The latest medical research on Kidney Cancer

The research magnet gathers the latest research from around the web, based on your specialty area. Below you will find a sample of some of the most recent articles from reputable medical journals about kidney cancer gathered by our medical AI research bot.

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Effect of high-dose glucocorticoids on markers of inflammation and bone metabolism in patients with primary glomerular disease.

Kidney and Blood Pressure Research

Glucocorticoids are one of the most commonly used drugs for treatment of inflammatory and autoimmune diseases. Sirtuin-1 (SIRT-1) belongs to family of proteins involved in protection against inflammation and oxidative stress. A role of SIRT-1 in regulation of bone metabolism during high-dose steroid therapy is unknown.

The study assessed influence of high doses of intravenous corticosteroids on plasma inflammation and bone markers in patients with primary glomerular disease.

The study included 40 patients (25 M, 15 F; mean age 53.1±14 years) with chronic kidney disease (mean estimated glomerular filtration rate (eGFR) 58.9±31.3 ml/min). The main inclusion criterion was clinical and histopathological diagnosis of primary glomerular disease and urine protein excretion >2.0 g/24h. The patients received intravenous pulses of methylprednisolone 20-30 mg/kg/day for three consecutive days followed by oral prednisone 0.8-1.0 mg/kg/day. The blood was taken before administration of methylprednisolone to assess plasma SIRT-1, sclerostin, calcium, phosphate and parathormone (PTH) and first morning urine sample was taken for measurement of calcium, phosphate and albumin to creatinine ratio. The same laboratory tests were repeated after 4, 7 and 30 days during steroid therapy.

Plasma SIRT-1 increased significantly during steroid administration. Plasma sclerostin did not change significantly. There was a significant linear negative correlation between changes of SIRT-1 levels and sclerostin throughout the study. In a multiple regression model changes of plasma sclerostin induced by steroid therapy explained the largest part of variance of respective changes of plasma SIRT-1.

Plasma SIRT-1 increase during high-dose corticosteroid therapy is negatively related to the change of plasma sclerostin that may suggest a protective role of SIRT-1 against the negative effects of steroid therapy on bone. .

Improvement in Kidney Function After Discontinuation of Fenofibrate in Outpatient Nephrology Consultation for Chronic Kidney Disease.

Kidney and Blood Pressure Research

It has been noted in observational and interventional studies that individuals exposed to fenofibrate can exhibit a rise in serum creatinine (sCr) concentration. However, it is not known to what extent this phenomenon impacts kidney function in patients who are referred to a nephrology clinic for consultation for chronic kidney disease (CKD).

We conducted a prospective observational study of patients referred to our nephrology clinic for a new evaluation of a rise in sCr or worsening CKD and who were on fenofibrate therapy. We examined the effect of discontinuation of fenofibrate on kidney function, change in sCr and estimated glomerular filtration (eGFR) at 3, 6 and 12 months.

A total of 22 patients (59% women, 86% white, 59% with type 2 diabetes, 18% with peripheral arterial disease) were captured over 2.5 years. Median sCr at the time of fenofibrate discontinuation was 1.9 (1.1-3.3) mg/dL and eGFR 32 (17-57) ml/min; proteinuria was absent in 17 (77%). Upon discontinuation of fenofibrate, median sCr decreased to 1.5 (0.9-2.4), 1.4 (1.0-2.5) and 1.4 (1.0-2.3) mg/dL at 3, 6, and 12 months respectively (p<0.05); whereas median eGFR increased to 44 (27-71), 45 (23-71) and 42 (21-71) ml/min respectively (p<0.05). A ≥30% rise in eGFR was observed in 59% of the patients at 3 months and it persisted in 45% and 50% of patients at 6 and 12 months, respectively.

Discontinuation of fenofibrate in patients referred for CKD evaluation can result in sustained reduction in sCr in about half of the patients and for up to 1 year. There is a need to raise awareness among primary practitioners about this phenomenon. Recognition of fenofibrate as a cause of rise in sCr could reduce unnecessary nephrology consultation and resource utilization.

