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Topic Review
Near-Infrared Fluorescent-Guided Robot-Assisted Renal Surgery
The use of Indocyanine Green in nephron-sparing robotic surgery has gained widespread recognition as a versatile, valuable, and safe technique. With its support in delineating tumor margins and vascular anatomy, in guiding selective or super selective clamping and in assessing kidney perfusion after resection and renorrhaphy, Indocyanine Green (ICG) offers real-time guidance to promote the better preservation of renal function.
  • 935
  • 19 Jun 2023
Topic Review
Tissue Engineering of the Urethra—Clinical Applications
Tissue engineering (TE) is a promising approach for repair/substitution of damaged tissues and organs. Urethral strictures are common and serious health conditions that impair quality of life and may lead to serious organ damage. The TE approach is promising and effective, but many issues remain that need to be addressed for broader adoption of TE in urethral repair. Better design of trials, better cooperation of research groups and centralization could lead to reduction of costs and slowly proceed to commercialization and routine use of TE products for urethral reconstruction.
  • 933
  • 23 Dec 2021
Topic Review
Is Adynamic Bone Always A Disease?
Adynamic bone (ADB) is characterized by suppressed bone formation, low cellularity, and thin osteoid seams in patients with chronic kidney disease (CKD). There is accumulating evidence supporting increasing prevalence of ADB, particularly in early CKD. Contemporarily, it is not very clear whether it represents a true disease, an adaptive mechanism to prevent bone resorption, or just a transitional stage. In the present review, we will discuss the up-to-date knowledge of the ADB and focus on its impact on bone health, fracture risk, vascular calcification, and long-term survival. Moreover, here it will emphasize the proper preventive and management strategies of ADB. It is still unclear whether ADB is always a pathologic condition or whether it can represent an adaptive process to suppress bone resorption and further bone loss. Here, this hard topic based on the available limited information in patients with CKD will tried to be discussed.
  • 933
  • 26 Dec 2022
Topic Review
Upregulation of PD-L1 Mitigates Cisplatin-Induced Acute Kidney Injury
The innate and adaptive immunities have been documented to participate in the pathogenesis of nephrotoxic acute kidney injury (AKI); however, the mechanisms controlling these processes have yet to be established. In cisplatin-induced AKI mouse model, researchers show pathological damage to the kidneys, with the classical markers elevated, consistent with the response to cisplatin treatment. Through assessments of the components of the immune system, both locally and globally, researchers demonstrate that the immune microenvironment of injured kidneys was associated with an increased infiltration of CD4+ T cells and macrophages concomitant with decreased Treg cell populations. Researchers' cell-based assays and animal studies further show that cisplatin exposure downregulated the protein levels of programmed death-ligand 1 (PD-L1), an immune checkpoint protein, in primary renal proximal tubular epithelial cells, and that these inhibitions were dose-dependent. After orthotopic delivery of PD-L1 gene into the kidneys, cisplatin-exposed mice displayed lower levels of both serum urea nitrogen and creatinine upon PD-L1 expression. Researchers data suggest a renoprotective effect of the immune checkpoint protein, and thereby provide a novel therapeutic strategy for cisplatin-induced AKI.
  • 929
  • 16 Dec 2021
Topic Review
Autologous Immune Cell-Based Therapy Treat Vasculogenic Erectile Dysfunction
Vasculogenic erectile dysfunction (ED) due to endothelial dysfunction and atherosclerosis of penile arteries is the most common cause of ED, especially in men over fifty. Cell-based regenerative therapies include platelet-rich plasma (PRP), both heterologous and autologous stem cell therapy (SCT), and peripheral blood mononuclear cells (PBMNC), highlighting the role played by immune cell populations, which may represent the new frontier of vasculogenic erectile dysfunction treatment.
  • 929
  • 06 Sep 2022
Topic Review
Bladder Management for Chronic Spinal Cord Injury Patients
Neurogenic lower urinary tract dysfunction, common in patients with chronic spinal cord injury, inevitably results in urological complications. To address neurogenic lower urinary tract dysfunction after spinal cord injury, proper and adequate bladder management is important in spinal cord injury rehabilitation, with the goal and priorities of the protection of upper urinary tract function, maintaining continence, preserving lower urinary tract function, improvement of spinal cord injury (SCI)  patients’ quality of life, achieving compatibility with patients’ lifestyles, and decreasing urological complications. 
