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2.
Int. j. morphol ; 38(2): 461-471, abr. 2020. graf
Artículo en Inglés | LILACS | ID: biblio-1056463

RESUMEN

This experiment was designed to study the administration of normal doses of one of recent antimalarial drug and coadministration of vitamin E on the kidney tissue. A total twenty-four adult male albino rats were used and divided into four groups: the first one served as a control, the second received artemether orally for three days consecutively. The rats of the third and fourth groups received the same dose of artemether concomitantly with 50 and 100 mg/kg vitamin E orally daily for 2 weeks. After the last dose, the rats were sacrificed and the kidney tissues with blood samples obtained and processed for light, electron microscopic and biochemical analysis. Histologically, artemether treated kidneys showed atrophied glomeruli with widened urinary space and kidney tubules were degenerated with disturbed contour and some vacuoles inside it. Ultrastructurally, the glomeruli of this group showed hypertrophic endothelial cells, irregularity of its basement membrane, disrupted foot processes and filtration slits. The kidney tubule cells showed loss of basal infoldings, cytoplasmic vacuolation, polymorphic damaged swollen mitochondria a loss of its microvilli towards its capillary lumen. Artemether plus vitamin E of the rat kidney groups showed improvement of morphological changes compared to the changes seen in artemether alone. These data were confirmed by biochemical findings with marked improvement of blood urea and creatinine levels and increase of anti-oxidant enzyme activities of glutathione peroxidase and superoxide dismutase in the vitamin E treated groups. The results of this study revealed that vitamins E can improve the adverse changes of artemether of rat renal tissue.


Este proyecto fue diseñado para estudiar la administración de dosis normales de uno de los medicamentos antipalúdicos y de la administración de vitamina E en el tejido renal. Se utilizaron 24 ratas albinas machos adultas divididas en cuatro grupos: el primero sirvió como control, el segundo recibió arteméter por vía oral durante tres días consecutivos. Las ratas del tercer y cuarto grupos recibieron la misma dosis de arteméter concomitantemente con 50 y 100 mg / kg de vitamina E por vía oral diariamente durante 2 semanas. Después de la última dosis, las ratas fueron sacrificadas y se obtuvo el tejido renal de cada muestra los cuales fueron procesados para análisis con microscopías de luz y electrónica, además de exámenes bioquímicos. Histológicamente, los riñones tratados con arteméter mostraron atrofia glomerular con espacio urinario ensanchado y túbulos renales degenerados con contorno alterado y algunas vacuolas en su interior. Ultraestructuralmente, los glomérulos de este grupo mostraron células endoteliales hipertróficas, irregularidad de su membrana basal, procesos alterados del pie y hendiduras de filtración. Las células del túbulo renal mostraron pérdida de inflexiones basales, vacuolación citoplasmática, mitocondrias dañadas y pérdida de sus microvellosidades hacia la luz capilar. Arteméter más vitamina E en los grupos de riñón de rata mostraron una mejora de los cambios morfológicos, en comparación con los cambios observados en arteméter solamente. Estos datos fueron confirmados por hallazgos bioquímicos con una marcada mejoría de los niveles de urea y creatinina en sangre y un aumento de las actividades enzimáticas antioxidantes de la glutatión peroxidasa y la superóxido dismutasa en los grupos tratados con vitamina E. Los resultados de este estudio revelaron que la vitamina E puede mejorar los cambios adversos del arteméter del tejido renal de la rata.


Asunto(s)
Animales , Masculino , Ratas , Vitamina E/farmacología , Lesión Renal Aguda/inducido químicamente , Arteméter/toxicidad , Vitamina E/administración & dosificación , Microscopía Electrónica , Biomarcadores/análisis , Ratas Wistar , Riñón/efectos de los fármacos , Riñón/patología , Riñón/ultraestructura , Antimaláricos/toxicidad
3.
Anticancer Res ; 40(3): 1747-1751, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32132083

RESUMEN

BACKGROUND/AIM: Previous reports have demonstrated that non-steroidal anti-inflammatory drugs (NSAIDs) are a risk factor for cisplatin-induced nephrotoxicity (CIN). Here, the results of these previous studies were comprehensively assessed via a meta-analysis. MATERIALS AND METHODS: After a database search to select eligible studies, a meta-analysis was performed using a forest plot, followed by an assessment of the heterogeneity and publication bias and a subgroup analysis. RESULTS: Seven studies were extracted as candidates. All were retrospective studies and evaluated the effect of NSAIDs on CIN as a secondary endpoint. According to the meta-analysis, total odds ratio was 1.88 (95% confidence interval=1.44-2.45). Further, high heterogeneity and publication bias were not observed. A subgroup analysis of the chemotherapy evaluation period revealed that CIN tended to be enhanced in the first course group (evaluation in only 1 course) and was significantly enhanced in the total course group (evaluation in 1 or more courses) by NSAIDs co-administration. CONCLUSION: NSAIDs co-administration could be a risk factor for CIN.


