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Severe acute kidney injury due to oxalate crystal induced severe interstitial nephritis:A case report

World Journal of nephrology 2024年第2期13卷 24-30页

作者： Maulik K Lathiya Praveen Errabelli Sasmit Roy Neeharik Mareedu department of Emergency Medicine Mayo Clinic Health SystemEau ClaireWI 54703United States department of nephrology Mayo Clinic Health SystemEau ClaireWI 54703United States department of nephrology Centra Lynchburg General HospitalLynchburgVA 24551United States department of nephrology UPMC Western MarylandCumberlandMD 21502United States

BACKGROUND Acute kidney injury(AKI)due to interstitial nephritis is a known condition primarily attributed to various *** medication-induced interstitial nephritis is common,occurrences due to non-pharmacological factors are *** report presents a case of severe AKI triggered by intratubular oxalate crystal deposition,leading to interstitial *** aim is to outline the case and its management,emphasizing the significance of recognizing uncommon causes of interstitial *** SUMMARY A 71-year-old female presented with stroke-like symptoms,including weakness,speech difficulties,and cognitive *** hypertension had been managed with hydrochlorothiazide(HCTZ)for over two *** admis-sion,severe hypokalemia and AKI were noted,prompting discontinuation of HCTZ and initiation of prednisolone for acute interstitial *** investigations,including kidney biopsy,confirmed severe acute interstitial nephritis with oxalate crystal deposits as the underlying *** treatment,initial renal function showed minimal ***,with prednisolone therapy and supportive measures,her condition gradually improved,high-lighting the importance of comprehensive *** This case underscores the importance of a thorough diagnostic approach in identifying and addressing uncommon causes of interstitial *** occurrence of interstitial nephritis due to oxalate crystal deposition,especially without typical risk factors,emphasizes the need for vigilance in clinical practice.

关键词： Acute kidney injury Interstitial nephritis Oxalate crystal Hydrochlorothiazide Hypokalemia Case report

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Sympathetic stimulation with norepinephrine may come at a cost

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Neural Regeneration Research 2019年第6期14卷 977-978页

作者： Lakshini Y.Herat Markus P.Schlaich Vance B.Matthews Dobney hypertension Centre School of Biomedical Science-Royal Perth Hospital UnitUniversity of Western Australia Dobney hypertension Centre School of Medicine - Royal Perth Hospital UnitUniversity of Western Australia department of Cardiology and department of nephrology Royal Perth Hospital

Norepinephrine(NE;also known as noradrenaline)is the body’s primary adrenergic neurotransmitter which belongs to the catecholamine *** has pharmacologic effects on theα1(Suita et al.,2015),α2(Schwartz,1997),β1,β2 andβ3(Tsukada et al.,2003)*** the brain,norepinephrine increases arousal and alertness,promotes vigilance,enhances formation and retrieval of memory,and focuses *** also increases restlessness and *** the remainder of the body,norepinephrine increases heart rate and blood pressure,triggers the release of glucose from energy stores,increases blood flow to skeletal muscle and increases muscle contraction,reduces blood flow to the gastrointestinal system and its motility and lastly,inhibits voiding of the bladder(Goldstein,2010).This last point is particularly interesting in the context of this perspective piece.

关键词： neurotransmitter norepinephrine increases focuses attention

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The Schlager mouse as a model of altered retinal phenotype

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Neural Regeneration Research 2020年第3期15卷 512-518页

作者： Lakshini Y.Herat Aaron L.Magno Márcio G.Kiuchi Kristy L.Jackson Revathy Carnagarin Geoffrey A.Head Markus P.Schlaich Vance B.Matthews Dobney hypertension Centre School of Biomedical Science-Royal Perth Hospital UnitUniversity of Western AustraliaPerthAustralia Research Centre Royal Perth HospitalPerthAustralia Dobney hypertension Centre School of Medicine-Royal Perth Hospital UnitUniversity of Western AustraliaPerthAustralia Neuropharmacology Laboratory Baker Heart and Diabetes InstituteMelbourneAustralia department of Cardiology and department of nephrology Royal Perth HospitalPerthAustralia

hypertension is a risk factor for a large number of vision-threatening eye *** this study,we investigated for the first time the retinal neural structure of the hypertensive BPH/2J mouse(Schlager mouse)and compared it to its control counterpart,the normotensive BPN/3J *** BPH/2J mouse is a selectively inbred mouse strain that develops chronic hypertension due to elevated sympathetic nervous system *** compared to the BPN/3J strain,the hypertensive BPH/2J mice showed a complete loss of outer layers of the neural retina at 21 weeks of age,which was indicative of a severe vision-threatening disease potentially caused by *** elucidate whether the retinal neural phenotype in the BPH/2J strain was attributed to increased BP,we investigated the neural retina of both BPN/3J and BPH/2J mice at 4 weeks of *** preliminary results showed for the first time that the BPH/2J strain develops severe retinal neural damage at a young *** findings suggest that the retinal phenotype in the BPH/2J mouse is possibly due to elevated blood pressure and may be contributed by an early onset spontaneous mutation which is yet to be identified or a congenital defect occurring in this *** characterization of the BPH/2J mouse strain is likely to i)elucidate gene defects underlying retinal disease;ii)understand mechanisms leading to neural retinal disease and iii)permit testing of molecules for translational research to interfere with the progression of retinal *** animal experiments were performed with the approval of the Royal Perth hospital Animal Ethics Committee(R535/17-18)on June 1,2017.