The correlation between ferroptosis and m6A methylation in patients with acute kidney injury.

Kidney and Blood Pressure Research

The present research analyzed the correlation between m6A methylation and ferroptosis associated genes (FAGs) in acute kidney injury (AKI) patients.

Bioinformatics analysis of microarray profiles (GSE30718) were performed to select differential expression genes (DEGs). FAGs are derived from systematic analysis of the aberrances and functional implications. The m6A methylation related genes were derived from the molecular characterization and clinical significance of m6A modulators. The multi-gene correlation of ferroptosis and M6A methylation modification were displayed. Then, the CIBERSORT algorithm was used to analyse the proportions of 22 immune cells infiltration.

In total, 349 DEGs were extracted between the AKI and control samples, among which 172 genes were up-regulated and 177 were down-regulated. FAGs (SLC1A5, CARS, SAT1, ACSL4, NFE2L2, TFRC and MT1G) and m6A methylation related genes (YTHDF3, WTAP and IGF2BP3) were significantly increased in AKI patients (P< 0.05). FAGs (SAT1, ACSL4 and NFE2L2) was positively correlated with the expression level of m6A methylation genes (P< 0.05). NFE2L2 has high diagnostic value, and level of NFE2L2 was negatively correlated with the degree of follicular helper T (TFH) cells infiltration.

Our research could provide a new theoretical basis for the pathogenesis and immune mechanism of AKI.

Physical Activity in Renal Disease (PAIRED) and the effect on hypertension: a randomized controlled trial.

Kidney and Blood Pressure Research

Exercise is an effective strategy for blood pressure (BP) reduction in the general population, but efficacy for the management of hypertension in CKD is not known. We evaluated the difference in 24-hour ambulatory systolic BP with exercise training in people with moderate to severe chronic kidney disease (CKD).

Participants with an estimated glomerular filtration rate (eGFR) of 15-44 mL/min per 1.73m2 and SBP >120 mmHg were randomized to receive thrice weekly, moderate intensity aerobic-based exercise over 24 weeks, or usual care. Phase 1 included supervised in-center and home-based sessions for eight weeks. Phase 2 was 16 weeks of home-based sessions. BP, arterial stiffness, cardiorespiratory fitness, and markers of CV risk were analyzed using mixed linear regression.

We randomized 44 people; 36% were female, median age was 69 years, 55% had diabetes and the median eGFR was 28 mL/min per 1.73m2. Compared with usual care, there was no significant change in 24-ambulatory SBP at eight weeks 2.96 mmHg (95% CI -2.56, 8.49) or 24 weeks. Peak oxygen uptake improved by 1.9 mL/kg/min in the exercise group (95% CI 0.03, 3.79) at eight weeks with a trend toward higher BMI 1.84 kg/m2 (95% CI -0.10, 3.78) and fat free mass, but this was not sustained at 24 weeks. Markers of CV risk were unchanged.

Despite an improvement in VO2peak and body composition, we did not detect a change in 24-hour ambulatory systolic BP in people with moderate to severe chronic kidney disease.

Cognitive impairment and kidney transplantation- underestimated, underrecognized but clinically relevant problem.

Kidney and Blood Pressure Research

Chronic kidney disease (CKD) affects the crosstalk between organs in the body and vast majority of studies were devoted to the interactions between the kidneys and the cardiovascular system. As of today, there is more evidence of the kidney and the central nervous system connections.

• Cognitive impairment in kidney transplant recipients is underestimated, underrecognized but clinically relevant problem. • The screening for cognitive declines after kidney transplantation is not yet a routine practice. • Several prospective and cross-sectional studies reported improvement across some of the assessed cognitive domains after transplantation.

Specific alterations of Gut microbiota in Chinese patients with Hypertension: A systematic review and meta-analysis.

