfermedades Renales/tratamiento farmacológico , Enfermedades Renales/metabolismo , Sistema Renina-Angiotensina/efectos de los fármacos , Corticoesteroides/biosíntesis , Antagonistas de Receptores de Angiotensina/uso terapéutico , Inhibidores de la Enzima Convertidora de Angiotensina/uso terapéutico , Humanos
11.
Zhonghua Yi Xue Yi Chuan Xue Za Zhi ; 37(2): 166-169, 2020 Feb 10.
Artículo en Chino | MEDLINE | ID: mdl-32034747

RESUMEN

OBJECTIVE: To detect variant of APOE gene in a Chinese Tibetan patient with lipoprotein glomerulopathy (LPG) confirmed by renal biopsy and to explore its pathogenesis. METHODS: Clinical and pathological data was collected. DNA was extracted from peripheral blood sample of the patient and subjected to PCR and Sanger sequencing. Pathogenicity of the variant was analyzed by bioinformatics software. RESULTS: Renal biopsy of the patient has confirmed the diagnosis of LPG. DNA sequencing suggested that the patient has carried a heterozygous c.527G>C (p.R176P) variant of the APOE gene (APOE Osaka/Kurashiki). Four cases of LPG have been found to carry the same variant, and the encoded amino acid (p.176R) is highly conserved during evolution. Bioinformatic analysis using SIFT, PolyPhen2 and PANTHER software all predicted the variant to be pathogenic. CONCLUSION: The discovery of author's patient provided further evidence for the pathogenicity of APOE Osaka/Kurashiki and, more importantly, provide new evidence for the multiracial origin of LPG-related APOE variants.


Asunto(s)
Apolipoproteínas E/genética , Enfermedades Renales/genética , Humanos , Glomérulos Renales , Mutación , Tibet
12.
N Engl J Med ; 382(7): 622-631, 2020 02 13.
Artículo en Inglés | MEDLINE | ID: mdl-32053298

RESUMEN

BACKGROUND: More effective and safer treatments are needed for antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis. METHODS: We conducted a randomized trial with a 2-by-2 factorial design to evaluate the use of plasma exchange and two regimens of oral glucocorticoids in patients with severe ANCA-associated vasculitis (defined by an estimated glomerular filtration rate of <50 ml per minute per 1.73 m2 of body-surface area or diffuse pulmonary hemorrhage). Patients were randomly assigned to undergo plasma exchange (seven plasma exchanges within 14 days after randomization) or no plasma exchange (control group). Patients were also randomly assigned to follow either a standard-dose regimen or a reduced-dose regimen of oral glucocorticoids. Patients were followed for up to 7 years for the primary composite outcome of death from any cause or end-stage kidney disease (ESKD). RESULTS: Death from any cause or ESKD occurred in 100 of 352 patients (28.4%) in the plasma-exchange group and in 109 of 352 patients (31.0%) in the control group (hazard ratio, 0.86; 95% confidence interval [CI], 0.65 to 1.13; P = 0.27). The results were similar in subgroup analyses and in analyses of secondary outcomes. We also assessed the noninferiority of a reduced-dose regimen of glucocorticoids to a standard-dose regimen, using a noninferiority margin of 11 percentage points. Death from any cause or ESKD occurred in 92 of 330 patients (27.9%) in the reduced-dose group and in 83 of 325 patients (25.5%) in the standard-dose group (absolute risk difference, 2.3 percentage points; 90% CI, -3.4 to 8.0), which met the criterion for noninferiority. Serious infections at 1 year were less common in the reduced-dose group than in the standard-dose group (incidence rate ratio, 0.69; 95% CI, 0.52 to 0.93), but other secondary outcomes were similar in the two groups. CONCLUSIONS: Among patients with severe ANCA-associated vasculitis, the use of plasma exchange did not reduce the incidence of death or ESKD. A reduced-dose regimen of glucocorticoids was noninferior to a standard-dose regimen with respect to death or ESKD. (Funded by the U.K. National Institute for Health Research and others; PEXIVAS Current Controlled Trials number, ISRCTN07757494; ClinicalTrials.gov number, NCT00987389.).


