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Introduction: Type 2 diabetes mellitus is a global epidemic affecting 462 million people all over the world.Chronic microvascular complications of Type 2 Diabetes mellitus include diabetic retinopathy, nephropathy and neuropathy. The prevalence of Vitamin D deficiency is estimated to be 1 billion, i.e.nearly 15% of the world's population. Vitamin D has important actions on glucose metabolism. These include improved insulin exocytosis, direct stimulation of insulin receptor, improved uptake of glucose by peripheral tissues, improving insulin resistance. Objectives: 1. To measure levels of 25 hydroxy Vitamin D in patients with T2DM. 2. To assess the extent of microvascular complications in patients with T2DM and the Link Between Vitamin D Status and Microvascular Complications in Type 2 Diabetes. Methodology: A prospective study was conducted at JJM Medical college, Davangere and the study included 72 patients. Physical examination and investigations were done including: 1. Dilated fundus examination by ophthalmologist. 2. Presence or absence of neuropathy was confirmed by nerve conduction study 3. Urine was tested for protein creatinine ratio. 4. 25 Hydroxy Vitamin D levels were analysed by Electrochemiiluminecence method with machine COBAS 6000. Results: The average duration of diabetes in our subjects was 7.51�37 years and 28(38.9%) had diabetes for less than 5 years.The number of patients with Vitamin D deficiency tended to increase when the duration of diabetes was more than 5 years. Of the 39(54.16%) subjects with microvascular complications most 28(71%) had Vitamin D deficiency. Conclusion: Vitamin D deficiency is significantly associated with poor glycaemic control in Type 2 DM. Vitamin D deficiency is more common in patients with type 2 diabetes with microvascular complications than in those without.

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Background: Diabetic nephropathy (DN) is a signi?cant complication of diabetes mellitus and is the leading cause of End-Stage Renal Disease (ESRD) globally. Early detection is crucial to prevent progression to ESRD. This study evaluates the effectiveness of Renal Artery Doppler ultrasound in the early identi?cation of DN. The study aims to assess the accuracy and reliability of Renal Artery DopplerAim and Objective: ultrasound in detecting early-stage DN. It seeks to identify speci?c Doppler parameters, such as resistive index, pulsatility index, and peak systolic velocity. Additionally, the study explores the correlation between Renal Artery Doppler ?ndings and traditional markers of DN, including the urinary albumin-to-creatinine ratio (ACR) and estimated glomerular ?ltration rate (eGFR). In this cross-sectional observational study,Methods: 150 diabetic patients aged 18-75 years were evaluated. Renal Artery Doppler parameters, including resistive index (RI), pulsatility index (PI), and peak systolic velocity (PSV), were measured and compared with ACR and eGFR. The resistive index (RI) showed a strong positiveResults: correlation with ACR (r = 0.68, p < 0.001) and a negative correlation with eGFR (r = -0.52, p < 0.001). The pulsatility index (PI) also correlated with ACR (r = 0.64, p < 0.001) and eGFR (r = -0.49, p < 0.001). The Renal Artery Doppler ultrasound demonstrated a sensitivity of 89.5%, a speci?city of 83.2%, a positive predictive value (PPV) of 85.7%, a negative predictive value (NPV) of 87.1%, and an overall diagnostic accuracy of 86.3%. These results suggest that Renal Artery Doppler ultrasound, particularly through the measurement of resistive and pulsatility indices, is a reliable and accurate method for early detection of diabetic nephropathy. This tool can be effectively used in clinical settings to monitor diabetic patients, enabling timely intervention to prevent or slow the progression of kidney disease. Renal Artery Doppler ultrasound is a reliable, non-Conclusion: invasive diagnostic tool for the early detection of diabetic nephropathy, offering high diagnostic accuracy.

