scholarly journals The Effects of Simvastatin on Proteinuria and Renal Function in Patients with Chronic Kidney Disease

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Bancha Satirapoj ◽  
Anan Promrattanakun ◽  
Ouppatham Supasyndh ◽  
Panbuppa Choovichian
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Function ◽  
Kidney Disease ◽  
Untreated Group ◽  
Lipid Lowering ◽  
Urine Protein ◽  
Beneficial Effects ◽  
Urine Protein Excretion ◽  
Protein Excretion ◽  
Simvastatin Group

Current data suggests that statins might have beneficial effects on renal outcomes. Beneficial effects of statin treatment on renal progression in advanced chronic kidney disease (CKD) are obviously controversial. In a retrospective, controlled study, the authors have evaluated the effects of 53-week treatment with simvastatin, versus no treatment on proteinuria and renal function among 51 patients with CKD stages III-IV. By the end of the 53-week treatment, urine protein excretion decreased from 0.96 (IQR 0.54, 2.9) to 0.48 (IQR 0.18, 0.79) g/g creatinine (P<0.001) in patients treated with simvastatin in addition to ACEI and ARBs, while no change was observed among the untreated patients. Moreover, a significantly greater decrease in urine protein excretion was observed in the simvastatin group as compared with the untreated group. The mean changes of serum creatinine and eGFR did not significantly differ in both groups. A significantly greater decrease in total cholesterol and LDL-cholesterol was found in the simvastatin group than in the untreated group. In summary, apart from lipid lowering among CKD patients, ingesting simvastatin was associated with a decrease in proteinuria. These statin effects may become important for supportive therapy in renal damage in the future.

Assessment of possible nephrotoxicity from iohexol in patients with normal and impaired renal function

1998 ◽  
Vol 39 (4) ◽  
pp. 362-367 ◽  
Author(s):  
S. Lundqvist ◽  
G. Holmberg ◽  
G. Jakobsson ◽  
F. Lithner ◽  
K. Skinningsrud ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Renal Function ◽  
Adverse Events ◽  
Serum Creatinine ◽  
Creatinine Clearance ◽  
Impaired Renal Function ◽  
Urine Protein ◽  
Urine Protein Excretion ◽  
Protein Excretion ◽  
Patients With Diabetes

Purpose: To evaluate the possible nephrotoxic effects of iohexol in patients with normal and impaired renal function. Material and Methods: A prospective urographic study using iohexol (50 ml, 300 mg I/ml) was performed in 100 patients, 63 with impaired renal function (IRF) and 37 with normal renal function (NRF). The group included 24 patients with diabetes mellitus, 17 of them with IRF. Renal function parameters and adverse events were recorded for one week after the urography. Results: There were no significant changes in serum creatinine, creatinine clearance, or β-2-microglobulin. The 24-h urine protein excretion showed a statistically significant increase in patients with NRF as well as in patients with IRF. Nine patients experienced adverse events but none of them required any treatment. Conclusion: Iohexol was tolerated well in patients with NRF and in patients with IRF without significant overall nephrotoxic effects. Some minor adverse events were recorded.

The Efficacy of Adipose-Derived Stem Cells (ADSCs) on Chronic Kidney Disease in Dogs

2019 ◽  
Vol 11 (12) ◽  
pp. 1724-1728
Author(s):  
Mengling Zhu ◽  
Xiaoyun Lai ◽  
Yixin Wen ◽  
Haibin Zhang
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Function ◽  
Treatment Group ◽  
Kidney Disease ◽  
Adipose Derived Stem Cells ◽  
Tubular Epithelial Cells ◽  
Renal Tubular Epithelial Cells ◽  
Urine Protein ◽  
Treatment Groups ◽  
Renal Tubular

