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Hepatocardiorenal syndrome in liver cirrhosis:Recognition of a new entity?

World Journal of Gastroenterology 2024年第2期30卷 128-136页

作者： Henry H L Wu Amina Rakisheva Arvind Ponnusamy Rajkumar Chinnadurai renal Research Kolling Institute of Medical ResearchRoyal North Shore Hospital&The University of SydneySt.Leonards(Sydney)2065New South WalesAustralia department of Cardiology City Cardiological CenterAlmaty 050000Kazakhstan department of renal Medicine Royal Preston HospitalPreston PR29HTUnited Kingdom Donal O’Donoghue renal Research Centre&department of renal Medicine Northern Care Alliance National Health Service Foundation TrustSalford M68HDUnited Kingdom

Emerging evidence and perspectives have pointed towards the heart playing an important role in hepatorenal syndrome(HRS),outside of conventional understanding that liver cirrhosis is traditionally considered the sole origin of a cascade of pathophysiological mechanisms directly affecting the kidneys in this *** the absence of established heart disease,cirrhotic cardiomyopathy may occur more frequently in those with liver cirrhosis and kidney *** is a specific form of cardiac dysfunction characterized by blunted contractile responsiveness to stress stimuli and altered diastolic relaxation with electrophysiological *** the clinical description of these potential cardiac-related complications of the liver,the role of the heart has traditionally been an overlooked aspect of circulatory dysfunction in *** from a physiological sense,temporality(prior onset)of cardiorenal interactions in HRS and positive effects stemming from portosystemic shunting demonstrated an important role of the heart in the development and progression of kidney dysfunction in cirrhotic *** this review,we discuss current concepts surrounding how the heart may influence the development and progression of HRS,and the role of systemic inflammation and endothelial dysfunction causing circulatory dysfunction within this *** temporality of heart and kidney dysfunction in HRS will be *** a subgroup of patients who receive portosystemic shunting,the dynamics of cardiorenal interactions following treatment is *** research to determine the unknowns in this topic is anticipated,hopefully to further clarify the intricacies surrounding the liver-heart-kidney connection and improve strategies for management.

关键词： Hepatorenal syndrome Cardiorenal syndrome Cirrhosis Cardiac dysfunction Circulatory dysfunction

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Understanding female urinary continencedlessons from complications of female urethral surgery

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Asian Journal of Urology 2024年第3期11卷 504-506页

作者： Sidhartha Kalra Atanu Kumar Pal Lalgudi Narayanan Dorairajan department of Urology and renal Transplantation Jawaharlal Institute of Post Graduate Medical Education and ResearchPuducherryIndia

Dear Editor,We share our experience of two significant complications associated with female urethroplasty and their management in understanding the factors contributing to urinary *** have also tried to assess the different components of female urinary continence mechanism and the ways to combat the postoperative urinary continence while performing female urethral surgeries(Fig.1).Informed consent was taken from each of the patients before their evaluation and *** were explained properly and informed consents were taken from them before the publication of this article.

关键词： urinary female urethral

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Predictive Factors of renal Damage during Sickle Cell Disease at the Hematology-Oncology department of Donka University Hospital

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Open Journal of Nephrology 2024年第3期14卷 302-312页

作者： Moussa Traoré Ansoumane Sayon Kanté Marthe Sidibé Mamady Diakité Mohammed Lamine Tégui Camara Foussény Diakité Mamadou Saliou Baldé Ibrahima Chérif Mustapha Komrabai-Kanu Mohammed Lamine Kaba Nephrology-Hemodialysis department of Donka University Hospital Conakry Guinea Hematology-Oncology department of Donka University Hospital Conakry Guinea Hematology-Oncology department of Ignace Deen University Hospital Conakry Guinea Medical Care Clinic Freetown Sierra-Leone

