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Contrast nephrotoxicity
Published in William H. Bush, Karl N. Krecke, Bernard F. King, Michael A. Bettmann, Radiology Life Support (Rad-LS), 2017
Factors that increase the risk of contrast-medium nephropathy are being identified more specifically.4–6 Pre-existing renal impairment (serum creatinine >132 μmol/L [1.5 mg/dL]) is the most significant risk factor, followed by albuminuria (> 2+), hypertension, age > 60 years, dehydration, uric acid (> 8.0 mg/dL) and multiple closely spaced doses of iodinated contrast material. Other risk factors include severe congestive heart failure, reduced effective arterial volume (as occurs in nephrosis and cirrhosis), multiple myeloma, and administration of a single high dose of contrast agent. Concomitant use of drugs that impair renal responses, such as angiotensin-converting-enzyme inhibitors (ACEI), antibiotics such as gentamicin, and non-steroidal anti-inflammatory drugs (NSAIDs) also increase the risk. Because many patients have more than one risk factor, it is not possible to determine the independent contribution of each factor to the development of renal failure. It is generally accepted that the coexistence of several of the factors increases the risk of contrast-induced nephropathy considerably. For example, a patient with diabetic nephropathy generally has at least three risk factors, namely reduced renal function, albuminuria and hypertension.
Applications of Pluripotent Stem Cells in the Therapy and Modeling of Diabetes and Metabolic Diseases
Published in Deepak A. Lamba, Patient-Specific Stem Cells, 2017
Suranjit Mukherjee, Shuibing Chen
In diabetic nephropathy, damages to microvessels of the kidney glomerulus lead to the leak of proteins into the urine and defective filtration of the blood, culminating in complete renal failure. While drugs are currently on the market to help slow the progression of renal failure, kidney transplants are eventually needed for end-stage renal failure. Much like the difficulty in directly accessing and studying retinal degradation in diabetic patients, the location of the kidney glomerulus makes it difficult for it to be directly studied without the use of invasive procedures on patients. Therefore, there is a hope to use iPSC-based disease modeling using hESC/iPSC-derived kidney cell types such as mesangial cells and podocytes to better understand diabetic renal failure, as well as to provide transplant opportunities for patients in need of improved kidney function.
Terahertz Time-Domain Spectroscopy in the Assessment of Diabetic Complications
Published in Andrey V. Dunaev, Valery V. Tuchin, Biomedical Photonics for Diabetes Research, 2023
Sviatoslav I. Gusev, Ravshanjon Kh. Nazarov, Petr S. Demchenko, Tianmiao Zhang, Olga P. Cherkasova, Mikhail K. Khodzitsky
Despite the fact that diabetes is one of the most common diseases, its effective diagnosis and therapy is an urgent task. In this regard, over the past decades, noninvasive methods have been developed [1,2]: reverse iontophoresis [3], infrared spectroscopy [4], Raman spectroscopy [5], impedance spectroscopy, etc.; however, the department for sanitary supervision of quality Food and Drug Administration approved only the GlucoWatch device, which works based on the phenomenon of reverse iontophoresis. The main obstacle to the development of a noninvasive glucometer is a low signal level from glucose molecules, which leads to low sensitivity and specificity in measuring sucrose content [6]. Today, there are various diagnostic methodologies, but one of the most promising of them is the optical diagnostic method. The composition and structure of blood are important indicators of diseases, including diabetes. For example, with an increase in glucose level, creatinine level can change simultaneously. A deviation of glucose from the normal level is considered as a symptom of impaired carbohydrate metabolism. In addition, one of the complications of diabetes is diabetic nephropathy. It can cause an increase in creatinine levels. An increase in bilirubin level is less common in patients with diabetes mellitus, but it may occur with concomitant liver disease [7]. The bilirubin level varies in a narrower range in patients that are not affected by liver disease than in patients with organ pathology. However, measuring the level of bilirubin, as well as other biochemical parameters, after a meal is difficult for current research methods used in routine clinical practice [7]. This is due to the fats that are obtained from food. Fats may cause an increase in the level of triglycerides in the blood, which leads to the errors in the analysis of blood composition [8].
A new one-dimensional copper(II) coordination polymer: crystal structure and treatment activity on diabetic nephropathy
Published in Inorganic and Nano-Metal Chemistry, 2021
Pan-Pan Lin, Qiao-Ling Xie, Ling-Wei Chen
Diabetes is the main cause of end-stage renal disease, and diabetic nephropathy is a disease characterized by persistent microalbumin in diabetic patients. At first, the glomerular filtration rate of patients is high, which is twice over that of normal people.[1] Some patients occasionally combined with microalbuminuria, and after about 20 years, the patient gradually develops a decline in glomerular filtration rate, mild proteinuria, followed by moderate proteinuria;[2] in the final stage, this disease will develop into severe urine protein, accompanied by chronic renal insufficiency and nephrotic syndrome, eventually develops into end-stage renal disease.