Asunto(s)
Vasculitis Asociada a Anticuerpos Citoplasmáticos Antineutrófilos/tratamiento farmacológico , Vasculitis Asociada a Anticuerpos Citoplasmáticos Antineutrófilos/terapia , Glucocorticoides/administración & dosificación , Fallo Renal Crónico/prevención & control , Intercambio Plasmático , Administración Oral , Adulto , Anciano , Vasculitis Asociada a Anticuerpos Citoplasmáticos Antineutrófilos/complicaciones , Vasculitis Asociada a Anticuerpos Citoplasmáticos Antineutrófilos/mortalidad , Terapia Combinada , Ciclofosfamida/uso terapéutico , Relación Dosis-Respuesta a Droga , Femenino , Glucocorticoides/efectos adversos , Humanos , Inmunosupresores/uso terapéutico , Incidencia , Quimioterapia de Inducción , Enfermedades Renales/complicaciones , Fallo Renal Crónico/epidemiología , Fallo Renal Crónico/etiología , Masculino , Persona de Mediana Edad , Intercambio Plasmático/efectos adversos , Rituximab/uso terapéutico
13.
Expert Rev Cardiovasc Ther ; 18(1): 33-39, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32003265

RESUMEN

Introduction: Contrast-induced nephropathy is a known complication that can occur after intravascular administration of iodinated contrast medium. Its consequences can range from a mild worsening of the renal function to renal failure requiring renal replacement therapy. There is no known effective treatment for contrast-induced nephropathy, and thus, efforts have focused on its prevention. Many approaches have been studied, but the most common strategy in use at the present time is prophylactic intravenous isotonic saline.Areas covered: This article reviews the data supporting the current practice of prophylactic periprocedural intravenous isotonic saline for lowering the incidence of contrast-induced nephropathy. We reviewed PubMed to search primarily for the latest clinical trials and meta-analyses pertaining to contrast-induced nephropathy and the use of prophylactic measures, specifically intravenous infusion of isotonic saline.Expert commentary: Currently, there are no universally accepted methods for the prevention of contrast-induced nephropathy. The best evidence for contrast-induced nephropathy prophylaxis is the administration of intravenous isotonic saline. Our review article provides an overview of the current knowledge, latest research, and current practice on contrast-induced nephropathy prophylaxis using intravenous isotonic saline administration.


Asunto(s)
Cateterismo Cardíaco/métodos , Angiografía Coronaria/métodos , Enfermedades Renales/prevención & control , Cateterismo Cardíaco/efectos adversos , Medios de Contraste/efectos adversos , Angiografía Coronaria/efectos adversos , Humanos , Infusiones Intravenosas , Enfermedades Renales/inducido químicamente , Insuficiencia Renal/inducido químicamente , Insuficiencia Renal/prevención & control , Resultado del Tratamiento
14.
Medicine (Baltimore) ; 99(3): e18798, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32011483

RESUMEN

RATIONALE: Renal hemosiderosis is a disease in which hemosiderin deposits in the renal cortex as a form of iron overload. However, cases of renal hemosiderosis due to intravascular hemolysis following mitral valve repair have been rarely reported. PATIENT CONCERNS: We present the case of a 62-year-old woman who developed asymptomatic urinary abnormalities including microscopic hematuria and proteinuria due to renal hemosiderosis following a mitral valve repair surgery performed two years earlier. DIAGNOSES: A percutaneous renal biopsy showed no specific glomerular abnormality, tubular atrophy, or interstitial fibrosis but extensive deposition of hemosiderin in the proximal tubule. The patient was diagnosed with renal hemosiderosis and chronic intravascular hemolysis following mitral valve repair. INTERVENTIONS: Our patient refused a mitral valve repeat surgery and hence was treated with oral iron preparations, N-acetylcysteine, and a ß-receptor blocker. OUTCOMES: Moderate mitral regurgitation with the regurgitant blood striking against the annuloplasty ring was confirmed on follow-up echocardiography. After the 24-month follow-up period, hemolytic anemia persisted, but there was no significant decline of renal function. LESSONS: For cases of chronic intravascular hemolysis accompanied with asymptomatic urinary abnormalities, a renal biopsy is required to exclude underlying kidney pathology and predict potential renal insufficiency.