Introduction: Sickle cell disease, which is the most common hereditary hemoglobinopathy in the world, attacks all body systems, particularly the kidneys. The view of this study was to investigate the predictive factors of kidney damage during sickle cell disease. Materials and methods: It was a retrospective, descriptive and analytical study on files of sickle cell patients hospitalized in the Hematology-Oncology department of Donka University Hospital during a period from January 1, 2016 to December 31, 2019. Records of sickle cell patients with one or more renal abnormalities were retained. Sickle cell patients without kidney damage were also selected for a comparative study. Only patients without sickle cell disease were excluded. Results: Seventy-five (75) medical records were collected during the study period. From these cases, thirteen (13) records with kidney disease were observed, a frequency of 17%. The mean age of patients was 24.2 years for extremes of 10 and 65 years. The sex ratio was 1.6 in favor of men. The SSFA2 form was the most represented with 92%. 24-hour proteinuria was measured in 13 patients between whom 6 patients (46.2%) had a proteinuria level ≤ 1 g. Eight (8) patients (61.5%) were in stage 1 of chronic kidney disease. The most common type of renal involvement was tubulo-interstitial nephropathy with 8 patients (61.5%). Bivariate analysis showed that elevated serum creatinine (P 2 form of the sickness (P Conclusion: After the observation of an increased serum creatinine and urea, a predominance observation of the SSFA2 form, it should be possible to target patients for whom screening for kidney damage should henceforth be systematic.

关键词： Kidney Damage Predictive Factors Sickle Cell Disease Donka

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Albumin use in cirrhosis:a nephrology viewpoint on key considerations and cautionary notes

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Hepatobiliary Surgery and Nutrition 2024年第3期13卷 536-539页

作者： Abhilash Koratala Amir Kazory Division of Nephrology Department of MedicineMedical College of WisconsinMilwaukeeWIUSA Division of Nephrology Hypertension and Renal TransplantationUniversity of FloridaGainesvilleFLUSA

The constant need to reduce the variability of clinical practice and to improve the quality of care of the patients and their outcomes have led to the increasing emphasis on evidence-based *** there is a paucity of robust data on a specific topic or there are conflicting conclusions from available studies,clinical practice recommendations may prove helpful to fill the gap and assist with clinical *** are a variety of such recommendations,such as consensus statements,practice guidelines,and position statements,each with a specific set of methodology and *** statements are comprehensive documents meant to elucidate,justify,and recommend a particular approach to a clinical *** papers often present a detailed understanding of the issues in question,discuss the pros and cons of the available options,and provide the rationale for the position that is set *** other forms of clinical practice consensus,position statements innately provide information on the level of evidence and the strength of what the panel of experts agrees *** are several consensus group methods by which these statements can be *** is a systematic process to create and measure consensus,which is particularly well suited where input is required from a large number of geographically dispersed experts.

关键词： Cirrhosis hepatorenal albumin point-of-care ultrasound(POCUS) ultrasound

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Engineering nanomedicines for immunogenic eradication of cancer cells:Recent trends and synergistic approaches

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Acta Pharmaceutica Sinica B 2024年第6期14卷 2475-2504页

作者： Ahmed O.Elzoghby Omar Samir Hagar E.Emam Ahmed Soliman Riham M.Abdelgalil Yomna M.Elmorshedy Kadria A.Elkhodairy Mahmoud L.Nasr Division of Engineering in Medicine and Division of renal Medicine Department of MedicineBrigham and Women's HospitalHarvard Medical SchoolBoston 02115MAUSA Cancer Nanotechnology Research Laboratory(CNRL) Faculty of PharmacyAlexandria UniversityAlexandria 21521Egypt