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This study investigated Yishentongluo Recipe (YSTLF) effects on renal oxidative stress and fibrosis in membranous nephropathy (MN) rats. MN was induced by cationized bovine serum albumin injection. Rats were divided into control, MN, YSTLF, and benazepril groups. After four weeks of treatment, urine protein levels (UTP), serum total cholesterol (TC), triglycerides (TG), total protein (TP), and albumin (ALB) were assessed. Kidney microstructure, IgG immune complex deposition, and protein expressions of superoxide dismutase (SOD), malondialdehyde (MDA), transforming growth factor ß1 (TGF-ß1), collagen I (Collagen-I), α-smooth muscle actin (α-SMA), nuclear factor E2-related factor (Nrf2), haem oxygenase 1 (HO-1), and NADPH oxidase 4 (NOX4) were evaluated. YSTLF and BNPL treatments reduced UTP, TC, TG, increased TP and ALB levels, downregulated TGF-ß1, Collagen-I, and α-SMA, and upregulated Nrf2, HO-1, and NOX4. YSTLF partially reversed SOD reduction and MDA elevation, suggesting its efficacy in alleviating renal oxidative stress and fibrosis in MN rats via Nrf2/HO-1 signaling pathway activation.

Este estudio investigó los efectos de la receta Yishentongluo (YSTLF) sobre el estrés oxidativo renal y la fibrosis en ratas con nefropatía membranosa (MN). La MN se indujo mediante inyección de albúmina sérica bovina cationizada. Las ratas se dividieron en grupos de control, MN, YSTLF y benazepril. Después de cuatro semanas de tratamiento, se evaluaron los niveles de proteína en orina (UTP), colesterol total (CT), triglicéridos (TG), proteína total (TP) y albúmina (ALB) en suero. Se evaluaron la microestructura renal, el depósito de complejos inmunes IgG y expresiones proteicas de superóxido dismutasa (SOD), malondialdehído (MDA), factor de crecimiento transformante ß1 (TGF-ß1), colágeno I (Colágeno-I), α-actina del músculo liso (α-SMA), el factor nuclear E2 (Nrf2), la hemooxigenasa 1 (HO-1) y la NADPH oxidasa 4 (NOX4). Los tratamientos con YSTLF y BNPL redujeron UTP, TC, TG, aumentaron los niveles de TP y ALB, regularon negativamente TGF-ß1, Colágeno-I y α-SMA, y regularon positivamente Nrf2, HO-1 y NOX4. YSTLF revirtió parcialmente la reducción de SOD y la elevación de MDA, lo que sugiere su eficacia para aliviar el estrés oxidativo renal y la fibrosis en ratas MN mediante la activación de la vía de señalización Nrf2/HO-1.

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Resumen Introducción : La nefropatía membranosa (NM) es la causa más frecuente de síndrome nefrótico primario en adultos (20-30%). En la microscopia óptica se obser va engrosamiento de membrana basal glomerular con aparición de espigas. Estos hallazgos histológicos no son evidentes en formas tempranas, en cuyo caso el patrón de depósito granular de IgG y/o C3 en la membrana basal por inmunofluorescencia (IF) permite diferenciarla de enfermedad por cambios mínimos (ECM). El sistema del complemento juega un papel central en la fisiopatología de la NM. C4d es producto de degradación y un marcador de la activación del complemento. La marcación con C4d en muestras de biopsias re nales, por técnica de inmunohistoquímica (IH) puede colaborar en el diagnóstico diferencial entre ambas glomerulopatías. Nuestro objetivo fue explorar el poder de discriminación del C4d para diferenciar NM de ECM en material de biopsias renales. Métodos : Se recuperaron muestras en parafina de biopsias renales con diagnóstico de NM y ECM realizados entre 1/1/2008 y 1/4/2019. Se realizaron tinciones de IH por técnica de inmunoperoxidasa con C4d usando un anticuerpo policlonal antihumano de conejo. Resultados : En todos los casos con NM (n = 27, 15 hombres) con mediana de edad de 63 (rango: 18-86) años se detectaron depósitos de C4d. En los 21 casos con ECM (12 hombres) con mediana de edad de 51 (rango: 18-87) años la marcación de C4d fue negativa. Conclusión : Los resultados indican que la marcación de la biopsia renal con C4d es una herramienta útil para el diagnóstico diferencial entre NM y ECM.