Asunto(s)
Lesión Renal Aguda/inducido químicamente , Antiinflamatorios no Esteroideos/uso terapéutico , Cisplatino/efectos adversos , Riñón/patología , Lesión Renal Aguda/patología , Antiinflamatorios no Esteroideos/farmacología , Humanos , Estudios Retrospectivos , Factores de Riesgo
4.
Bratisl Lek Listy ; 121(2): 143-150, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32115968

RESUMEN

OBJECTIVES: This study was aimed to explore the effects of follistatin on cisplatin-induced renal dysfunction, histopathological changes, apoptosis, inflammation and oxidative damage in rats. BACKGROUND: Follistatin plays an important role in the developmental and regeneration processes of kidney by blocking the actions of activin, which is a member of transforming growth factor-ß superfamily. METHODS: Twenty seven rats were separated into 4 equal groups: Control, Cp (cisplatin, 6 mg/kg, intrapertoneally (ip)), F1 (cisplatin + 1 µg/day follistatin ip for 4 consecutive days) and F4 (cisplatin + 4 µg/day follistatin ip single dose) groups. Renal health was monitored by blood urea nitrogen, serum creatinine and histological analysis. Apoptosis, inflammation and oxidative stress was investigated in kidney tissue. Activin A levels in serum and kidney were evaluated as well. RESULTS: Follistatin administration showed a considerable nephroprotective effect against cisplatin-induced nephrotoxicity by preventing renal functional and structural abnormalities, apoptosis and inflammation. The activin A levels in both serum and kidney were also suppressed by follistatin administration. CONCLUSION: Exogenous follistatin ameliorates acute kidney injury, by blocking activin A. The renoprotective effect of follistatin against cisplatin-induced nephrotoxicity appears to be associated with its anti-inflammatory, antiapoptotic and direct nephroprotective actions (Tab. 1, Fig. 7, Ref. 23).


Asunto(s)
Lesión Renal Aguda , Cisplatino , Folistatina , Lesión Renal Aguda/inducido químicamente , Lesión Renal Aguda/tratamiento farmacológico , Animales , Apoptosis/efectos de los fármacos , Cisplatino/efectos adversos , Folistatina/farmacología , Folistatina/uso terapéutico , Inflamación , Riñón , Estrés Oxidativo , Ratas
5.
Medicine (Baltimore) ; 99(10): e19473, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32150109

RESUMEN

BACKGROUND: Renal insufficiency is an important predictor of contrast-induced acute kidney injury (CI-AKI). We performed a meta-analysis to examine the effects of short-term statin therapy on the incidence of CI-AKI, particularly in patients with renal insufficiency. METHODS: A systematic search was conducted to retrieve randomized controlled trials (RCTs) that investigated the impact of statin pretreatment before administration of contrast media on the development of CI-AKI in patients with mild to moderate renal insufficiency. The primary outcome was development of CI-AKI. The secondary outcome was the incidence ofacute kidney injury requiring hemodialysis. RESULTS: Data analysis from 8 RCTs, which included a total of 2313 subjects in the statin-treated group and 2322 in the control group, showed that statin pretreatment was associated with significant reduction of the risk of CI-AKI (relative risk [RR] = 0.59; 95% confidential interval [CI] 0.44-0.79; P = .0003, I = 0%). A beneficial effect of statin on preventing CI-AKI was consistent, regardless of the dose of statin and use of N-acetylcysteine. In subgroup analysis based on baseline estimated glomerular filtration rate (eGFR), patients with baseline eGFR <60 mL/min/1.73 m (RR = 0.63; 95% CI 0.41-0.98; P = .04, I = 0%) and 30 < eGFR < 90 mL/min/1.73 m (RR = 0.56; 95% CI 0.39-0.82; P = .003, I = 0%) showed significant reduction of risk of CI-AKI. CONCLUSION: Statin pretreatment is effective at preventing CI-AKI and should be considered in patients with preexisting renal insufficiency.


Asunto(s)
Lesión Renal Aguda/prevención & control , Medios de Contraste/efectos adversos , Angiografía Coronaria/efectos adversos , Inhibidores de Hidroximetilglutaril-CoA Reductasas/uso terapéutico , Lesión Renal Aguda/inducido químicamente , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Humanos , Inhibidores de Hidroximetilglutaril-CoA Reductasas/administración & dosificación , Ensayos Clínicos Controlados Aleatorios como Asunto
6.
PLoS One ; 15(2): e0229377, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32084231