Asunto(s)
Implantación de Prótesis de Válvulas Cardíacas , Hemólisis , Hemosiderosis/diagnóstico , Enfermedades Renales/diagnóstico , Complicaciones Posoperatorias/diagnóstico , Femenino , Hemosiderosis/etiología , Hemosiderosis/patología , Humanos , Enfermedades Renales/etiología , Enfermedades Renales/patología , Persona de Mediana Edad , Insuficiencia de la Válvula Mitral/cirugía , Complicaciones Posoperatorias/patología
15.
Acta Cir Bras ; 34(12): e201901201, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32022101

RESUMEN

PURPOSE: To evaluate the effect of Rut-bpy (Cis-[Ru(bpy)2(SO3)(NO)]PF 6), a novel nitric oxide donor, able to modulate the histological changes caused by the NASID (meloxicam). METHODS: Wistar rats were assigned into three groups (n=6 rats/group): Sham group (saline solution), NSAID group (meloxicam - 15 mg/kg) and Rut-bpy group (100 mg/kg of Rut-bpy associated with 15mg/kg of meloxicam). At the end of experiments, kidneys were removed for histological study, fractal dimension and lacunarity in all animals. RESULTS: At the histological examination, all animals (six animals - 100 %) in the NSAID group had membrane thickening and other changes (necrosis, acute tubular congestion and vascular congestion); on the other hand, only one animal (16.6 %) of the Rut-bpy group had congestion. The fractal dimension and lacunarity were greater in the control and Rut-bpy group than in NSAIDs group (p<0.05). CONCLUSION: Rut-bpy may prevent renal histological changes in rats caused by meloxicam.


Asunto(s)
Antiinflamatorios no Esteroideos/efectos adversos , Enfermedades Renales/inducido químicamente , Enfermedades Renales/prevención & control , Meloxicam/efectos adversos , Donantes de Óxido Nítrico/farmacología , Compuestos Organometálicos/farmacología , Rutenio/farmacología , 2,2'-Dipiridil/análogos & derivados , Animales , Fractales , Enfermedades Renales/patología , Masculino , Distribución Aleatoria , Ratas Wistar , Reproducibilidad de los Resultados
16.
Chem Biol Interact ; 318: 108977, 2020 Feb 25.
Artículo en Inglés | MEDLINE | ID: mdl-32035863

RESUMEN

Excess weight and obesity increase the risk of developing major risk factors for chronic kidney disease. Lignin comprises 20%-30% of the global plant biomass; however, it is not well utilized because of its resistance to chemical and biological degradation. We investigated whether low-molecular-weight oxidized lignophenol (LOLP), a lignin derivative, could alter inflammation and fibrosis in the kidneys of a high-fat diet (HFD)-fed mice. Male mice were divided into three treatment groups: HFD; HFD +0.3% LOLP; and HFD +0.6% LOLP. The control mice (Cont) were fed a low-fat diet. Macrophage kinetics, the degree of fibrosis, the extent of phosphorylation of AMP-activated protein kinase (AMPK), and mRNA expression of proinflammatory mediators in the kidneys were examined. The number of macrophages, the percentage of fibrotic area, and the mRNA expression of proinflammatory markers, TNF-α and Ccl2, and a marker of fibrosis, TGF-ß, were significantly higher in the kidneys of mice in the HFD group than those in the Cont group. Conversely, treatment with 0.6% LOLP for 8 weeks significantly suppressed the degree of macrophage infiltration, interstitial fibrotic area, and the increased mRNA expression of proinflammatory and fibrosis markers induced by HFD. In conclusion, LOLP suppressed macrophage infiltration and the increase in fibrotic area, and upregulated AMPK phosphorylation in the kidneys of HFD-fed mice; thus, it may ameliorate HFD-induced kidney injury.