Abstract Introduction : Membranous nephropathy (MN) is the most common cause of primary nephrotic syndrome in adults (20-30%). Light microscopy shows thickening of glomerular basement membrane with appearance of spikes. These histological findings are not evident in early forms, in which case the granular deposition pattern of IgG and/or C3 in the basement membrane by immunofluorescence (IF) constitutes the diagnostic tool that allows to differentiate it from minimal change disease (MCD). Complement system plays a key role in the pathophysiology of MN. C4d is a degradation prod uct and a marker of the complement system activation. C4d labelling by immunohistochemical (HI) technique can help in the differential diagnosis between both glomerulopathies NM and MCD when the material for IF is insufficient and light microscopy is normal. Our objective was to explore the discrimination power of C4d to differentiate between MN and MCD in renal biopsy material. Methods : Paraffin-embedded samples were recovered from renal biopsies with a diagnosis of MN and MCD performed between 1/1/2008 and 4/1/2019. IH staining was performed by immunoperoxidase technique using a rabbit anti-human C4d polyclonal antibody. Results : In all cases with MN (n = 27, 15 males) with a median age of 63 (range: 18-87) years, C4d deposits were detected. In 21 cases with MCD (12 males) with a median age of 51 (range: 18-87) years, the C4d marking was negative in every samples. Conclusion : The results indicate that the marking of the renal biopsy with C4d is a useful tool for the dif ferential diagnosis between NM and MCD.

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Nephropathy complicates 5-10% of pregnancies in women with diabetes and is associated with adverse maternal and fetal outcome. Degree of renal impairment and proteinuria in early pregnancy predicts pregnancy outcome. Diabetes presenting as nephropathy at diagnosis is less frequent. We report a case of biopsy proven diabetic nephropathy that was diagnosed during second trimester of pregnancy when she presented with early onset preeclampsia with nephrotic range proteinuria, moderate anemia. Anti hypertensives and insulin were titrated. She was on strict antepartum fetal surveillance. She had periodic follow up with nephrologist. Caesarean section was performed at 33 weeks because of imminent eclampsia with transverse lie. Postoperative recovery was uneventful. Control of hypertension is cornerstone in the management as this delays the progression of the disease.

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The current study aims to assess the content of coffee oil, diterpenes, caffeine, and chlorogenic acid in coffee beans, and to evaluate the effects of roasting degrees on bioactive compound levels in Coffea arabica and their associations with glycated hemoglobin levels and kidney function parameters in streptozotocin-induced diabetic rats. These constituents were quantified using Soxhlet, liquid–liquid extraction (LLE), and high-performance liquid chromatography (HPLC)-diode array detecto (DAD). The outcomes exhibited a positive correlation between levels of coffee oil and diterpenes with a roasting degree. However, it demonstrated a negative correlation between caffeine and chlorogenic acid with a roasting degree. The male rats were categorized into two sections: healthy (nondiabetic) and streptozotocin-induced diabetic groups. Rats have daily administrated 2 ml of coffee extract using an oral gavage subjected to different roasting degrees for 3 weeks. Fasting blood glucose (FBG), urea, and creatinine in serum were assayed at baseline and end of the experiment. The highest significant elevation (Pa = 0.016) in the mean urea and creatinine levels was noted in the diabetic group administrated with dark coffee extract whereas the lowest elevation was in the diabetic group administrated with green coffee extract. In conclusion, our study has shown that coffee roasting degree may have a potential negative effect on kidney function that may accelerate or exacerbate diabetic nephropathy in induced diabetic rats. A noteworthy change in urea levels was observed in diabetic rats treated with dark-roasted coffee, which might be attributed to the decline in antioxidant constituents: chlorogenic acids and diterpenes.

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INTRODUCTION: IgA nephropathy is the most common glomerulopathy in the world, it has a wide clinical expression, from asymptomatic to rapidly progressive glomerulonephritis. The definitive diagnosis is renal biopsy, within which the IgA pattern can be identified, including thrombotic microangiopathy. CLINICAL CASE: 28-year-old female patient, with a history of preeclampsia in the last pregnancy, presents high blood pressure, hematuria and proteinuria. Study begins with initially negative results. Renal biopsy confirms IgA nephropathy with thrombotic microangiopathy. DISCUSSION: Vascular damage is underestimated in IgA nephropathy. Thrombotic microangiopathy can be associated with various clinical manifestations, however when it is associated with IgA Nephropathy it is usually associated with proteinuria, arterial hypertension and elevation of creatinine. In the presence of microangiopathy, secondary causes must be ruled out. In general, there is no pathognomonic serological marker. Eventually patients could benefit from the use of eculizumab. CONCLUSION: IgA nephropathy is the most common glomerulopathy worldwide; there is a wide range of clinical presentations, among which thrombotic microangiopathy can be found. This presentation is associated with a higher risk of progression to end-stage renal disease.