RESUMEN

BACKGROUND: Cisplatin is a highly effective chemotherapeutic agent. However, acute kidney injury (AKI) limits its subsequent use, resulting in poor cancer prognosis. Dipeptidyl peptidase-4 (DPP-4) inhibitors have been reported to attenuate cisplatin-induced AKI in animal models, but the effect in human patients remains to be clarified. We hypothesized that DPP-4 inhibitors can prevent cisplatin-induced AKI in diabetic-cancer patients. METHODS: We retrospectively reviewed all consecutive cancer patients who were treated with a first cycle of cisplatin-containing regimen between January 2011 and October 2019. We analysed data of diabetic-cancer patients treated with high-dose cisplatin (> 50 mg/m2)-containing regimens. The change of estimated glomerular filtration rate (eGFR) within 2 weeks after cisplatin treatment was compared between the patients treated with DPP-4 inhibitors and those treated without DPP-4 inhibitors. RESULTS: A total of 455 patients were treated with cisplatin during the period. Of these, 34 patients were eligible for the analysis. The change of eGFR was significantly less in the patients treated with DPP-4 inhibitors, compared to those without DPP-4 inhibitors [the percentages of eGFR decline (mean ± SD) was 23.6 ± 20.3% vs 43.1± 20.1%, respectively; P = 0.010]. Furthermore, the incidence of AKI was significantly less in the patients treated with DPP-4 inhibitors (25% vs 64%, respectively; P = 0.026). CONCLUSIONS: DPP-4 inhibitors may decrease the risk of cisplatin-induced AKI in diabetic patients.


Asunto(s)
Lesión Renal Aguda/tratamiento farmacológico , Antineoplásicos/efectos adversos , Cisplatino/efectos adversos , Complicaciones de la Diabetes , Diabetes Mellitus/fisiopatología , Inhibidores de la Dipeptidil-Peptidasa IV/uso terapéutico , Neoplasias/tratamiento farmacológico , Lesión Renal Aguda/inducido químicamente , Anciano , Femenino , Tasa de Filtración Glomerular , Humanos , Masculino , Persona de Mediana Edad , Neoplasias/patología , Pronóstico , Estudios Retrospectivos
7.
Angiology ; 71(4): 366-371, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-32000500

RESUMEN

Contrast-induced nephropathy (CIN) accounts for about 10% of all hospital-acquired acute kidney injury. We aimed to assess the role of the combination of 2 inflammatory biomarkers, the C-reactive protein (CRP)/albumin ratio (CAR), in the development of CIN after percutaneous coronary intervention (PCI) in patients with non-ST-elevation myocardial infarction (NSTEMI). Patients with NSTEMI (n = 205) treated by PCI were classified according to the development of CIN. Both groups were compared according to clinical, laboratory, and demographic characteristics, including inflammatory biomarkers and specifically, CAR. Contrast-induced nephropathy was observed in 10.2% of patients. More advanced age, the presence of diabetes and dyslipidemia, left ventricular ejection fraction, and CAR correlated with the development of CIN. Analysis also showed a significant association between CAR and the development of CIN (CAR in CIN (+): 8.54 ± 8.48, range: 0.7-32, median: 7.13 vs CAR in CIN (-): 2.36 ± 3.01, range: 0.1-24, median: 1.33, P < .001). Multivariate logistic regression analysis showed the impact of CAR on the development of CIN (odds ratio: 1.244, 95% confidence interval: 1.102; 1.392, P < .01). We conclude that CAR, as a combination of 2 inflammatory biomarkers, is a more accurate predictor of CIN development compared with the single-marker assessment of albumin and CRP in the context of NSTEMI.


Asunto(s)
Lesión Renal Aguda/inducido químicamente , Albúminas/metabolismo , Proteína C-Reactiva/metabolismo , Medios de Contraste/efectos adversos , Infarto del Miocardio sin Elevación del ST/sangre , Adulto , Anciano , Anciano de 80 o más Años , Biomarcadores/metabolismo , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Infarto del Miocardio sin Elevación del ST/cirugía , Intervención Coronaria Percutánea , Valor Predictivo de las Pruebas , Estudios Prospectivos
8.
Anticancer Res ; 40(2): 635-643, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-32014904

RESUMEN

BACKGROUND/AIM: Contrast-induced AKI (CI-AKI) is an important clinical complication of intravascular use of iodinated contrast agents. The aim of the present study was to investigate the renoprotective effect of Apela on contrast-induced acute kidney injury. MATERIALS AND METHODS: Blood samples from patients exposed to iodinated contrast agent were collected to assay for Apela and creatinine levels. The effects of ELA32 (Apela 32) on iodixanol-induced apoptosis, inflammation response, mitochondrial ROS production and DNA damage were examined in NRK-52E renal tubular epithelial cells. RESULTS: Plasma Apela levels were decreased in patients exposed to the contrast agent. Iodixanol-induced apoptosis was reduced in ELA32 treated NRK-52E cells (p<0.05). ELA32 treatment inhibited iodixanol-induced mitochondrial ROS generation (p<0.01). Iodixanol-induced inflammatory cytokines TNFa and IL-6 and inflammatory genes Nrf2 and ICAM-1 were reduced by ELA32 treatment (p<0.01). Reduced Apela expression in iodixanol-treated cells was partially restored by ELA32 treatment (p<0.05). ELA32 treatment suppressed iodixanol-induced up-regulation of DNA damage-associated gene P-ATR and p-CHK1 as well as apoptosis-associated gene C-caspase 3 (p<0.05). CONCLUSION: Administration of iodinated contrast agent reduces Apela expression. ELA32 treatment reduces iodixanol-induced apoptosis, inflammatory response and mitochondrial and DNA damage in renal tubular epithelial cells.


