فهرست مطالب

  • Volume:8 Issue:1, 2019
  • تاریخ انتشار: 1397/10/16
  • تعداد عناوین: 11
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  • Mehdi Nematbakhsh , , * Page 1
    The two important arms of renin angiotensin system (RAS) are angiotensin II (Ang II) and angiotensin1-7 (Ang1-7). Both of these peptides are present in the kidney, while the renal hemodynamic responses to these peptides act differently in kidney circulation. For this short-review, we used a variety of sources including PubMed, Google Scholar, and Scopus. Although in normal physiological condition, Ang1-7 has been known as an inactive agent in the renal system, however in past years many experimental and clinical reports indicated the protective role of Ang1-7 in renal hemodynamics and functions under different circumstances. In the current article, the possible renoprotective role of Ang1-7 was briefly reviewed.
    Keywords: Renin angiotensin system, Angiotensin II, Angiotensin1-7, Vascular endothelium, Kidney injury, Bradykinin receptors
  • Esmaeel Babaeenezhad , Hassan Ahmadvand , Reza Mohammadrezaei Kkorramabadi*, Shahrokh Bagheri , Peyman Khosravi , Parisa Jamor Page 2
    Context: The pathogenesis of renal damage as a risk factor of renal failure can be due to oxidative stress resulting from an imbalance between the production of free radicals and antioxidants. Therefore, antioxidant therapy can be a good strategy to decrease the effects of such diseases. Hence, the aim of this review was to evaluate the protective effect of olive oil as an herb rich in antioxidant compounds on kidney damage in previous studies. Evidence Acquisitions: Present review is based on scrutinizing the contents of relevant papers searched in PubMed, Google Scholar, EBSCO, Embase, directory of open access journals (DOAJ), Web of Science and Scopus.
    Results
    Numerous studies have introduced herbal treatments, being rich sources of antioxidants, as appropriate alternatives for several diseases, including renal damage, when considering the pathogenesis of the diseases. The olive has also been recommended as a plant that has different therapeutic effects, and its therapeutic effects on the kidneys are mentioned in several studies, including the reduction of renal damage parameters and an increase in the antioxidant power of enzymes in the body.
    Conclusions
    Considering the numerous studies on animal models, particularly rats and renal cell lines, olive oil can be used as a reliable method for the treatment of various kidney damages. However, further studies are also recommended in humans.
    Keywords: Olive, Oxidative stress, Renal failure
  • Heshmatolah Shahbazian , Samaneh Salehipour Bavarsad , Hamid Yaghooti*, Seyyed Mostafa Saadati , Samaneh Olapour Page 3
    Background
    Advanced glycation end-products (AGEs) cause proinflammatory responses and macromolecular damages. Advanced oxidation protein products (AOPPs) are protein biomarkers for oxidative stress. Levels of AGEs and AOPPs increase with the progression of chronic renal dysfunction.
    Objectives
    In this study, we aimed to measure these species in patients with renal transplantation and to analyze their correlation with the measured glomerular filtration rate (GFR) and renal function parameters. Patients and
    Methods
    Eighty renal transplant patients and normal subjects were recruited. GFR was measured by the two-sample plasma method with technetium-99m-labeled diethylenetriaminepentaacetic acid (TC99m-DTPA) clearance. Biochemical measurements included creatinine, cystatin C, urea, total protein, and pentosidine. Serum AGEs were determined using a fluorometric assay and AOPPs were estimated spectrophotometrically.
    Results
    The measured GFR found to be significantly decreased in renal transplant patients compared to the control subjects (P< 0.001). Levels of AGEs, AOPPs, serum creatinine, and cystatin C were increased in renal transplant patients with lower values of measured GFR (mGFR). A significant association between the levels of AGEs species (serum fluorescence and pentosidine) and mGFR when adjusted for creatinine and other risk factors in multiple linear regression model analysis was found (P=0.05 and P=0.001, respectively).
    Conclusions
    This study demonstrated increased levels of pentosidine and AGEs in transplant recipients were associated with decreased mGFR. Their accumulation can be predictive for the progression of chronic allograft loss of function.
    Keywords: Renal transplantation, Advanced glycation end-products, Allograft dysfunction, Glomerular filtration rate, End-stage renal disease, Oxidative stress..
  • Sayyedehnikta Kasae , Saeid Keshavarz , Bahar Mazaheri , Behzad Zolfaghari , Ardeshir Talebi , Mehdi Nematbakhsh Page 4
    Background
    Nephrotoxicity is the cisplatin therapy side effect due to stress oxidative formation and lack of antioxidants.
