“Development and validation towards a Nomogram to predict acute kidney Injury following PCNL”

World Journal of Urology, Journal Year: 2025, Volume and Issue: 43(1)

Published: Feb. 24, 2025

Abstract Objectives To evaluate the occurrence, risk factors, and outcomes of post PCNL (Percutaneous Nephrolithotomy) Acute Kidney Injury (AKI), with a secondary goal developing nomogram for post-PCNL AKI prediction. Methods A prospective observational study was conducted enrolling 333 patients who underwent between February 2022 2023. Patient demographics, comorbidities, perioperative lab parameters, stone characteristics, intraoperative details, postoperative were assessed. Logistic regression analyses employed to construct predicting AKI. Results 40 (12.4%) experienced AKI, recovery observed in all cases during 3-month follow-up. Female gender ( p = 0.002), hypertension( 0.022), higher serum uric acid levels( 0.003), staghorn calculi( 0.001), Hounsfield Units( 0.013), bilateral PCNL( < larger tract size( 0.017), longer operative time( greater volume( 0.025), baseline creatinine total leukocyte count( 0.005), fever( 0.001) significantly associated group. Regression analysis identified female (OR 0.26, 0.035), levels(OR 1.62, PCNL(OR 12.55, operation time(OR 1.02, 0.047), volume(OR 1.12, 0.015) as independent factors The internally validated nomogram( n 70) demonstrated excellent diagnostic performance, an area under ROC curve 0.984(95% CI, 0.001). Conclusion occurs approximately 12% undergoing PCNL. We several significant predictors including gender, hypertension, hyperuricemia, units, volume, PCNL, access size, time. Awareness these is crucial optimizing management improving patient outcomes.

Language: Английский

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Hinokitiol Prevents Diabetic Acute Kidney Injury by Mitigating ER Stress

Cell Biology International, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 27, 2025

ABSTRACT Acute kidney injury (AKI) in diabetic conditions often advances to chronic disease (CKD), exacerbated by ischemia–reperfusion (IRI) through pathomechanisms such as endoplasmic reticulum (ER) stress and inflammation. Currently, available treatment options for AKI are not uniformly effective, highlighting the need novel interventions. This study aimed examine renoprotective effects of hinokitiol, a natural tropolone compound, against with its capability decrease ER inflammation, along apoptosis. involved NRK‐52E cells grown in‐vitro under high‐glucose subjected 10 mM sodium azide elicit hypoxia/reperfusion (HRI). The expression key markers like binding immunoglobulin protein (BiP), R/PKR‐like kinase (PERK), eukaryotic initiation factor‐2 (eIF2α) well inflammatory proteins was markedly diminished hinokitiol pretreatment (50 μM). Hinokitiol further reduced apoptosis cells. Similarly, in‐vivo study, male Wistar rats STZ‐induced Type 1 diabetes (55 mg/kg, i.p .) were treated 50 100 mg/kg/day . 5 days, followed induction via bilateral IRI. significantly elevated plasma blood urea nitrogen (BUN), creatinine, urinary molecule‐1 (KIM‐1) levels tubular damage rats. also respective expressions rats, demonstrated immunohistochemical analysis immunoblotting. These findings suggest that alleviates modulating PERK/CHOP/NF‐κB axis, likeliness viable therapeutic technique alleviating AKI.

Language: Английский

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Network pharmacology combined with molecular docking and dynamics to assess the synergism of esculetin and phloretin against acute kidney injury-diabetes comorbidity

Molecular Diversity, Journal Year: 2024, Volume and Issue: 29(1), P. 1 - 19

Published: April 5, 2024

Language: Английский

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Pros and Cons of Inpatient SGLT2i Use for Hyperglycemia and Heart Failure

Journal of the Endocrine Society, Journal Year: 2025, Volume and Issue: 9(2)

Published: Jan. 6, 2025

Abstract Sodium-glucose cotransporter 2 inhibitors (SGLT2is), originally approved by the US Food and Drug Administration for glycemic control in type diabetes mellitus (DM2), have shown substantial cardiovascular renal benefits, leading to their expanded use managing heart failure (HF) chronic kidney disease outpatient setting. Despite these inpatient hyperglycemia management is not universally endorsed due safety concerns inadequate data. However, emerging evidence suggests potential advantages of initiating SGLT2i treatment patients during hospitalization setting HF. While SGLT2is are recommended hyperglycemia, initiation HF provides significant benefits. We review current literature on pros cons using hospitalized DM2 provide guidance careful patient selection risk mitigation use.

Language: Английский

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XueBiJing injection reduced mortality in sepsis patients with diabetes

Frontiers in Pharmacology, Journal Year: 2025, Volume and Issue: 16

Published: Feb. 27, 2025

Sepsis patients with diabetes are at a high clinical risk. It is well reported that XueBiJing injection has good benefit in sepsis individuals. However, there no relevant report about the efficacy and safety of XBJ comorbid diabetes. Data two large randomized controlled trials (XBJ-SAP (ChiCTR-TRC-13003534) EXIT-SEP (NCT0323874)) were combined, post hoc analyses performed. further divided into XBJ-treated group placebo based on inclusion exclusion criteria. The primary (28-day mortality) secondary outcomes (mortality ICU post-randomization hospital, acute physiology, chronic health evaluation II (APACHE II) score sequential organ failure assessment (SOFA) score) compared between treatment groups status baseline. Moreover, occurrence adverse events (AEs) was also assessed. At study baseline, total 378 (227 men [60.0%] 151 women [40.0%]; mean [SD] age, 60.3 [11.1] years) considered to have diabetes, which 177 received 201 administration. Among these mortality 28 days significantly lower than (29 173 [16.8%] vs. 56 198 [28.3%], P = 0.01), absolute risk difference 11.5% (95% CI, 3.1%-19.9%). Furthermore, overall incidence when used (24.4% [42 172 patients] 27.7% [54 195 patients]. present underscores pivotal role modulating immune response among suffering from mellitus, exploring positive effects mellitus. those consistent trial findings, demonstrating efficacious suggesting need for special precautions. ChiCTR-TRC-13003534 NCT0323874.

