Intravenous amino acid for kidney protection: current understanding and future perspectives DOI Creative Commons
Yuki Kotani, Martina Baiardo Redaelli, Alessandro Pruna

et al.

Clinical Kidney Journal, Journal Year: 2024, Volume and Issue: 18(2)

Published: Dec. 26, 2024

Acute kidney injury (AKI) is a common complication in critically ill and perioperative patients associated with mortality, morbidity, medical costs, progression to chronic function. Unfortunately, despite numerous research efforts, until recently, there was no AKI preventive therapy supported by level 1 evidence. Among the several factors that contribute renal damage, two of major triggers development are hypoperfusion medullary hypoxia. The intravenous administration mixture amino acids promotes prevention through multiple mechanisms: recruitment functional reserve, increased blood flow, improvements oxygenation. Such mechanisms action led glomerular filtration rate urine output preclinical pilot clinical studies. To test if these benefits on physiological parameters could be translated into clinically meaningful outcomes, multicenter, randomized, placebo-controlled, trial conducted cardiac surgery setting. 3511 adult undergoing elective cardiopulmonary bypass, acid administration, compared placebo, significantly reduced occurrence AKI, providing first evidence an effective treatment for prevention. In this review, we provide epidemiology pathophysiology surgery-associated concept reserve. Then, summarize underlying infusion as renoprotective strategy its Finally, discuss existing gaps future directions promising intervention.

Language: Английский

Acute kidney injury DOI
Marlies Ostermann, Nuttha Lumlertgul, Rachel Jeong

et al.

The Lancet, Journal Year: 2025, Volume and Issue: 405(10474), P. 241 - 256

Published: Jan. 1, 2025

Language: Английский

Citations

4
Ameliorative Effect of Sipunculus nudus Hydrolysate on Cisplatin-Induced Nephrotoxicity by Mitigating Oxidative Stress, Inflammation and Apoptosis DOI Creative Commons

Susu Tao,

Yi Qi, Jialong Gao

et al.

Marine Drugs, Journal Year: 2025, Volume and Issue: 23(3), P. 100 - 100

Published: Feb. 24, 2025

The present study investigated the protective effects and possible mechanisms of an ultrafiltration fraction Sipunculus nudus hydrolysate (UFSH) on cisplatin-induced kidney damage in a mouse model. results showed that UFSH significantly attenuated nephrotoxicity by inhibiting increases blood urea nitrogen (BUN) serum creatinine (SCr). Additionally, treatment alleviated renal histopathological changes, such as significant dilation tubules, cast formation, tubular cell necrosis, well tubulointerstitial fibrosis. Moreover, decreased oxidative stress increasing activities antioxidant enzymes SOD GSH-Px, while reducing malondialdehyde (MDA) level kidney. Furthermore, inhibited inflammatory cytokines, including Interleukin 1-beta (IL-1β), Interleukin-6 (IL-6), Tumor necrosis factor-alpha (TNF-α). Western blotting revealed phosphorylation inflammation-associated MAPK/NF-κB signaling pathway, lowered expression apoptosis-related protein Bax, reversed reduction anti-apoptotic Bcl-2 protein. This investigation demonstrated can ameliorate mitigating stress, inflammation, apoptosis.

Language: Английский

Citations

1
Kidney Function and Extreme Endurance Races: Risks, Mechanisms, and Preventing Strategies DOI Creative Commons

Julia Kulbacka,

Karol Dziedzic,

Filip Arczewski

et al.

Quality in Sport, Journal Year: 2025, Volume and Issue: 37, P. 57434 - 57434

Published: Jan. 15, 2025

Background: The increasing popularity of ultra-endurance sports emphasizes the need for a deeper understanding their health implications, particularly impact on kidney function. Given kidneys’ crucial role in waste filtration, fluid and electrolyte balance, close connection to physiological demands intense physical activity, it requires detailed investigation from this perspective. Purpose: objective study is present current state knowledge topic function context sports. It examines risk factors, underlying mechanisms, potential strategies preventing renal injuries associated with these specific types activities. Findings: Ultra-endurance significant risks health, including acute injury (AKI) estimated affect approximately 40% participants, rhabdomyolysis dehydration, which are often compounded by additional factors such as gastrointestinal distress use non-steroidal anti-inflammatory drugs (NSAIDs). There improved diagnostic criteria detect population, novel biomarkers neutrophil gelatinase-associated lipocalin (NGAL), molecule-1 (KIM-1), cystatin C showing promise. A multifaceted preventive approach mandatory pre-event screening, personal monitoring devices, proper hydration nutrition, adequate race preparation, avoidance NSAIDs mitigate maintain athletes.