Resistance to cancer immunotherapy is mainly attributed to poor tumor immunogenicity as well as the immunosuppressive tumor microenvironment(TME)leading to failure of immune *** therapeutic strategies including chemotherapy,radiotherapy,photodynamic,photothermal,magnetic,chemodynamic,sonodynamic and oncolytic therapy,have been developed to induce immunogenic cell death(ICD)of cancer cells and thereby elicit immunogenicity and boost the antitumor immune ***,many challenges hamper the clinical application of ICD inducers resulting in modest immunogenic ***,we outline the current state of using nanomedicines for boosting ICD of cancer ***,synergistic approaches used in combination with ICD inducing nanomedicines for remodeling the TME via targeting immune checkpoints,phagocytosis,macrophage polarization,tumor hypoxia,autophagy and stromal modulation to enhance immunogenicity of dying cancer cells were *** further highlight the emerging trends of using nanomaterials for triggering amplified ICD-mediated antitumor immune *** reticulum localized ICD,focused ultrasound hyperthermia,cell membrane camouflaged nanomedicines,amplified reactive oxygen species(ROS)generation,metallo-immunotherapy,ion modulators and engineered bacteria are among the most innovative *** challenges,merits and demerits of ICD inducer nanomedicines were also discussed with shedding light on the future role of this technology in improving the outcomes of cancer immunotherapy.

关键词： Immunogenic cell death Immunogenic eradication Nanomedicines Drug delivery Cancer immunotherapy Antitumor immunity T cells Tumor associated antigens Synergistic immune response

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Impact of low-intensity extracorporeal shockwave therapy on vascular parameters and sexual function in patients with arteriogenic erectile dysfunction

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Asian Journal of Andrology 2024年第4期26卷 344-348页

作者： Matteo Rubino Anna Ricapito Marco Finati Ugo G Falagario Pasquale Annese Vito Mancini Gian Maria Busetto Luigi Cormio Giuseppe Carrieri Carlo Bettocchi Andrology Unit Department of Urology and Renal TransplantationUniversity of FoggiaFoggia 71122Italy department of Molecular Medicine and Surgery Karolinska InstitutetStockholm 17177Sweden department of Urology Bonomo Teaching HospitalUniversity of FoggiaAndria 76123Italy.

Previous published studies have shown an improvement of penile hemodynamic parameters after low-intensity extracorporeal shockwave therapy(Li-ESWT).However,the clinical significance of these findings remains unclear,and definitive selection criteria for Li-ESWT based on preexisting comorbidities have yet to be *** was an observational study of 113 patients with ED,evaluated between January 2019 and December 2021 in Andrology Unit at the department of Urology and renal Transplantation,University of Foggia(Foggia,Italy).Penile dynamic Doppler was performed to evaluate vascular parameters and 5-item version of the International Index of Erectile Dysfunction(IIEF-5)questionnaire was administered to assess the severity of *** was repeated 1 month after *** with a peak systolic velocity(PSV)30 cm s−1 at posttherapeutic penile dynamic Doppler.A clinically significant IIEF-5 score improvement was observed in 7 patients,21 patients,and 2 patients with mild-to-moderate,moderate,and severe pretreatment ED,*** different outcomes were assessed based on smoking habits,previous pelvic surgery,or use of oral phosphodiesterase-5 inhibitor(PDE5i).On the other side,only 1(6.7%)in 15 patients with diabetes mellitus showed an IIEF-5 score improvement after *** treatment determined a significant increase in PSV and correlated IIEF-5 improvement in ED *** advantage seemed particularly evident for moderate ED and was not affected by smoking habits,previous pelvic surgery,and use of ***,diabetic patients did not benefit from the treatment.

关键词： arteriogenic erectile dysfunction International Index of Erectile Function low-intensity extracorporeal shockwave therapy peak systolic velocity

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Update on the reciprocal interference between immunosuppressive therapy and gut microbiota after kidney transplantation

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World Journal of Transplantation 2024年第1期14卷 72-83页

作者： Maurizio Salvadori Giuseppina Rosso department of renal Transplantation Careggi University HospitalFlorence 50139TuscanyItaly Division of Nephrology San Giovanni di Dio HospitalFlorence 50143ToscanaItaly