Language: Английский

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Risk of acute kidney injury in dapagliflozin users with type 2 diabetes: A nationwide propensity score‐matched cohort study in Korea

Pharmacotherapy The Journal of Human Pharmacology and Drug Therapy, Journal Year: 2025, Volume and Issue: unknown

Published: April 11, 2025

Abstract Background Several previous studies have identified a potential risk of acute kidney injury (AKI) associated with sodium‐glucose cotransporter‐2 (SGLT‐2) inhibitors, based on adverse event reports. However, recent European observational shown conflicting results. Objective To evaluate the AKI in patients type 2 diabetes (T2DM) who were treated dapagliflozin compared sitagliptin. Method We conducted retrospective cohort study T2DM newly prescribed or sitagliptin between September 1, 2014, and June 30, 2021, using nationwide National Health Insurance Review Assessment (HIRA) Service database Korea. Propensity scores estimated multivariable logistic regression model, matching was performed at 1:1 ratio to balance groups. The outcome interest occurrence hospitalization 90 days post‐exposure, captured by validated algorithm International Classification Diseases 10th Revision (ICD‐10) code: N17. Hazard ratios (HR) 95% confidence intervals (CI) calculated Cox proportional hazards model. Results Among 94,977 users matched users, events occurred 132 versus 198 incidence rates 2.92 8.93 per 1000 person‐years, respectively. 34% lower (HR: 0.66, CI: 0.53–0.83) users. This protective effect remained consistent sensitivity analyses. Conclusion Contrary United States Food Drug Administration's safety warning, our findings suggest that may against T2DM. is from post‐marketing serve as supportive evidence.

Language: Английский

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Use of Potentially Nephrotoxic Drugs in Type 2 Diabetes Patients on SGLT2i: A Trajectories Analysis

Pharmacoepidemiology and Drug Safety, Journal Year: 2025, Volume and Issue: 34(2)

Published: Jan. 22, 2025

ABSTRACT Purpose To characterize trajectories of nephrotoxic potential (NxP) drug use among older adults with Type 2 Diabetes (T2D) treated SGLT2is and identify associated patient characteristics. Methods Using 2012–2019 Medicare data, we selected patients T2D who filled at least one prescription for SGLT2is. Index date was the first SGLT2i filled. We quantified number drugs NxP used every month during 12 months following index date. The monthly counts were incorporated into group‐based trajectory model to groups similar patterns. Finally, performed a multinomial logistic regression examine association between characteristics group membership. Results study cohort comprised 8811 beneficiaries initiated period mean age 67.5 ± 10.6 years. identified 3 use: no ( n = 2142, 24%), low 4752, 54%) high 1917, 22%) NxP, falling these categories based on they over time: drugs, drug, or two more drugs. Age, gender, low‐income subsidy eligibility clinical Conclusions successfully three groups, substantial proportion showing NxP. Both social factors

Language: Английский

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Perioperative and periprocedural management of GLP-1 receptor-based agonists and SGLT2 inhibitors: narrative review and the STOP-GAP and STOP DKA-2 algorithms

Current Medical Research and Opinion, Journal Year: 2025, Volume and Issue: unknown, P. 1 - 17

Published: Jan. 28, 2025

The GLP-1 receptor-based agonists (GLP-1RAs) and SGLT2 inhibitors (SGLT2i) are major twenty first century breakthroughs in diabetes obesity medicine but there important safety considerations regarding the perioperative periprocedural management of individuals who treated with these agents. GLP-1RAs have been linked to an increased risk retained gastric contents pulmonary aspiration while SGLT2i can be associated diabetic ketoacidosis. This manuscript provides a narrative review available evidence for risks people prescribed SGLT2i. authors provide expert opinion-driven recommendations algorithms on how safely manage under perioperative/periprocedural settings.

Language: Английский

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Laboratory Changes in Contrast-Induced Nephropathy in Patients with Type 2 Diabetes Mellitus

Published: March 1, 2025

Language: Английский

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Low-Protein Diets Could Be Effective and Safe in Elderly Patients with Advanced Diabetic Kidney Disease

Nutrients, Journal Year: 2024, Volume and Issue: 16(14), P. 2230 - 2230

Published: July 11, 2024

Low-protein diets (LPDs) seem to improve metabolic complications of advanced CKD, thus postponing kidney replacement therapy (KRT) initiation. However, the nutritional safety LPDs remains debatable in patients with diabetic disease (DKD), especially elderly. This is a sub-analysis prospective unicentric interventional study which assessed effects LPD DKD, focusing on feasibility and elderly patients. Ninety-two DKD stable CKD stage 4+, proteinuria >3 g/g creatininuria, good status, confirmed compliance protein restriction, were enrolled received (0.6 g mixed proteins/kg-day) supplemented ketoanalogues essential amino acids for 12 months. Of total group, 42% median eGFR 12.6 mL/min 5.14 creatininuria. In patients, decreased by 70% compared baseline. The rate function decline was 0.1 versus 0.5 mL/min-month before enrolment. Vascular events occurred 15% cases, not related intervention, but severity higher MAP. be safe effective KRT while preserving status.

Language: Английский

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