To investigate the therapeutic effect of adipose-derived stem cells (ADSCs) on chronic kidney disease (CKD) in dogs, blood routine examination, urine protein quantitative test, renal function test, urine sediment staining microscopy and B-ultrasonic test of kidney were used to compare the treatment of chronic kidney disease in dogs treated with three different therapies (NT treatment group: traditional supportive therapy group; MT1 treatment group: ADSCs treatment group; MT2 treatment group: NT mixed MT1 treatment group). Results showed that the numbers of red blood cells (RBC), hemoglobin (HGB) and hematocrit (HCT) in MT1 and MT2 treatment groups were higher than those in the NT group, and the urine protein excretion and the levels of serum urea and creatinine in MT1 and MT2 treatment groups were lower than those in the NT treatment group. Besides, there was no further deterioration of kidney morphology in MT1 and MT2 treatment groups. However, a large number of renal tubular epithelial cells and epithelial casts were observed in NT treatment group, while only a small number of renal tubular epithelial cells were observed in MT1 and MT2 treatment groups, indicating the intravenous injection of ADSCs can significantly improve the physical signs and renal function of dogs with CKD, and combined with the traditional therapy, ADSCs has a good prospect for the treatment of CKD in dogs.

Age-related renal function decline in Fabry disease patients on enzyme replacement therapy: a longitudinal cohort study

2018 ◽  
Vol 34 (9) ◽  
pp. 1525-1533 ◽  
Author(s):  
Christoffer V Madsen ◽  
Henrik Granqvist ◽  
Jørgen H Petersen ◽  
Åse K Rasmussen ◽  
Allan M Lund ◽  
...  
Keyword(s):  
Renal Function ◽  
Enzyme Replacement Therapy ◽  
Fabry Disease ◽  
Replacement Therapy ◽  
Standard Deviation Score ◽  
Urine Protein ◽  
Enzyme Replacement ◽  
Urine Protein Excretion ◽  
Protein Excretion ◽  
Function Loss

Abstract Background Nephropathy is common in Fabry disease (FD). Prior studies of renal function during enzyme replacement therapy (ERT) have primarily used estimated glomerular filtration rate (eGFR). We studied the attrition of renal function in FD by measured GFR (mGFR) and urine protein excretion, and explored the influence of age. Methods This was a long-term observational study of a nationwide, family-screened cohort of FD patients. All Danish genetically verified FD patients on ERT, without end-stage renal disease at baseline and with three or more mGFR values were included. Results In all, 52 patients with consecutive mGFR values (n = 841) over median 7 years (range 1–13) were evaluated. Blood pressure remained normal and urine protein excretion was unchanged. Plasma globotriaosylceramide (Gb-3) levels normalized while plasma lyso-Gb-3 remained abnormal in 34% of patients. Baseline mGFR was 90 ± 3 mL/min/1.73 m2 and rate of renal function loss 0.9 ± 0.2 mL/min/1.73 m2/year. Baseline eGFR was 97 ± 5 mL/min/1.73 m2 and rate of renal function loss 0.8 ± 0.3 mL/min/1.73 m2/year. mGFR was age- adjusted to renal healthy non-FD subjects, giving a standard deviation score of −0.8 ± 0.2 with an annual slope of −0.03 ± 0.01 (P = 0.099), without differences between genders. Age grouping of age-adjusted data showed exaggerated renal function loss with age. Urine albumin–creatinine ratio (UACR) &gt;300 mg/g was associated with faster renal function loss, independent of baseline mGFR, age and gender. Conclusions ERT-treated FD patients did not have a faster attrition of renal function than renal healthy non-FD subjects (background population). The rate of renal function loss with age was independent of gender and predicted by high UACR. We suggest cautious interpretation of non-age-adjusted FD renal data.

scholarly journals MO024WHAT IS THE BEST PREDICTABLE LIPID SUBFRACTION FOR CARDIOVASCULAR OUTCOMES AND ALL-CAUSE MORTALITY IN PATIENTS WITH ADVANCED CHRONIC KIDNEY DISEASE?

