ABSTRACT
The kidneys have a close functional relationship with other organs especially the lungs. This connection makes the kidney and the lungs as the most organs involved in the multi-organ failure syndrome. The combination of acute lung injury (ALI) and renal failure results a great clinical significance of 80% mortality rate. Acute kidney injury (AKI) leads to an increase in circulating cytokines, chemokines, activated innate immune cells and diffuse of these agents to other organs such as the lungs. These factors initiate pathological cascade that ultimately leads to ALI and acute respiratory distress syndrome (ARDS). We comprehensively searched the English medical literature focusing on AKI, ALI, organs cross talk, renal failure, multi organ failure and ARDS using the databases of PubMed, Embase, Scopus and directory of open access journals. In this narrative review, we summarized the pathophysiology and treatment of respiratory distress syndrome following AKI. This review promotes knowledge of the link between kidney and lung with mechanisms, diagnostic biomarkers, and treatment involved ARDS induced by AKI.
ABSTRACT
N 3 Fatty acids reduce the risk of cardiovascular disease. Previous studies have shown that they may reduce inflammation, oxidative stress, and fat mass in patients with type 2 diabetes, but the results are inconclusive, due, in part, to type of omega 3 fatty acids used. The aim of this study was to determine the effects of pure eicosapentaenoic [EPA] and docosahexaenoic acids [DHA], the two major omega 3 fatty acids, on inflammation, oxidative stress, and fat mass in patients with type 2 diabetes. Sixty patients with DM II were randomly allocated to receive daily either tilde1 gr EPA or tilde1 gr DHA, or a canola oil as placebo for 12 weeks in a randomized triple blind, placebo controlled trial. Serum MDA, CRP, body weight, BMI, and fat mass were measured at baseline and after intervention. Forty five patients with a mean [ +/- SD] age of 54.9 +/- 8.2 years with BMI of 27.6 +/- 4.1 kg/m[2] and fasting blood glucose 96.0 +/- 16.2 mg/dl completed the intervention. Neither EPA nor DHA had significant effects on serum FBS, C reactive protein, body weight, BMI, and fat mass after intervention [P > 0.05]. In addition, while MDA increased 18% in the placebo group [P = 0.009], it did not change in the EPA or DHA group [P > 0.05]. Twelve weeks of supplementation with 1gr/d EPA or DHA prevent increasing oxidative stress without changing marker of inflammation. This study is the first report demonstrating that neither EPA nor DHA have effects on body fat mass in type 2 diabetic patients