INTRODUCCIÓN: La nefropatía por IgA es la glomerulopatía más frecuente en el mundo, tiene una amplia expresión clínica, desde asintomática hasta glomerulonefritis rápidamente progresivas. El diagnóstico definitivo es la biopsia renal, dentro de las cuales se puede identificar el patrón de la IgA, dentro de los cuales está la microangiopatía trombótica. CASO CLÍNICO: Paciente femenina 28 años, con antecedentes de preeclampsia en último embarazo, presenta hipertensión arterial, hematuria y proteinuria. Se inicia estudio con resultados inicialmente negativos. Biopsia renal confirma nefropatía por IgA con microangiopatía trombótica. DISCUSIÓN: En la nefropatía por IgA se subestima el daño vascular. La microangiopatía trombótica se puede asociar con varias manifestaciones clínicas, sin embargo, cuando está asociada a NIgA suele estar asociado con proteinuria, hipertensión arterial y elevación y creatinina. Ante la presencia de microangiopatía, se deben descartar causas secundarias de la misma. En general no existe un marcador serológico patognomónico. Eventualmente los pacientes se podrían beneficiar del uso de eculizumab. CONCLUSIÓN: La nefropatía por IgA es la glomerulopatía más frecuente a nivel mundial, existe una gran gama de presentaciones clínicas, dentro de las cuales se puede encontrar microangiopatía trombótica. Esta última presentación se asocia con mayor riesgo de progresión a enfermedad renal en etapa terminal.

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IgG4-related disease (ER-IgG4) is a group of systemic fibro-inflammatory diseases, whose renal involvement is rare and difficult to diagnose. Diagnosis is usually made by serological and histological studies. Treatment is based on systemic corticosteroids. The renal prognosis is determined by the patient's comorbidities and the degree of fibrosis in the renal biopsy. We present the case of an elderly patient with exacerbated chronic kidney disease, whose study showed nephropathy associated with ER-IgG4.

La enfermedad relacionada a IgG4 (ER-IgG4) es un grupo de enfermedades fibro-inflamatorias sistémicas, cuya afectación renal es poco frecuente y de difícil diagnóstico. Habitualmente el diagnóstico se realiza mediante estudios serológicos e histológicos. El tratamiento se basa en corticoides sistémicos. El pronóstico renal está determinado por las comorbilidades del paciente y el grado de fibrosis en la biopsia renal. Se presenta el caso de un paciente adulto mayor con enfermedad renal crónica reagudizada, cuyo estudio demostró nefropatía asociada a ER-IgG4.

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Acute kidney injury (AKI) with evidence of hemolysis is associated with tropical infections. However, pigment-induced AKI can happen with relatively uncommon genetic causes of hemolytic anemia, i.e., glucose 6-phosphate deficiency (G6PD). We share our experience of one such patients whose clinical presentation was rapidly progressive glomerulonephritis. On evaluation, she had a history of usage of some drugs and with G6PD estimation revealing deficient status even during the episode while other tests such as Coomb's test and bone marrow biopsy was normal. The kidney biopsy revealed diffuse tubular injury with presence of several coarse granular/pigmented casts in tubular lamina. She was managed with hemodialysis and showed complete recovery. Thus, in tropical countries G6PD deficiency although is not common, should be considered among patients who presented as rapidly progressive renal failure (RPRF) and having history of precipitating factors for G6PD deficiency and a detailed hemolytic work-up needs to be carried out as an important cause of preventable recurrent AKI in tropical countries.

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Aims: The study aims to comprehensively analyze diabetic nephropathy's risk factors and treatment patterns, exploring diverse factors for enhanced prevention and personalized management. Study Design: Prospective study design. Place and Duration of Study: The study was conducted for 5 months at Trust Multispeciality Hospital, Kakinada. Methodology: This retroactive chart analysis of non-critical outpatients folders of Trust Hospital that refers to the mentioned period (11/2022 -04/2023) will use Excel software. Results: A variety of risk factors promote the development and progression of diabetic nephropathy, including elevated glucose levels, high blood pressure, obesity, the long duration of diabetes, and dyslipidemia. These risk factors are modifiable by hyperglycemic agents, anti-hypertensives, and lipid-lowering agents. Most of the people who are prone to diabetic nephropathy are between 40 and 70 years of age. Males are most affected (80%) compared to females (20%). Oral hypoglycemic agents (97%) and calcium channel blockers (50%) play a major role in reducing the progression of diabetic nephropathy by controlling blood pressure and glucose levels in the subject. Obesity is also a notable risk factor for end-stage renal disease patients.

