The phagocytic and candidacidal functions of polymorphonuclear leukocytes were evaluated in uremic patients. Neutrophils were derived from 12 patients treated by regular hemodialysis, eight nondialyzed uremic patients (glomerular filtration rate less than 20 ml/min), and nine healthy subjects. The ability of the neutrophils, suspended in autologous plasma, to phagocytize and kill Candida albicans cells was determined in vitro. The percentages of cells showing phagocytosis were 48.5 +/- 11.3 (SD) in the dialyzed patients, 52.7 +/- 13 in the nondialyzed uremic patients and 52.7 +/- 16.7 in the control group. The percentages of the yeast cells killed were also similar in the three groups: 27.6, 25.4, and 26.8%, respectively. There appears to be no impairment in the effector functions of the neutrophils in uremia. A possible depressive effect of the uremic plasma is also excluded.
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Kidney Med
January 2025
Department of Internal Medicine, Section of Cardiovascular Medicine, Yale University School of Medicine, New Haven, CT.
Rationale & Objective: Peritoneal dialysis (PD) solutions provide both clearance of uremic toxins and sodium and water. An intraperitoneal (IP) solution of icodextrin and glucose designed without the requirement for uremic toxin clearance could provide substantially greater sodium and water removal than PD solutions.
Study Design: We examined varying concentrations of icodextrin and dextrose IP solutions in rats.
J Nephrol
January 2025
Nephrology Unit, V. Fazzi Hospital, Lecce, Italy.
Background: The KDIGO recommendation in acute kidney injury (AKI) patients requiring kidney replacement therapy is to deliver a Urea Kt/V of 1.3 for intermittent thrice weekly hemodialysis, and an effluent volume of 20-25 ml/kg/hour when using continuous renal replacement therapy (CRRT). Considering that prior studies have suggested equivalent outcomes when using CRRT-prolonged intermittent renal replacement therapy (PIRRT) effluent doses below 20 mL/kg/h, our group investigated the possible benefits of low effluent volume CRRT-PIRRT (12.
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December 2024
Renal Pathophysiology Laboratory, Hospital das Clínicas, University of São Paulo School of Medicine, São Paulo, Brazil.
In glomerulopathies, endothelial dysfunction and the presence of histological vascular lesions such as thrombotic microangiopathy, arteriolar hyalinosis, and arteriosclerosis are related to a severe clinical course and worse renal prognosis. The endothelial cell, which naturally has anti-inflammatory and anti-thrombotic regulatory mechanisms, is particularly susceptible to damage caused by various etiologies and can become dysfunctional due to direct/indirect injury or a deficiency of protective factors. In addition, endothelial regulation and protection involve participation of the complement system, factors related to angiogenesis, the renin-angiotensin system (RAS), endothelin, the glycocalyx, the coagulation cascade, interaction between these pathways, interactions between glomerular structures (the endothelium, mesangium, podocyte, and basement membrane) and interstitial structures (tubules, arterioles and small vessels).
View Article and Find Full Text PDFTheranostics
January 2025
Department of Nephrology, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, 300 Guangzhou Road, Nanjing 210029, China.
Chronic kidney disease (CKD) is a global public health issue, with vascular calcification (VC) being a common and deadly complication. Despite its prevalence, the underlying mechanisms of VC remain unclear. In this study, we aimed to investigate whether and how Otubain-2 (OTUB2) contributes to VC.
View Article and Find Full Text PDFCureus
December 2024
Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA.
Calciphylaxis is a rare but potentially life-threatening disease that is not yet completely understood. It occurs mainly in patients with chronic kidney disease termed calcific uremic arteriolopathy (CUA) but also affects patients with normal renal function. Although this disease's pathogenesis is unclear, it is associated with the dysregulation of calcium and phosphate and subsequent calcification of peripheral arterioles.
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