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Yaerim Kim ◽  
Jeongsoo Yoon ◽  
Jin Hyuk Paek ◽  
Woo Yeong Park ◽  
Kyubok Jin ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Function ◽  
Kidney Disease ◽  
Cox Regression ◽  
Lipid Lowering ◽  
Major Adverse Cardiovascular Events ◽  
Advanced Chronic Kidney Disease ◽  
Linear Pattern ◽  
All Cause Mortality ◽  
Multiple Covariates

Abstract Background and Aims Dyslipidemia is an essential parameter for the prediction of cardiovascular disease (CVD). We aimed to investigate the most valuable subfraction of lipid for predicting CVD in patients with chronic kidney disease (CKD). Method We retrospectively reviewed the National Health Insurance Service database for people who received nationwide health screening in 2009. All subjects exposed with lipid-lowering agent before screening were excluded. The population was divided as control, early CKD (eGFR 45-60 ml/min/m2), and advanced CKD (eGFR &lt;45 ml/min/m2) by estimated glomerular filtration rate. Each subfraction of lipid profile, including LDL, TG, HDL, and TG/HDL, was categorized by decile, and the reference was the fifth decile. The end-point of the study was major adverse cardiovascular events (MACCE). The hazard ration (HR) of MACCE was calculated using Cox regression models after adjustment of multiple covariates. Results A total of 3,634,915 examiners were included in this study, with 66,810 (1.8%) and 404,315 (11.1%) in advanced and early CKD, respectively. For all populations, LDL, TG, HDL, and TG/HDL showed a linear relationship to MACCE. Except HDL, all subfraction showed positive correlation with the risk for MACCE: adjusted HR (aHR) in tenth decile, 1.45 (1.42-1.49) in LDL; 1.25 (1.22-1.28) in TG; 1.30 (1.27-1.33) in TG/HDL; 0.88 (0.85-0.90) in HDL. Although these patterns were similar in TG, HDL, and TG/HDL for all-cause mortality, only LDL showed different pattern for the two outcomes. In the subgroup analysis using LDL, according to the renal function, the significance for the outcomes and a linear pattern was decreased in the advanced CKD group. For the TG/HDL, although the significance was deceased, the linear pattern has maintained in the advanced CKD group (Fig 1). Conclusion The pattern and significance of lipid subfraction were different according to the grade of renal function. Thus, TG/HDL should be additionally considered with LDL as a target variable in patients with advanced CKD.

scholarly journals Association of Calcitriol Supplementation with Reduced COVID-19 Mortality in Patients with Chronic Kidney Disease: A Population-based Study

2021 ◽  
Author(s):  
Joaquim Oristrell ◽  
Joan C. Oliva ◽  
Isaac Subirana ◽  
Enrique Casado ◽  
Didier Dominguez ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Vitamin D ◽  
Renal Function ◽  
Kidney Disease ◽  
Population Based ◽  
Inverse Association ◽  
Population Based Study ◽  
Advanced Chronic Kidney Disease ◽  
Beneficial Effects ◽  
Reduced Risk

Treatment with calcitriol, the hormonal form of vitamin D, has shown beneficial effects in ex-perimental models of acute lung injury. In this study we aimed to analyze the associations be-tween calcitriol supplementation and the risk of SARS-CoV2 infection or COVID-19 mortality. Individuals &ge;18 years old living in Catalonia and supplemented with calcitriol from April 2019 to February 2020 were compared with propensity score matched controls. Outcome variables were SARS-CoV2 infection, severe COVID-19 and COVID-19 mortality. Associations between calcitriol supplementation and outcome variables were analyzed using multivariable Cox proportional regression. A total of 8076 patients were identified as being on calcitriol treatment. Advanced chronic kidney disease and hypoparathyroidism were the most frequent reasons for calcitriol supplementation in our population. Calcitriol use was associated with reduced risk of SARS-CoV2 infection (HR 0.78 [CI 95% 0.64-0.94], p=0.010), reduced risk of severe COVID-19 and reduced COVID-19 mortality (HR 0.57 (CI 95% 0.41-0.80), p=0.001) in patients with advanced chronic kidney disease. In addition, an inverse association between mean daily calcitriol dose and COVID-19 severity or mortality was observed in treated patients, independently of renal function. Our findings point out that patients with advanced chronic kidney disease could benefit from calcitriol supplementation during the COVID-19 pandemic.