Asunto(s)
Lesión Renal Aguda/inducido químicamente , Medios de Contraste/efectos adversos , Daño del ADN/genética , Células Epiteliales/metabolismo , Riñón/fisiopatología , Mitocondrias/metabolismo , Hormonas Peptídicas/genética , Ácidos Triyodobenzoicos/efectos adversos , Apoptosis , Humanos
10.
Am Heart J ; 221: 67-73, 2020 03.
Artículo en Inglés | MEDLINE | ID: mdl-31931418

RESUMEN

BACKGROUND: When prescribing diuretics in the postcardiac surgical intensive care unit (ICU), clinicians may use central venous pressure (CVP) to assess volume status and the risk of acute kidney injury (AKI). In this study, we examined how the risk of diuretic-associated AKI varied with CVP in patients undergoing cardiac surgery. METHODS: We used the Medical Information Mart for Intensive Care database to study adults admitted to the postcardiac surgical ICU at an urban, academic medical center between 2001 and 2012. We examined the odds of AKI per 1-mm Hg increase in CVP among patients receiving intravenous loop diuretics using multivariable adjusted logistic regression. We examined the risk of AKI among patients with diuretic use (vs nonuse) across tertiles of CVP using inverse probability treatment weighting. RESULTS: Among 4,164 patients receiving intravenous loop diuretics, the adjusted odds of subsequent AKI were 1.11 (95% CI 1.08-1.13) times higher per mm Hg increase in mean CVP. This association was log-linear across the entire range of CVPs observed. In the analysis of diuretic use (n = 5,396), the adjusted risk ratio for AKI with diuretic use (vs nonuse) was 1.33 (95% CI 1.21-1.47) and did not materially differ across tertile of CVP. CONCLUSIONS: Higher rather than lower CVP is an independent marker of AKI risk. The risk of AKI associated with diuretic use may not be influenced by CVP. Novel methods of assessing volume status and AKI risk are needed to guide patient selection for diuretic therapy.


Asunto(s)
Lesión Renal Aguda/inducido químicamente , Procedimientos Quirúrgicos Cardíacos , Presión Venosa Central , Cuidados Posoperatorios , Inhibidores del Simportador de Cloruro Sódico y Cloruro Potásico/efectos adversos , Lesión Renal Aguda/epidemiología , Anciano , Anciano de 80 o más Años , Puente Cardiopulmonar , Puente de Arteria Coronaria , Femenino , Humanos , Unidades de Cuidados Intensivos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Análisis Multivariante
11.
Rev Assoc Med Bras (1992) ; 66Suppl 1(Suppl 1): s82-s90, 2020 Jan 13.
Artículo en Inglés | MEDLINE | ID: mdl-31939540

RESUMEN

Acute kidney injury is a very common diagnosis, present in up to 60% of critical patients, and its third main cause is drug toxicity. Nephrotoxicity can be defined as any renal injury caused directly or indirectly by medications, with acute renal failure, tubulopathies, and glomerulopathies as common clinical presentations. Some examples of drugs commonly associated with the acute reduction of glomerular filtration rate are anti-inflammatories, antibiotics, such as vancomycin and aminoglycosides, and chemotherapeutic agents, such as cisplatin and methotrexate. Cases of tubulopathy are very common with amphotericin B, polymyxins, and tenofovir, and cases of glomerulopathies are common with VEGF inhibitors, bisphosphonates, and immunotherapy, and it is also common to have more than one clinical presentation related to a single agent. Early diagnosis is essential for the good evolution of the patient, with a reduction of renal exposure to the toxic agent, which requires knowing the risk factors and biomarkers. General measures such as correcting hydroelectrolytic disorders and hypovolemia, monitoring the serum level, avoiding combinations with the synergy of renal injury, and looking for similar options that are less toxic are the foundations for the treatment of complications that are still common and often preventable.


Asunto(s)
Lesión Renal Aguda/inducido químicamente , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos , Lesión Renal Aguda/epidemiología , Humanos , Síndrome Nefrótico/inducido químicamente , Síndrome Nefrótico/epidemiología , Factores de Riesgo
12.
Life Sci ; 242: 117239, 2020 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-31901444

