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Topic Review
Endogenous and pharmacological Nrf2 activation in CKD
The nuclear factor erythroid 2‐related factor 2 (Nrf2) protects the cell against oxidative damage. The Nrf2 system comprises a complex network that functions to ensure adequate responses to redox perturbations, but also metabolic demands, and cellular stresses. It must be kept within a physiologic activity range. Oxidative stress and alterations in Nrf2 system activity are central for chronic kidney disease (CKD) progression and CKD-related morbidity. Activation of the Nrf2 system in CKD is in multiple ways related to inflammation, kidney fibrosis, and mitochondrial and metabolic effects. In human CKD, both endogenous Nrf2 activation and repression exist. The state of the Nrf2 system varies with cause of kidney disease, comorbidities, stage of CKD, and severity of uremic toxin accumulation and inflammation. Earlier CKD stage, rapid progression of kidney disease, and inflammatory processes are associated with more robust Nrf2 system activation. Advanced CKD is associated with stronger Nrf2 system repression. Nrf2 activation is related to oxidative stress and moderate uremic toxin and nuclear factor kappa B (NF-κB) elevations. Nrf2 repression relates to high uremic toxin and NF-κB concentrations, and may be related to Kelch-like ECH-associated protein 1 (Keap1)-independent Nrf2 degradation. Pharmacological Nrf2 activation by bardoxolone methyl, curcumin, and resveratrol have been described but new strategies for Nrf2-targeted therapies in CKD need to be developed.
  • 1.0K
  • 17 May 2023
Topic Review
Soluble Isoform of Flt-1 in Chronic Kidney Disease
Placental growth factor (PlGF) and its receptor, fms-like tyrosine kinase-1 (Flt-1), are important regulators involved in angiogenesis, atherogenesis, and inflammation. Elevation of circulating soluble isoform of Flt-1 (sFlt-1) and downregulation of sFlt-1 in the vascular endothelium by uremic toxins and oxidative stress both exacerbate heart failure and atherosclerosis. Circulating sFlt-1 is inconsistent with sFlt-1 synthesis, because levels of matrix-bound sFlt-1 are much higher than those of circulating sFlt-1, as verified by a heparin loading test, and are drastically reduced in chronic kidney disease (CKD).
  • 1.0K
  • 30 Nov 2022
Topic Review
AN69 Membrane in Hemodialysis Patients
Patients undergoing hemodialysis (HD) experience serious cardiovascular complications, through malnutrition, inflammation, and atherosclerosis. Amputation for peripheral arterial disease (PAD) is more prevalent in patients undergoing HD than in the general population. In addition, revascularization procedures in dialysis patients are often associated with subsequent amputation and high mortality rates. To improve the prognosis of dialysis patients, malnutrition and inflammation must be properly treated, which necessitates a better understanding of the characteristics of dialysis membranes. Herein, the characteristics of several dialysis membranes were studied, with a special reference to the AN69 membrane, noting several similarities to low-density lipoprotein (LDL)-apheresis, which is also applicable for the treatment of PAD. Both systems (LDL-apheresis and AN69) have anti-inflammatory and anti-thrombogenic effects because they use a negatively charged surface for extracorporeal adsorptive filtration from the blood/plasma, and contact phase activation. The concomitant use of both these therapeutic systems may have additive therapeutic benefits in HD patients. 
  • 1.0K
  • 14 Feb 2023
Topic Review
Finerenone
Chronic kidney disease (CKD) is one of the most common complications of diabetes mellitus and an independent risk factor for cardiovascular disease. Despite guideline-directed therapy of CKD in patients with type 2 diabetes, the risk of renal failure and cardiovascular events still remains high, and diabetes remains the leading cause of end-stage kidney disease in affected patients. To date, current medications for CKD and type 2 diabetes mellitus have not reset residual risk in patients due to a high grade of inflammation and fibrosis contributing to kidney and heart disease.
  • 1.0K
  • 30 Jun 2023
Topic Review
Microplastics Effects on Kidney Tissues and Cells
Microplastics (MPs) have become ubiquitous and humans are exposed daily to inhalation or ingestion of plastic microparticles. Studies performed using mainly spectroscopy or spectrometry-based techniques have shown astounding evidence for the presence of MPs in human tissues, organs and fluids. The placenta, meconium, breast milk, lung, intestine, liver, heart and cardiovascular system, blood, urine and cerebrovascular liquid are afflicted by MPs’ presence and deposition. 