The role of the laboratory in evaluation of kidney function

1991 ◽  
Vol 37 (6) ◽  
pp. 785-796 ◽  
Author(s):  
Eric P Cohen ◽  
Jacob Lemann
Keyword(s):  
Kidney Disease ◽  
Kidney Function ◽  
Laboratory Measurements ◽  
Water Metabolism ◽  
Urine Protein ◽  
Electrolyte Disturbances ◽  
Urine Protein Excretion ◽  
Protein Excretion ◽  
Reliable Interpretation

Abstract Evaluation of kidney function by physical examination alone is imprecise and limited. Quantitative, reproducible assessment of kidney function required laboratory measurements of substances in plasma and urine, followed by reliable interpretation. Thus, glomerular filtration, urine protein excretion, water metabolism, and electrolyte disturbances may be quantified. These data are very useful in the single and serial assessment of patients with kidney disease and in evaluation of the effects of treatment.

Fenofibrate lowers blood pressure in two genetic models of hypertension

2000 ◽  
Vol 78 (5) ◽  
pp. 367-371 ◽  
Author(s):  
Raied Khaled Shatara ◽  
Dale W Quest ◽  
Thomas W Wilson
Keyword(s):  
Blood Pressure ◽  
Weight Gain ◽  
High Salt ◽  
Lipid Lowering ◽  
Urine Protein ◽  
High Salt Diet ◽  
Salt Diet ◽  
Urine Protein Excretion ◽  
Protein Excretion ◽  
Sd Rats

Fenofibrate, a commonly used lipid lowering drug, induces the expression of the gene coding for cytochrome P450-4A, whose major product is 20-hydroxyeicosatetraenoic acid (20-HETE). 20-HETE, a potassium channel antagonist, could increase or decrease blood pressure (BP). We studied the effects of four weeks of oral fenofibrate on BP, urine output (UVol), plasma renin activity (PRA), and urine protein excretion in young (4-5 weeks) stroke prone spontaneously hypertensive rats (SHRSP), older (25 weeks) SHRSP, Dahl salt sensitive rats (Dahl S) on a high salt diet, Dahl S rats on a normal salt diet, and normotensive Sprague-Dawley (SD) rats. Fenofibrate prevented the increase in BP in 4-5 week old SHRSP, reduced BP in 25 week old SHRSP, but had no effect on BP in normotensive SD rats. Similarly, fenofibrate prevented the increase in BP in Dahl S rats on a high salt diet, but had no effect in Dahl S rats on a low salt diet. Fenofibrate increased UVol (and reduced weight gain) in young SHRSP and tended to increase it in other groups. It also increased PRA 2 to 5-fold in all groups except older SHRSP. Young SHRSP receiving fenofibrate excreted significantly less urine protein than control rats. The drug reduced proteinuria in Dahl S rats on high salt diet, but had no significant effect on proteinuria in other groups. In summary, fenofibrate reduced blood pressure and weight gain, increased UVol and PRA, and reduced urine protein excretion in young SHRSP. Other groups of animals showed these changes to a variable, but directionally similar extent. These findings are consistent with a natriuretic effect of fenofibrate. Key words: hypertension, animal models, natriuresis, fenfibrate, lipid lowering agents.

Stroke in chronic renal failure

2008 ◽  
Vol 149 (15) ◽  
pp. 691-696
Author(s):  
Dániel Bereczki
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Renal Disease ◽  
Chronic Renal Disease ◽  
Kidney Diseases ◽  
Cerebrovascular Diseases ◽  
Lipid Lowering ◽  
Increased Risk ◽  
Intracerebral Hemorrhages

Chronic kidney diseases and cardiovascular diseases have several common risk factors like hypertension and diabetes. In chronic renal disease stroke risk is several times higher than in the average population. The combination of classical risk factors and those characteristic of chronic kidney disease might explain this increased risk. Among acute cerebrovascular diseases intracerebral hemorrhages are more frequent than in those with normal kidney function. The outcome of stroke is worse in chronic kidney disease. The treatment of stroke (thrombolysis, antiplatelet and anticoagulant treatment, statins, etc.) is an area of clinical research in this patient group. There are no reliable data on the application of thrombolysis in acute stroke in patients with chronic renal disease. Aspirin might be administered. Carefulness, individual considerations and lower doses might be appropriate when using other treatments. The condition of the kidney as well as other associated diseases should be considered during administration of antihypertensive and lipid lowering medications.

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