Paz Castro Fernández*, Carmen Vozmediano Poyatos, Martin Negreira Caamaño, Daniel Campos Valverde, Luis Piccone Saponara, Guillermo Ferrer García, Gloria García Conejo, Roger Cox Conforme, Marcos Santos-Olmo Montoya and Agustín Carreño Parrilla
DOI: 10.37421/2161-0959.2023.13.461
Objective: There are clinical conditions with histological evidence of non-ischemic myocardial necrosis that are associated with elevated troponin levels, such as the structural and functional alterations of the Left Ventricle (LV) that occur in Left Ventricular Diastolic Dysfunction (LVDD). We analyzed the relationship between the ultrasensitive Troponin I biomarker (TnI-US) and LVDD in a cohort of asymptomatic Hemodialysis (HD) patients.
Methods: Descriptive cross-sectional study including 80 patients. Categorical variables were compared using Chi2 test, and quantitative variables were compared with Student's t-test or Mann-Whitney U-test. ROC curve to determine the predictive value of TnI-US levels for LVDD. Logistic regression analysis to determine the factors independently associated with LVDD.
Results: The mean TnI-US was 31.2 ± 59.3 pg/ml, and 40% of patients had TnI-US >20 pg/ml. These patients had higher frequency of LVDD (56.3% vs. 25%, p=0.005). 37.5% of patients had LVDD and higher proportion of moderate/severe Left Ventricular Hypertrophy (LVH) (63.3% vs. 36.7%, p=0.02), lower heart rate at the start of HD (66.9 ± 8.6 bpm vs. 77.2 ± 43.6 bpm, p=0.03), and higher TnI-US (47.4 ± 81.9 pg/ml vs. 21.5 ± 38.1 pg/ml, p=0.005). Logistic regression analysis showed that TnI-US >20 pg/ml [OR: 4.1 (95% CI 1.3-12.1), p=0.01] and moderate/severe LVH [OR: 5.1 (95% CI 1.7-15.2), p=0.003] were independently associated with LVDD, while an increase in heart rate [OR: 0.9 (95% CI 0.8-0.9); p=0.02] was independently associated with a lower risk of LVDD.
Conclusion: TnI-US can be used as a biomarker for LVDD in asymptomatic patients on HD.
DOI: 10.37421/2161-0959.2023.13.462
Renal impairment, including chronic kidney disease, represents a significant global health challenge with a growing prevalence. Timely and accurate prediction of renal impairment progression is crucial for effective patient management, resource allocation, and the development of personalized treatment plans. In recent years, artificial intelligence and machine learning have emerged as powerful tools for enhancing our ability to predict and manage renal impairment progression. This research article explores the applications of AI and ML in predicting renal impairment progression, discusses their benefits, challenges, and the future outlook for this transformative field.
DOI: 10.37421/2161-0959.2023.13.463
DOI: 10.37421/2161-0959.2023.13.464
DOI: 10.37421/2161-0959.2023.13.465
DOI: 10.37421/2161-0959.2023.13.466
DOI: 10.37421/2161-0959.2023.13.467
Renal impairment, characterized by a decline in kidney function, represents a significant health challenge affecting millions of individuals worldwide. The kidneys play a vital role in maintaining homeostasis by filtering waste products and regulating fluid and electrolyte balance. Impairment of renal function can lead to a cascade of complications, including chronic kidney disease and end-stage renal disease, necessitating renal replacement therapy such as dialysis or transplantation. Pharmacological interventions play a critical role in managing renal impairment, and this article provides an overview of current trends and future prospects in this field.
DOI: 10.37421/2161-0959.2023.13.468
DOI: 10.37421/2161-0959.2023.13.469
Diabetic nephropathy is a prevalent and debilitating complication of diabetes mellitus that significantly contributes to the global burden of chronic kidney disease. While it is well-established that diabetes is a major risk factor for the development of renal impairment, the precise mechanisms underlying this complex interplay between metabolic factors and renal dysfunction remain a subject of ongoing research. This article reviews the multifaceted relationship between diabetes and renal impairment, exploring the intricate web of metabolic factors and their influence on renal health. Understanding these mechanisms is critical for the development of effective prevention and treatment strategies for diabetic nephropathy.
DOI: 10.37421/2161-0959.2023.13.470
Emmanuel Anteyi*, Natarajan Ranganathan and Usha Vyas
DOI: 10.37421/2161-0959.2024.14.481
Chronic Kidney Disease (CKD) is a worldwide public health problem associated with high morbidity, mortality, and socioeconomic burden. Despite recent advances in pathogenesis and effective Standard of Care (SOC) therapy, the incidence of end stage renal disease remains high, attributed to the complex and diverse pathophysiological pathways in progression of CKD. Among the many pathogenetic pathways, inflammation plays the most central role in disease progression and related complications. Current SOC treatment to slow CKD progression has not adequately addressed these complex processes as a result of persistence of low-grade inflammation occurring at all stages of CKD. Previous attempts to address the inflammatory pathway with specific anti-inflammatory agents were, in certain cases discontinued for reasons ranging from drug safety to efficacy concerns, and business development decisions. Recent research findings demonstrating direct correlation between systemic inflammation associated gut microbiota changes and CKD progression, provided a potential novel therapeutic approach to target the inflammatory pathways. Exploring current scientific knowledge of modulating gut microbiome with microbiome-based therapies provides options in addressing these complex pathogenetic mechanisms of CKD-induced inflammation.