Asunto(s)
Proteínas Quinasas Activadas por AMP/metabolismo , Dieta Alta en Grasa/efectos adversos , Enfermedades Renales/inducido químicamente , Lignina/química , Fenoles/química , Fenoles/farmacología , Animales , Proteínas de Unión al Calcio/genética , Proteínas de Unión al Calcio/metabolismo , Activación Enzimática/efectos de los fármacos , Fibrosis/inducido químicamente , Inflamación/inducido químicamente , Inflamación/tratamiento farmacológico , Enfermedades Renales/prevención & control , Macrófagos/efectos de los fármacos , Macrófagos/metabolismo , Masculino , Ratones , Ratones Endogámicos C57BL , ARN Mensajero , Receptores Acoplados a Proteínas G/genética , Receptores Acoplados a Proteínas G/metabolismo
17.
Med J Aust ; 212(3): 133-139, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-31910303

RESUMEN

Treatment options for type 2 diabetes have expanded. While metformin remains the first line treatment in most cases, choices for second line treatment now extend beyond sulfonylureas and include the sodium-glucose cotransporter 2 (SGLT2) inhibitors, glucagon-like peptide 1 (GLP1) receptor agonists, and dipeptidyl peptidase 4 (DPP4) inhibitors. SGLT2 inhibitors are recommended for people with atherosclerotic cardiovascular disease, heart failure or kidney disease. Diabetic ketoacidosis is an uncommon but important side effect; its occurrence can be minimised with appropriate patient education and management, especially during perioperative periods and times of illness. GLP1 receptor agonists are recommended for people with atherosclerotic cardiovascular disease. Gastrointestinal side effects are common but are less prominent with the longer acting agents and can be minimised with slow titration of the shorter acting agents. DPP4 inhibitors are generally well tolerated, but alogliptin and saxagliptin should be used with caution in people with risk factors for heart failure. To optimise the management of type 2 diabetes, clinicians need to be aware of the pharmacological characteristics of each class of blood glucose-lowering medications and of the effect on cardiovascular health and renal function, balanced by potential adverse effects. Medications that have cardiovascular or renal benefits should be prescribed for patients with these comorbidities, and this is reflected in recent international guidelines.


Asunto(s)
Diabetes Mellitus Tipo 2/tratamiento farmacológico , Inhibidores de la Dipeptidil-Peptidasa IV/uso terapéutico , Hipoglucemiantes/uso terapéutico , Inhibidores del Cotransportador de Sodio-Glucosa 2/uso terapéutico , Glucemia , Enfermedades Cardiovasculares/prevención & control , Diabetes Mellitus Tipo 2/complicaciones , Inhibidores de la Dipeptidil-Peptidasa IV/farmacología , Humanos , Hipoglucemiantes/farmacología , Enfermedades Renales/prevención & control , Ensayos Clínicos Controlados Aleatorios como Asunto , Inhibidores del Cotransportador de Sodio-Glucosa 2/farmacología
18.
High Blood Press Cardiovasc Prev ; 27(1): 9-17, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31975151

RESUMEN

The presence of hypertensive mediated organ damage is related to increased vascular risk and mortality and its prevention should be a therapeutic target and a surrogate marker of in/adequate blood pressure control. In old adult hypertensive patients the therapeutic target should be to prevent major cardiovascular events, but in young hypertensive subjects the focus should be pointed on preventing the development of hypertensive mediated organ damage, since most of the hard events are preceded by functional and structural tissues injury. Hypertension Guidelines of the European Society of Cardiology and European Society of Hypertension recognizes that some variables like electrocardiographic or echocardiographic left ventricle hypertrophy, chronic kidney disease or advance retinopathy, all considered as hypertensive mediated organ damage, may be modifiers of cardiovascular risk estimated by the SCORE system, and for that reason they should be screened in hypertensive patients. It is well known the problem of limited health systems financial resources in many low and even median income countries which precludes the possibilities of generalizing the search for hypertension mediated organ damage in all hypertensive patients. In these scenario the recommendation to perform a detailed screening should be critically evaluated. Some questions remained unanswered: the screening generalization of hypertensive mediated organ damage should modify the cardiovascular risk score of the patients, if its presence could modify the therapeutic approach, and as a consequence, if the treatment adjustment should prolong life expectancy and ameliorate the quality of life.


