The ferric conundrum: which intravenous iron preparations are preferred for chronic kidney disease patients?

Implication for health policy/practice/research/medical education: It has been demonstrated that iron deposition in the kidney is a harbinger of poor prognosis, but it is not clear whether kidney failure/damage predisposes iron deposition, or iron deposition activates an oxidative cascade and causes kidney damage. Until this issue is clarified, it will be difficult to predict the risks or benefits of any iron infusion for chronic kidney disease. © 2022 The Author(s).Open access journalThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

Lung cancer and kidney injury: An updated review

Lung cancer is the leading cause of cancer deaths worldwide, accounting for an estimated 1.8 million deaths. Lung cancer is also the most common primary cancer leading to soft tissue (ST) metastasis. Renal disease may occur as a direct or indirect consequence of the cancer itself (e.g., post-renal obstruction, compression, or infiltration), its treatment (e.g., radiotherapy or chemotherapy), or its related complications (e.g., opportunistic infection). Existing evidence shows that the most frequent primary solid tumor responsible for renal metastasis is pulmonary carcinoma, followed by gastric, breast, soft tissue, and thyroid carcinomas. Chronic kidney disease is a potential risk factor in the survival of patients with lung cancer. In this review, we will discuss causes of kidney injury in relation to lung cancer, potential mechanisms of kidney injury, and treatment options. © 2021 The Author(s); Published by Society of Diabetic Nephropathy Prevention.Open access journalThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

Sphingosine 1 phosphate agonists (SPI): A potential agent to prevent acute lung injury in COVID-19

SARS-CoV-2 is a worldwide pandemic, that has led to the morbidity and mortality of millions of people. This virus rapidly proliferates and destroys lung epithelial cells directly, which is worsened by a subsequent cytokine storm. This cytokine storm diffusely damages the alveolar barriers and leads to fibrin and fluid exudation, hyaline membrane formation, and infiltration of inflammatory cells into the lung causing acute respiratory distress syndrome (ARDS). To date, there exists no medication to treat SARS-CoV-2 infection and novel new therapeutics are still being explored to prevent or limit the damage to the lung. Sphingosine 1-phosphate (S1P) is an effective bioactive lipid mediator and its related signaling pathways are vital for endothelial cell integrity. Stabilizing the pulmonary endothelial barrier and decreasing the inflammatory infiltrate by S1P analogs such as Fingolimod (FTY720-P) would be a new therapeutic approach for the hindrance of pulmonary exudation and subsequent ARDS. Copyright © 2021 The Author(s); Published by Nickan Research Institute. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Open access journalThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

Seasonal variation of vitamin D in patients on hemodialysis

Background: Seasonal and racial differences in serum 25-hydroxyvitamin D levels have been studied extensively in the general population but not in patients with end-stage renal disease (ESRD) Methods Serum 25-hydroxyvitamin D levels, the best available index of vitamin D nutrition, was measured at the end of summer (September) in 142 chronic hemodialysis patients and again at the end of winter (April) in 73 of these 142 patients, to determine the prevalence and risk factors for vitamin D deficiency Results. The prevalence of vitamin D depletion, as defined by serum 25-hydroxyvitamin D level of less than 20 ng/ml (50 nmol/l), was 54% at the end of summer and further increased to 86% by the end of winter (p < 0 0001 summer vs winter). We observed that women and African-Americans had a greater prevalence of hypovitaminosis D (p < 0.0002 and p < 0 001 for both comparisons, respectively). Surprisingly, diabetic status, age, and the duration of ESRD were not associated with a significant increase in risk of vitamin D depletion Conclusion Vitamin D depletion is present in about half of ESRD patients with marked seasonal variations Patients with ESRD should have more frequent assessments of their vitamin D nutrition by serum 25-hydroxyvitamin D levels, and vitamin D supplementation should be routinely prescribed, which may prevent many of the complications related to vitamin D deficiency and secondary hyperparathyroidism

Understanding kidney injury in covid-19; a pressing priority

The 2019 novel coronavirus disease (COVID-19) is a newly defined infectious and highly contagious acute disease caused by the severe acute respiratory syndrome coronavirus 2 ( (SARS-CoV-2). COVID-19 is mainly characterized by an acute respiratory disease however it can also affect multiple other organ systems such as the kidney, gastrointestinal tract, heart, vascular system, and the central nervous system. Kidney involvement is frequent in patients with COVID-19 and this review aims to explore the available data on kidney and COVID-19. In conclusion, COVID-19 infection can affect renal function and may cause acute kidney injury (AKI), due to several mechanisms that need to be fully elucidated. As only supportive management strategies are available for treating AKI in COVID-19, it is necessary to identify and preserve renal function during SARS-CoV-2 infection. © 2021 The Author(s).Open access journalThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

Effect of bromhexine on clinical outcomes and mortality in COVID-19 patients: A randomized clinical trial

Introduction: Bromhexine is a potential therapeutic option in COVID-19, but no data from a randomized clinical trial has been available. The present study aimed to evaluate the efficacy of bromhexine in intensive care unit (ICU) admission, mechanical ventilation, and mortality in patients with COVID-19. Methods: An open-label randomized clinical trial study was performed in Tabriz, North-West of Iran. They were randomized to either the treatment with the bromhexine group or the control group, in a 1:1 ratio with 39 patients in each arm. Standard therapy was used in both groups and those patients in the treatment group received oral bromhexine 8 mg three times a day additionally. The primary outcome was a decrease in the rate of ICU admissions, intubation/mechanical ventilation, and mortality. Results: A total of 78 patients with similar demographic and disease characteristics were enrolled. There was a significant reduction in ICU admissions (2 out of 39 vs. 11 out of 39, P = 0.006), intubation (1 out of 39 vs. 9 out of 39, P = 0.007) and death (0 vs. 5, P = 0.027) in the bromhexine treated group compared to the standard group. No patients were withdrawn from the study because of adverse effects. Conclusion: The early administration of oral bromhexine reduces the ICU transfer, intubation, and the mortality rate in patients with COVID-19. This affordable medication can easily be administered everywhere with a huge positive impact(s) on public health and the world economy. Altogether, the verification of our results on a larger scale and different medical centers is strongly recommended.Open access journalThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]