Language: Английский

Citations

0
A Mini Review: Role of Novel Biomarker for Kidney Disease of Future Study DOI Creative Commons
Palash Mitra, Sahadeb Jana, Suchismita Roy

et al.

Advances in Biomarker Sciences and Technology, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 1, 2025

Language: Английский

Citations

0
Is High-Dose Ubiquinone Therapy Before Cardiac Surgery Enough to Reduce the Incidence of Cardiac Surgery-Associated Acute Kidney Injury? A Randomized Controlled Trial DOI Creative Commons

Hrvoje Vučemilović,

Ruben Kovač,

Lada Stanišić

et al.

Antioxidants, Journal Year: 2025, Volume and Issue: 14(2), P. 243 - 243

Published: Feb. 19, 2025

Cardiac surgery-related acute kidney injury (CS-AKI) is a decrease in function after open-heart surgery, affecting up to 50% of patients. The pathophysiology CS-AKI involves ischemia-reperfusion injury, inflammation, and oxidative stress. Ubiquinone potent antioxidant, we hypothesized that it could both the incidence severity CS-AKI. intervention group received ubiquinone (8 mg/kg/day) divided into three daily doses, while control placebo. primary outcome was CS-AKI, which manifested as an increase creatinine ≥26.5 µmol/L or urine output below 0.5 mL/kg/h for 6 h. Out 73 patients, 39.7% (N = 29) developed including 35.3% 43.6% placebo (X2(1,N 73) 0.4931, p 0.4825). secondary outcomes revealed experienced reduced postoperative bleeding, with median (IQR) drainage 320 mL (230-415) compared 420 (242.5-747.5) (t(35.84) 2.055, 0.047). hs-TnI level 239.5 ng/mL (113.25-382.75) surgery 366 (234.5-672.5) (p 0.024). In conclusion, there no significant difference between groups. Postoperative bleeding were significantly among patients receiving ubiquinone.

Language: Английский

Citations

0
Advances in the diagnosis of early biomarkers for acute kidney injury: a literature review DOI Creative Commons
Haifeng Yang, Yanqin Chen, Jiajia He

et al.

BMC Nephrology, Journal Year: 2025, Volume and Issue: 26(1)

Published: March 5, 2025

Acute kidney injury (AKI) is a critical condition with diverse manifestations and variable outcomes. Its diagnosis traditionally relies on delayed indicators such as serum creatinine urine output, making early detection challenging. Early identification essential to improving patient outcomes, driving the need for novel biomarkers. Recent advancements have identified promising biomarkers across various biological processes. Tubular markers, including neutrophil gelatinase-associated lipocalin (NGAL), molecule-1 (KIM-1), N-acetyl-β-D-glucosaminidase (NAG), liver-type fatty acid-binding protein (L-FABP), offer insights into tubular damage. Inflammatory repair-associated biomarkers, interleukin-18 (IL-18), monocyte chemotactic protein-1 (MCP-1), osteopontin (OPN), C-C motif chemokine ligand 14 (CCL14), reflect ongoing recovery Additionally, stress repair markers like tissue inhibitor of metalloproteinase-2 (TIMP-2) insulin-like growth factor-binding protein-7 (IGFBP-7), alongside filtration cystatin C (CysC) proenkephalin (PenKid®) e.tal, further enhance diagnostic precision. Oxidative stress-related Superoxide Dismutase 1 (SOD1), also contribute valuable information. Emerging candidates, microRNAs, soluble urokinase plasminogen activator receptor (SuPAR), chitinase-3-like (CHI3L1), hold substantial promise AKI prognosis. This review summarizes progress in biomarker research, highlighting their clinical utility exploring potential refine management strategies. These findings new perspective integrating routine practice, ultimately care.

Language: Английский

Citations

0
Nafamostat Mesylate Regulates Glycosylation to Alleviate Aristolochic Acid Induced Kidney Injury DOI Creative Commons

Pei Xie,

Huijun Liu,

Xingli Huo

et al.

Toxins, Journal Year: 2025, Volume and Issue: 17(3), P. 145 - 145

Published: March 18, 2025

Acute kidney injury (AKI) is a condition with poor prognosis, exacerbated by the lack of effective therapeutic options and inadequately understood underlying mechanisms. Glycosylation, post-translational modification proteins, essential for maintaining protein stability function, its dysregulation leads to misfolding amyloid aggregation. Glycosylation dynamics are implicated in several pathologies, including inflammation, cancer, AKI, highlighting potential regulating glycosylation preventing aggregation AKI treatment. This study investigates effect nafamostat mesylate (NM) on vivo. Using optical spectroscopy other analytical techniques, we demonstrate that NM restores levels inhibits aristolochic-acid-induced acute injury. The mechanism likely involves enzymatic modulation corrects hypoglycosylation prevents aggregation, promoting proper folding enhancing stability. These findings suggest may provide novel strategy glycosylation-related diseases, underscoring early intervention treatment these conditions.