Asunto(s)
Antihipertensivos/uso terapéutico , Presión Sanguínea/efectos de los fármacos , Cardiopatías/prevención & control , Hipertensión/tratamiento farmacológico , Enfermedades Renales/prevención & control , Enfermedades Vasculares/prevención & control , Antihipertensivos/efectos adversos , Diagnóstico Precoz , Cardiopatías/diagnóstico , Cardiopatías/mortalidad , Cardiopatías/fisiopatología , Humanos , Hipertensión/diagnóstico , Hipertensión/mortalidad , Hipertensión/fisiopatología , Enfermedades Renales/diagnóstico , Enfermedades Renales/mortalidad , Enfermedades Renales/fisiopatología , Medición de Riesgo , Factores de Riesgo , Factores de Tiempo , Resultado del Tratamiento , Enfermedades Vasculares/diagnóstico , Enfermedades Vasculares/mortalidad , Enfermedades Vasculares/fisiopatología
19.
Rev Med Suisse ; 16(676-7): 63-67, 2020 Jan 15.
Artículo en Francés | MEDLINE | ID: mdl-31961087

RESUMEN

Impact of gliflozines and rituximab in the treatments of diabetic and membranous nephropathies respectively has been confirmed. Roxadustat may be the new promising treatment of renal anemia. Long-acting erythropoietins may be associated with a higher death rate than short-acting ones in hemodialysis patients. Kidneys of HCV-seropositive donors can be proposed to any wait-listed patient for renal transplantation. Immunosupression minimizing the use of calcineurin inhibitors may be achieved with an everolimus-based protocol.


Asunto(s)
Enfermedades Renales , Trasplante de Riñón , Nefrología , Humanos , Riñón , Nefrología/tendencias , Diálisis Renal
20.
Cell Physiol Biochem ; 54(1): 88-109, 2020 Jan 29.
Artículo en Inglés | MEDLINE | ID: mdl-31990489

RESUMEN

Extracellular vesicles (EVs) are important mediators of intercellular communication. Since EVs are also released during pathological conditions, there has been considerable interest in their potential as sensitive biomarkers of cellular stress and/or injury. In the context of kidney disease, urinary EVs are promising indicators of glomerular and tubular damage. In the present review we discuss the role of urinary EVs in kidney health and disease. Our focus is to explore urinary large EVs (lEVs, often referred to as microparticles or microvesicles) as direct and noninvasive early biomarkers of renal injury. In this regard, studies have been demonstrating altered levels of urinary lEVs, especially podocyte-derived lEVs, preceding the decrease of renal function assessed by classical markers. In addition, we discuss the role of small EVs (sEVs, often referred to as exosomes) and their contents in kidney pathophysiology. Even though results concerning the production of sEVs during diseased conditions are varied, there has been a consensus on the importance of urinary sEV content assessment in kidney disease. These mediators, including EV-released miRNAs and mRNAs, are responsible for EV-mediated signaling in the regulation of renal cellular homeostasis, pathogenesis and regeneration. Finally, steps necessary for the validation of EVs as reliable markers will be discussed.


Asunto(s)
Vesículas Extracelulares/patología , Enfermedades Renales/diagnóstico , Glomérulos Renales/patología , Túbulos Renales/patología , Animales , Biomarcadores/análisis , Biomarcadores/orina , Humanos , Enfermedades Renales/patología , Enfermedades Renales/orina
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