Kidney and Blood Pressure Research

China has the largest absolute burden of hypertension (HTN) in the world. Gut dysbiosis may be a potentially modifiable risk factor for HTN. However, the characteristics of gut microbiota in Chinese populations with HTN remain to be determined.

We systematically searched for studies comparing the gut microbial in HTN with healthy controls in databases. The cut-off date was December 30, 2021. Semiquantitative analysis and meta-analysis with standardized mean differences of the alteration in gut microbiota were carried out.

A total of 16 studies involving 2372 patients with HTN and 849 controls were included, covering 16 Chinese provinces or regions. The present study supports that compared to healthy population, the diversity of patients with HTN is significantly compromised, while richness is overall preserved. To be specific, a significant increase of the Firmicutes(F)/Bacteroidetes(B) ratio is considered as a special parameter of gut microbiota in HTN patients. The increased abundance of phylum Firmicutes, genus Megasphaera, Escherichia_Shigella, and Klebsiella, while the lower abundance of phylum Bacteroidetes, genus Bifidobacterium, Faecalibacterium, Roseburia, and Ruminococcus may be associated with HTN. The gut microbial metabolism in HTN was more abundant in LPS biosynthesis, membrane transport, and steroid degradation.

Variation in gut microbial parameters is likely associated with Chinese patients with HTN. Further investigations should distinguish geographical and ethnic characteristics to develop in-depth knowledge of the underlying mechanisms by which gut dysbiosis contributes to HTN.

Intravascular Renal Denervation Reduces Ambulatory and Office Blood Pressure in Patients with Essential Hypertension: A Meta-Analysis of Randomized Sham-Controlled Trials.

Kidney and Blood Pressure Research

This meta-analysis was designed to evaluate the antihypertensive efficacy of intravascular renal denervation (RDN) in patients with essential hypertension, especially to determine the magnitude of blood pressure (BP) reduction with RDN therapy using second-generation catheters.

PubMed was searched to identify randomized sham-controlled trials from inception through August 2021. The endpoints were changes in 24-hours (24-h) ambulatory BP or office BP (OBP). This meta-analysis was performed by calculating the weighted mean difference (WMD) with 95% confidence interval (CI) using the random-effects model when the I2 index was < 50%. Fixed-effects model was used when the I2 index was ≥ 50%.

A total of 1297 patients were included in 8 randomized, sham-controlled trials in this meta-analysis. Intravascular RDN reduced 24-h ambulatory systolic BP (SBP) -3.02 (WMD, 95% CI, -4.95, -1.10, p <0.01,) and diastolic BP (DBP) -1.66 (WMD, 95% CI, -2.44, -0.88, p<0.001) mm Hg, respectively. In the studies using first-generation catheters, the WMD of 24-h ambulatory SBP and DBP changes between intravascular RDN and sham-control were -2.67 (95% CI, -5.08, -0.27; P<0.05) and -0.82 (95% CI, -2.19, 0.56; P>0.05) mm Hg. In the studies using second-generation catheters, the WMD of 24-h ambulatory SBP and DBP changes between intravascular RDN and sham-control were -3.14 (95% CI, -5.94, -0.33, p<0.05) and -2.06 (95% CI, -3.02, -1.11, p<0.001) mm Hg. Intravascular RDN using second-generation catheters reduced office SBP -6.30 (WMD, 95% CI, -7.67, -4.93, p<0.001) and DBP -3.88 (WMD, 95% CI, -4.44, -3.33, p<0.001) mm Hg, respectively.

Intravascular RDN using second-generation catheters reduces ambulatory and office BP in patients with essential hypertension. The selection of appropriate hypertensive patients may be the major challenge for the performance of intravascular RDN in routine clinical practice.

The dopamine system: insights between kidney and brain.

