Paz Castro Fernández*, Carmen Vozmediano Poyatos, Martin Negreira Caamaño, Daniel Campos Valverde, Luis Piccone Saponara, Guillermo Ferrer García, Gloria García Conejo, Roger Cox Conforme, Marcos Santos-Olmo Montoya and Agustín Carreño Parrilla
DOI: 10.37421/2161-0959.2023.13.461
Objective: There are clinical conditions with histological evidence of non-ischemic myocardial necrosis that are associated with elevated troponin levels, such as the structural and functional alterations of the Left Ventricle (LV) that occur in Left Ventricular Diastolic Dysfunction (LVDD). We analyzed the relationship between the ultrasensitive Troponin I biomarker (TnI-US) and LVDD in a cohort of asymptomatic Hemodialysis (HD) patients.
Methods: Descriptive cross-sectional study including 80 patients. Categorical variables were compared using Chi2 test, and quantitative variables were compared with Student's t-test or Mann-Whitney U-test. ROC curve to determine the predictive value of TnI-US levels for LVDD. Logistic regression analysis to determine the factors independently associated with LVDD.
Results: The mean TnI-US was 31.2 ± 59.3 pg/ml, and 40% of patients had TnI-US >20 pg/ml. These patients had higher frequency of LVDD (56.3% vs. 25%, p=0.005). 37.5% of patients had LVDD and higher proportion of moderate/severe Left Ventricular Hypertrophy (LVH) (63.3% vs. 36.7%, p=0.02), lower heart rate at the start of HD (66.9 ± 8.6 bpm vs. 77.2 ± 43.6 bpm, p=0.03), and higher TnI-US (47.4 ± 81.9 pg/ml vs. 21.5 ± 38.1 pg/ml, p=0.005). Logistic regression analysis showed that TnI-US >20 pg/ml [OR: 4.1 (95% CI 1.3-12.1), p=0.01] and moderate/severe LVH [OR: 5.1 (95% CI 1.7-15.2), p=0.003] were independently associated with LVDD, while an increase in heart rate [OR: 0.9 (95% CI 0.8-0.9); p=0.02] was independently associated with a lower risk of LVDD.
Conclusion: TnI-US can be used as a biomarker for LVDD in asymptomatic patients on HD.
DOI: 10.37421/2161-0959.2023.13.462
Renal impairment, including chronic kidney disease, represents a significant global health challenge with a growing prevalence. Timely and accurate prediction of renal impairment progression is crucial for effective patient management, resource allocation, and the development of personalized treatment plans. In recent years, artificial intelligence and machine learning have emerged as powerful tools for enhancing our ability to predict and manage renal impairment progression. This research article explores the applications of AI and ML in predicting renal impairment progression, discusses their benefits, challenges, and the future outlook for this transformative field.
DOI: 10.37421/2161-0959.2023.13.463
DOI: 10.37421/2161-0959.2023.13.464
DOI: 10.37421/2161-0959.2023.13.465
DOI: 10.37421/2161-0959.2023.13.466
DOI: 10.37421/2161-0959.2023.13.467
Renal impairment, characterized by a decline in kidney function, represents a significant health challenge affecting millions of individuals worldwide. The kidneys play a vital role in maintaining homeostasis by filtering waste products and regulating fluid and electrolyte balance. Impairment of renal function can lead to a cascade of complications, including chronic kidney disease and end-stage renal disease, necessitating renal replacement therapy such as dialysis or transplantation. Pharmacological interventions play a critical role in managing renal impairment, and this article provides an overview of current trends and future prospects in this field.
DOI: 10.37421/2161-0959.2023.13.468
DOI: 10.37421/2161-0959.2023.13.469
Diabetic nephropathy is a prevalent and debilitating complication of diabetes mellitus that significantly contributes to the global burden of chronic kidney disease. While it is well-established that diabetes is a major risk factor for the development of renal impairment, the precise mechanisms underlying this complex interplay between metabolic factors and renal dysfunction remain a subject of ongoing research. This article reviews the multifaceted relationship between diabetes and renal impairment, exploring the intricate web of metabolic factors and their influence on renal health. Understanding these mechanisms is critical for the development of effective prevention and treatment strategies for diabetic nephropathy.
DOI: 10.37421/2161-0959.2023.13.470
Emmanuel Anteyi*, Natarajan Ranganathan and Usha Vyas
DOI: 10.37421/2161-0959.2024.14.481
Chronic Kidney Disease (CKD) is a worldwide public health problem associated with high morbidity, mortality, and socioeconomic burden. Despite recent advances in pathogenesis and effective Standard of Care (SOC) therapy, the incidence of end stage renal disease remains high, attributed to the complex and diverse pathophysiological pathways in progression of CKD. Among the many pathogenetic pathways, inflammation plays the most central role in disease progression and related complications. Current SOC treatment to slow CKD progression has not adequately addressed these complex processes as a result of persistence of low-grade inflammation occurring at all stages of CKD. Previous attempts to address the inflammatory pathway with specific anti-inflammatory agents were, in certain cases discontinued for reasons ranging from drug safety to efficacy concerns, and business development decisions. Recent research findings demonstrating direct correlation between systemic inflammation associated gut microbiota changes and CKD progression, provided a potential novel therapeutic approach to target the inflammatory pathways. Exploring current scientific knowledge of modulating gut microbiome with microbiome-based therapies provides options in addressing these complex pathogenetic mechanisms of CKD-induced inflammation.
The purpose of this minireview is to discuss the role of inflammation associated with gut microbiome changes in CKD progression and gut microbiome-based therapeutic options to slow CKD progression.
DOI: 10.37421/2161-0959.2024.14.488
DOI: 10.37421/2161-0959.2024.14.489
DOI: 10.37421/2161-0959.2024.14.484
Renal Replacement Therapy plays a crucial role in the management of end-stage renal disease, a condition characterized by the irreversible loss of kidney function. As the prevalence of ESRD continues to rise globally, the demand for effective and efficient renal replacement therapies is more pressing than ever. In recent years, technological advancements have revolutionized the landscape of kidney care, offering new possibilities for improving the outcomes and quality of life for patients undergoing RRT. This article explores the significant role that technology plays in transforming renal replacement therapy and its impact on the field of kidney care.
DOI: 10.37421/2161-0959.2024.14.482
Diabetic Nephropathy (DN) is a serious and common complication of diabetes mellitus, affecting a significant number of individuals worldwide. It is a progressive kidney disease that develops in patients with diabetes, ultimately leading to renal failure if left untreated. Understanding the molecular mechanisms underlying diabetic nephropathy is crucial for developing effective therapeutic strategies to manage and prevent its progression. This article explores the intricate molecular pathways involved in the development and progression of diabetic nephropathy.
DOI: 10.37421/2161-0959.2024.14.483
The renal tubules play a crucial role in the intricate functioning of the kidneys, facilitating the reabsorption of essential substances and the excretion of waste products. Tubular diseases, characterized by the dysfunction of these vital structures, can have profound implications for overall kidney health. This article delves into the pathogenesis of tubular diseases, exploring the underlying mechanisms and highlighting emerging therapeutic strategies that hold promise in managing these conditions. Before delving into the complexities of tubular diseases, it is essential to understand the anatomy and physiology of renal tubules. The nephron, the functional unit of the kidney, consists of the renal corpuscle and renal tubule.
DOI: 10.37421/2161-0959.2024.14.485
DOI: 10.37421/2161-0959.2024.14.486
DOI: 10.37421/2161-0959.2024.14.490
DOI: 10.37421/2161-0959.2024.14.487
Journal of Nephrology & Therapeutics received 784 citations as per Google Scholar report