The climate impact of dialysis.

Purpose Of Review: A reciprocal relationship currently exists between climate change and healthcare, mutually influencing each other. There have been significant planetary shifts in recent decades, marked by escalating temperatures, frequent natural calamities, a disturbing surge in climate-linked fatalities, and a heightened incidence of kidney disease diagnoses.

Recent Findings: Dialysis, a life-preserving treatment for kidney failure, extends to 2-3 million patients globally, mainly through in-centre haemodialysis.

Four-Year-Olds Share General Knowledge and Use Generic Language When Teaching.

Young children's receptiveness to teaching is unquestioned, but their understanding of pedagogy has only begun to be explored. Two experiments ( = 90; 45 female) with 4-year-olds from racially and ethnically diverse backgrounds were conducted to test if they exchange general information and use generic language when teaching. Children in both experiments taught more general than episodic information and used more generic than episodic language when teaching.

Anti-GBM Disease after Oxford-AstraZeneca ChAdOx1 nCoV-19 Vaccination: A Report of Two Cases.

There have been reports of rare de novo glomerular diseases following vaccination for coronavirus disease 2019 (COVID-19). We report two cases of anti-glomerular basement membrane (GBM) disease in previously healthy females after Oxford-AstraZeneca COVID-19 vaccine (ChAdOx1 nCoV-19). The first case was a 69-year-old female who developed lethargy and anuria approximately 8 weeks after her first dose of Oxford-AstraZeneca COVID-19 vaccine.

Patient awareness and beliefs about the risk factors and comorbidities associated with chronic kidney disease : A mixed-methods study.

Aim: Diabetes, hypertension and smoking may contribute to the development and progression of chronic kidney disease (CKD) and its complications. The aim of this study was to assess patients' awareness and beliefs about these and other risk factors associated with CKD.

Methods: Participants with CKD Stages 1-5 were purposively sampled for participation in a mixed methods study.

Knowledge deficit of patients with stage 1-4 CKD: a focus group study.

Background: Patients with early-stage chronic kidney disease (CKD) must make lifestyle modifications and adhere to treatment regimens to prevent their progression to end-stage kidney disease. The aim of this study was to elicit the perspectives of patients with stage 1-4 CKD about their disease, with a specific focus on their information needs in managing and living with CKD and its sequelae.

Methods: Patients with CKD stages 1-4 were purposively sampled from three major hospitals in Sydney, Australia to participate in focus groups.

Paradoxically Low Levels of Total and HMW Adiponectin in Relation to Metabolic Parameters in a Tongan Population.

Aim. Adiponectin has demonstrated anti-inflammatory and insulin sensitising properties, and low circulating levels may be an important risk factor for diabetes. We examined levels of adiponectin and its insulin-sensitising HMW isoform and their relationship with metabolic parameters in Tongans, a population prone to type II diabetes.

Factor H binds to the N-terminus of adiponectin and modulates complement activation.

The adipokine adiponectin circulates in high concentration, and activates the classical pathway of complement by binding C1q, leading to the activation of C3 and formation of the membrane attack complex. Such behaviour is potentially pathophysiological. However, we showed adiponectin captured the complement inhibitor Factor H both as a pure protein and from human serum.

Review article: Adiponectin: its role in kidney disease.

The multifactorial glycoprotein, adiponectin has demonstrable insulin-sensitizing, anti-atherogenic and anti-inflammatory properties. However, despite the prevalence of both insulin-resistance and vascular disease in patients with end-stage kidney disease, levels of adiponectin are high. Adiponectin circulates in different sizes (the high-molecular-weight (HMW) isoform is thought to be the most insulin-sensitizing type) and binds to two receptors, adiponectin receptors (AdipoR) 1 and 2.

Adiponectin is present in the urine in its native conformation, and specifically reduces the secretion of MCP-1 by proximal tubular cells.

Aim: To determine whether adiponectin detected in urine is present in its native form and if adiponectin receptors (AdipoR) present and functional in proximal tubular (HK-2) cells.

Background: Adiponectin is a protein with anti-inflammatory, anti-atherogenic and insulin-sensitizing properties. It has previously been detected antigenically in the urine in several forms of renal disease.

