Relationship between Estimated Glomerular Filtration Rate (eGFR) and Metabolic Syndrome in Japanese

We investigated the link between renal function as evaluated by estimated glomerular filtration rate (eGFR) and metabolic syndrome in Japanese. A total of 11,711 Japanese subjects, aged 20-79 years, were recruited in a cross-sectional clinical investigation. From this group, we further investigated the data on 1,576 subjects. eGFR was calculated using serum creatinine (Cr), age and sex. The diagnosis of metabolic syndrome was based on the Japanese criteria. In the first analysis, 288 men (7.8%) and 498 women (6.2%) were diagnosed with reduced eGFR (<60ml/min). eGFR was not correlated with anthropometric, body composition parameters in either sex. In the second analysis, in subjects without medications, 132 men (20.8%) and 15 women (1.6%) were diagnosed with metabolic syndrome. eGFR was lower in men with abdominal obesity and in women with hypertension was than in those without. Among Japanese not taking medications, lower eGFR may be a characteristic of men with abdominal obesity and of women with hypertension

Decreasing Abdominal Circumference Is Associated with Improving Estimated Glomerular Filtration Rate (eGFR) with Lifestyle Modification in Japanese Men: A Pilot Study

The link between changes in a subject's metabolic syndrome components and his estimated glomerular filtration rate (eGFR) was evaluated in healthy Japanese men. We used data from 120 Japanese men (45.5±8.4 years) with a 1-year follow up. eGFR was defined by a new equation developed for Japan. There were no significant differences in eGFR between men with and without metabolic syndrome components at baseline. Subjects were given advice for dietary and lifestyle improvement. At the 1-year follow up, almost all metabolic syndrome components were significantly improved. However, eGFR was significantly decreased. The changes in eGFR were weakly correlated with abdominal circumference (r＝－0.232, p＝0.0106). A decrease in abdominal circumference may be associated with improving eGFR in Japanese men

Influencing Factors for Dietary Behaviors of Patients with Diabetic Nephropathy

The aim of this study was to clarify the factors influencing the dietary behavior of patients with diabetic nephropathy. One hundred twenty-two patients with type 2 diabetes were recruited from the outpatients of Okayama University Hospital in Okayama, Japan. We performed a cross-sectional study using a questionnaire including 206 items among 18 categories as follows:background factors, coping behavior (coping scale), degree of uncertainty in illness (uncertainty scale), and dietary behavior. The data were analyzed by correlation analysis, t-test, one-way analysis of variance, Pearson correlation analysis, and multiple regression analysis. We found that those patients with microalbuminuria alone tended to recognize more mild about their kidney status than those with macroalbuminuria and chronic renal failure. We also found that common factors influencing the dietary behavior of diabetic patients with and without nephropathy are as follows:1. coping with the problem (beta0.342, p0.01);2. anxiety about prognosis (beta0.344, p0.01);3. sex (beta0.234, p0.05);4. uncertainty regarding treatment (beta0.377, p0.01);5. negative coping (beta0.354, p0.01);and 6. employment status (beta0.367, p0.01). Coping and uncertainty in illness had a significant relation to positive support and lack of support. To maintain appropriate dietary behavior in diabetic patients, medical staff need to determine what the social supports are important for the patient, and also to ensure good communication among healthcare personnel as well as positive support for patients and families.</p

Decreasing Systolic Blood Pressure Is Associated with Improving Estimated Glomerular Filtration Rate (eGFR) with Lifestyle Modification in Japanese Healthy Women

The link between changes in a subject's metabolic syndrome components and her estimated glomerular filtration rate (eGFR) was evaluated in healthy Japanese women. We used data for 53 Japanese women (46.0±10.9 years) with a 1-year follow up. eGFR was defined by a new equation developed for Japan. There were no significant relationships between eGFR and clinical parameters at baseline. Subjects were given advice for dietary and lifestyle improvement. At the 1-year follow up, eGFR was significantly increased. In addition, changes in eGFR were weakly correlated with systolic blood pressure(r＝－0.306, p＝0.0260). A decrease in systolic blood pressure may be associated with improving eGFR in Japanese women