Gut microbiota is often modified after kidney *** principally happens in the first period after *** and,most of all,immunosuppressive drugs are the main *** relationship between immunosuppressive drugs and the gut microbiota is *** one side immunosuppressive drugs modify the gut microbiota,often generating dysbiosis;from the other side microbiota may interfere with the immunosuppressant pharmacokinetics,producing products more or less active with respect to the original *** phenomena have influence over the graft outcomes and clinical consequences as rejections,infections,diarrhea may be caused by the dysbiotic ***,calcineurin inhibitors such as tacrolimus and cyclosporine,mycophenolate mofetil and mTOR inhibitors are the immunosuppressive drugs whose effect on the gut microbiota is better *** contrast is well known how the gut microbiota may interfere with glucocorticoids,which may be transformed into *** may be transformed by microbiota into a product called M1 that is 15-fold less active with respect to *** pro-drug mycophenolate mofetil is normally transformed in mycophenolic acid that according the presence or not of microbes producing the enzyme glucuronidase,may be transformed into the inactive product.

关键词： Immunosuppressive therapy Kidney transplantation Gut microbiota Dysbiosis Pathobionts Graft outcomes

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A Chinese Multi-Specialty Delphi Consensus to Optimize RAASi Usage and Hyperkalaemia Management in Patients with Chronic Kidney Disease and Heart Failure

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Chinese Medical Sciences Journal 2024年第2期39卷 79-90页

作者： Ming-Hui Zhao Wei Chen Hong Cheng Bi-Cheng Liu Zhi-Guo Mao Zhuang Tian Gang Xu Jing-Min Zhou renal Division Peking University First HospitalBeijing 100034China department of Nephrology The First Affiliated HospitalSun Yat-Sen UniversityGuangzhou 510080China department of Nephrology Capital Medical UniversityBeijing 100029China department of Nephrology Southeast University Zhongda HospitalNanjing 210009China department of Nephrology Shanghai Changzheng HospitalShanghai 200003China department of Cardiology Peking Union Medical College HospitalBeijing 100730China renal Division Tongji Medical College of Huazhong University of Science and TechnologyWuhan 430030China department of Cardiology Zhongshan HospitalFudan UniversityShanghai 200032China

Objective Variations are present in common clinical practices regarding best practice in managing hyperkalaemia(HK),there is therefore a need to establish a multi-specialty approach to optimal renin angiotension-aldosterone system inhibitors(RAASi)usage and HK management in patients with chronic kidney disease(CKD)&heart failure(HF).This study aimed to establish a multi-speciality approach to the optimal use of RAASi and the management of HK in patients with CKD and *** A steering expert group of cardiology and nephrology experts across China were convened to discuss challenges to HK management through a nominal group *** group then created a list of 41 statements for a consensus questionnaire,which was distributed for a further survey in extended panel group of cardiologists and nephrologists across *** was assessed using a modified Delphi technique,with agreement defined as"strong"(≥75%and<90%)and"very strong"(≥90%).The steering group,data collection,and analysis were aided by an independent *** A total of 150 responses from 21 provinces across China were recruited in the *** were comprised of an even split(n=75,50%)between cardiologists and *** 41 statements achieved the 75%consensus agreement threshold,of which 27 statements attained very strong consensus(≥90%agreement)and 14 attained strong consensus(agreement between 75%and 90%).Conclusion Based on the agreement levels from respondents,the steering group agreed a set of recommendations intended to improve patient outcomes in the use of RAASi therapy and HK management in China.

关键词： Sardiorenal syndrome chronic kidney failure heart failure hyperkalemia multidisciplinary communication RAASi

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Polystyrene nanoplastics induce glycolipid metabolism disorder via NF-κB and MAPK signaling pathway in mice

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Journal of Environmental Sciences 2024年第3期137卷 553-566页

作者： Xingpei Fan Xiaoyan Li Jiaxin Li Yuxia Zhang Xiangjuan Wei Hailong Hu Boya Zhang Haining Du Meimei Zhao Ruijiao Zhu Daqian Yang Yuri Oh Ning Gu School of Life Science and Technology Harbin Institute of TechnologyHarbin 150001China State Key Laboratory of Urban Water Resource and Environment Harbin Institute of TechnologyHarbin 150006China department of Medicine Renal Electrolyte and Hypertension DivisionDepartment of GeneticsPerelman School of MedicineUniversity of PennsylvaniaPhiladelphia 19104USA Faculty of Education Wakayama UniversityWakayama 640-8441Japan

