Hypertension Management in Patients with Chronic Kidney Disease

Hypertension and chronic kidney disease are closely linked. Patients with chronic kidney disease have hypertension almost universally and uncontrolled hypertension accelerates the decline in kidney function. The pathophysiology of hypertension in chronic kidney disease is complex, but is largely related to reduced nephron mass, sympathetic nervous system overactivation, involvement of the renin-angiotensin-aldosterone system, and generalized endothelial dysfunction. Consensus guidelines for blood pressure targets have adopted a blood pressure \u3c120/80 mm Hg in native chronic kidney disease and \u3c130/80 mm Hg in kidney transplant recipients. Guidelines also strongly advocate for renin-angiotensin-aldosterone system blockade as the first-line therapy

Kidney Disease after Heart and Lung Transplantation

Chronic kidney disease (CKD) is not only common after lung and heart transplantation but also is associated with increased morbidity and mortality due to multiple pre-, peri- and post-transplant factors. While the exact incidence of CKD in this population is not well-defined, it seems to have gradually increased over the years as older recipients are more frequently considered. The increasing success of the procedure and expanding transplant candidate pool has allowed many with comorbid conditions to receive a transplant, which was considered prohibitive in the past. This review presents risk factors that have been linked to CKD as well as interventions that may help alleviate this serious problem. The impact of pretransplant renal function and the overexaggerated role of chronic nephrotoxicity of calcineurin inhibitors is discussed in detail. Until the exact pathophysiology of kidney disease is better understood, there is a dire need to expand the research agenda beyond observational studies

The Kidney in Heart Failure: The Role of Venous Congestion

Heart failure can lead to renal impairment, an interaction now termed cardiorenal syndrome. The prevalent physiological explanation for the renal impairment that accompanies heart failure centers around the forward failure hypothesis, which emphasizes the role of left ventricular dysfunction in causing edema, and the backward failure hypothesis, which singles out venous congestion as the dominant mechanism of edema and reduced glomerular filtration rate. In this review, we provide an appraisal on venous congestion, an extremely important contributor that has received little attention. We also summarize the pharmacology of loop diuretics, explain current understanding of diuretic resistance, and address controversies regarding decongestive treatments

(E)-Methyl 2-(3-cinnamoyl­thio­ureido)acetate

In the title compound, C13H14N2O3S, the methyl 2-(3-formyl­thio­ureido)acetate fragment and the phenyl ring adopt an E configuration. The mol­ecule exhibits an intra­molecular N—H⋯O hydrogen bond, which completes a six-membered ring. The crystal packing is stabilized by inter­molecular N—H⋯S contacts, generating a two-dimensional hydrogen-bonding network

Methyl 3-(3-benzoyl­thio­ureido)propano­ate

In the title compound, C12H14N2O3S, the propyl acetate group and the benzoyl group adopt a cis–trans conformation, respectively, with respect to the thiono S atom across the C—N bonds. The phenyl ring is twisted relative to the the thio­urea mean plane, forming a dihedral angle of 24.16 (9)°. An intra­molecular N—H⋯O hydrogen bond occurs. The crystal packing is stabilized by inter­molecular N—H⋯O and C—H⋯O hydrogen bonds, forming a chain along the a axis

Donor Age, Cold Ischemia Time, and Delayed Graft Function

Background and objectives Increased donor age is one of the most important risk factors for delayed graft function (DGF), and previous studies suggest that the harmful effect of cold ischemia time is increased in kidneys from older donors. Our aim was to study the association of increased donor age and cold ischemia time with the risk of delayed graft function in a large cohort kidney transplants from the current era. Design, setting, participants, & measurements The Scientific Registry of Transplant Recipients was used for this observational, retrospective registry analysis to identify all deceased donor kidney transplantations in the United States between 2010 and September 2018, who were on dialysis pretransplantation (n=90,810). The association of donor age and cold ischemia time with the risk of DGF was analyzed in multivariable models adjusted for recipient characteristics (age, race, sex, diabetes, calculated panel-reactive antibodies, pretransplant dialysis duration) and donor characteristics (cause of death, sex, race, body mass index, creatinine, donation after circulatory death status, history of hypertension, and HLA mismatch). Results Cold ischemia time and donor age were independently associated with the risk of DGF, but the risk of DGF was not statistically significantly lower in donor age categories between 50 and 64 years, compared with donors ?65 years. The harmful association of cold ischemia time was not higher in kidneys from older donors in any age category, not even among donation after circulatory death donors. When donor risk was assessed with kidney donor profile index, although a statistically significant interaction with cold ischemia time was found, no practically meaningful increase in cold-ischemia susceptibility of kidneys with a high kidney donor profile index was found. Conclusions We were unable to demonstrate an association between donor age and DGF. The association of longer cold ischemia time with the risk of DGF was not magnified in older or more marginal donors.Peer reviewe

