To guide the development of therapeutic interventions for acute kidney injury, elucidating the deleterious pathways of this global health problem is highly warranted. Emerging evidence has indicated a pivotal role of endothelial dysfunction in the etiology of this disease. We found that the class III semaphorin SEMA3C was ectopically upregulated with full length protein excreted into the blood and truncated protein secreted into the urine upon kidney injury and hypothesized a role for SEAM3C in acute kidney injury. Sema3c was genetically abrogated during acute kidney injury and subsequent kidney morphological and functional defects in two well-characterized models of acute kidney injury; warm ischemia/reperfusion and folic acid injection were analyzed. Employing a beta actin-dependent, inducible knockout of Sema3c, we demonstrate that in acute kidney injury SEMA3C promotes interstitial edema, leucocyte infiltration and tubular injury. Additionally, intravital microscopy combined with Evans Blue dye extravasation and primary culture of magnetically sorted peritubular endothelial cells identified a novel role for SEMA3C in promoting vascular permeability. Thus, our study points to microvascular permeability as an important driver of injury in acute kidney injury, and to SEMA3C as a novel permeability factor and potential target for therapeutic intervention.
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http://dx.doi.org/10.1016/j.kint.2021.12.028 | DOI Listing |
JAMA Intern Med
January 2025
Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
Importance: No large randomized clinical trial has directly compared empagliflozin with dapagliflozin, leaving their comparative effectiveness regarding kidney outcomes unknown.
Objective: To compare kidney outcomes between initiation of empagliflozin vs dapagliflozin in adults with type 2 diabetes who were receiving antihyperglycemic treatment.
Design, Setting, And Participants: This target trial emulation used nationwide, population-based routinely collected Danish health care data to compare initiation of empagliflozin vs dapagliflozin in adults with type 2 diabetes who received antihyperglycemic treatment between June 1, 2014, and October 31, 2020.
Mol Genet Genomics
January 2025
Department of Emergency, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, 441000, China.
Acute kidney injury (AKI) is one of the most serious and common complications in the course of sepsis, known for its poor prognosis and high mortality rate. Recently, ferroptosis, as a newly discovered regulatory cell death, might be closely associated with the progression of AKI. METTL14 is a writer of RNA m6A, an abundant epigenetic modification in transcriptome with broad function.
View Article and Find Full Text PDFPediatr Nephrol
January 2025
Faculty of Medicine, Department of Pharmacology, Kırıkkale University, Kırıkkale, Turkey.
Homogentisic acid (HGA) accumulation in alkaptonuria (AKU) causes injuries in various organs including the kidney. We present a case of a 9-year-old girl initially diagnosed with AKU-related nephropathy due to proteinuria found in her urine analyses. Despite 1 month of ramipril treatment, the patient's proteinuria progressed, and as a result, kidney biopsy and nitisinone treatment were planned.
View Article and Find Full Text PDFPediatr Crit Care Med
January 2025
Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA.
Objectives: To report the feasibility of a fluid management practice bundle and describe the pre- vs. post-implementation prevalence and odds of cumulative fluid balance greater than 10% in critically ill pediatric patients with respiratory failure.
Design: Retrospective cohort from May 2022 to December 2022.
J Trauma Acute Care Surg
January 2025
From the Division of Urology, Department of Surgery (S.K., J.B.M.), University of Utah School of Medicine, Salt Lake City, Utah; Department of Surgery (G.T.T.), Scripps Memorial Hospital La Jolla, La Jolla, California; Division of Urology, Department of Surgery (R.M.), University of Toronto, Toronto, Ontario, Canada; Department of Radiology (J.A.G.), University of Washington, Harborview Medical Center, Seattle, Washington; Department of Surgery (C.C.), UC Health Medical Center of the Rockies, Loveland, Colorado; Department of Surgery (K.L.K.), University of California San Francisco Fresno, Fresno, California; Department of Surgery (M.C.), Case Western Reserve University, Cleveland, Ohio; Shock Trauma Center (R.A.K.), University of Maryland School of Medicine, Baltimore, Maryland; Division of Acute Care and Regional General Surgery (N.L.W., B.L.Z.), University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin; and Scott Department of Urology (M.C.), Baylor College of Medicine, Houston, Texas.
The American Association for the Surgery of Trauma initially published the organ injury scaling for the kidney in 1989, which was subsequently updated in 2018. This current American Association for the Surgery of Trauma kidney organ injury scaling update incorporates the latest evidence in diagnosis and management of renal trauma and is based upon a multidisciplinary consensus. These changes reflect the near universal use of computed tomography for renal trauma evaluation and the widespread adoption of conservative management across all grades of renal trauma.
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