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Diabetic nephropathy (DN) is the microvascular complication of type-2 diabetes that leads to end-stage renal disease. The angiotensin-converting enzyme gene that is a part of the renin-angiotensin-aldosterone system is considered one of the candidate genes responsible for the genetic predisposition of DN. To compare serum angiotensin converting enzyme (ACE) levels, the pattern of ACE gene polymorphism in patients with type-2 diabetes with or without nephropathy, to find the association between ACE gene polymorphism and various stages of DN, the association between serum ACE levels and various stages of DN. We enrolled 108 patients diagnosed with type-2 diabetes and 108 DN patients. Serum levels were estimated by ELISA and gene polymorphism was performed with gene sequencing. It was found that the serum ACE levels were higher in DN patients than in type-2 diabetics although the p-value was not significant. There was no significant association between serum ACE levels and various stages of nephropathy. The wild (GG genotype) distribution was more predominant in type-2 diabetic patients than in DN patients. There was a significant difference in the frequency of genotype with various stages of nephropathy and estimated glomerular filtration rate which was statistically significant (p = 0.0018). In summary, the study did not find a significant association between serum ACE levels and DN, nor did it observe a substantial impact of ACE gene polymorphism on serum ACE levels in DN patients. The findings also indicated that the ACE gene polymorphism might not have a direct influence on albuminuria stages. However, the wild-type genotype showed a trend toward protection against albuminuria development, while the carrier patients had a higher prevalence of severe albuminuria. Further research with larger sample sizes and longitudinal studies may provide deeper insights into the role of serum ACE levels and ACE gene polymorphism in the development and progression of DN.

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Oxalate Nephropathy (ON) represents a serious condition characterized by a decline in renal function associated with calcium oxalate crystal deposition within renal tubules. It can arise from Primary Hyperoxaluria (PH) due to genetic defects or secondary causes such as increased dietary oxalate intake. We present a case of a 46-year-old male with facial puffiness, abdominal pain, and pedal oedema, diagnosed with acute kidney injury superimposed on probable chronic kidney disease. Diagnostic investigations revealed bilateral renal echogenicity and severe acute tubular injury with calcium oxalate crystal deposition on renal biopsy. A 24-hour urinary oxalate analysis confirmed ON. Despite the absence of identifiable risk factors, the patient was categorized as probable primary oxalate nephropathy, pending genetic testing results. Management included thrice-weekly haemodialysis and assessment for liver-kidney transplant. Early identification and intervention are crucial in ON to prevent progression to renal failure, emphasizing the need for heightened clinical suspicion and timely management strategies.

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Context: Diabetic nephropathy is one of the microvascular complications of diabetes mellitus, capable of leading to end-stage renal disease. Diabetic nephropathy could only be identified through renal biopsy testing, which is expensive and can impose a financial burden on patients. Therefore, there is a necessity to develop a cost-effective method for identifying diabetic nephropathy. Aim: To evaluate the correlation between RBC parameters, such as RDW and MCV values, as prognostic biomarkers for patients with diabetic nephropathy. Methods and Material: Study Design: Prospective comparative study. Study Site: Sudha Institute of Medical Science, Erode. Study Duration: Study was carried out over six-months. Sample Size: 101 diabetic nephropathy patients and 101 type 2 diabetes mellitus patients. Statistical Analysis: Pearson correlation. Results: The majority of diabetic nephropathy patients were 40 years old or older, and most of them were males. Among the study participants, a significant number of male participants had habits of smoking and alcohol consumption. The duration of diabetes and BMI exhibited a strong correlation with the occurrence of diabetic nephropathy. Furthermore, there were notable increases in urea, creatinine, FBS, RBS, PPBS, and HbA1C, alongside a decrease in MCV and eGFR as diabetic nephropathy progressed. Conclusions: Our research indicates a positive correlation between RDW and HbA1c, FBS, RBS, PPBS, urea, and creatinine. In contrast, negative correlation of RDW with MCV and eGFR. MCV is negatively correlated with HbA1c, FBS, RBS, PPBS, urea, creatinine. In contrast, positive correlation between MCV and eGFR.

