Clinical and experimental nephrology
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Clin. Exp. Nephrol. · Dec 2015
Randomized Controlled Trial Multicenter StudyAnti-albuminuric effects of spironolactone in patients with type 2 diabetic nephropathy: a multicenter, randomized clinical trial.
Several studies have demonstrated that spironolactone has an anti-albuminuric property in diabetic nephropathy. As an adverse event, spironolactone often induces the elevation of creatinine levels with hypotension and hyperkalemia. Therefore, we aimed to evaluate the efficacy and safety of spironolactone in Japanese patients with type 2 diabetes treated with either angiotensin-converting enzyme inhibitors or angiotensin receptor blockers. ⋯ Spironolactone reduced albuminuria along with conventional RAS inhibitors in patients with diabetic nephropathy. Our study suggests that spironolactone exerts anti-albuminuric effects independent of systemic hemodynamic alterations.
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Clin. Exp. Nephrol. · Dec 2015
The prognostic value of positive T-wave in lead aVR in hemodialysis patients.
Given that cardiac disease is the leading cause of mortality in hemodialysis (HD) patients, identification of patients at risk for cardiac mortality is crucial. The aim of this study was to determine if positive T-wave amplitude in lead aVR (TaVR) was predictive of cardiovascular (CV) mortality and sudden cardiac death (SCD) in a group of HD patients. ⋯ In HD patients, positive TaVR is an independent and powerful predictor of CV mortality as well as SCD. This simple ECG parameter provides additional information beyond what is available with other known traditional risk factors and allows the identification of patients most at risk of CV events.
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Clin. Exp. Nephrol. · Dec 2015
Comparison of two fluid solutions for resuscitation in a rabbit model of crush syndrome.
Crush syndrome is a common injury, the main characteristics of which include acute kidney injury. However, there is still lack of reliable animal model of crush syndrome, and it also remains controversial as to which type of fluid should be chosen as a more appropriate treatment option for prevention and treatment of acute kidney injury. ⋯ The rabbit model of crush syndrome showed clinical features consistent with those of crush syndrome. There was no significant difference in the ability of preventing AKI after a crush injury between the two fluid solutions, while SAL/HES can improve the survival rate.
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Clin. Exp. Nephrol. · Dec 2015
Association of arginine vasopressin surrogate marker urinary copeptin with severity of autosomal dominant polycystic kidney disease (ADPKD).
Experimental studies suggest a detrimental role for cyclic adenosine monophosphate (cAMP) and vasopressin in the pathogenesis of autosomal dominant polycystic kidney disease (ADPKD). It is unknown, however, whether urinary cAMP and copeptin concentration are associated with disease severity in patients with ADPKD. ⋯ In ADPKD subjects, a higher u-copeptin is associated with disease progression, suggesting that u-copeptin may be a new surrogate marker to predict renal prognosis in ADPKD.
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Clin. Exp. Nephrol. · Dec 2015
Olmesartan protects endothelial cells against oxidative stress-mediated cellular injury.
The primary cause of death of hemodialysis (HD) patients is cardiovascular disease, and increased oxidative stress has been proposed to be involved in the disease pathogenesis. In this study, we examined the effect of olmesartan on oxidative stress induced by angiotensin II, lipopolysaccharide, indoxyl sulfate, advanced oxidation protein products (AOPP) or hydrogen peroxide (H2O2), which are known to be present at higher concentrations in the blood of HD patients, using human umbilical vein endothelial cells (HUVECs). ⋯ These results demonstrated that the antioxidant activity of olmesartan might contribute to both its vasculoprotective and anti-hypertensive effects.