RESUMEN

AIMS: Reactive oxygen species (ROS) and pro-inflammatory cytokines play a critical role in organ damage induced by ethanol consumption. Interleukin (IL)-10 maintain tissue homeostasis through restriction of excessive inflammatory responses and inhibition of ROS generation. These responses limit unnecessary tissue damage in the cardiorenal system. We hypothesized that IL-10 would limit the deleterious effects induced by ethanol consumption in the cardiorenal system. MATERIALS AND METHODS: Male C57BL/6J wild-type (WT) or IL10-deficient mice (IL-10-/-) were treated with ethanol (20% v/v) for 6 weeks. KEY FINDINGS: IL-10 deficiency was associated with an increased mortality rate. Ethanol consumption decreased plasma levels of IL-10 in WT mice. Increased levels of IL-6 were detected in the aorta from IL-10-deficient mice, but not WT mice. No alterations in the levels of urea, creatinine, sodium, potassium or creatine kinase (CK)-MB were found after treatment with ethanol. Augmented concentration of thiobarbituric acid reactive substances (TBARS) was found in the left ventricle (LV) of IL-10-deficient mice, but not WT mice. Increased levels of superoxide anion (O2-) were found in the renal cortex of both WT and IL-10-deficient mice. Renal cortex from WT mice chronically treated with ethanol showed decreased levels of H2O2. No changes in the expression of Nox1, Nox4 or catalase were found in the renal cortex from ethanol-treated mice. SIGNIFICANCE: IL-10 limited the production of ROS and the synthesis of pro-inflammatory cytokines induced by ethanol in the cardiorenal system. These findings provided novel evidence that IL-10 counteracted the initial mechanisms whereby ethanol induces its cardiorenal damages.


Asunto(s)
Etanol/efectos adversos , Corazón/efectos de los fármacos , Interleucina-10/metabolismo , Riñón/efectos de los fármacos , Lesión Renal Aguda/inducido químicamente , Animales , Western Blotting , Forma MB de la Creatina-Quinasa/sangre , Creatinina/sangre , Interleucina-10/sangre , Interleucina-10/fisiología , Masculino , Ratones , Ratones Endogámicos C57BL , Potasio/sangre , Sodio/sangre , Urea/sangre
13.
Ann Hematol ; 99(3): 627-633, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-31965273

RESUMEN

Acute kidney injury (AKI) after hematopoietic stem cell transplantation (HSCT) is associated with high mortality rates. To determine the incidence and risk factors associated with AKI in patients undergoing HSCT during the infusion period, patients admitted for HSCT from 2012 to 2015 were studied. AKI was classified according to the KDIGO (Kidney Disease Improving Global Outcomes) criteria. We analyzed the main comorbidities, underlying conditions, types of transplant, preparative regimens, and use of potentially nephrotoxic drugs as risk factors for AKI. Among the 180 patients (median age 53 years), 69 (36.5%) developed AKI (23 KDIGO 1, 28 KDIGO 2, and 18 KDIGO 3), 49 (50.0%) undergoing allogeneic and 20 (22.3%) autologous transplantation, and 18 (9.4%) required dialysis. The main comorbidities were hypertension (38; 19.8%), and diabetes (19; 9.9%). The median pre-transplant creatinine was 0.7 mg/dl. Twenty-one patients died (10.9%). The risk factors for AKI in allogeneic HSCT were as follows: baseline estimated glomerular filtration rate (eGFR) (RR 1.12 (1.02-1.22), p = 0.019), use of vasopressors (RR 3.72 (2.20-6.29), p < 0.001), and use of methotrexate (RR 1.83 (1.08-3.11), p = 0.025). Male gender (RR 5.91 (1.65-21.16), p = 0.006), baseline eGFR (RR 1.22 (1.04-1.43), p = 0.011), and use of aminoglycosides (RR 3.92 (1.06-14.44), p = 0.041) were the risk factors for AKI associated with autologous HSCT. During hospitalization for HSCT, AKI was a common problem. The use of a low dose of methotrexate to prevent graft versus host disease was associated with its occurrence.


Asunto(s)
Lesión Renal Aguda , Enfermedad Injerto contra Huésped , Trasplante de Células Madre Hematopoyéticas , Metotrexato , Acondicionamiento Pretrasplante/efectos adversos , Lesión Renal Aguda/inducido químicamente , Lesión Renal Aguda/mortalidad , Adolescente , Adulto , Anciano , Aloinjertos , Autoinjertos , Supervivencia sin Enfermedad , Femenino , Enfermedad Injerto contra Huésped/mortalidad , Enfermedad Injerto contra Huésped/prevención & control , Humanos , Masculino , Metotrexato/administración & dosificación , Metotrexato/efectos adversos , Persona de Mediana Edad , Estudios Retrospectivos , Factores de Riesgo , Tasa de Supervivencia
14.
Int J Antimicrob Agents ; 55(3): 105889, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-31923573

RESUMEN

Colistin is the last-resort antimicrobial agent against infections caused by multidrug-resistance Gram-negative bacteria (MDR-GNB). However, a differing risk of colistin-associated acute kidney injury (CA-AKI) has been demonstrated without affecting mortality, thus the association and its importance needs to be questioned. To assess the impact of this adverse effect, a meta-analysis comparing colistin with other antibiotics in treating MDR-GNB infections was conducted. The PubMed, Embase and Cochrane Library electronic databases were searched up to 31 December 2018 for cohort studies and randomised controlled trials with at least two arms with one arm containing colistin-based treatment. The primary endpoint was the incidence of AKI. The secondary endpoint was 30-day all-cause mortality. A total of 34 studies, including 26 regarding colistin-based therapy versus other antibiotics and 9 regarding colistin monotherapy versus combination therapy, were included. The incidence of CA-AKI was 32.3%. Colistin was associated with an 82% higher incidence of AKI than other antibiotics [odd ratio (OR) = 1.82, 95% confidence interval (CI) 1.13-2.92; P = 0.01]. Most CA-AKI events were mild and reversible without a higher rate of mortality or the requirement for renal replacement therapy (RRT). Only 1.0% of patients required RRT for > 4 weeks. Compared with colistin monotherapy, combination therapy was associated with a significantly lower incidence of AKI (OR = 1.46, 95% CI 1.10-1.94; P = 0.009), particularly in combination with a carbapenem (OR = 1.97, 95% CI 1.30-2.99; P = 0.001). In conclusion, CA-AKI might not be an important limitation of colistin in MDR-GNB therapy.