    Objectives
    The role of aerobic exercise and three different doses of unripe grape extract as an antioxidant on cisplatin-induced nephrotoxicity were studied
    Materials and Method
    Seventy male Wistar rats were randomly divided into groups of control, cisplatin (2.5 mg/kg/d for 7 days), aerobic exercise + cisplatin and unripe grape extract and also aerobic exercise + unripe grape extract. Aerobic exercise was administered in period of 7 weeks (5 days/week, 1 h/d), and unripe grape extract was used in three different doses of 20, 100, 200 mg/ kg/d for period of 7 weeks.
    Results
    Cisplatin elevated the serum levels of blood urea nitrogen (BUN), creatinine and malondialdehyde (MDA), and also kidney weight and kidney tissue damage score and decreased body weight and the kidney tissue levels of nitrite significantly (P<0.05), but aerobic exercise or unripe grape extract did not alter the parameters toward normal levels.
    Conclusions
    Based on these findings, aerobic exercise and antioxidant such as unripe grape extract may not protect the kidney against cisplatin-induced nephrotoxicity during anti-cancer therapy
    Keywords: Cisplatin, Aerobic exercise, Unripe grape extract
  • Amal Labib , Marwa M Shakweer*, Manal I Salman , Elham I Seif Page 5
    Background
    Renal amyloidosis is a well-known disease. The forms of amyloidosis that are frequently associated with renal involvement are AL and AA amyloidosis. In Theodor Bilharz Institute, in Egypt, 2.5% of the total number of renal biopsies examined showed amyloidosis including secondary type in 80% and primary type in 20% of cases.
    Objectives
    To investigate the prevalence of amyloidosis among Egyptian renal patients within 25 years and to screen the amyloid type whether AA or AL.
    Materials and Methods
    Demographic and pathological data of archived renal biopsies presented to Ain Shams University hospitals in 25 years (1990-2015) were the material of this study. The diagnosis of all renal biopsies included in the study was confirmed by electron microscopy (EM). Immunohistochemical (IHC) staining of paraffin blocks for amyloid typing was carried out on archived material from (2010-2015).
    Results
    Of a total number of 3962 biopsies examined; 118 were renal amyloidosis (2.97%). IHC typing of the screened samples revealed positive staining for amyloid A protein in 14 cases (73.68%). Light chain AL amyloidosis was found in 5 cases (26.3%).
    Conclusions
    Renal amyloidosis is not uncommon in Egypt. AA amyloidosis represents the commonest type of renal amyloidosis in this study. The most common underlying disease was systemic inflammatory diseases, on top of familial Mediterranean fever (FMF).
    Keywords: AA amyloidosis, AL amyloidosis, Familial Mediterranean fever, Renal amyloidosis
  • Parisa Jamor , Hassan Ahmadvand , Hesam Ashoory , Esmaeel Babaeenezhad Page 6
    Background
    Myeloperoxidase (MPO) is involved in the initiation, progression, and complications of atherosclerosis in diabetic patients.
    Objectives
    In the current study, the impact of alpha-lipoic acid (LA), a natural antioxidant and a cofactor in the enzyme complexes on MPO, catalase (CAT) and glutathione peroxidase (GPx) activity, glutathione (GSH) and malondialdehyde (MDA) level, histopathology of kidney and expression of antioxidant enzymes, superoxide dismutase (SOD), GPx and CAT which are involved in the detoxification of reactive oxygen species (ROS), was evaluated in alloxan-induced diabetic rats.
    Materials and Methods
    In this study, 30 male Rattus norvegicus rats randomly divided into three groups; control (C), non-treated diabetic (NTD), and LA-treated diabetics (LATD) was induced by alloxan monohydrate (100mg/kg; subcutaneous [SC]). Then treatment was performed with alphaLA (100 mg/kg intraperitoneal (i.p) daily to 6 weeks). Blood sample of animals collected to measure levels of MPO, CAT and GPx activity GSH and MDA. Kidney paraffin sections were prepared to estimate histological studies and to measure quantitative gene expression SOD, GPX and CAT in kidney.
    Results
    Induction of diabetes led to a significant increase in MPO and MDA, reduced GSH level and GPx and CAT activities (P < 0.05). However, treatment with alpha-LA led to a significant elevation in GPx, CAT and GSH levels with a reduction in MPO activities and MDA levels (P < 0.05). Furthermore, the real-time reverse transcriptase-polymerase chain reaction (RT-PCR) analysis results showed increased expressions of GPx, CAT and SOD enzyme in the treatment group compared with the diabetic control group. Histopathological lesions such as increased glomerular volume and lymphocyte infiltration were attenuated in the alpha-LA treated group.
    Conclusions
    Our findings indicated that alpha-LA supplementation is effective in preventing complications induced by oxidative stress and atherosclerosis in diabetic rats.
