Creatine pretreatment prevents birth asphyxia–induced injury of the newborn spiny mouse kidney

Background: Acute kidney injury (AKI) is a major complication for infants following an asphyxic insult at birth. We aimed to determine if kidney structure and function were affected in an animal model of birth asphyxia and if maternal dietary creatine supplementation could provide an energy reserve to the fetal kidney, maintaining cellular respiration during asphyxia and preventing AKI.Methods: Pregnant spiny mice were maintained on normal chow or chow supplemented with creatine from day 20 gestation. On day 38 (term ~39 d), pups were delivered by cesarean section (c-section) or subjected to intrauterine asphyxia. Twenty-four hours after insult, kidneys were collected for histological or molecular analysis. Urine and plasma were also collected for biochemical analysis.Results: AKI was evident at 24 h after birth asphyxia, with a higher incidence of shrunken glomeruli (P < 0.02), disturbance to tubular arrangement, tubular dilatation, a twofold increase (P < 0.02) in expression of Ngal (early marker of kidney injury), and decreased expression of the podocyte differentiation marker nephrin. Maternal creatine supplementation prevented the glomerular and tubular abnormalities observed in the kidney at 24 h and the increased expression of Ngal.Conclusion: Maternal creatine supplementation may prove useful in ameliorating kidney injury associated with birth asphyxia

Urological implications of cyclophosphamide and ifosfamide

Cyclophosphamide and ifosfamide are commonly used cytotoxic medications that are indicated in a wide range of conditions, both benign and malignant. Complications of their use include well-recognized acute and chronic urological side-effects. Haemorrhagic cystitis, nephrotoxicity and transitional cell carcinoma can be directly attributed to the use of these agents, and are potentially fatal. Preventive measures can be used in an attempt to minimize the rate of complications. Urological intervention may be required in the acute and long-term management of patients who have received oxazaphosphorine agents. This article reviews current literature, sourced using a MEDLINE search of the keywords with cross-referencing. All articles were reviewed by abstract. Selection of articles was on the basis of randomized controlled trials and articles adding new or significant information