Asunto(s)
Lesión Renal Aguda/inducido químicamente , Antibacterianos/administración & dosificación , Colistina/efectos adversos , Bacterias Gramnegativas/efectos de los fármacos , Infecciones por Bacterias Gramnegativas/tratamiento farmacológico , Lesión Renal Aguda/mortalidad , Lesión Renal Aguda/terapia , Adulto , Antibacterianos/uso terapéutico , Carbapenémicos/farmacología , Carbapenémicos/uso terapéutico , Estudios de Cohortes , Colistina/uso terapéutico , Farmacorresistencia Bacteriana Múltiple/efectos de los fármacos , Humanos , Incidencia , Terapia de Reemplazo Renal
15.
World Neurosurg ; 136: 136-139, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-31954899

RESUMEN

BACKGROUND: Encephalopathy is reported to have affected 250,000 people in the United States over the last decade, with considerable morbidity and mortality. Baclofen, a gamma-aminobutyric acid-B agonist that acts on the central nervous system, is the drug most widely used to treat spasticity. Baclofen overdose is a potentially deadly condition that can cause encephalopathy and can result from multiple etiologies. Renal disease can contribute to baclofen overdose and encephalopathy, and there are currently no dosing recommendations for patient's on baclofen with renal impairment. CASE DESCRIPTION: We report an unusual case of a man aged 35 years who presented with persistent fevers, seizures, and normal mentation. The patient presented with intrathecal baclofen use and prior exposure to West Nile Virus. He developed acute kidney injury at hospital secondary to vancomycin use, and mental status declined. CONCLUSIONS: This case highlights that patients with baclofen overdose can initially appear to have serious brain injury, however, full patient recovery can occur in <72 hours. This case provides additional insight into the guidelines for the treatment and management for unknown cause encephalopathy. This case also highlights the link between renal disease, baclofen, and encephalopathy through a review of the literature.


Asunto(s)
Baclofeno/efectos adversos , Encefalopatías/inducido químicamente , Agonistas de Receptores GABA-B/efectos adversos , Espasmo/tratamiento farmacológico , Lesión Renal Aguda/inducido químicamente , Adulto , Antibacterianos/efectos adversos , Antibacterianos/uso terapéutico , Baclofeno/administración & dosificación , Encefalopatías/complicaciones , Encefalopatías/fisiopatología , Electroencefalografía , Fiebre/etiología , Fiebre/fisiopatología , Agonistas de Receptores GABA-B/administración & dosificación , Humanos , Bombas de Infusión Implantables , Infusión Espinal , Masculino , Meropenem/uso terapéutico , Paraplejía/complicaciones , Convulsiones/etiología , Convulsiones/fisiopatología , Espasmo/etiología , Traumatismos de la Médula Espinal/complicaciones , Vancomicina/efectos adversos
16.
Food Chem Toxicol ; 135: 110901, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31654708

RESUMEN

Acute kidney injury (AKI) is an abrupt loss of kidney function with high mortality. Inflammatory is considered driving the progression of AKI. Salvianolic acid A (SA), one of the major ingredients of Salvia miltiorrhiza Bunge, displays plenty of biological effects. Herein, the effect of SA on lipopolysaccharide (LPS)-induced AKI in mice and further related mechanism in inflammatory cells were explored. In vivo experiments demonstrated that SA significantly ameliorated LPS-challenged AKI by preventing glomerulus atrophy and decreasing plasma creatinine and blood urea nitrogen (BUN) levels. Meanwhile, SA significantly decreased the release of serum inflammatory cytokines and blocked macrophage infiltration in damaged renal tissue. In in vitro studies, SA significantly decreased TNF-α and IL-6 release levels and altered the expression of cyclooxygenase-2 (COX-2) and inducible nitric oxide synthase (iNOS) in LPS-stimulated macrophages, which were consistent with the results from in vivo experiments. Furthermore, SA that bound to Toll-Like Receptor 4 (TLR4) was able to reduce endoplasmic reticulum (ER) stress and reactive oxygen species (ROS) generation in response to LPS stimulation. All silence of TLR4 gene, ROS scavenger and Ca2+ chelator decreased inflammatory cytokines releases. Taken together, SA could be used as a potential therapeutic agent for preventing AKI by suppressing inflammatory responses.