    Keywords: Diabetes mellitus, Alpha-lipoic acid, Glutathione peroxidase, Catalase
  • Safendra Siregar*, Tjahjodjati Romdam*, Henry Stanzah , Irfan Firmansyah Page 7
    Background
    Ischemia/reperfusion (I/R) is often a complication of bleeding shock, renal dysfunction and renal vessel operation. Nitric oxide (NO) as an important vasodilator is produced by endothelial cells. NO stimulates the generation of cyclic guanosine monophosphate (cGMP). Phosphodiesterase (PDE) is an intracellular enzyme which hydrolyzes cGMP into an inactive metabolite. It effectively decreases cGMP level. PDE is an intracellular enzyme which hydrolyzes cGMP into an inactive metabolite. It effectively decreases cGMP level. Therefore, an inhibition of PDE can increase cGMP level. PDE5 inhibitor is a compound which inhibits or acts antagonistically against biosynthesis or act of PDE. PDE5 inhibitor is now commonly used for the treatment of pulmonary artery hypertension and erectile dysfunction. According to some latest researches, long-acting PDE5 inhibitor (Tadalafil) reduces renal I/R injury in experiments with Wistar rats.
    Objectives
    The purpose of this study was to determine the effect of long-acting PDE5 inhibitor on renal I/R injury in Wistar rats.
    Materials and Methods
    Rats were divided into three groups; sham group, a right nephrectomy was performed. Control group, a right nephrectomy was performed followed by an occlusion on left renal pedicle for 60 minutes and a perfusion was performed for 60 minutes. Tadalafil group; the same treatment was performed as to group control, plus administering tadalafil as a PDE5 inhibitor (10 mg/kg), given by a nasogastric tube 60 minutes before the operation. A left nephrectomy was performed on the mice to determine the value of cystatin C level and histopathology.
    Results
    The mean necrosis of tubular renal cells indicates that highest mean necrosis of tubular renal cells was at group control (mean score, 8.6±0.84), and the lowest mean necrosis of tubular renal cells was at sham group (mean score, 4.4±0.52) which indicates a significant difference between the sham and control groups (P<0.05). For the tadalafil group mean score of renal tubular necrosis cell was 6.9±1.45, which also indicates a significant difference between this group with sham group and control (P<0.05). Highest mean cystatin C levels related to group control, mean score was 1.51 ± 0.13 mg/dL, which indicates a significant difference with the sham group (P<0.05), but there is no significant difference with the tadalafil group.
    Conclusion
    The results of this study showed that the administration of PDE5 inhibitor (tadalafil) improves reperfusion ischemic injury. Although it did not decrease the level of cystatin C, it significantly reduced tubular necrosis.
    Keywords: Tadalafil, PDE5 inhibitor, Renal ischemia, reperfusion injury, Cystatin C
  • Soheila Asadi , Mohammad Taghi Goodarzi , Jamshid Karimi , Mohammad Hashemnia , Iraj Khodadadi* Page 8
    Background
    Since the importance of oxidative stress in the development of diabetic nephropathy (DN) has previously been established, the therapeutic effects of various natural antioxidant agents or synthetic drugs have so far been investigated.
    Objectives
    The aim of this study was to investigate the beneficial effects of curcumin (a natural polyphenol) and metformin (a common therapeutic medicine for type 2 diabetes) on oxidative status in kidney of type 1 diabetic rats.
    Materials and Methods
    In this experimental study 60 male Wistar rats were divided into 10 groups. Type 1 diabetes was induced by streptozotocin. Rats received chow diet and treated with either normal saline in control (N) and diabetic control (D) groups or different doses of metformin (Met) (300 or 500 mg/kg body weight) or curcumin (Cur) (50 or 150 mg/kg body weight) in N+Met300, N+Met500, N+Cur50, N+Cur150, D+Met300, D+Met500, D+Cur50, and D+Cur150 groups. Urinary creatinine, urea, and protein were measured. Total antioxidant capacity (TAC), total oxidant status (TOS), malondialdehyde (MDA), and the activity of superoxide dismutase (SOD), glutathione peroxidase (GPx), and catalase were assessed in kidney tissues.
    Results
    Both metformin and curcumin showed significant effects on urinary creatinine, urea, and protein levels (P value for all was <0.001). Unlike metformin, curcumin completely restored TAC and TOS (P<0.001), and MDA (P=0.012) in kidney tissues and significantly recovered the activities of SOD (P= 0.003), GPx (P< 0.001), and catalase (P=0.011).
    Conclusions
    Curcumin was found more effective than metformin in attenuating oxidative status in DN.