Lifestyle Modification Is Associated with Improving Estimated Glomerular Filtration Rate (eGFR) and Proteinuria in Japanese with Proteinuria

The link between lifestyle modification and changes in both proteinuria and estimated glomerular filtration rates (eGFRs) was evaluated in Japanese subjects with proteinuria who were not taking medications. We used data from 51 men (35.8±10.0 years) and 74 women (38.0±11.0 years) with proteinuria at baseline and a 1-year follow up. eGFR was defined by a new equation developed specifically for Japanese subjects. Subjects were given advice for dietary and lifestyle improvement at the initial appointment. At the 1-year follow up, eGFR was increased in both sexes, but not at significant levels. (men:p＝0.7709, women:p＝0.2180). Proteinuria was also improved in many subjects. A decrease in proteinuria may be associated with improving eGFR in Japanese

Suramin prevents the development of diabetic kidney disease by inhibiting NLRP3 inflammasome activation in KK-Ay mice

Aims/Introduction Nucleotide-binding oligomerization domain-like receptor family pyrin domain containing 3 (NLRP3) inflammasomes produce IL-18 upon being activated by various stimuli via the P2 receptors. Previously, we showed that serum and urine IL-18 levels are positively associated with albuminuria in patients with type 2 diabetes, indicating the involvement of inflammasome activation in the pathogenesis of diabetic kidney disease (DKD). In the present study, we investigated whether the administration of suramin, a nonselective antagonist of the P2 receptors, protects diabetic KK.Cg-A(y)/TaJcl (KK-Ay) mice against DKD progression. Materials and Methods Suramin or saline was administered i.p. to KK-Ay and C57BL/6J mice once every 2 weeks for a period of 8 weeks. Mouse mesangial cells (MMCs) were stimulated with ATP in the presence or absence of suramin. Results Suramin treatment significantly suppressed the increase in the urinary albumin-to-creatinine ratio, glomerular hypertrophy, mesangial matrix expansion, and glomerular fibrosis in KK-Ay mice. Suramin also suppressed the upregulation of NLRP3 inflammasome-related genes and proteins in the renal cortex of KK-Ay mice. P2X4 and P2X7 receptors were significantly upregulated in the isolated glomeruli of KK-Ay mice and mainly distributed in the glomerular mesangial cells of KK-Ay mice. Although neither ATP nor suramin affected NLRP3 expression in MMCs, suramin inhibited ATP-induced NLRP3 complex formation and the downstream expression of caspase-1 and IL-18 in MMCs. Conclusions These results suggest that the NLRP3 inflammasome is activated in a diabetic kidney and that inhibition of the NLRP3 inflammasome with suramin protects against the progression of early stage DKD

Involvement of MAPKs in ICAM-1 Expression in Glomerular Endothelial Cells in Diabetic Nephropathy

Inflammatory processes are involved in the pathogenesis of diabetic nephropathy. The aim of this study was to clarify the role of mitogen-activated protein kinase (MAPK) pathways for induction of intercellular adhesion molecule-1 (ICAM-1) expression in glomerular endothelial cells under diabetic conditions. We examined the expression of ICAM-1 in the kidneys of experimental diabetic rats. Human glomerular endothelial cells (GE cells) were exposed to normal glucose concentration, high glucose concentration (HG), or high mannitol concentration (HM), and then the expression of the ICAM-1 protein and the phosphorylation of the 3 subfamilies of mitogen-activated protein kinase (MAPK) were determined using Western blot analysis. Next, to evaluate the involvement of MAPKs in HG- or HM-induced ICAM-1 expression, we preincubated GE cells with the inhibitors for ERK, p38 or JNK 1h prior to the application of glucose or mannitol. Expression of ICAM-1 was increased in the glomeruli of diabetic rats. Both HG and HM induced ICAM-1 expression and phosphorylation of ERK1/2, p38 and JNK in GE cells. Expression of ICAM-1 was significantly attenuated by inhibitors of ERK, p38 and JNK. We conclude that activation of ERK1/2, p38 and JNK cascades may be involved in ICAM-1 expression in glomerular endothelial cells under diabetic conditions