Effects of medium cut-off dialysis membranes on inflammation and oxidative stress in patients on maintenance hemodialysis

YETER, hasan h/0000-0002-5787-1048WOS:000548170700003PubMed: 32661626Purpose Medium cut-off membranes were developed for providing increased clearance of larger middle-molecule uremic toxins. We compared the effect of low-flux, medium cut-off, and high-flux membranes on chronic inflammation and oxidative stress in patients with maintenance hemodialysis. Methods A total of 42 patients were enrolled in this study. Total antioxidant status, total oxidant status, paraoxonase-1, ischemia-modified albumin, total Thiol, disulfide bond, and native Thiol were measured to determine oxidative stress. C-reactive protein was measured to define inflammation. Results 37% of the total patients were females, and the mean age was 52.9 +/- 16 years. Serum albumin and Kt/V were similar between groups during the study period. We did not find any significant difference at baseline in the 3rd and 6th months of the study when we compared the inflammatory marker and oxidative indicator levels between three hemodialysis membranes in the whole study group. In the subgroup analysis of 19 patients with a high C-reactive protein level, we found that the medium cut-off membrane significantly reduced serum C-reactive protein level, when compared to low-flux and high-flux membrane [2.8 mg/L vs. 13.7 mg/L and 6.1 mg/L, respectively,p = 0.05]. However, we did not find a significant change in oxidative stress indicators in patients with high C-reactive protein levels between the three dialysers. Conclusion The medium cut-off membrane has favorable effects on inflammation in patients with maintenance hemodialysis. However, this positive effect could not be demonstrated in oxidative stress

Prognostic factors in glomerular diseases with crescents

Introduction. More than 50% of glomerular crescent formation is required for a diagnosis of crescentic glomerulonephritis in a kidney biopsy. Although treatment protocols have been established for diffuse crescentic glomerulonephritis, there is no standard treatment for patients with fewer crescents in renal biopsies. In this study the importance of crescent percentage and clinical features on renal survival independent of underlying disease was investigated

Relationship between Serum Adipocyte Fatty Acid-Binding Protein Levels and Systemic Inflammation in Hemodialysis Patients

WOS: 000533604700003Objective: Adipocyte fatty acid-binding protein (A-FABP) is expressed in adipose tissue and macrophages. It regulates cholesterol trafficking and is involved in atherosclerosis formation. A-FABP levels are associated with cardiovascular diseases (CVDs) in patients with or without chronic kidney disease. In this study, we evaluated A-FABP levels in healthy controls and hemodialysis (HD) patients and compared the results with C-reactive protein (CRP) and interleukin-6 (IL-6) levels to determine their relationship with systemic inflammation. Materials and Methods: The study comprised 23 healthy controls and 70 HD patients, excluding individuals with an active infection, malignancy, anorexia, obesity, and hypo- or hyperthyroidism. Demographic features, laboratory findings, A-FABP levels, and levels of inflammatory markers were evaluated between and within the groups. Results: Levels of A-FABP and inflammatory markers were significantly higher in HD patients. In the HD group, 20% of the patients had documented CVD. Levels of A-FABP and inflammatory markers were similar in nondiabetic and diabetic HD patients. Age was negatively correlated with A-FABP levels. Presence of diabetes was not correlated with A-FABP. Serum CRP and IL-6 levels were significantly correlated with A-FABP levels (r=0.354, p=0.003 and r=0.393, p=0.001, respectively). Conclusion: A-FABP levels are elevated in HD patients. Systemic inflammation is significantly related to A-FABP levels in both nondiabetic and diabetic HD patients and decreases with age. Findings of this study support the adverse cardiovascular effects of systemic inflammation in HD patients.Gazi University School of MedicineGazi UniversityThe authors declared that this study has received financial support from the Gazi University School of Medicine Scientific Research and Project Unit

Role of silymarin (Silybum marianum) in the prevention of colistin-induced acute nephrotoxicity in rats