关键词： blood pressure eye hypertension mice neural regeneration retina Schlager mouse sympathetic nervous system

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Sodium glucose co-transporter 2 inhibition reduces succinate levels in diabetic mice

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World Journal of Gastroenterology 2020年第23期26卷 3225-3235页

作者： Lakshini Y Herat Natalie C Ward Aaron L Magno Elizabeth P Rakoczy Marcio G Kiuchi Markus P Schlaich Vance B Matthews School of Biomedical Sciences Dobney Hypertension CentreRoyal Perth Hospital UnitUniversity of Western AustraliaPerth 6000Australia Faculty of Health and Medical Sciences University of Western AustraliaCrawley 6009Australia Faculty of Health Sciences School of Public HealthCurtin UniversityBentley 6102Australia Research Centre Royal Perth HospitalPerth 6000Australia department of Molecular Ophthalmology University of Western AustraliaCrawley 6009Australia Dobney hypertension Centre School of MedicineRoyal Perth Hospital UnitUniversity of Western AustraliaPerth 6000Australia department of Cardiology and department of nephrology Royal Perth HospitalPerth 6000Australia

BACKGROUND Type 1 diabetes(T1D) is associated with major chronic microvascular complications which contribute significantly to diabetes associated *** protein primarily responsible for glucose reabsorption in the kidney is sodium glucose co-transporter 2(SGLT2). Presently, SGLT2 inhibitors are widely used in diabetic patients to improve blood glucose levels and prevent cardiovascular and renal complications. Given the broad therapeutic application of SGLT2 inhibitors, we hypothesised that SGLT2 inhibition may exert its protective effects via alterations of the gut microbiome and tested this in a type 1 diabetic mouse model of diabetic *** To determine whether the treatment with two independent SGLT2 inhibitors affects gut health in a type 1 diabetic mouse *** The SGLT2 inhibitors empagliflozin or dapagliflozin(25 mg/kg/d) or vehicle dimethylsulfoxide(DMSO) were administered to C57 BL/6 J, Akita, Kimba and Akimba mice at 10 wk of age for 8 wk via their drinking water. Serum samples were collected and the concentration of succinate and the short chain fatty acid(SCFA) butyric acid was measured using gas chromatography-mass spectrometry. Enzyme-linked immunosorbent assay(ELISA) was performed to determine the concentration of insulin and leptin. Furthermore, the norepinephrine content in kidney tissue was determined using ELISA. Pancreatic tissue was collected and stained with haematoxylin and eosin and analysed using brightfield *** Due to the presence of the Akita allele, both Akita and Akimba mice showed a reduction in insulin production compared to C57 BL/6 J and Kimba ***, Akita mice also showed the presence of apoptotic bodies within the pancreatic islets. The acinar cells of Akita and Akimba mice showed swelling which is indicative of acute injury or pancreatitis. After 8 wk of SGLT2 inhibition with dapagliflozin, the intermediate metabolite of gut metabolism known as succinate was significantly reduced

关键词： Sodium glucose co-transporter inhibitors Sodium glucose co-transporter 2 Diabetes Diabetic retinopathy Mouse Gut microbiota Empagliflozin Dapagliflozin Succinate Akimba

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Do We Have a Biocompatible Peritoneal Dialysis Fluid?

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Open Journal of nephrology 2012年第3期2卷 29-34页

作者： Shadi Hassan Batya Kristal Khalid Khazim Fadi Hassan Dunia Hassan Kamal Hassan Faculty of Medicine in the galilee Bar-Ilan University Safed Israel Internal Medicine department-Carmel Medical Center Haifa Israel nephrology and hypertension department-western galilee hospital Nahariya Israel Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel

Objective: Cardiovascular disease remains the leading cause of morbidity and mortality in patients on maintenance dialysis. Diabetes mellitus, dyslipidemia, hypertension, inflammation and hyperhomocyteinemia are major cardiovascular risk factors. Aim: to evaluate the effects of Icodextrin and amino acid peritoneal dialysis fluid (AAPDF) on these major cardiovascular risk factors looking for a more biocompatible PDF formula. Methods: 24 adult stable peritoneal dialysis patients were included in the study. 12 patients received 2L Icodextrin and other 12 patients received 2L AAPDF in their dialysis prescription for 8 weeks. Results: Icodextrin decreased fasting plasma glucose (p Conclusions: A biocompatible PDF should provide not only adequate dialysis and ultrafiltration but should also improve nutritional and metabolic status, blood pressure control and reduce inflammation and plasma homocyteine.