Adiponectin binds C1q and activates the classical pathway of complement.

The adipose-specific protein adiponectin binds to a number of target molecules, including damaged endothelium and the surface of apoptotic cells. However, the significance of this binding remains unclear. This study demonstrates the binding of purified C1q to recombinant adiponectin under physiological conditions, and the dependence of this upon Ca(++) and Mg(++).

The effect of renal transplantation on adiponectin and its isoforms and receptors.

Insulin resistance (IR) and other proatherogenic risk factors associated with end-stage kidney disease (ESKD) are improved by renal transplantation. Adiponectin is a protein with insulin-sensitizing, anti-inflammatory, and antiatherogenic properties. It exists in several isoforms, but the high molecular weight (HMW) isoform correlates best with insulin sensitivity.

Glycosylation of human adiponectin affects its conformation and stability.

The collagenous region of adiponectin is glycosylated in vitro with glucosylgalactosyl moieties on four conserved lysines. We investigated the glycosylation of human adiponectin in vivo. Sugar vicinyl hydroxides on adiponectin were oxidized with 10 or 1 mM metaperiodate, and the result analyzed by two-dimensional electrophoresis and immunoblotting.

Up-regulation of adiponectin, its isoforms and receptors in end-stage kidney disease.

Background: Despite the favourable effects of adiponectin on the vasculature and insulin resistance (IR), levels are increased in patients with end-stage kidney disease (ESKD), in whom both IR and atherosclerosis are prevalent.

Methods: To investigate this paradox, we examined the distribution of adiponectin isoforms, the expression of adiponectin receptor (AdipoR) mRNA on peripheral blood mononuclear cells (PBMC) in 41 patients with ESKD on haemodialysis and 41 matched controls, and its function by adenosine monophosphate-activated protein kinase (AMPK) phosphorylation of AdipoR on PBMC. We also compared the expression of AdipoR on PBMC with that on muscle and subcutaneous and visceral fat in 10 patients undergoing elective cholecystectomy.

Human adiponectin binds to bacterial lipopolysaccharide.

Adiponectin has anti-inflammatory and anti-atherogenic properties in addition to its acknowledged roles in insulin sensitivity and energy homeostasis. These properties include the suppression of lipopolysaccharide [LPS]-mediated inflammatory events. We demonstrated that both recombinant and native adiponectin directly bind LPS derived from three different bacteria.

Should we quantify insulin resistance in patients with renal disease?

Cardiovascular disease is a major cause of morbidity and mortality in dialysis patients. Vascular disease develops before the initiation of dialysis, and it is now recognized that chronic kidney disease (CKD) is an independent risk factor for cardiovascular disease. Death from cardiovascular disease is a more common endpoint of CKD than progression to dialysis.

The metabolism of isoforms of human adiponectin: studies in human subjects and in experimental animals.

Objective: Little is known of the metabolism of different isoforms of adiponectin. We therefore (a) characterised the size distribution of human adiponectin in relation to gender, body composition and following a challenge with a fat meal or oral glucose in humans, and (b) studied the metabolism of isoforms of human adiponectin in rabbits.

Method: Electrophoresis, blotting and chromatography were used to characterise human adiponectin in 36 healthy subjects, including 15 with at least two first-degree relatives with type 2 diabetes, before and after consumption of a fatty meal or glucose.

Outcome of overseas commercial kidney transplantation: an Australian perspective.

Lack of donors has led to a worldwide increase in commercial kidney transplantation programs where recipients acquire kidneys either from executed prisoners or live non-related donors. Commercial transplantation is prohibited by legislation in Australia. Our centres have had 16 patients who have travelled overseas to receive a commercial kidney transplant; five have subsequently died.

Renal imaging in pyelonephritis.

Background: Pyelonephritis accounts for a significant number of hospital admissions. It is unclear from existing literature whether all patients requiring admission to hospital should undergo renal imaging or if there is a subset that indicates clinical parameters for those who are more likely to have significant renal imaging abnormalities.

Method And Results: We undertook a retrospective study of 60 consecutive patients hospitalized with pyelonephritis, the majority of whom underwent renal ultrasound at the time of admission.