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Do SGLT2 Inhibitors Protect the Kidneys? An Alternative Explanation.
Endocr Metab Immune Disord Drug Targets
January 2025
Sheba Medical Center, Institute of Endocrinology, Tel-Hashomer, Israel.
SGLT2 inhibitors are a family of drugs that were developed to treat diabetes mellitus. In randomized controlled trials, SGLT2 inhibitors seem to prevent kidney deterioration in patients with nephropathies, both diabetic and non-diabetic. However, in contrast to biochemical/physiological results (proteinuria and serum creatinine levels) that improve in all studies, the clinical results (all-cause mortality, cardiovascular death, need for dialysis, or renal transplant) do not consistently improve.
View Article and Find Full Text PDFImproving Renal Protection in Chronic Kidney Disease Associated with Type 2 Diabetes: The Role of Finerenone.
Endocr Metab Immune Disord Drug Targets
January 2025
Department of Internal Medicine, Division of Nephrology and Hypertension, Faculty of Medicine, Dr. Cipto Mangunkusumo Hospital, Universitas Indonesia, Jakarta, Indonesia.
Chronic kidney disease (CKD) is a major complication of type 2 diabetes mellitus (T2D), which often leads to diabetic kidney disease (DKD). Traditional therapies, including renin- angiotensin-aldosterone system inhibitors and sodium-glucose cotransporter-2 inhibitors, are effective in slowing CKD progression. However, these approaches are insufficient to comprehensively inhibit mineralocorticoid receptor (MR) overactivation in the kidneys, which remains a significant driver of inflammation, fibrosis, and oxidative stress.
View Article and Find Full Text PDFFluid Management in Critical Care: New Insights Into Optimal Fluid Therapy.
Cureus
December 2024
Critical Care Medicine, Star Care Multispeciality Hospital, Kozhikode, IND.
Background: Fluid management is a crucial critical care component, influencing outcomes such as organ function, renal integrity, and survival in critically ill patients. Recent evidence suggests that balanced crystalloids may offer advantages over isotonic saline, particularly in reducing the risk of acute kidney injury (AKI) and other complications. This study aimed to evaluate the impact of balanced crystalloids versus isotonic saline on clinical outcomes in the intensive care unit (ICU), focusing on AKI, renal replacement therapy (RRT), and mortality.
View Article and Find Full Text PDFCryoglobulinemia Complicated by Pneumonia.
Cureus
December 2024
Pulmonology, Israeli-Georgian Multiprofile Medical Center "Healthycore", Tbilisi, GEO.
This study describes a 64-year-old female with a history of hepatitis C and cryoglobulinemia, who presented with respiratory symptoms, including dry cough, shortness of breath, and fever, alongside joint pain and fatigue. Initial workup revealed interstitial pneumonia, supported by chest imaging, and the patient was treated for pneumonia with standard antibiotic therapy. Despite no renal involvement, a hallmark of cryoglobulinemia, further testing confirmed elevated serum cryoglobulin levels.
View Article and Find Full Text PDFPostpartum Hellp Syndrome Associated With Posterior Reversible Encephalopathy Syndrome.
Eur J Case Rep Intern Med
December 2024
Critical Care, Intensive Care Unit, Centro Hospitalar Universitário de Santo António, Porto, Portugal.
Unlabelled: Haemolysis, elevated liver enzymes and low platelets (HELLP) syndrome is a poorly understood, life-threatening multisystemic condition related to pregnancy with a rapid onset, typically observed in patients with severe pre-eclampsia. Various mechanisms may lead to diffuse endothelial damage associated with HELLP and possible brain involvement. A comprehensive review of PubMed, Embase and Cochrane databases was conducted to examine the clinical, laboratory and radiological features associated with postpartum HELLP syndrome, particularly its potential association with posterior reversible encephalopathy syndrome (PRES).
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