  • 929
  • 28 Jan 2023
Topic Review
Middle Molecular Uremic Toxin and Blood Purification Therapy
The purpose of blood purification therapy is to remove uremic toxins, and middle molecules (MMs) are a specific target. An MM is defined as a solute that passes through the glomerulus with a molecular weight in the range of 0.5–58 kDa, and new classifications of “small-middle 0.5–15 kDa,” “medium-middle 15–25 kDa,” and “large-middle 25–58 kDa” were proposed. 
  • 924
  • 23 Feb 2024
Topic Review
SARS-CoV-2 in Kidney Transplant Recipients
The COVID-19 pandemic has had a striking impact on kidney transplantation globally. Patients with chronic kidney disease (CKD) and kidney transplant patients are one of the populations most vulnerable to the risks of COVID-19. In the United States alone, there are more than half a million people living with end stage renal disease (ESRD).More than 105,234 kidney transplants were performed in 2019 all over the globe. After the outbreak of COVID-19, all surgeries were stopped as an early response to the pandemic. A drastic fall in the number of kidney transplants was observed, with a fall rate of 59.2% from the 105,234-plus kidney transplants (KTx) in 2019 to 42,948 KTx in 2020.
  • 920
  • 09 Feb 2022
Topic Review
Fibroblast Growth Factor 23
FGF23 is a bone-derived hormone that is essential for regulating vitamin D and phosphate homeostasis. 
  • 912
  • 29 Mar 2022
Topic Review
Extracellular Matrix Environment of ccRCC
The extracellular matrix (ECM) controls fundamental properties of tumors, including growth, blood vessel investment, and invasion. The ECM defines rigidity of tumor tissue and individual ECM proteins have distinct biological effects on tumor cells. The most frequent initiating genetic mutation in ccRCC (clear cell renal cell carcinoma) inactivates the VHL gene, which plays a direct role in organizing the ECM.
  • 911
  • 15 Sep 2022
Topic Review
Detrusor Sphincter Dyssynergia in Spinal Cord Injury Patients
Detrusor sphincter dyssynergia (DSD) is defined as a detrusor contraction concurrent with an involuntary contraction of the urethral and/or periurethral striated muscle. The most recent International Continence Society (ICS) 2020 Standards define DSD as a dyscoordination between detrusor and rhabdosphincter function during voiding due to a neurological abnormality (i.e., detrusor contraction synchronous with the contraction of the urethral and/or periurethral striated muscle). This is a feature of neurological bladder voiding disorders. DSD generally occurs due to a lesion above the sacral level and below the pons.
  • 903
  • 09 Jun 2022
Topic Review
Impaired Pressure-Natriuresis
Blood pressure is a heritable trait because hypertension occurs with a familial tendency. The heritability of sitting and standing blood pressure was estimated to be between 39% and 63% in twins and between 16% and 22% in families. Although the brain, kidneys, and blood vessels are major organs involved in regulating blood pressure and inducing hypertension, the kidneys have a unique relationship with blood pressure, suggesting that some genetic factors elevating or decreasing blood pressure exist in the kidney.
  • 901
  • 23 Jan 2024
Topic Review
GLP-1 Receptor Agonists in DKD
Diabetic kidney disease (DKD) is one of the most common complications in type 2 diabetes mellitus (T2D) and a major cause of morbidity and mortality in diabetes. Previous studies have demonstrated that GLP-1 receptor agonists (GLP-1 RA) have improved macrovascular and microvascular outcomes independent of glycemic differences, including DKD. GLP-1Ras’ improvement on kidney physiology is mediated by natriuresis, reduction in hyperfiltration and renin-angiotensin-aldosterone system (RAAS) activity and anti-inflammatory properties. These findings translate into improved clinical outcomes such as an enhanced urine albumin-to-creatinine ratio (UACR) and a reduction in renal impairment and the need for renal replacement therapies (RRT).
  • 894
  • 16 Sep 2021
Topic Review
Non-Coding RNAs in Kidney Diseases
Acute kidney injury (AKI) is characterized by an acute loss of renal function that reduces urinary excretion of toxic substances. The accumulation of these waste products in blood can be lethal depending on the duration and severity of AKI, triggering the use of dialysis to ensure patient survival. The pathophysiology of AKI is complex, including a number of processes that promote direct tubular cell death, obstruction and activation of renal vessels and tubular lumen, exacerbated inflammatory response and oxidative stress.
  • 888
  • 25 Jun 2021
Topic Review
Planned Pregnancy in Kidney Transplantation
Pregnancy is not contraindicated in kidney transplant women but entails risks of maternal and fetal complications. Three main conditions can influence the outcome of pregnancy in transplant women: preconception counseling, maternal medical management, and correct use of drugs to prevent fetal toxicity. 