The purpose of this minireview is to discuss the role of inflammation associated with gut microbiome changes in CKD progression and gut microbiome-based therapeutic options to slow CKD progression.
DOI: 10.37421/2161-0959.2024.14.482
Diabetic Nephropathy (DN) is a serious and common complication of diabetes mellitus, affecting a significant number of individuals worldwide. It is a progressive kidney disease that develops in patients with diabetes, ultimately leading to renal failure if left untreated. Understanding the molecular mechanisms underlying diabetic nephropathy is crucial for developing effective therapeutic strategies to manage and prevent its progression. This article explores the intricate molecular pathways involved in the development and progression of diabetic nephropathy.
DOI: 10.37421/2161-0959.2024.14.483
The renal tubules play a crucial role in the intricate functioning of the kidneys, facilitating the reabsorption of essential substances and the excretion of waste products. Tubular diseases, characterized by the dysfunction of these vital structures, can have profound implications for overall kidney health. This article delves into the pathogenesis of tubular diseases, exploring the underlying mechanisms and highlighting emerging therapeutic strategies that hold promise in managing these conditions. Before delving into the complexities of tubular diseases, it is essential to understand the anatomy and physiology of renal tubules. The nephron, the functional unit of the kidney, consists of the renal corpuscle and renal tubule.
DOI: 10.37421/2161-0959.2024.14.484
Renal Replacement Therapy plays a crucial role in the management of end-stage renal disease, a condition characterized by the irreversible loss of kidney function. As the prevalence of ESRD continues to rise globally, the demand for effective and efficient renal replacement therapies is more pressing than ever. In recent years, technological advancements have revolutionized the landscape of kidney care, offering new possibilities for improving the outcomes and quality of life for patients undergoing RRT. This article explores the significant role that technology plays in transforming renal replacement therapy and its impact on the field of kidney care.
DOI: 10.37421/2161-0959.2024.14.485
DOI: 10.37421/2161-0959.2024.14.486
DOI: 10.37421/2161-0959.2024.14.487
DOI: 10.37421/2161-0959.2024.14.488
DOI: 10.37421/2161-0959.2024.14.489
DOI: 10.37421/2161-0959.2024.14.490
DOI: 10.37421/2161-0959.2024.14.491
Renal replacement therapy has undergone remarkable advancements in recent years, revolutionizing the landscape of dialysis technologies. As the prevalence of chronic kidney disease continues to rise globally, innovative approaches to renal replacement therapy have become increasingly crucial in enhancing patient outcomes and quality of life. This comprehensive review explores the latest developments in dialysis technologies, shedding light on their impact on the field of nephrology. As the field of renal replacement therapy continues to evolve, future directions are marked by a multidisciplinary approach, incorporating innovations in nanotechnology, biotechnology, artificial intelligence, and patient-centered care.
DOI: 10.37421/2161-0959.2024.14.492
Environmental toxins are ubiquitous in our surroundings and can have profound effects on human health, including renal function. Epidemiological studies have provided valuable insights into the association between exposure to various environmental toxins and the risk of kidney disease. This research article reviews the current evidence on the effect of environmental toxins on renal function, highlighting key findings from epidemiological studies and discussing potential mechanisms of toxicity. Understanding these associations is crucial for developing preventive strategies and mitigating the impact of environmental toxins on kidney health.
DOI: 10.37421/2161-0959.2024.14.493
DOI: 10.37421/2161-0959.2024.14.494
Microbiota dysbiosis, characterized by alterations in the composition and function of the gut microbiota, has been increasingly recognized as a significant factor in various diseases. In recent years, growing evidence suggests that microbiota dysbiosis may play a crucial role in the pathogenesis and progression of renal impairment. This systematic review aims to summarize the current understanding of the relationship between microbiota dysbiosis and renal impairment by analyzing relevant literature. A comprehensive search of electronic databases was conducted to identify relevant studies published up to [insert date]. Studies investigating the association between microbiota dysbiosis and renal impairment in humans and animal models were included. The findings of this review underscore the importance of understanding microbiota dysbiosis as a potential modifiable risk factor for renal impairment and suggest the possibility of novel therapeutic interventions targeting the gut microbiota to prevent or manage renal diseases.