Asunto(s)
Lesión Renal Aguda/prevención & control , Antiinflamatorios/uso terapéutico , Ácidos Cafeicos/uso terapéutico , Lactatos/uso terapéutico , Sustancias Protectoras/uso terapéutico , Lesión Renal Aguda/inducido químicamente , Animales , Estrés del Retículo Endoplásmico/efectos de los fármacos , Lipopolisacáridos , Sistema de Señalización de MAP Quinasas/efectos de los fármacos , Macrófagos/metabolismo , Masculino , Ratones , Ratones Endogámicos BALB C , Factor 88 de Diferenciación Mieloide/metabolismo , Células RAW 264.7 , Especies Reactivas de Oxígeno/metabolismo , Receptor Toll-Like 4/metabolismo
17.
J Biochem Mol Toxicol ; 34(2): e22431, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31833131

RESUMEN

Cisplatin-induced nephrotoxicity persists as a clinical problem despite several supportive measures to alleviate renal damage. Daidzein (DZ), a dietary isoflavone having antioxidant and anti-inflammatory activity, is investigated in this study for protective effects against cisplatin-induced renal injury in rats. DZ (25, 50, or 100 mg/kg; intraperitoneally; 10 days) was administered along with Cisplatin, single dose, on the 7th day of the experiment. On the 11th day, the rats were euthanized, and different samples were collected for analysis. Biochemical, histopathological, and molecular parameters were assessed to evaluate the effect of daidzein. Cisplatin injection resulted in renal dysfunction, lipid peroxidation that led to consumption of antioxidants, exaggerated apoptosis, and inflammation. These changes were associated with increase in the signaling proteins. DZ attenuated the toxic effects of cisplatin on the kidney at 100 mg/kg dose. The study concludes with the finding that daidzein imparts protection against the nephrotoxic effect of Cisplatin and can be considered as a novel, potential therapy.


Asunto(s)
Lesión Renal Aguda/inducido químicamente , Lesión Renal Aguda/dietoterapia , Antiinflamatorios/uso terapéutico , Antioxidantes/uso terapéutico , Apoptosis/efectos de los fármacos , Cisplatino/farmacología , Isoflavonas/uso terapéutico , Sistema de Señalización de MAP Quinasas/efectos de los fármacos , Nefritis/dietoterapia , Estrés Oxidativo/efectos de los fármacos , Animales , Antiinflamatorios/administración & dosificación , Antiinflamatorios/farmacología , Antioxidantes/administración & dosificación , Antioxidantes/farmacología , Cisplatino/efectos adversos , Citocinas/sangre , Isoflavonas/administración & dosificación , Isoflavonas/farmacología , Riñón/efectos de los fármacos , Peroxidación de Lípido/efectos de los fármacos , Hígado/efectos de los fármacos , Masculino , Ratas , Resultado del Tratamiento
18.
Toxicon ; 174: 57-63, 2020 Jan 30.
Artículo en Inglés | MEDLINE | ID: mdl-31887316

RESUMEN

Hemiscorpius lepturus envenomation induces acute kidney injury (AKI) through hemoglubinoria and mitochondrial dysfunction. Mitochondria supports ATP production to promote the regulation of fluid and electrolyte balance. Mitochondrial homeostasis in different metabolic environments can be adjusted by overexpression of PGC-1α. High reactive oxygen species (ROS) production after H. lepturus envenomation and heme oxygenase-1 (HO-1) overexpression causes ATP depletion as well as mitochondrial homeostasis disruption, which lead to progression in renal diseases. The present study aims to evaluate the role of venom induced-AKI in modulating mitochondrial function in cell death and metabolic signaling associated with PPAR-α, PGC-1α, and Nrf-2 as the main transcription factors involved in metabolism. Based on the data, two significant events occurred after envenomation: reduction of gl glutathione level and overexpression of the cytoprotective enzyme HO-1. Apaoptosis induction is associated with a significant decrease in the transcription of PPAR-α, PGC-1α and Nrf-2 after administrating lethal dose of venom (10 mg/kg). Furthermore, at the lower doses of venom (1 and 5 mg/kg), with a significant recovery accompanied with PGC-1α upregulation occurs after AKI. As the findings indicate, PGC-1α has a key role in restoring the mitochondrial function at the recovery phase of mouse model of AKI, which highlights the PGC-1α as a therapeutic target for venom induced-AKI prevention and treatment.


