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Glomerulosclerosis
Published in Charles Theisler, Adjuvant Medical Care, 2023
Glomeruli are the functional units of the kidneys that enable nephrons to filter waste products such as urea out of the blood. Glomerulosclerosis is scarring or hardening of the glomeruli. This damage can result in proteinuria (loss of large amounts of protein [i.e., albumen] from the blood into the urine), microscopic hematuria (blood and casts in the urine), hypertension, and the nephrotic syndrome (proteinuria plus low albumen and high fat in the blood along with edema in the legs feet or ankles). Glomerulosclerosis may develop in children or adults. African Americans are at higher risk.
Renal Disease; Fluid and Electrolyte Disorders
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
The underlying glomerular disease is treated if possible. Diuretics help to control the oedema and lipid-lowering drugs are used for hypercholesterolaemia. In severe cases, anticoagulation is used to prevent venous thrombosis.
Potential of Fenugreek in Management of Kidney and Lung Disorders
Published in Dilip Ghosh, Prasad Thakurdesai, Fenugreek, 2022
Amit D. Kandhare, Anwesha A. Mukherjee-Kandhare, Subhash L. Bodhankar
Glomerulonephritis or nephritis is a severe and life-threatening illness that occurs due to inflammation of the glomeruli. Although prevalence is low, nephritis can be rapidly progressive and the patient may need immediate treatment. Additionally, damage to the glomerulus results in arterial hypertension and renal failure. Glomerulonephritis includes many diseases, namely anti- GBM antibody disease, IgA nephropathy, lupus nephritis, and ANCA-associated vasculitis (McAdoo and Pusey 2017). The pathophysiology remains unknown for glomerulonephritis; however, bacterial and viral infections have been encountered frequently during a clinical investigation (Couser and Johnson 2014). The recommended treatment regimen for glomerulonephritis includes daily administration of oral steroids such as cyclophosphamide and plasma exchange to decrease the serum levels of anti-GBM antibodies. Although these therapies are more efficient in removing antibodies from serum, their cost and availability have acted as limitations in widespread clinical practice.
Expression of interferon-stimulated gene 20 (ISG20), an antiviral effector protein, in glomerular endothelial cells: possible involvement of ISG20 in lupus nephritis
Published in Renal Failure, 2023
Takao Karasawa, Riko Sato, Tadaatsu Imaizumi, Masashi Fujita, Tomomi Aizawa, Koji Tsugawa, Deborah Mattinzoli, Shogo Kawaguchi, Kazuhiko Seya, Kiminori Terui, Kensuke Joh, Hiroshi Tanaka
Based on our experimental results, we suggest that the dynamic regional expression of ISG20 may be associated with the activation of innate immune reactions in GECs. Thus, altered levels of ISG20 and other components of the TLR3/IFN-β/ISG axis in resident renal cells might be a characteristic in patients with glomerular diseases, particularly LN [14–16,19]. Further detailed studies focusing on the interactions between these ISGs and the downstream expression of chemokines/cytokines are necessary. We also consider that the overexpression of ISG20 and its downstream inflammatory mediators, including CX3CL1, may be involved in the pathogenesis of glomerular inflammation. Thus, the pharmacological modulation of these signaling pathways might be a novel therapeutic approach for the treatment of glomerular diseases, particularly LN.
Effectiveness of thiazide and thiazide-like diuretics in advanced chronic kidney disease: a systematic review and meta-analysis
Published in Renal Failure, 2023
Flávio Teles, Jorge Artur Peçanha de Miranda Coelho, Rosivânia Maria Albino, Fernanda Cristina Verçosa Pacheco, Evilly Rodrigues de Oliveira, Marcelo Augusto Duarte Silveira, Audes Diógenes M. Feitosa, Rodrigo Bezerra
CKD is now considered a worldwide public health problem, and hypertension is its second most frequent cause. Thus, restricting the use of thiazides to individuals with a GFR greater than 40 mL/min/1.73 m2 means that a considerable portion of the hypertensive population does not receive this treatment. Therefore, based on the most recent evidence, guidelines, such as those proposed by the KDIGO Work Group, do not agree with the ACC/AHA and ESC/ESH recommendation to avoid thiazides in advanced CKD [28]. An additional finding in the present study was the significant mean difference in GFR with thiazides in this population of patients with advanced CKD, most of whom also used loop diuretics. Despite the reduction in GFR, there was no description of severe forms of acute kidney injury. The decrease in GFR could be caused by a drop in glomerular hydraulic pressure, which has already been shown in experiments with rats that had advanced CKD and were being treated with hydrochlorothiazide [29]. Furthermore, drugs with a well-established nephroprotective effect, such as angiotensin-converting enzyme inhibitors and angiotensin receptor blockers, and more recently SGLT2i can also reduce glomerular filtration in a transient way but with a long-term beneficial result. However, we can only speculate, and long-term studies will be needed to better clarify this issue.
Multifunctional nanoparticles encapsulating methotrexate and curcumin for holistic management of rheumatoid arthritis: in-vitro and pre-clinical assessment
Published in Drug Development and Industrial Pharmacy, 2023
Ayesha Syed, Preeti Karwa, Kusum Devi Vemula
In the normal control group Figure 13(A), kidney tissue exhibited normal renal glomeruli (arrow) and proximal tubules (back arrow). Glomerulus is a solid structure with a round shape, proximal tubules with cuboid-round celled and villi. In the positive control group, Figure 13(B) glomerulus (arrow) showed endothelial cells desquamation. Bowman’s capsule (arrowhead) showed Bowman’s space becoming stretched with necrosis. Tubular Contortus (*) showed infiltration of inflammatory cells followed by necrosis. Figure 13(C) Group treated with the marketed formulation of MTX showing renal toxicity with changed histology of kidney. Glomerulus (arrow) showed endothelial cells desquamation. Bowman’s capsule (arrowhead) bowman’s space becoming stretched with necrosis. Tubular Contortus (*) showed infiltration of inflammatory cells followed by necrosis. Figure 13(D) group treated with BSA-MTX-CUR-NPs showed regular histopathology of the tissue analogous to the normal control group.