Ogut, Betul/0000-0002-1385-7324; Pasaoglu, Ozge Tugce/0000-0002-5221-9034; DERICI, ULVER/0000-0002-9741-6779; sutcuoglu, osman/0000-0003-3835-2741WOS:000520339700001PubMed: 32174194Silymarin (Silybum marianum) has some protective effects against drug toxicity (cisplatin, acetaminophen, adriamycin, gentamicin etc.). Colistin is a strong antimicrobial, which is frequently used in the treatment of resistant gram-negative bacterial infections in recent years although it has nephrotoxic potential. This study was aimed to determine the role of silymarin against colistin-induced acute nephrotoxicity (CIN). Rats were randomly divided into four groups. The control group was treated with tap water whereas groups 2 and 3 received silymarin (orally, 100 mg/kg/day) and colistin (intraperitoneally, 750.000 IU/kg/day) for seven days, respectively. Group 4 received both 750,000 IU/kg/day colistin and 100 mg/kg/day silymarin for seven days. After euthanasia, histopathological and biochemical examinations were completed for the kidney tissue specimens and blood samples. All parameters of the control and silymarin groups were similar. Severe weight loss was seen in the groups receiving colistin (groups 3 and 4). Silymarin significantly increased glutathione peroxidase and superoxide dismutase levels when administered with colistin in group 4 only. Acute tubular injury, tubular necrosis, meduller congestion, interstitial inflammation and apoptotic indices of colistin group were significantly higher than the control group. The administration of colistin with silymarin (group 4) was able to make some improvements in tubular necrosis and significant increase in antioxidant capacity. Silymarin increased antioxidant enzyme activity only when used in combination with colistin. The effects of silymarin may become more pronounced when used at higher doses or with a longer duration of treatment and may prevent nephrotoxicity.Turkish Society of Hypertension and Kidney DiseasesThis study was supported by Turkish Society of Hypertension and Kidney Diseases

Is it possible to prevent contrast-induced nephropathy with dexpanthenol?

Derici, Mehmet Kursat/0000-0002-8260-7492; Ogut, Betul/0000-0002-1385-7324WOS: 000477631100016PubMed: 31190296PurposeContrast-induced nephropathy (CIN) is one of the side effects of diagnostic procedures. Oxidative stress plays an important role in CIN's pathophysiology. Dexpanthenol (Dexp) is a substance with antioxidant efficacy. We investigated the likely protective effects of dexpanthenol for CIN.MethodsTwenty-four Sprague-Dawley rats were divided randomly into four groups of 6 rats; control (group 1), Dexp (group 2), CIN (group 3) and Dexp+CIN (group 4). All rats were restricted of water moderately to facilitate of nephrotoxicity. Dexp was administered into the intraperitoneally at a dose of 500mg/kg for 5days in groups 2 and 4. The same amount of saline was applied via intraperitoneally to group 1 and 3. In CIN and Dexp+CIN groups, L-NAME (10mg/kg), tenoxicam (0.5mg/kg) and sodium amidotrizoate (10ml/kg) were administered on the 4th day via the tail vein for CIN. All rats were euthanized on the 6th day and samples for biochemical and pathological evaluations were collected.ResultsWhen the Dexp+CIN group and the CIN group were compared, it was found to be provide a significant decline at the level of acute tubular injury and necrosis in kidney biopsies by dexp. Furthermore Dexp significantly reduced the serum cystatin C (Cys-C) levels, not serum creatinine. There was no statistically significant difference between the groups in total oxidant and antioxidant levels.ConclusionsDexpanthenol did not have significant effect on oxidative stress of acute kidney injury on this rat model. However, it has ameliorated serum Cys-C levels and histopathological findings of CIN.Turkish Society of Hypertension and Kidney DiseaseThis study was supported by Turkish Society of Hypertension and Kidney Disease

Role of silymarin (Silybum marianum) in the prevention of colistin-induced acute nephrotoxicity in rats

Ogut, Betul/0000-0002-1385-7324; Pasaoglu, Ozge Tugce/0000-0002-5221-9034; sutcuoglu, osman/0000-0003-3835-2741; DERICI, ULVER/0000-0002-9741-6779WOS: 000520339700001PubMed: 32174194Silymarin (Silybum marianum) has some protective effects against drug toxicity (cisplatin, acetaminophen, adriamycin, gentamicin etc.). Colistin is a strong antimicrobial, which is frequently used in the treatment of resistant gram-negative bacterial infections in recent years although it has nephrotoxic potential. This study was aimed to determine the role of silymarin against colistin-induced acute nephrotoxicity (CIN). Rats were randomly divided into four groups. The control group was treated with tap water whereas groups 2 and 3 received silymarin (orally, 100 mg/kg/day) and colistin (intraperitoneally, 750.000 IU/kg/day) for seven days, respectively. Group 4 received both 750,000 IU/kg/day colistin and 100 mg/kg/day silymarin for seven days. After euthanasia, histopathological and biochemical examinations were completed for the kidney tissue specimens and blood samples. All parameters of the control and silymarin groups were similar. Severe weight loss was seen in the groups receiving colistin (groups 3 and 4). Silymarin significantly increased glutathione peroxidase and superoxide dismutase levels when administered with colistin in group 4 only. Acute tubular injury, tubular necrosis, meduller congestion, interstitial inflammation and apoptotic indices of colistin group were significantly higher than the control group. The administration of colistin with silymarin (group 4) was able to make some improvements in tubular necrosis and significant increase in antioxidant capacity. Silymarin increased antioxidant enzyme activity only when used in combination with colistin. The effects of silymarin may become more pronounced when used at higher doses or with a longer duration of treatment and may prevent nephrotoxicity.Turkish Society of Hypertension and Kidney DiseasesThis study was supported by Turkish Society of Hypertension and Kidney Diseases