    Keywords: Curcumin, Diabetic nephropathies, Metformin, Oxidative stress, Diabetic kidney disease, Reactive oxygen species
  • Farzanehsadat , Minoo , Mahdieh Jamshidi , Elham Ramezanzadeh*, Mohammadtaghi Najafi , Azam Alamdari Page 9
    Introduction
    Hypertension seems to be a major problem in dialysis patients. Fibroblast growth factor-23 (FGF-23) appears to be a risk factor for mortality in patients with end-stage renal disease (ESRD).
    Objectives
    This study aims to investigate FGF-23 and its association with blood pressure and pulse pressure among hemodialysis patients. Patients and
    Methods
    This cross-sectional multicenter study was performed on 135 patients aged 18 years and over with ESRD treated with hemodialysis. Systolic and diastolic blood pressure of all patients was measured. FGF-23, uric acid, Na and K were measured using blood test and fasting. We used univariate and multivariate linear and non-linear regression.
    Results
    The mean age of patients was 56.45±13.64 years. Around 60% of patients were male. The mean and median FGF-23 in patients was 855.07±43.33 pg/mL and 762.6 pg/mL (IQR=456.6-1430.3) respectively. After adjustment for age, gender, dialysis time, uric acid, Na, K and kt/V, FGF-23 had quadratic association with pulse pressure. We found, each 10-unit (pg/mL) increase in FGF-23 was significantly associated with 0.50 mm Hg decrease in minimum pulse pressure (P=0.002) and 0.42 mm Hg decrease in mean pulse pressure (P= 0.009).
    Conclusions
    FGF23 had a significant association with dialysis vintage and a significant reverse association with minimum and mean pulse pressure.
    Keywords: Fibroblast growth factor-23, Blood pressure, Pulse pressure, Hemodialysis
  • Brent Taiting Xia , Aleksandr Aleksandrovich Reznichenko , Madison Colyn Cuffy*, Ervin Steve Woodle Page 10
    Background
    Pseudoaneurysm after renal transplantation is a rare but serious complication.
    Case Presentation
    We report a case of a 76-year-old man who presented six weeks after kidney transplant with a large pseudoaneurysm arising from the renal artery anastomosis, causing renal vein compression and renal allograft dysfunction. Prior to the removal of the transplanted kidney, an in situ cold perfusion of the allograft was performed. The pseudoaneurysm was repaired ex vivo and the renal artery was reconstructed. External iliac vein was reconstructed with deceased donor interposition allograft, and the kidney was then re-implanted. The patient recovered with immediate allograft function.
    Conclusions
    Successful surgical management of a large renal allograft arterial pseudoaneurysm involves avoidance of dissection of the pseudoaneurysm, utilization of in situ cold perfusion and en-bloc removal of the kidney together with pseudoaneurysm, and pseudoaneurysm incision and vascular bypass reconstruction ex vivo
    Keywords: Renal transplant, Pseudoaneurysm, Vascular reconstruction, Re-implantation
  • Fahd Touzani , Agnieszka Pozdzik , Concetta Catalano Page 11
    Background
    Lupus nephritis (LN) is characterized by glomerular immune-complex deposits usually in a full house (FH) pattern. In contrast, ANCA-associated glomerulonephritis (GN) is typically pauci-immune GN. Patients fulfilling both systemic lupus erythematosus (SLE) and ANCAassociated vasculitis (AAV) classification criteria defining "SLE/AAV overlap syndrome" have been rarely reported. However, FH nephropathy (FHN) without overt SLE at presentation is described and considering an overlap syndrome in this situation is challenging.
    Case Presentation
    A 40-year-old man presented to the emergency because of hemoptysis and macroscopic haematuria. We found acute kidney injury (plasma creatinine 5.16 mg/dL, N: 0.72- 1.17) with an active urinary sediment (proteinuria 3+, haematuria 3+). Chest computerized tomography showed intra-alveolar diffuse haemorrhage confirming pulmonary-renal syndrome. High titers of anti-MPO ANCA in the absence of ANA strongly correlated with microscopic polyangiitis. Kidney biopsy confirmed crescentic GN, however FH immunofluorescence (IF) pattern suggested a LN (class IV). Despite plasma exchanges associated to steroids and rituximab, kidney function declined and haemodialysis was initiated. During 12 months of follow-up on azathioprine-low dose steroids treatment, he remains still asymptomatic. However, considering the appearance of antinuclear antibodies (ANA), presence of antiphospholipid antibodies and low complement level, we considered the diagnosis of SLE/AAV overlap syndrome.
    Conclusions
    SLE/AAV overlap syndrome is a very rare condition and has a very poor kidney function outcome. We underline that the patients with AAV and FHN require a regular screening for clinical and biological SLE criteria, even in their absence at initial presentation as it could develop later.
    Keywords: Systemic lupus erythematosus, ANCA-associated vasculitis, Microscopic polyangiitis, Lupus nephritis, Overlap syndrome