  • 884
  • 14 Oct 2021
Topic Review
Oxalate Homeostasis in Non-Stone-Forming Chronic Kidney Disease
Oxalate is often referred to as an “anti-nutrient” because of its ability to bind with minerals and form various solubility complexes. Specifically, oxalate is a negatively charged ion that forms crystals by binding with positively charged ions, such as calcium, magnesium, iron, zinc, sodium, and potassium.
  • 880
  • 13 Jun 2023
Topic Review
Involvement of Interleukin 17 in Renal Cell Carcinoma
IL-17A (traditionally known as IL-17, in the past also termed as CTLA-8) is the first and best characterized member in its family composed of IL-17A, B, C, D, E (also known as Il-25), and F. IL-17 was first discovered in 1993, although it became well-known in 2005 with the finding of a new population of CD4+ Th cells—Th17 that expressed this cytokine. Naive CD4+ T-cells are triggered to differentiate into Th17 in the presence of both TGF-β and Il-6. The differentiation is characterized by the production of IL-17, Il-21, and ROR-yt (transcription factor). The differentiation of Th17 cells also depends on dendritic cells which produce IL-1, IL-6, and IL-23. These molecules preferentially activate STAT-3 which induces transcription factor ROR-yt. ROR-yt is also expressed in the presence of STAT-3 that is activated by Il-6, Il-21, and Il-23. There is also an autocrine generation of Th17 by Il-21 that is derived from these T-cells. Moreover, Il-21 leads to Il-23 receptor expression of Th17 and their susceptibility to Il-23 (produced by dendritic cells) stimulation. This cytokine gives Th17 phenotype stability and helps them with acquiring effector functions.
  • 872
  • 13 Sep 2022
Topic Review
Cadmium Exposure Cause Kidney Damage
The growing number of reports indicating unfavorable outcomes for human health upon environmental exposure to cadmium (Cd) have focused attention on the threat to the general population posed by this heavy metal. The kidney is a target organ during chronic Cd intoxication. The current levels of environmental exposure to Cd may increase the risk of clinically relevant kidney damage, resulting in, or at least contributing to, the development of chronic kidney disease (CKD).
  • 870
  • 26 May 2023
Topic Review
Microbiome in Chronic Kidney Disease
Chronic kidney disease (CKD) is a progressive disease, with high morbidity and mortality in adult population. Its incidence is increasing constantly, and approximately 10% of people are affected by some form of CKD, which is associated with almost 1.2 million deaths worldwide. Cardiovascular disease is the main cause of death, followed by infections and malignancies. The gut microbiome is a complex collection of microorganisms with discrete characteristics and activities. Its important role is not restricted to food digestion and metabolism, but extends to the evolution, activation and function of the immune system. Several factors, such as mode of birth, diet, medication, ageing and chronic inflammation, can modify the intestinal microbiota. Chronic kidney disease (CKD) seems to have a direct and unique effect, as increased urea levels result in alteration of the gut microbiome, leading to overproduction of its metabolites. Therefore, potentially noxious microbial uremic toxins, which have predominantly renal clearance, including p-cresyl sulfate, indoxyl sulfate and N-oxide of trimethylamine [Trimethylamine-N-Oxide (TMAO)], accumulate in human’s body, and are responsible not only for the clinical implications of CKD, but also for the progression of renal failure itself. Certain changes in gut microbiome are observed in patients with end stage renal disease (ESRD), either when undergoing hemodialysis or after kidney transplantation.
  • 868
  • 22 Nov 2022
Topic Review
Intravesical Contrast-Enhanced MRI
While the poor resolution of soft tissue obtained by widely available imaging options such as abdominal sonography and radiation-based CT leaves them only suitable for measuring the gross tumor volume and bladder wall thickening, dynamic contrast-enhanced magnetic resolution imaging (DCE MRI) is demonstrably superior in resolving muscle invasion. However, major barriers still exist in its adoption. Instead of injection for DCE-MRI, intravesical contrast-enhanced MRI (ICE-MRI) instills Gadolinium chelate (Gadobutrol) together with trace amounts of superparamagnetic agents for measurement of tumor volume, depth, and aggressiveness. ICE-MRI leverages leaky tight junctions to accelerate passive paracellular diffusion of Gadobutrol (604.71 Daltons) by treading the paracellular ingress pathway of fluorescein sodium and of mitomycin (<400 Daltons) into bladder tumor. The soaring cost of diagnosis and care of bladder cancer could be mitigated by reducing the use of expensive operating room resources with a potential non-surgical imaging option for cancer surveillance, thereby reducing over-diagnosis and over-treatment and increasing organ preservation.
  • 868
  • 08 Jun 2023
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