Discontinuation of Eculizumab treatment after hematological remission in patients with atypical and drug-induced hemolytic uremic syndrome

Introduction. The aim was to evaluate the effect of therapeutic plasma exchange (TPE) and eculizumab on hematological and renal survival in atypical hemolytic uremic syndrome (aHUS), and additionally, to examine the reliability of discontinuation of eculizumab treatment

The relationship between adiponectin levels and proinflammatory cytokines and left ventricular mass in dialysis patients

WOS: 000269100900007PubMed: 19384839Introduction: Adiponectin is increased in end-stage renal disease. However, efforts to clarify the cause of that increase and its clinical effects have been inconclusive. The aim of this study was to compare serum adiponectin levels of dialysis patients against healthy individuals and evaluate the relationship among adiponectin levels, IL-6, TNF-alpha and left ventricular mass index (LVMI). Methods: Adiponectin, IL-6 and TNF-a measurements and echocardiographic evaluations were performed in 36 hemodialysis, 30 continuous ambulatory peritoneal dialysis (CAPD) patients and 22 healthy volunteers. Adiponectin, IL-6 and TNF-alpha levels were measured by ELISA. Results: Adiponectin was found to be higher in hemodialysis (52.78 +/- 18.01 ng/mL) and CAPD (52.96 +/- 17.53 ng/mL) groups than controls (28.36 +/- 13.20 ng/ mL; p = 0.0003, p = 0.0003, respectively). No difference was observed between the hemodialysis and CAPD groups. Adiponectin was positively correlated with IL-6 (r = 0.293, p = 0.02), TNF-alpha (r = 0.458, p = 0.0003) and LVMI (r = 0.283, p = 0.02). In the partial correlation analysis, by controlling for body mass index, the correlation between adiponectin and TNF-alpha (r = 0.466, p = 0.0003) persisted. When IL- 6 was controlled with TNF- a, the relation between adiponectin and LVMI disappeared (r = 0.145, p = 0.30). In the linear regression analysis, with adiponectin as the dependent variable, and IL-6, TNF-alpha and body mass index as independent variables, a significant relationship was found between adiponectin and TNF-alpha (beta = 0.488, p = 0.001). Conclusions: Increased adiponectin seems to be associated with increased proinflammatory cytokines in dialysis patients, and this relationship suggests adiponectin may have a role in the development of left ventricular hypertrophy

High neutrophil-to-lymphocyte ratio predicts acute allograft rejection in kidney transplantation: a retrospective study

Background/aim: Our research focused on the identification of easily available and sensitive markers for early prediction of acute kidney allograft rejection (AR). We aimed to investigate the association between neutrophil-to-lymphocyte ratio (NLR) and AR in kidney transplant patients. Materials and methods: The medical records of 51 kidney transplant patients {[}12 female/39 male; median age of 32 (IQR: 24-44) years] were evaluated retrospectively. We considered a cut-off value of >2.5 as high NLR. Results: A total of 22 biopsy-proven AR patients and 29 controls were evaluated. The AR group had a higher NLR compared to the controls (P < 0.001). NLR levels over 2.5 {[}95\% CI: 54.88 (9.96-302.3), P < 0.001] were significantly associated with AR in univariate analysis. The NIA levels were the only significant factor associated with AR in multivariate models, in model 1 (adjusted by age and sex) {[}95\% CI: 114 (11.1-1175), P < 0.001], and in model 2 (adjusted by steroid dosage, uric acid, and NLR) 195\% CI: 4.60 (1.59-29.3), P = 0.004]. Conclusion: Our data showed that higher NLR values (>2.5) are associated with AR in kidney transplant patients, leading to the conclusion that NLR might be an easily available and useful marker option for detection of AR in this patient population