Nanoplastics-induced developmental and reproductive toxicity,neurotoxicity and immunotoxicity are a focus of widespread ***,the effects of nanoplastics(NPs)on glycolipid metabolism and the precise underlying mechanisms are unclear at ***,we showed that oral administration of polystyrene nanoparticles(PS-NPs)disrupts glycolipid metabolism,with reactive oxygen species(ROS)identified as a potential key signaling *** PS-NPs treatment,excessive production of ROS induced the infammatory response and activated the antioxidant pathway through nuclear factor-erythroid factor 2-related factor *** activation of nuclear factor-κB(NFκB)signaling pathway induced the phosphorylation of the mitogen-activated protein kinases(MAPK)signaling pathway,which induced the activation of extracellular regulated kinases(ERK)and *** activation of the MAPK signaling proteins induced high continued phosphorylation of insulin receptor substrate-1,in turn,leading to decreased protein kinase B(Akt)activity,which weakened the sensitivity of liver cells to insulin signals and induced insulin *** parallel,phosphorylation of Akt led to loss of control of Fo XO1,a key gene of gluconeogenesis,activating transcription of glucose-6-phosphatase(G6PC)and phosphoenolpyruvate carboxykinase(PEPCK)in a manner dependent on PGC1α.Moreover,the activated ERK promoted lipid accumulation through ERK-PPARγ***,sterol regulatory element-binding protein-1 and levels of its downstream lipogenic enzymes,ACC-1,were *** treatment with the antioxidant resveratrol,PS-NPs-induced glucose and lipid metabolic disorders were improved by inhibiting ROS-induced activation of NFκB and MAPK signaling pathway in *** on above,PS-NPs exposure disrupts glycolipid metabolism in mice,with ROS identified as a potential key signaling molecule.

关键词： Nanoplastics Resveratrol Hyperglycemia Lipid metabolism Infammatory response Reactive oxygen species(ROS)

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Peritoneo-Vaginal Leaks in Peritoneal Dialysis: A Report of 3 Cases

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Open Journal of Nephrology 2024年第2期14卷 176-184页

作者： Mariam Jdidou Sara Elmakkoul Nabil Hmaidouch Naima Ouzeddoun Loubna Benamar department of Nephrology Dialysis and Renal Transplantation Ibn Sina University Hospital Rabat Morocco

Introduction: Peritoneal dialysis (PD) is an extra-renal purification technique indicated for patients with end-stage kidney disease (ESKD). Although it has many advantages, it also has a number of complications, such as peritoneo-vaginal leakage of dialysate. Cases Reports: Three male patients, aged 70, 50 and 77 respectively, with ESKD were placed on PD. All three patients presented with inadequate drainage and the progressive appearance of bilateral hydrocele, which occurred one year (late leakage), two and four days (early leakage) respectively after the initiation of exchanges. The etiological investigation led to the conclusion of a peritoneo-vaginal leak associated with an inguinal hernia in only one case. The two cases of early leakage were treated by temporary suspension of PD, with a good response in one case and failure in the second, leading to hisdefinitive transfer to hemodialysis (HD);however, the hernia repair enabled immediate resumption of PD in the third patient. Discussion and Conclusion: Peritoneo-vaginal leakage is a rare mechanical complication in PD. The clinical examination plays an essential role in confirming the diagnosis and in the therapeutic decision. If the diagnosis is uncertain, or if there is a clinical need to show the anatomy of the leak, an imaging approach becomes desirable. This complication should not prevent the progression of PD in the management of patients with ESKD.

关键词： Peritoneal Dialysis Peritoneal Leakage Hernia-Peritoneal Scintigraphy

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