DOI: 10.37421/2161-0959.2024.14.495
DOI: 10.37421/2161-0959.2024.14.496
DOI: 10.37421/2161-0959.2024.14.497
DOI: 10.37421/2161-0959.2024.14.498
DOI: 10.37421/2161-0959.2024.14.499
Renal impairment and cardiovascular disease often coexist and exhibit a complex interplay, leading to significant morbidity and mortality worldwide. This research paper aims to explore the intricate relationship between renal impairment and CVD, focusing on the underlying pathophysiological mechanisms, shared risk factors, and clinical implications. Understanding this relationship is crucial for early detection, risk stratification, and optimal management strategies to improve outcomes in affected individuals. Renal impairment and cardiovascular disease represent major public health challenges, with substantial overlap in their epidemiology and clinical manifestations. Chronic kidney disease is recognized as a potent risk factor for the development and progression of cardiovascular events, while CVD, particularly hypertension, atherosclerosis, and heart failure, significantly contributes to the progression of renal dysfunction. This paper aims to delve into the complex relationship between renal impairment and CVD, highlighting the underlying mechanisms and clinical implications.
DOI: 10.37421/2161-0959.2024.14.450
DOI: 10.37421/2161-0959.2024.14.511
DOI: 10.37421/2161-0959.2024.14.512
DOI: 10.37421/2161-0959.2024.14.513
Renal transplantation is the treatment of choice for End-Stage Renal Disease, offering improved survival and quality of life compared to dialysis. However, the success of renal transplantation is heavily dependent on the effective management of immunosuppression to prevent graft rejection while minimizing adverse effects. This meta-analysis examines the impact of various immunosuppressive therapies on renal transplant outcomes, including graft survival, patient survival, acute rejection rates, and long-term complications. By analyzing data from multiple randomized controlled trials and cohort studies, we aim to provide a comprehensive overview of the efficacy and safety profiles of different immunosuppressive regimens. Our findings suggest that while newer immunosuppressive agents have improved graft survival rates, they are associated with an increased risk of infection and malignancy. This study highlights the need for personalized immunosuppressive strategies to optimize transplant outcomes while minimizing risks
DOI: 10.37421/2161-0959.2024.14.514
Hyperkalemia, defined as an elevated serum potassium level, is a common and potentially life-threatening complication of Chronic Kidney Disease. As kidney function declines, the ability to excrete potassium diminishes, leading to its accumulation in the blood. Hyperkalemia can result in severe cardiac arrhythmias and muscle weakness, necessitating prompt and effective management. This article reviews the underlying mechanisms of hyperkalemia in CKD, including impaired renal potassium excretion, altered cellular distribution of potassium, and the impact of medications such as renin-angiotensin-aldosterone system inhibitors. Additionally, we discuss various strategies for managing hyperkalemia in CKD patients, ranging from dietary modifications and potassium-binding agents to the use of novel pharmacological treatments. Understanding these mechanisms and management strategies is crucial for optimizing care and preventing the adverse outcomes associated with hyperkalemia in CKD.
DOI: 10.37421/2161-0959.2024.14.515
Acute Kidney Injury (AKI) is a common and severe condition characterized by a sudden decline in kidney function, often resulting in high morbidity and mortality. Early detection of AKI is crucial for improving patient outcomes, yet traditional diagnostic methods, primarily based on serum creatinine levels, are often delayed and inadequate. This review explores recent advancements in the identification and validation of novel biomarkers for the early detection of AKI. We discuss the biological roles of these biomarkers, their clinical utility, and the challenges associated with their implementation in routine clinical practice. The review highlights promising biomarkers such as neutrophil gelatinase-associated lipocalin, kidney injury molecule-1 (KIM-1), and interleukin-18 (IL-18), which have shown potential in detecting AKI at earlier stages, thereby enabling timely interventions. These novel biomarkers could revolutionize AKI management by providing more sensitive and specific tools for early diagnosis.
DOI: 10.37421/2161-0959.2024.14.516
DOI: 10.37421/2161-0959.2024.14.517
DOI: 10.37421/2161-0959.2024.14.518
DOI: 10.37421/2161-0959.2024.14.519
Chronic Kidney Disease is a significant complication in diabetic patients, often leading to end-stage renal disease. Recent studies have identified Sodium-Glucose Cotransporter-2 (SGLT2) inhibitors as an effective therapeutic class for not only managing hyperglycemia but also for slowing the progression of CKD in diabetic patients. This review discusses the mechanisms by which SGLT2 inhibitors exert renoprotective effects, examines clinical trial data, and explores the implications for treatment strategies in diabetic nephropathy. Our findings suggest that SGLT2 inhibitors significantly reduce the risk of CKD progression, providing a promising avenue for improving long-term renal outcomes in diabetic patients.
DOI: 10.37421/2161-0959.2024.14.520
Journal of Nephrology & Therapeutics received 784 citations as per Google Scholar report
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