Propyl 2-(3-benzoyl­thio­ureido)acetate

The title compound, C13H16N2O3S, is a thio­urea derivative with benzoyl and propoxycarbonyl­methyl groups attached to the two terminal N atoms. These groups adopt trans and cis configurations, respectively, with respect to the S atom across the thio­urea C—N bonds. The compound crystallizes in the P21/c space group with Z = 8, resulting in two unique molecules in the asymmetric unit linked by C—H⋯S and C—H⋯O hydrogen bonds, forming a one-dimensional zigzag chain along the c axis

Livestock Production and Economic Implications from Augmenting Degraded Rangeland with \u3ci\u3eAtriplex halimus\u3c/i\u3e and \u3ci\u3eSalsola vermiculata\u3c/i\u3e in Northwest Syria

Three stocking rates (low: one sheep 2.25 ha-1, medium: one sheep 1.5 ha-1 year-1 and high: one sheep 0.75 ha-1 year-1) were studied for 7 seasons (1990/91-1996/97) on native range and on pasture over sown with fodder shrubs at Maragha, northwest Syria. There were 8 Awassi sheep in each stocking rate treatment, and the treatments were replicated 3 times in fenced paddocks. Milk yield, lamb production, live weight and supplementary feeding of the sheep were monitored. The results showed significantly higher forage availability on the range over-sown with fodder shrubs by 82% and 41% in the medium and high rainfall seasons, respectively and by 142% and 379% in the average and low rainfall seasons, compared with the native pasture. The total energy used in the supplementary feed was greater under the native pasture than that in the shrub-sown pasture in 5 out of 7 seasons, while crude protein consumption was greater in the native pasture than on the shrub-sown pasture in all 7 seasons. Milk production and lamb body mass were higher on shrub-sown pasture than those in native pasture in 4 and 6 out the 7 seasons, respectively. Benefits obtained from reduced feed costs, extra milk and lamb sales were higher on shrub-sown pasture than those in the native pasture in 5 out of the 7 seasons. Total benefits measured over the entire study period were highest under the high stocking rate, reaching about 77 US $ ha-1. We concluded that shrub plantation in west Asia could safely be utilized at stocking rate of one sheep 0.75 ha-1 year-1 for the benefits of the pasture and users

Susceptibility of Japanese quails (Cortunix cortunix japonica) to experimental infection with Newcastle disease virus, Kudu 113 strain

This study was carried out to determine the response of Japanese quails experimentally infected with Newcastle disease virus (NDV) kudu 113 strain using a haemagglutination inhibition test and the ability of the species to transmit the infection to chickens. The administration of kudu 113 strain of Newcastle disease virus (108.5 /ml) orally at 0.1ml/quail in the infected group (group B) resulted in an antibody response with a geometric mean titre of 23.79 on day 32 when compared to non-infected quails (group A) which did not show (p>0.05) evidence of Newcastle disease antibodies throughout the experiment and also differed significantly (p<0.05) from group B, indicating that oral inoculation of the virus was successful and the birds were infected. Clinical signs of ND were first observed in the quails 7 days post-infection (pi) with effects on egg production and egg quality. The transmission of the velogenic NDV from the quails (group B) to the sentinel chickens was clinically evident 4 days after they were placed in close contact with the infected quails. There was 100% mortality in the sentinel chickens between 4 to 7 days post contact. Thus, quails could serve as a potential source of ND for chickens