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ABSTRACT We present a case of a 69-year-old man who presented for routine check-up and was incidentally found to have kidney failure with an initially unrevealing history and bland urinary sediment. He was diagnosed with oxalate nephropathy in the setting of chronic turmeric supplementation and chronic antibiotic therapy with associated diarrhea. Our case provides several key insights into oxalate nephropathy. First, the diagnosis requires a high index of clinical suspicion. It is uncommonly suspected clinically unless there is an obvious clue in the history such as Roux-en-Y gastric bypass or ethylene glycol poisoning. Diagnosis can be confirmed by histopathologic findings and corroborated by serum levels of oxalate and 24-hour urinary excretion. Second, the diagnosis can often be missed by the pathologist because of the characteristics of the crystals unless the renal pathologist has made it a rule to examine routinely all H&E sections under polarized light. This must be done on H&E, as the other stains dissolve the crystals. Third, one oxalate crystal in a routine needle biopsy is considered pathologic and potentially contributing to the AKI or to the CKD in an important way. Fourth, secondary oxalosis can be largely mitigated or prevented in many cases, especially iatrogenic cases. This can come through the surgeon or the gastroenterologist providing proper instructions to patients on an oxalate-restricted diet or other specific dietary measures. Lastly, this case highlights the success that results from cooperation and communication between the pathologist and the treating physician.

RESUMO Relatamos o caso de um homem de 69 anos que se apresentou para exame de rotina e descobriu-se incidentalmente que ele tinha insuficiência renal, com histórico inicialmente não revelador e sedimento urinário brando. Ele foi diagnosticado com nefropatia por oxalato no contexto de suplementação crônica de cúrcuma e antibioticoterapia crônica com diarreia associada. Nosso caso fornece diversas sugestões importantes sobre nefropatia por oxalato. Primeiro, o diagnóstico requer elevado índice de suspeita clínica. A suspeita clínica é incomum, a menos que haja evidência óbvia no histórico, como bypass gástrico em Y de Roux ou envenenamento por etilenoglicol. O diagnóstico pode ser confirmado por achados histopatológicos e corroborado por níveis séricos de oxalato e excreção urinária de 24 horas. Segundo, o diagnóstico pode passar despercebido pelo patologista devido às características dos cristais, a menos que o patologista renal estabeleça como regra examinar rotineiramente todas as seções coradas com H&E sob luz polarizada. Isso deve ser feito com H&E, pois, outras colorações dissolvem os cristais. Em terceiro lugar, um cristal de oxalato em biópsia por agulha de rotina é considerado patológico, contribuindo potencialmente para LRA ou para DRC de maneira significativa. Em quarto lugar, a oxalose secundária pode ser amplamente mitigada ou prevenida em muitos casos, especialmente casos iatrogênicos. Isso pode ser feito pelo cirurgião ou pelo gastroenterologista, fornecendo instruções adequadas aos pacientes sobre uma dieta restrita em oxalato ou outras medidas dietéticas específicas. Por fim, esse caso destaca o sucesso que resulta da cooperação e comunicação entre o patologista e o médico assistente.

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Objective: the present study aimed to evaluate the prevalence of diabetic nephropathy and diabetic retinopathy, in addition to the associations that can be established between these microvascular complications of diabetes mellitus. Methods: this was a retrospective study, a systematic review without metaanalysis. The authors used the Pubmed and SciELO databases to search the terms "diabetic nephropathy", "diabetic retinopathy" and "type 2 diabetes", including publications dated 2011 to 2021. Results/Discussion: the results presented were a synthesis of patients with both pathologies and their correlations, in addition to associated laboratory changes and agreement between the stages or severity of both conditions. Conclusions: DN and DR are pathologies that are directly interconnected and cause repercussions for patients.

Objetivo: o presente estudo teve como objetivo avaliar a prevalência de nefropatia diabética e retinopatia diabética, além das associações que podem ser estabelecidas entre essas complicações microvasculares do diabetes mellitus. Métodos: estudo retrospectivo, revisão sistemática sem metanálise, os autores utilizaram as bases de dados Pubmed e SciELO para busca dos termos "nefropatia diabética", "retinopatia diabética" e "diabetes tipo 2", incluindo publicações datadas de 2011 a 2021. Resultados/Discussão: os resultados apresentados foram uma síntese dos pacientes com ambas as patologias e suas correlações, além de alterações laboratoriais associadas e concordância entre os estágios ou gravidade de ambas as condições. Conclusões: ND e RD são patologias que estão diretamente interligadas e causam repercussões aos pacientes.