关键词： Icodextrin Amino Acids PDF Homocyteine Carbohydrates Lipids Inflammation

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Interactions of Vitamin D Receptor Polymorphisms with Hypertriglyceridemia and Obesity in Chinese Individuals Susceptible to hypertension and Diabetes Comorbidity

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Biomedical and Environmental Sciences 2023年第2期36卷 196-200页

作者： SUN Hua Lei ZHAO Tong ZHANG Dong Dong FENG Ming Ming XU Ze HUANG Hao Yue ZHANG Luo Ya LI Wen Jie LI Xing DUAN Jia Yu LI Jia department of Nutrition the First Affiliated Hospital of Zhengzhou UniversityZhengzhou 450001HenanChina department of Integrated Traditional and western nephrology the First Affiliated Hospital of Zhengzhou UniversityZhengzhou 450052HenanChina Research Institute of nephrology Zhengzhou UniversityZhengzhou 450052HenanChina department of Nutrition and Food Hygiene College of Public HealthZhengzhou UniversityZhengzhou 450001HenanChina

hypertension(HTN)and type 2 diabetes mellitus(T2DM)are interconnected metabolic diseases[1,2]that considerably increase susceptibility to microvascular and macrovascular *** many patients,HTN and diabetes comorbidity(HDC)is caused by mutual pathogenic pathways,such as endothelial dysfunction,atherosclerosis,oxidative stress,and vascular inflammation[1].Hence.

关键词： morbidity inflammation diseases

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Effect of Shexiang Baoxin Pill(麝香保心丸) in Alleviating Early Hypertensive Renal Injury in Rats

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Chinese Journal of Integrative Medicine 2021年第1期27卷 47-53页

作者： ZHAO Jia-hui ZHANG Lei LIU Yang CHENG Qing-li department of Geriatric nephrology Chinese PLA General HospitalBeijing(100853)China

Objective:To investigate the effect of Shexiang Baoxin Pill(麝香保心丸,SBP)on early hypertensive renal injury in rats and to explore the possible ***:Twelve-week-old spontaneous hypertensive rats(SHRs)with high-salt diet(dietary containing 8%NaCl)were randomized into the SBP group[40 mg/(kg·d)],losartan potassium group[20 mg/(kg·d)]and saline group by stratified random sampling method,12 in each *** pressure and urea albumin creatinine ratio were *** 10 weeks,the expression levels of serum creatinine(Scr),hypersensitive C-reactive protein(hs-CRP),interleukin(IL)-1β,IL-6,tumor necrosis factorα(TNF-α),and transforming growth factorβ(TGF-β)in serum were *** pathology periodate-schiff staining was ***-quantitative count of macrophage infiltration was determined by immunochemistry of CD68 ***-time quantitative polymerase chain reaction and western blot were performed to examine the mRNA and protein expressions of Toll-like receptor 4(TLR4),nuclear factorκB(NF-κB),monocyte chemokine peptide(MCP-1),inducible nitric oxide synthase(iNOS),and arginase-1(Arg-1).Results:SBP did not affect the mortality of SHR(P<0.05).SBP significantly reduced the level of elevated blood pressure of SHRs,but the effect was less significantly than that of losartan *** decreased urine protein(P<0.01)and the expression levels of IL-1β,IL-6,TNF-α,and TGF-βin *** 22-week-old SHRs showed mild proliferation of glomerular endothelial cells,glomerular ischemic lesions,inflammatory cell infiltration in renal tubular interstitium and *** SBP and losartan potassium had alleviated renal pathological change,and significantly reduced the infiltration of macrophage(P<0.05,P<0.01).SBP and losartan potassium decreased the expressions of TLR4,NF-κB,MCP-1,iNOS,and ***:SBP significantly modified the early hypertensive renal injury by reducing inflammation,and the effect was similar to losartan potassium.