Asunto(s)
Coactivador 1-alfa del Receptor Activado por Proliferadores de Peroxisomas gamma/metabolismo , Venenos de Escorpión/toxicidad , Escorpiones/fisiología , Lesión Renal Aguda/inducido químicamente , Animales , Expresión Génica , Ratones , Pruebas de Toxicidad Aguda
19.
Life Sci ; 242: 117227, 2020 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-31881226

RESUMEN

INTRODUCTION: Misuse of AAS is emergent among both genders, however, few studies were performed evaluating AAS effects on female body and none evaluate the impact of nandrolone decanoate (ND) in renal function. AIM: Determine the effects of chronic treatment with ND on kidney function of female rats and evaluate the influence of oxidative stress on it. MATERIAL AND METHODS: Female rats were separated into two groups (n = 8 each), the treated group (DECA), which received ND at a dose of 20 mg/kg/week (i.m), and the control group (C), which was treated with the vehicle (peanut oil, i.m.). All treatments were performed during eight weeks. After this period, 24 h urine, blood and organs (heart, gastrocnemius muscle, liver and kidney) were collected. Organ hypertrophy was calculated, and kidney collagen content was evaluated. AOPP, TBARS, SOD and catalase activity were determined in the kidney. Moreover, proteinuria and creatinine clearance were also investigated. KEY-FINDINGS: Hypertrophy was observed in the liver, gastrocnemius muscle, heart and kidney. Kidney hypertrophy was followed by a reduced organ function and an increase in collagen deposition. Oxidative stress upsurge occurred in both proteins and lipids, followed by a reduction in SOD activity. SIGNIFICANCE: Administration of DN in rats was followed by renal damage and kidney fibrosis due to increased oxidative stress on that organ.


Asunto(s)
Lesión Renal Aguda/inducido químicamente , Anabolizantes/efectos adversos , Homeostasis/efectos de los fármacos , Nandrolona Decanoato/efectos adversos , Estrés Oxidativo/efectos de los fármacos , Lesión Renal Aguda/metabolismo , Lesión Renal Aguda/fisiopatología , Anabolizantes/farmacología , Animales , Western Blotting , Catalasa/metabolismo , Femenino , Riñón/efectos de los fármacos , Riñón/metabolismo , Riñón/patología , Riñón/fisiología , Nandrolona Decanoato/farmacología , Ratas , Ratas Wistar , Superóxido Dismutasa/metabolismo
20.
Rev. Pesqui. (Univ. Fed. Estado Rio J., Online) ; 12: 460-465, jan.-dez. 2020. tab
Artículo en Inglés, Portugués | LILACS, BDENF - Enfermería | ID: biblio-1053063

RESUMEN

Objetivo: Determinar a prevalência da nefropatia induzida por contraste em pacientes cardiopatas submetidos a procedimentos angiográficos de diagnóstico e/ou tratamento. Método: Estudo prospectivo, quantitativo, realizado no setor de hemodinâmica de um hospital de grande porte, situado na região norte do Rio Grande do Sul, Brasil. A amostra foi constituída por 79 participantes através do cálculo de tamanho amostral. Resultados: A amostra foi formada por 52 (65,8%) homens e 27 (34,2%) mulheres. A idade média foi de 65,9 ± 9,52 anos. A incidência de nefropatia induzida por contraste foi de 30,38%, totalizando 24 pacientes. Conclusão: Foi evidenciada uma alta prevalência de nefropatia por contraste, apesar dos pacientes apresentarem poucos fatores de risco, o que ressalta a necessidade de medidas preventivas e redução do volume de contraste


Objective: To determine the prevalence of contrast-induced nephropathy in cardiac patients undergoing diagnostic and / or treatment angiographic procedures. Method: A prospective, quantitative study in the hemodynamics sector of a large hospital, located in the northern region of Rio Grande do Sul, Brazil. The sample consisted of 79 participants through the calculation of sample size. Results: The sample consisted of 52 (65.8%) men and 27 (34.2%) women. The mean age was 65.9 ± 9.52 years. The incidence of contrast-induced nephropathy was 30,38%, totaling 24 patients. Conclusion: A high prevalence of contrast nephropathy was evidenced, despite the fact that patients presented few risk factors, which highlights the need for preventive measures and reduction of contrast volume


Objetivo: Determinar la prevalencia de la nefropatía inducida por contraste en pacientes cardiopatas sometidos a procedimientos angiográficos de diagnóstico y / o tratamiento. Método: Estudio prospectivo, cuantitativo, realizado en el sector de hemodinámica de un hospital de gran porte, situado en la región norte de Rio Grande do Sul, Brasil. La muestra fue constituida por 79 participantes a través del cálculo de tamaño muestral. Resultados: La muestra fue formada por 52 (65,8%) hombres y 27 (34,2%) mujeres. La edad media fue de 65,9 ± 9,52 años. La incidencia de nefropatía inducida por contraste fue del 30,38%, totalizando 24 pacientes. Conclusión: Se evidenció una alta prevalencia de nefropatía por contraste, a pesar de que los pacientes presentaban pocos factores de riesgo, lo que resalta la necesidad de medidas preventivas y reducción del volumen de contraste


Asunto(s)
Humanos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Angiografía/efectos adversos , Cardiopatías/complicaciones , Cardiopatías/diagnóstico por imagen , Enfermedades Renales/inducido químicamente , Enfermedades Renales/epidemiología , Estudios Prospectivos , Medios de Contraste/efectos adversos , Enfermedad Coronaria/complicaciones , Lesión Renal Aguda/inducido químicamente , Hemodinámica
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