Kidney disease in diabetes: From mechanisms to clinical presentation and treatment strategies.

Metabolic and haemodynamic perturbations and their interaction drive the development of diabetic kidney disease (DKD) and its progression towards end stage renal disease (ESRD). Increased mitochondrial oxidative stress has been proposed as the central mechanism in the pathophysiology of DKD, but other mechanisms have been implicated. In parallel to increased oxidative stress, inflammation, cell apoptosis and tissue fibrosis drive the relentless progressive loss of kidney function affecting both the glomerular filtration barrier and the renal tubulointerstitium.

Vascular growth factors as potential new treatment in cardiorenal syndrome in diabetes.

Background: Cardiorenal syndrome in diabetes is characterised by alterations of the cardiovascular system paralleled by kidney disease with progressive renal function decline. In diabetes, chronic metabolic and haemodynamic perturbations drive endothelial dysfunction, inflammation, oxidative stress and progressive tissue fibrosis which, in turn, lead to heart and renal anatomo-functional damage. In physiology, vascular growth factors have been implicated in vascular homeostasis; their imbalance, in disease setting such as diabetes, leads to vascular dysfunction and cardiorenal damage.

Calcitonin Gene-Related Peptide Protects Against Cardiovascular Dysfunction Independently of Nitric Oxide In Vivo.

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The endoplasmic reticulum stress and the unfolded protein response in kidney disease: Implications for vascular growth factors.

Acute kidney injury (AKI) and chronic kidney disease (CKD) represent an important challenge for healthcare providers. The identification of new biomarkers/pharmacological targets for kidney disease is required for the development of more effective therapies. Several studies have shown the importance of the endoplasmic reticulum (ER) stress in the pathophysiology of AKI and CKD.

Endoplasmic Reticulum stress in chronic kidney disease. New molecular targets from bench to the bedside.

The identification of new biomarkers/pharmacological targets for chronic kidney disease (CKD) is required for the development of more effective therapies. Several studies in vitro and in vivo have shown the importance of the endoplasmic reticulum (ER) (cellular organelle devolved to protein biosynthesis and maturation, and cellular detoxification processes) in the pathophysiology of CKD. Hence, the synthesis and development of novel drugs against the different ER intracellular pathways is crucial in order to slow down the development and progression of renal diseases.

Overexpression of Circulating Soluble Nogo-B Improves Diabetic Kidney Disease by Protecting the Vasculature.

Damage to the vasculature is the primary mechanism driving chronic diabetic microvascular complications such as diabetic nephropathy, which manifests as albuminuria. Therefore, treatments that protect the diabetic vasculature have significant therapeutic potential. Soluble neurite outgrowth inhibitor-B (sNogo-B) is a circulating N-terminus isoform of full-length Nogo-B, which plays a key role in vascular remodeling following injury.

The Myth of Water and Salt: From Aquaretics to Tenapanor.

The impact of water intake has been studied in several renal diseases. For example, increasing water intake is useful to prevent primary and secondary nephrolithiasis. In autosomal dominant polycystic kidney disease, arginine vasopressin (AVP) is involved in the progression of the disease, and water intake could play a therapeutic role by inhibiting the synthesis of AVP, but its efficacy is still controversial.

Persistent left superior vena cava and partially left inferior vena cava: a case report of a dangerous central venous catheterization.

Background: The coexistence of a double superior vena cava (SVC) and a partially left inferior vena cava (PLIVC) with a circumaortic collar, associated with other congenital malformations, was not described previously.

Case Description: We present a 33-year-old woman in hemodialysis with complete exhaustion of the brachial routes for vascular access, admitted to our Nephrology Unit for a long-term central venous catheter (CVC) implant, usually by us performed under EchoScopic Technique (EST), an echographic venipuncture followed by continuous radioscopic control of guidewire and catheter in all the steps of implant. An intraoperative venography showed a complete stop of right internal jugular vein, a right SVC, a persistent left SVC, a left inferior vena cava in the iliac and subrenal tracts, a circumaortic venous collar in the renal tract, and normal right suprarenal and hepatic tracts.

Renoprotective effect of erythropoietin in zebrafish after administration of gentamicin: an immunohistochemical study for β-catenin and c-kit expression.

Background: Gentamicin is an aminoglycoside antibiotic widely used in the treatment of infections caused by Gram-negative bacteria. The main limitation to its therapeutic effectiveness is the potential nephrotoxicity. Erythropoietin has a tissue protective effect widely demonstrated in the kidney.