关键词： hypertension kidney injury Shexiang Baoxin Pill Chinese medicine inflammation

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Establish Albumin-creatinine Ratio Reference Value of Adults in the Rural Area of Hebei Province

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Chinese Medical Sciences Journal 2016年第1期31卷 23-30页

作者： Qiao-jing Liang Wen Huang Guo-juan Zhang Ning-li Wang department of nephrology Beijing Tongren Eye CenterBeijing Tongren HospitalCapital Medical University Beijing Institute of Ophthalmology Beijing Tongren Eye CenterBeijing Tongren HospitalCapital Medical University

Objective To establish albumin-creatinine ratio （ACR） reference value of the rural population in Hebei province. Methods This study enrolled 5154 participants. By excluding subjects with hypertension, diabetes, dyslipidemia, cardiovascular and cerebrovascular diseases, kidney diseases, and overweight condition, as well as those with an estimated glomerular filtration rate （eGFR）（60 ml/（min· 1.73 m^2）, apparently healthy subjects （1168） were selected. Urine albumin was measured by using the immunoturbidimetic method, serum creatinine was measured by using Jaffe＇s kinetic method on a morning spot-urine sample, and ACR was calculated. The 95th percentile of ACR in the healthy subjects was used as the normal upper limit. Results The normal upper limit of ACR was 28.71 mg/g （3.25 mg/retool） for males and 31.85 mg/g （3.60 rag/retool） for females. Based on this ACR reference value, the age-gender standardized prevalence of albuminuria in the rural areas of Hebei province was 12.9%. Conclusion The ACR reference value in the rural of Hebei province is higher than that of the western population.

关键词： albumin-creatinine ratio albuminuria chronic kidney disease

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Advance in Pathogenesis of Gout and Related Gene Polymorphism

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Medicinal Plant 2019年第6期10卷 1-3,5页

作者： Lamei ZHOU Wen XU Chunqing LI department of Rheumatology and Immunology Wuxi Hospital of Traditional Chinese MedicineWuxi 214000China department of nephrology Wuxi Integrated Traditional Chinese and Western Medicine HospitalWuxi 214000China

Gout is an independent risk factor for hypertension,diabetes mellitus,hyperlipidemia,coronary heart disease and cerebral *** present,the studies on the mechanism of gout at home and abroad have mainly focused on immune inflammation,gene polymorphism and related *** acid deposition or crystal precipitation activates phagocytes,fibroblasts and mast cells in synovium,produces IL-1β,TNF and chemokine IL-8(CXCL8),thereby activating neutrophils,urate crystal polyanion surface can be coated with immunoglobulins and other serum proteins as substrates for complement activation,complement substitution pathways and classical complement pathways to activate *** acid crystals activate inflammation-related signal transduction pathways including the activation of inflammation-related signal transduction pathway by uric acid crystals and TLRS/MyD88 signal transduction *** polymorphism is related to inflammation and signaling pathway,EGF gene is closely related to gout inflammation,which may be involved in the regulation of gout inflammation,among which NLRP3 inflammatory signaling pathway and gene polymorphism have been deeply studied in the pathogenesis of gout,which is the main therapeutic target of anti-inflammatory and uric acid lowering.

关键词： Gout Uric acid crystals Inflammation-related signal transduction pathway Gout-related gene polymorphism

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Epidemiology,clinical characteristics,and management of chronic kidney disease in human immunodeficiency virusinfected patients

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World Journal of nephrology 2015年第3期4卷 388-395页

作者： Minoru Ando Naoki Yanagisawa Division of nephrology Department of MedicineTokyo Metropolitan Komagome Hospital Division of Infectious Diseases Department of MedicineTokyo Metropolitan Komagome Hospital

Antiretroviral therapy has markedly reduced acquired immune deficiency syndrome-related deaths and opportunistic infectious diseases. This has resulted in prolonged survival of individuals infected with the human immunodefciency virus （HIV）. However, this improvement in survival has been accompanied by an increase in the incidence of chronic kidney disease （CKD） and end-stage renal disease. CKD is now epidemic among HIV-infected populations in both western and Eastern countries. Risk factors associated with CKD in HIV-infected populations include aging, hypertension, diabetes mellitus, co-infection with hepatitis C virus, a low CD4 cell count, and a high HIV viral load. Clinical experience has shown that HIV-infected individuals often have one or more concurrent risk factors for CKD. The cumulative effect of multiple risk factors on the development of CKD should be noted in this population. Glomerular disease directly related to HIV infection, so-called HIV-associated nephropathy, remains an important cause of CKD among a limited HIV population of African descent, but is less likely to be common among other urban HIV populations. The impact of exposure to nephrotoxic antiretroviral agents on the development of kidney disease is both an old and a new concern. In particular, the association of tenofovir with kidney tubular injury has been an area of great interest. The fndings regarding tenofovir’s adverse effect on long-term kidney function vary among studies. The early identifcation and treatment of CKD is recommended for reducing the burden of patients requiring dialysis in HIV-infected populations. Periodic monitoring of urinary concentrations of albumin, protein, and tubular injury markers such as low-molecular-weight proteins may be useful for the early diagnosis of patients at risk for incident CKD. This review focuses on recent epidemiology, clinical characteristics, and management of CKD in a contemporary HIV-infected population.

关键词： Antiretroviral therapy Tenofovir Human immunodeficiency virus-associated nephropathy Albuminuria Renal tubular biomarkers Cystatin C Diabetes mellitus hypertension

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