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SUMMARY: This study assessed the effects of Acacia Senegal (AS) combined with insulin on Na+/K+-ATPase (NKA) activity and mRNA expression, serum glucose, renal function, and oxidative stress in a rat model of diabetic nephropathy (DN). Sixty rats were equally divided into six groups: normal control, normal+AS, diabetic (DM), DM+insulin, DM+AS, and DM+insulin+AS groups. Diabetes mellitus (type 1) was induced by a single injection of streptozotocin (65 mg/kg), and insulin and AS treatments were carried until rats were culled at the end of week 12. Serum glucose and creatinine levels, hemoglobin A1c (HbA1c) were measured. Renal homogenate levels of NKA activity and gene expression, malondialdehyde, superoxide dismutase (SOD), catalase and reduced glutathione (GSH) were evaluated as well as kidney tissue histology and ultrastructure. Diabetes caused glomerular damage and modulation of blood and tissue levels of creatinine, glucose, HbA1c, malondialdehyde, NKA activity and gene expression, SOD, catalase and GSH, which were significantly (p<0.05) treated with AS, insulin, and insulin plus AS. However, AS+insulin treatments were more effective. In conclusion, combined administration of AS with insulin to rats with DN decreased NKA activity and gene expression as well as oxidative stress, and improved glycemic state and renal structure and function.

Este estudio evaluó los efectos de Acacia senegal (AS) combinada con insulina sobre la actividad Na+/K+- ATPasa (NKA) y la expresión de ARNm, la glucosa sérica, la función renal y el estrés oxidativo en un modelo de nefropatía diabética (ND) en ratas. Sesenta ratas se dividieron equitativamente en seis grupos: control normal, normal+AS, diabética (DM), DM+insulina, DM+AS y DM+insulina+AS. La diabetes mellitus (tipo 1) se indujo mediante una única inyección de estreptozotocina (65 mg/kg), y los tratamientos con insulina y AS se llevaron a cabo hasta que las ratas fueron sacrificadas al final de la semana 12. Se midieron niveles séricos de glucosa y creatinina, hemoglobina A1c (HbA1c). Se evaluaron los niveles de homogeneizado renal de actividad NKA y expresión génica, malondialdehído, superóxido dismutasa (SOD), catalasa y glutatión reducido (GSH), así como la histología y ultraestructura del tejido renal. La diabetes causó daño glomerular y modulación de los niveles sanguíneos y tisulares de creatinina, glucosa, HbA1c, malondialdehído, actividad y expresión génica de NKA, SOD, catalasa y GSH, los cuales fueron tratados significativamente (p<0,05) con AS, insulina e insulina más AS. Sin embargo, los tratamientos con AS+insulina fueron más efectivos. En conclusión, la administración combinada de AS con insulina a ratas con DN disminuyó la actividad de NKA y la expresión genética, así como el estrés oxidativo, y mejoró el estado glucémico y la estructura y función renal.

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SARS-CoV-2 infection is a major pandemic that has involved all continents in the world. It has caused almost seven million deaths since its onset. SARS-CoV-2 commonly enters cells by binding to angiotensin-converting enzyme 2 (ACE2) molecules on the surface of cells in the human body. SARS-CoV-2 infection, although mild in many patients, has the potential to cause dysfunction of many organ systems in the body. The body response to the internalisation of the virus in the epithelial cells of the lungs can lead to alveolar epithelial inflammation, commonly referred to as the exudative phase of acute respiratory distress syndrome (ARDS). Cardiac symptoms shown by patients infected with SARS-CoV-2 include chest tightness/pain and palpitations. These features can be because of newly developed or worsening ischaemic heart disease and arrythmias, respectively. SARS-CoV-2 infection is known to cause a clinical condition known as COVID-19-associated nephropathy (COVAN), a disease quite similar to HIV-associated nephropathy (HIVAN). Like HIVAN, COVAN is relatively more common in people of African descent and is associated with the APOL1 variant gene. Researchers have not identified unique morphological changes that could be used to identify the infection in tissues. Hence, the use of RT-PCR for diagnosis is still very important.