Renal biopsy: Still a landmark for the nephrologist.

Renal biopsy was performed for the first time more than one century ago, but its clinical use was routinely introduced in the 1950s. It is still an essential tool for diagnosis and choice of treatment of several primary or secondary kidney diseases. Moreover, it may help to know the expected time of end stage renal disease.

Sclerostin levels in uremic patients: a link between bone and vascular disease.

Sclerostin is a marker of low-turnover bone disease in end stage renal disease patients. The aim of this study was to evaluate serum sclerostin in uremic patients, analyzing its behavior during a single hemodialysis session. Twenty-one adult patients on intermittent hemodialysis treatment were enrolled.

Arnaldo Da Villanova medieval physician (1235-1311). A first approach.

Arnaldo de Villanova, was a Catalan Physician, born in Villanova de Grau, a suburb of Valencia - Spain about 1235. He died off the coast of Genoa in 1311 during a sea voyage departing from Messina in Sicily, during a diplomatic mission by Pope Clement V in Avignon on orders by the King of Sicily. He was a so famous and clever scientist of the thirteenth century, to give his name to the Universitary Hospital of Montpellier - France.

Treatment of kidney diseases in the thermal springs of Pithecusa during the XVIII Century.

The island of Pithecusa (Ischia) is a volcanic island in the Tyrrhenian Sea in the north end of the Gulf of Naples at about 30 kilometers from the same city. Pithecusa is very popular for its hot springs which even the ancients used. This report aims to analyze the renal therapeutic benefits of the Pithacusa thermal mineral spring through a review of two different manuscripts: i) "Di Napoli il seno cratero"(The gulf of Naples) of Domenico Antonio Parrino (1642-1708) and ii) "De' rimedi naturali che sono nell'isola di Pithecusa oggi detta Ischia"(On the natural cures of the island of Pithecusa known today as Ischia)of Giulio Iasolino (1583-1622).

The concept of the urine test and specific reaction of the urine in various diseases according to Enrico Cauchi - member of the medical council of Malta (1933).

The Study of urine from the outset has always aroused the interest of scientists and physicians all over the world, from ancient Greeks and Romans to Hindus , Hulcos in Mexico, Australian native etc. The urine in such case was considered not only as a waste product but also as a therapeutic product. In the late XIX century scientific knowledge had already identified the function of substances that favor the increase of urinary output, and physicians over the centuries have always tried to analyze urine in various ways.

[Metformin and Diabetes: still has a sense of its use in patients CKD stage II or is an additional risk factor?].

Unlabelled: Pz woman of 62 years comes to P.S.G.

Kidney disease and psoriasis: novel evidences beyond old concepts.

Psoriasis is an immune-mediated inflammatory disease for a long time considered as a type of pathology characterized by an exclusive skin involvement. Recently it has been shown that patients affected by this disease have a higher risk of developing comorbidities such as cardiovascular diseases, arterial hypertension, diabetes mellitus, and metabolic syndrome. Even the kidneys can be affected by psoriasis through three different mechanisms: immune-mediated renal damage, drug-related renal damage and chronic renal damage.

[Periorbital purpura: a pathognomonic but late sign of AL amyloidosis].

Introduction: AL amyloidosis is the most common type of systemic amyloidosis and is caused by the deposition of an amyloidogenic protein composed of immunoglobulin light chains produced by a clonal population of plasma cells.

Case Report: We report the case of a 77-year-old woman with arterial hypotension, peripheral edema and renal failure. Electrocardiogram reveals low voltage on peripheral leads.

Salt-water imbalance and fluid overload in hemodialysis patients: a pivotal role of corin.

Natriuretic peptides (NP) play a key role in regulation of salt and water balance. Corin, a serine protease which activates NP, plays a key role in regulation of blood pressure and cardiac function. The aim of the study was to evaluate the involvement of corin in renal physiopathology, analyze its levels in dialyzed patients and evaluate its relation with fluid overload and comorbidities such as heart failure and blood hypertension.

Vascular access for hemodialysis: current perspectives.

A well-functioning vascular access (VA) is a mainstay to perform an efficient hemodialysis (HD) procedure. There are three main types of access: native arteriovenous fistula (AVF), arteriovenous graft, and central venous catheter (CVC). AVF, described by Brescia and Cimino, remains the first choice for chronic HD.