Kidney and Blood Pressure Research

Chronic kidney disease (CKD) is one of the most common diseases in adult age and it is typical of older adults. Recent data suggest that almost half of the elders have CKD. It is now clear that CKD is accompanied, in the early stages, by cognitive impairment, together with depression and subtle abnormalities in motor control (such as gait and balance alterations).

Several observations suggest a limited relevance of the dopaminergic system in CKD-related cognitive impairment. However, a common sleep disturbance in CKD, the restless leg syndrome, improves with dopaminergic drugs. Therefore, it remains to be established the role of the dopamine system in subtle motor dysfunction observed in CKD, such as tremors, gait alterations, and central sleep apnea.

Long term impact of the COVID-19 associated AKI: the relationship between kidney recovery and mortality in a 10-month follow-up cohort study.

Kidney and Blood Pressure Research

Corona Virus-2019 (COVID-19) associated acute kidney injury (AKI) and its short and mid-term effect on kidney has been well established in the previous literature, indicating a high number of AKI in hospitalized patients associated with high rates of mortality, followed by high rates of unresolved kidney injury at the time of discharge. However, the long-term impact of AKI and its resulting lack of recovery at discharge has not been investigated. Herein, we sought to explore the possible relationship between AKI and unresolved kidney injury and post-discharge mortality.

In this cohort study, patients hospitalized with COVID-19 who survived to the discharge were followed for a median of 9.6 months. AKI during hospitalization based on the staging according to KDIGO criteria and Kidney injury status at the time of discharge and other comorbidities and mortality during the follow-up period, were recorded. Using Cox proportional hazards regression, the desired association was investigated after adjustment for potential confounders.

Among 1017 discharged patients, 298 patients (29.3%) experienced AKI during hospitalization according to KDIGO criteria, of whom 178 patients (59.7%) were diagnosed with unresolved kidney injury at the time of discharge. After adjusting for potential confounders, Cox regression indicated that AKI stage 3 (HR: 4.56, 95% CI: 1.89-10.99, p=0.001) and unresolved kidney injury at the time of discharge (HR: 2.09, 95% CI: 1.18-3.73, p=0.011) were significantly associated with mortality during the post-discharge period. Additionally, Kaplan-Meier curves for overall survival indicated an increased risk of mortality in patients with stage 2, stage 3 AKI, and unresolved kidney injury at the time of discharge. ( P<0.001) Conclusion: Overall, it was shown that patients with COVID-19 who develop AKI, mainly stage 2 and 3, and patients with unresolved kidney injury at the time of discharge, were at increased risk of mortality, even after hospitalization for an extended time.

Naringenin alleviates obesity-associated hypertension by reducing hyperlipidemia and oxidative stress.

Kidney and Blood Pressure Research

Naringenin, a natural resource-derived flavanone, exhibits a plethora of pharmacological properties. The present study aimed to investigate the effects of Naringenin on obesity-associated hypertension and its underlying mechanism.

Obesity-associated hypertension rat model was established with a high-fat diet (HFD) and was administrated with Naringenin (25, 50, 100 mg/kg). Body and fat weight were recorded and blood pressure was measured. Serum lipid parameters (cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglycerides), oxidative stress biomarkers (malondialdehyde (MDA), superoxide dismutase (SOD), nitrite oxide (NO), and glutathione (GSH)), and adipocytokines (leptin and adiponectin) were determined. The expressions of signal transducer and activator of transcription (STAT) 3 were determined by using Western blotting.

Treatment with Naringenin (100 mg/kg) reduced body and fat weight in HFD-induced rats. Besides, treatment with Naringenin (50 and 100 mg/kg) reduced blood pressure and regulated lipid parameters by decreasing cholesterol, triglycerides, and LDL and increasing HDL. Treatment with Naringenin (50 and 100 mg/kg) reduced serum MDA and NO, whereas increased serum SOD and GSH. Furthermore, Treatment with Naringenin (50 and 100 mg/kg) regulated adipocytokines and decreased the phosphorylation of STAT3.