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Out of diseases affecting kidney functions in humans, immunoglobulin A (IgA) nephropathy is the most common. Available treatments are mainly targeted to reduce proteinuria and creatinine levels and corticosteroids are the mainstay therapy to delay the end-stage renal disease (ESRD). However, corticosteroids are associated with dire adverse effects in 55% of the patients receiving the treatment consisting of metabolic disorders, osteoporosis, and others which drive the idea for the search for anti-inflammatory drugs which alleviate inflammation and fibrosis in the kidneys of the patients resulting in either cure or at least delay the ESRD. Phytomolecules have long been associated with the effective treatment of various disorders since ages. This study focuses on identifying the immunomodulatory pure molecules isolated from plants which can be studied for their effect in alleviating IgA nephropathy. All the phytomolecules mentioned in this study have inflammation-reducing properties as is evident from many studies mentioned here and IgA nephropathy, being an autoimmune disease, can be a good target of these phytomolecules. Various pathological pathways of IgA nephropathy can be targeted with these phytomolecules and this study is an effort to find out the rationale behind the choice of the molecules based on their ability to target the effector molecules of those pathological pathways.

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Background: PCI necessitates the usage of iodinated contrast agent which in some cases is accompanied by CIN and the potential for worse outcomes. The current study aimed to use the CHA2DS2-VASc score with its simple and available components as a predictor of risk of developing CIN in NSTEMI cases who will undergo PCI. Methods: This single center observational study was conducted on 200 cases diagnosed with NSTEMI who were subjected to primary PCI. The basic level of serum Cr was detected at time of admission followed by monitoring for 48?h, and seven days following the approach to detect the occurrence of CIN. Electrocardiogram (ECG) and transthoracic echocardiography are assessed to all patients. Results: At cut off ?2 (area under curve (AUC)=0.649), CHA2DS2-VASc could be used as a predictor for post-PCI CIN with sensitivity and specificity, PPV, NPV and accuracy of 77.6%, 52.3%, 34.5%, 87.8% and 58.5% respectively. There was a statistically significant correlation between occurrence of CIN and all the studied factors (female sex, HTN, DM, anemia, CHF, hemoglobin (HBG), pre-existing renal disease, previous stroke, pre-creatinine, 48hrs and 7 days post-creatinine, pre glomerular filtration rate (GFR) and cha2ds-vasc score and dehydration) with exception of age and vascular disease (p>0.05) being non-significant. Contrast volume, CHA2DS VASC score, metformin use, eGFR after 48h and ACEI /ARB II antagonists ’inhibitor use were significant independent predictors for CIN. Conclusions: In NSTEMI cases who are subjected to PCI, CHADS2 VASC score ? 2 is accompanied by a high risk for CIN and in hospital morbidity and mortality. CHA2DS2-VASC score is considered a useful novel, easy, and reliable method to anticipate CIN in NSTEMI cases undergoing urgent P.

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Background: Contrast-Induced Nephropathy (CIN) presents a significant risk in non-ST elevation acute coronary syndrome (NSTE-ACS) patients undergoing percutaneous coronary intervention (PCI). This study investigates the association between the Fibrinogen-to-Albumin Ratio (FAR) and CIN in such patients. Material & Methods: This cross-sectional study was conducted at the Department of Cardiology, National Institute of Cardiovascular Diseases (NICVD), Dhaka, from June 2019 to May 2020. 200 NSTE-ACS patients undergoing PCI were categorized into two groups based on FAR: Group I (FAR ? 0.106, n=100) and Group II (FAR < 0.106, n=100). Clinical parameters, including pulse rate, blood pressure, and biochemical markers, were analyzed. The incidence of CIN and the role of FAR as a predictive marker were statistically evaluated. Results: Baseline clinical parameters showed no significant differences between the groups, with pulse rates averaging 88.8�.4 bpm in Group I and 87.7�.4 bpm in Group II (p=0.62). Troponin I levels were higher in Group I (42.1�.6 ng/dl) compared to Group II (35.5�.6 ng/dl, p=0.07). Group I also exhibited higher hemoglobin levels (12.5�5 gm/dl vs. 12.0�5 gm/dl in Group II, p=0.02). The incidence of CIN was significantly higher in Group I at 12%, compared to 2% in Group II. FAR was identified as a significant predictor of CIN, with an odds ratio of 11.45 (p=0.006). Conclusions: The study establishes FAR as a significant independent predictor of CIN in NSTE-ACS patients undergoing PCI. These findings suggest that FAR can be an effective biomarker for assessing CIN risk, potentially guiding more tailored patient management strategies in this high-risk group.