11 research outputs found
Is Nebivolol Really Effective in Preventing Contrast Induced Nephropathy?
PubMedID: 26496491Background/Aims: Contrast induced nephropathy (CIN) has multifactorial etiopatogenesis including oxidative stress and vasoconstriction. Nebivolol is an antioxidant and has vasodilatatory effect via NO release and may prevent CIN development. We have noticed that a few number of studies that have evaluated the effectiveness of nebivolol for the prevention of CIN used serum creatinine (sCr) levels for CIN detection. However, sCr is an insensitive marker for renal damage. Therefore in this study we used serum neutrophil-gelatinase associated lipocalin (NGAL), a more sensitive marker of renal damage, to evaluate preventive role of nebivolol in CIN. Methods: 159 patients undergoing coronary angiography (CAG) who had at least one risk factor for CIN were divided into nebivolol (+) and (-) groups. CIN was defined as a rise in sCr of 0.5mg/dl or a 25% increase from the baseline value. Serum Cr, glomerular filtration rate (eGFR) and NGAL levels were assessed before and 48 h after CAG. Mehran risk scores were calculated for both groups. Results: Both groups were similar in terms of baseline characteristics, Mehran risk scores, and current medications. Clinically, CIN developed at similar rates in both groups. Serum Cr, eGFR and NGAL values were similar in both groups before and after CAG. Serum Cr and NGAL levels increased and eGFR decreased significantly compared to the levels before CAG. Patients who developed CIN were significantly older (p=0.003), and were more likely to have DM (p=0.012), a higher mean contrast agent volume (p<0.001), and a higher Mehran score (p <0.001). We did not observe any favorable effect of Nebivolol in the prevention of CIN in patients undergoing CAG. Conclusion: According to the results of our study Nebivolol does not seem to prevent CIN in patients undergoing CAG. However, further randomised controlled trials with more sensitive renal damage markers are obviously needed to understand the actual effect of nebivolol on CIN especially through oxidative pathways and in high risk patients. © 2015 S. Karger AG, Basel
Strain wave elastography for evaluation of renal parenchyma in chronic kidney disease.
Chronic kidney disease (CKD) is an important and costly health problem in developed countries and has a tendency to progress to end-stage renal disease regardless of the aetiology. This progress ends in interstitial fibrosis, which decreases the elasticity of tissue. Elastography is a developing technique to assess tissue elasticity. The aim of this study was to determine the difference of strain index (SI) value of renal parenchyma between patients with CKD and healthy individuals. In addition, SI differences of inter-stages were studied
Strain wave elastography for evaluation of renal parenchyma in chronic kidney disease
Objective: Chronic kidney disease (CKD) is an important and costly
health problem in developed countries and has a tendency to progress to
end-stage renal disease regardless of the aetiology. This progress ends
in interstitial fibrosis, which decreases the elasticity of tissue.
Elastography is a developing technique to assess tissue elasticity. The
aim of this study was to determine the difference of strain index (SI)
value of renal parenchyma between patients with CKD and healthy
individuals. In addition, SI differences of inter-stages were studied.
Methods: Toshiba (Toshiba Medical Systems Corporation, Otawara, Japan)
Aplio (TM) 500 ultrasound device and 3.5-to 5.0-MHz convex probe were
used for the elastography examinations.
Results: A total of 58 patients with CKD from nephrology and
endocrinology clinics (30 males and 28 females; mean age, 56.14 +/-
11.60 years) and 40 normal healthy individuals (19 males and 21 females;
mean age, 51.70 +/- 11.71 years) were included in this prospective
study. The mean SI of normal healthy individuals and patients with CKD
(regardless of stages) was 0.42 +/- 0.30 and 1.81 +/- 0.88, respectively
(p<0.001). SI values were not statistically significant among the CKD
stages (except CKD Stages 1 and 3). The area under the receiver
operating characteristic curve was 0.956 for SI. The optimal cut-off
value for the prediction of CKD was 0.935 (sensitivity, 88\% and
specificity, 95\%).
Conclusion: SI value of sonoelastography can be used to differentiate
patients with CKD and healthy individuals. Sonoelastography is an
acceptable technique to approach patients with CKD, but we have not
shown that it can reliably differentiate different stages.
Advances in knowledge: Determining a cut-off SI value between normal and
diseased renal parenchyma can help in the diagnosis of CKD