Language: Английский

Citations

0
ICU ‘Magic Numbers’: The Role of Biomarkers in Supporting Clinical Decision-Making DOI Creative Commons
Francesco Cipulli, Eleonora Balzani,

Giuseppe Marini

et al.

Diagnostics, Journal Year: 2025, Volume and Issue: 15(8), P. 975 - 975

Published: April 11, 2025

Critical care medicine is a highly complex field where diagnosing diseases and selecting effective therapies pose daily challenges for clinicians. In critically ill patients, biomarkers can play crucial role in identifying addressing clinical problems. Selecting the right utilizing them effectively lead to more informed decisions, ultimately impacting patient outcomes. However, each biomarker has its strengths limitations, making thorough understanding essential accurate diagnosis treatment management. For instance, neuron-specific enolase (NSE) commonly used predict outcomes out-of-hospital cardiac arrest (OHCA), procalcitonin (PCT) levels strongly correlate with bacterial infections, NT-proBNP serves as reliable indicator of stress. Additionally, serum creatinine (SCr) remains fundamental renal diagnostics, while prealbumin helps differentiate catabolic anabolic phases patients. This narrative review highlights carefully selected set known their utility reliability guiding critical decisions. Further refining application biomarkers-especially by integrating into multimodal approach-will enhance clinicians' ability navigate care, always striving improve

Language: Английский

Citations

0
Timing of kidney replacement therapy in critically ill patients: A call to shift the paradigm in the era of artificial intelligence DOI Creative Commons
Ounci Es-saad,

Abdellah Darraz,

Rajae Alkouh

et al.

Science Progress, Journal Year: 2025, Volume and Issue: 108(2)

Published: April 1, 2025

Acute kidney injury (AKI) is a common condition in intensive care units (ICUs) and associated with high mortality rates, particularly when replacement therapy (KRT) becomes necessary. The optimal timing for initiating KRT remains subject of ongoing debate. Emerging tools methodologies, such as machine learning advanced sub-phenotyping, offer promising insights into refining AKI management. Moving beyond the traditional “early” versus “delayed” paradigm heavy reliance on serum creatinine measurements, there an opportunity to develop treatment strategies tailored unique pathophysiological medical context each patient. Such individualized approaches could potentially improve outcomes transform management ICUs. However, not without risks. Hemodynamic instability poses significant challenge, complicating critically ill patients. selection modality—whether intermittent hemodialysis, continuous renal therapy, or peritoneal dialysis—introduces additional complexities. Each modality has distinct advantages limitations, requiring careful, patient-specific approach ensure care. This decision-making process further influenced by availability specialized equipment trained personnel, resources that may be limited some settings. Notably, current evidence does demonstrate clear survival recovery benefit from early initiation dialysis. narrative review explores debates surrounding methodology, highlighting importance adopting patient-centric, navigate evolving landscape

Language: Английский

Citations

0
A Pragmatic Approach to Acute Cardiorenal Syndrome: Diagnostic Strategies and Targeted Therapies to Overcome Diuretic Resistance DOI Open Access
Patrick Tran,

Laith Khweir,

Michael Kuehl

et al.

Journal of Clinical Medicine, Journal Year: 2025, Volume and Issue: 14(9), P. 2996 - 2996

Published: April 26, 2025

Cardiorenal syndrome (CRS) is a challenging condition characterised by interdependent dysfunction of the heart and kidneys. Despite advancements in understanding its pathophysiology, clinical management remains complex due to overlapping mechanisms high rates diuretic resistance. Relevant literature was identified through comprehensive narrative review PubMed, Embase, Cochrane Library databases, focusing on pivotal trials relating CRS from 2005 2024. This aims provide pragmatic, evidence-based approach acute addressing common misconceptions, outlining diagnostic strategies, proposing structured algorithm manage We discuss role thoracic venous excess ultrasound (VeXUS) providing reliable measures systemic congestion, natriuresis-guided sequential nephron blockade, more targeted therapies, including ultrafiltration refractory cases. In addition, we explore emerging that target renal hypoperfusion congestion CRS. Designed for broad audience, general physicians, cardiologists, nephrologists, this integrates evidence with practical guidance support effective timely decision-making care patients

Language: Английский

Citations

0