Naringenin ameliorates obesity-associated hypertension by regulating lipid disorder and oxidative stress.

Requirement of Na+/H+ exchanger NHE1 for vasopressin-induced osteogenic signaling and calcification in human aortic smooth muscle cells.

Kidney and Blood Pressure Research

Vasopressin is a powerful stimulator of vascular calcification, augmenting osteogenic signaling in vascular smooth muscle cells (VSMCs) including up-regulation of the transcription factors core-binding factor α-1 (CBFA1), msh homeobox 2 (MSX2), and SRY-Box 9 (SOX9), as well as of tissue-nonspecific alkaline phosphatase (ALPL). Vasopressin-induced osteogenic signaling and calcification require the serum- & glucocorticoid-inducible kinase 1 (SGK1). Known effects of SGK1 include up-regulation of Na+/H+ exchanger 1 (NHE1). NHE1 further participates in the regulation of reactive oxygen species (ROS). NHE1 has been shown to participate in the orchestration of bone mineralization. The present study, thus, explored whether vasopressin modifies NHE1 expression and ROS generation, as well as whether pharmacological inhibition of NHE1 disrupts vasopressin-induced osteogenic signaling and calcification in VSMCs.

Human aortic smooth muscle cells (HAoSMCs) were treated with vasopressin in the absence or presence of SGK1 siRNA, SGK1 inhibitor GSK-650394, and NHE1 blocker cariporide. Transcript levels were determined by using qRT-PCR, protein abundance by western blotting, ROS generation with 2',7'-dichlorofluorescein diacetate (DCFDA) fluorescence, as well as ALP activity and calcium content by using colorimetric assays.

Vasopressin significantly enhanced the NHE1 transcript and protein levels in HAoSMCs, effects significantly blunted by SGK1 inhibition with GSK-650394 or SGK1 siRNA. Vasopressin increased ROS accumulation, an effect significantly blocked by NHE1 inhibitor cariporide. Vasopressin further significantly increased osteogenic markers CBFA1, MSX2, SOX9, and ALPL transcript levels, as well as ALP activity and calcium content in HAoSMCs, all effects significantly blunted by SGK1 silencing or in the presence of GSK-650394 and cariporide.

Vasopressin stimulates NHE1 expression and ROS generation, an effect dependent on SGK1 and required for vasopressin-induced stimulation of osteogenic signaling and calcification of VSMCs.

The DiaCoVAb study in South Italy: immune response to Sars-CoV-2 vaccination in dialysis patients.

Kidney and Blood Pressure Research

Since the pandemic of Coronavirus Disease 2019 (COVID-19) started from December 2019, remarkable numbers of infections and deaths associated with COVID-19 have been recorded worldwide. End-Stage Renal Disease (ESRD) patients on dialysis are particularly at high risk of infections due to impairments in the innate and adaptive immune system. Vaccination on dialysis patients (DP) still remains challenging, because of the variable response and low seroconversion rate compared with healthy controls (HC). Therefore, it is urgently necessary to establish a different vaccination strategy for DP, in terms of dose and administration time.

Here, we report an observational prospective cohort study in which the immunogenic efficacies of SARS-CoV-2 vaccine BNT162b2 on DP and HC were evaluated by absolute quantification of IgG levels in the blood.

DP showed a delayed seroconversion after two vaccine doses, with a low absolute IgG levels compared to HC. While healthy populations reached complete seroconversion within 10 days from the administration of second dose, only 76% of DP were seropositive. After booster dose, DP strongly improved seroconversion rate as well as antibody levels, reaching 97% seropositivity and 50 times enhancement on antibody levels.

These results prompt to suggest an additional vaccine dose in DP, reducing the interval of time from the second dose. Since few data are available on immune response in DP overtime after three vaccine doses currently, our study is among the first reports demonstrating the improved seropositivity and IgG levels in DP after booster vaccine dose.