  • 1.0K
  • 12 Oct 2023
Topic Review
Infection-Related Glomerulonephritis and C3 Glomerulopathy
The comprehensive concept of “infection-related glomerulonephritis (IRGN)” has replaced that of postinfectious glomerulonephritis (PIGN) because of the diverse infection patterns, epidemiology, clinical features, and pathogenesis. In addition to evidence of infection, hypocomplementemia particularly depresses serum complement 3 (C3), with endocapillary proliferative and exudative GN developing into membranoproliferative glomerulonephritis (MPGN); also, C3-dominant or co-dominant glomerular immunofluorescence staining is central for diagnosing IRGN. Moreover, nephritis-associated plasmin receptor (NAPlr), originally isolated from the cytoplasmic fraction of group A Streptococci, is vital as an essential inducer of C3-dominant glomerular injury and is a key diagnostic biomarker for IRGN. Meanwhile, “C3 glomerulopathy (C3G)”, also showing a histological pattern of MPGN due to acquired or genetic dysregulation of the complement alternative pathway (AP), mimics C3-dominant IRGN. Initially, C3G was characterized by intensive “isolated C3” deposition on glomeruli.
  • 1.0K
  • 22 May 2023
Topic Review
Animal Drugs Used to Treat Urinary Stones
Animals like plants are also medicinal agents for the prevention and cure of different health problems all over the world practically in about all human cultures. The concept of zootherapy is very old and has strong evidence of the medicinal use of animal resources. There are many animals with the potential to treat urolithiasis.
  • 1.0K
  • 15 Aug 2022
Topic Review
Lupus Nephritis
Lupus nephritis (LN) is a frequent and severe manifestation of systemic lupus erythematosus. The main goal of the management of LN is to avoid chronic kidney disease (CKD). Lupus nephritis (LN) occurs in 12 to 69% of patients suffering from systemic lupus erythematosus (SLE), depending on case series. Based on clinical and laboratory findings, it affects around 50% of SLE patients, while the rates of biopsy-proven LN are somewhat lower. LN is more prevalent in Asian than in African or Hispanic and European patients.
  • 991
  • 18 May 2021
Topic Review
Dietary Fiber in Progression of Chronic Kidney Disease
Nutrition is one of the fundamental approaches to promoting and preventing all kinds of diseases, especially kidney diseases. Dietary fiber forms a significant aspect of renal nutrition in treating chronic kidney disease (CKD). Dietary fiber intake influences the composition and metabolism of the gut microbiome with proven roles in reducing uremic toxin production, preserving kidney function, and retarding the progression of CKD through mechanisms of regulating metabolic, immunological, and inflammatory processes. Understanding dietary fiber’s pathogenesis and mechanistic action in modulating host and microbiome interactions provides a potential adjunct therapeutic target for preventing, controlling, and treating CKD patients.
  • 982
  • 14 Mar 2022
Topic Review
Surgical Management of Male Infertility
A male factor plays a significant role in a couple’s reproductive success. While advances in assisted reproductive technologies (ART) such as intracytoplasmic sperm injection (ICSI) have made it possible to overcome many of the traditional barriers to male fertility (such as low sperm count, impaired motility, and abnormal morphology), reproductive urologists remain essential to treating couples affected by male infertility. Specifically, reproductive urologists play a key role in treating men who do not have sperm readily available in the ejaculate, in allowing couples to use less invasive ART techniques, and/or in enhancing ART outcomes.
  • 975
  • 24 Aug 2022
Topic Review
miR-21 in Kidney Injuries and Diseases
miR-21, one of the best-characterized miRNAs to date, has received much attention in renal physiology in particular given its high degree of conservation and expression in kidneys, as well as its potent pathogenic role in various debilitating renal diseases. In contrast with normal kidney function, miR-21 switches to a powerful and overactive mediator under stress conditions. In particular, miR-21 is one of the most highly upregulated miRNAs in a wide panel of tissue injuries, and may act as a cellular sensor of injuries that mediates tissue regeneration.
  • 975
  • 24 Nov 2022
Topic Review
Indication for Renal Biopsy
Acute and progressive chronic kidney diseases are subject to a variety of inflammatory and autoimmune processes, which are often accompanied by degenerative lesions or are also genetically determined. Renal biopsies are the gold standard for diagnosis, staging, and prognosis of underlying parenchymal kidney disease.
  • 974
  • 06 Nov 2023
Topic Review
Cell-Free DNA and Bladder Cancer
Bladder cancer (BC) is the 10th most frequent cancer in the world. The initial diagnosis and surveillance of BC require a combination of invasive and non-invasive methods, which are costly and suffer from several limitations. Cystoscopy with urine cytology and histological examination presents the standard diagnostic approach. Various biomarkers (e.g., proteins, genes, and RNAs) have been extensively studied in relation to BC.
  • 966
  • 24 Nov 2022
Topic Review
Primary Pathogenic Mechanisms of Chronic Kidney Disease
Chronic kidney disease (CKD) is a growing global public health problem. Much research has investigated well-accepted pathogenic factors contributing to CKD onset and progression, such as obesity, hypertension, dyslipidemia, and diabetes mellitus. Accumulated evidence has suggested that pathogenic mechanisms, including mitochondria dysfunction, oxidative stress, inflammation, and dysregulation of the gut microbiome, play pivotal roles in the development and progression of CKD. 
  • 961
  • 24 Aug 2022
Topic Review
Treatment for Vascular Calcification in Chronic Kidney Disease
Vascular calcification (VC) is one of the major causes of cardiovascular morbidity and mortality in patients with chronic kidney disease (CKD). VC is a complex process expressing similarity to bone metabolism in onset and progression. VC in CKD is promoted by various factors not limited to hyperphosphatemia, Ca/Pi imbalance, uremic toxins, chronic inflammation, oxidative stress, and activation of multiple signaling pathways in different cell types, including vascular smooth muscle cells (VSMCs), macrophages, and endothelial cells.
  • 956
  • 22 Aug 2023
Topic Review
Two-Component Regulatory Systems in Urinary Tract Infections
Two-component signaling systems (TCSs) are finely regulated mechanisms by which bacteria adapt to environmental conditions by modifying the expression of target genes. In bacterial pathogenesis, TCSs play important roles in modulating adhesion to mucosal surfaces, resistance to antibiotics, and metabolic adaptation. In the context of urinary tract infections (UTI), one of the most common types infections causing significant health problems worldwide, uropathogens use TCSs for adaptation, survival, and establishment of pathogenicity. 
  • 952
  • 10 Feb 2023
Topic Review
Oncolyic Virotherapy for Prostate Cancer
As the most common cancer of the genitourinary system, prostate cancer (PCa) is a global men′s health problem whose treatments are an urgent research issue. Treatment options for PCa include active surveillance (AS), surgery, endocrine therapy, chemotherapy, radiation therapy, immunotherapy, etc. However, as the cancer progresses, the effectiveness of treatment options gradually decreases, especially in metastatic castration-resistant prostate cancer (mCRPC), for which there are fewer therapeutic options and which have a shorter survival period and worse prognosis. For this reason, oncolytic viral therapy (PV), with its exceptional properties of selective tumor killing, relatively good safety in humans, and potential for transgenic delivery, has attracted increasing attention as a new form of anti-tumor strategy for PCa.
  • 949
  • 01 Nov 2022
Topic Review
ABO Blood Type
Venous thromboembolism, which includes both deep venous thrombosis and pulmonary embolism, is a major cause of morbidity and mortality among patients with cancer. The impact of ABO blood type in the development of venous thromboembolism in cancer patients remains controversial. To develop a sense of current opinion in this area, we conducted a systematic review and meta-analysis. Blood type is routinely determined preoperatively by objective and standardized methods, and our results suggest that these blood type results are useful for risk stratification and potentially for encouraging appropriate strategies for implementation of prophylactic treatment strategy in venous thromboembolism management. 
  • 943
  • 24 Aug 2021
Topic Review
Electrolyzed Hydrogen Water for CKD and Hemodialysis
Chronic kidney disease (CKD), which is globally on the rise, has become an urgent challenge from the perspective of public health, given its risk factors such as end-stage renal failure, cardiovascular diseases, and infections. The pathophysiology of CKD, including dialysis patients, is deeply associated with enhanced oxidative stress in both the kidneys and the entire body. Therefore, the introduction of a safe and widely applicable antioxidant therapy is expected as a measure against CKD. Electrolyzed hydrogen water (EHW) generated through the electrolysis of water has been confirmed to possess chemical antioxidant capabilities. In Japan, devices producing this water have become popular for household drinking water. In CKD model experiments conducted to date, drinking EHW has been shown to suppress the progression of kidney damage related to hypertension. Furthermore, clinical studies have reported that systemic oxidative stress in patients undergoing dialysis treatment using EHW is suppressed, leading to a reduction in the incidence of cardiovascular complications.
  • 937
  • 26 Jan 2024
Topic Review
Impact of COVID-19 on Kidney of Diabetic Patients
Given the current state of COVID-19, it is crucial to reveal its evolving relationship with and effect on different body organ systems and their diseases. The severity and outcome of COVID-19 have a very complex relationship, especially to the vital organs including the kidney, either in their state of health or disease. Additionally, it is well known that diabetes affects the kidney, leading to diabetic nephropathy. The kidney is also affected by different pathological and immunopathological reactions with COVID-19 infection, leading to acute kidney injury.
  • 935
  • 27 Jun 2022
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