Research - Kidney Disease
Secondhand Smoke Linked with Higher Kidney Disease Risk
Even low amounts of exposure may affect kidney health.
A new study has uncovered a link between exposure to secondhand smoke and the development of chronic kidney disease (CKD). The study, which appears in an upcoming issue of the Clinical Journal of the American Society of Nephrology(CJASN), provides additional rationale for strengthening public smoking restriction policies and supporting educational programs about the harms of secondhand smoke.
Cigarette smoking and exposure to secondhand smoking have been linked with higher risks of various diseases, but their effects on kidney health are unclear. A team from Korea led by Jung Tak Park, MD, PhD (Yonsei University College of Medicine) and Jong Hyun Jhee, MD (Inha University College of Medicine) conducted a study to investigate the association between secondhand smoke exposure and CKD in adults who had never smoked.
The study included 131,196 never-smokers who participated in the Korean Genome and Epidemiology Study from 2001 to 2014. Participants were classified into 3 groups based on frequency of secondhand smoke exposure as assessed with survey questionnaires: no-exposure, less than 3 days per week of exposure, and 3 or more days per week of exposure.
Participants with less than 3 days per week and those with 3 or more days per week of exposure had 1.48-times and 1.44-times higher odds of having CKD when compared with participants with no secondhand cigarette exposure.
In an additional analysis, the researchers assessed the risk of receiving a new diagnosis of CKD over an average follow-up of 8.7 years among 1,948 participants. Compared with the no-exposure group, the risk for developing CKD was 66% and 59% higher in participants with 3 or more days per week and less than 3 days per week of exposure, respectively.
“Secondhand smoke exposure at home or in the workplace is still prevalent despite legislative actions prohibiting public smoking. This exposure was found to be clearly related with CKD, even with less-frequent amounts of secondhand smoke exposure,” said Dr. Park.
Source : American Society of Nephrology via Newswise
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Renoprotective effect of Spirulina platensis extract against nicotine-induced oxidative stress-mediated inflammation in rats
Walid E.ZahranManal A.Emam
Background: Nicotine is an important factor in the pathogenesis of renal injury in smokers. Purpose: The purpose of the present study was to investigate the renoprotective effect of Spirulina platensis extract (SP) against chronic nicotine administration in rats.
Methods: Nicotine intoxication was induced with 0.5 mg/kg BW. Rats received 500 mg SP/kg BW by gastric gavage over 4 weeks.
Results: Our data revealed that nicotine induced renal dysfunction manifested by significant abnormal levels of kidney function markers (creatinine and urea) accompanied by increased levels of oxidative stress biomarker (malondialdehyde) and inflammatory markers (nitric oxide, Interleukin-6 and tumor necrosis factor-α) while antioxidant status as glutathione level and glutathione S-transferase activity were found to be decreased significantly as compared with controls. It is worthy to note that nicotine toxicity induced significant increments in the protein expression levels of nuclear factor kappa B as well as caspase-3. Histopathological observations showed tubular necrosis and congestion in the endothelial lining glomerular tuft and epithelial lining renal tubules with nicotine intoxication. Interestingly, our data demonstrated that SP supplementation significantly improved the nicotineinduced kidney dysfunction, alleviated the induced-lipid peroxidation, inflammatory, apoptotic protein markers, and boosted the enzymatic/non-enzymatic antioxidants. Moreover, it attenuated the nicotineinduced histopathological alterations of the kidney architecture.
Conclusion: Thus, it is tempting to recommend dietary approaches with Spirulina platensis extract for smokers to minimize the deleterious effect of chronic nicotine consumption and exposure-related problems towards kidney injury via its antioxidant, anti-inflammatory and antiapoptotic properties.
Source : Journal Phytomedicine
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Red Meat Intake and Risk of ESRD
- Quan-Lan Jasmine Lew*,
- Tazeen Hasan Jafar†‡,
- Hiromi Wai Ling Koh§,
- Aizhen Jin‖,
- Khuan Yew Chow‖,
- Jian-Min Yuan¶** and
- Woon-Puay Koh†§
Randomized controlled trials suggest that protein restriction may retard the progression of CKD toward ESRD. However, the effects of dietary protein intake level and the food sources of dietary protein on the risk of ESRD in the general population remain unclear. We investigated these effects in the Singapore Chinese Health Study, a prospective population-based cohort that recruited 63,257 Chinese adults aged 45–74 years from 1993 to 1998. We collected habitual diet information via a validated semiquantitative food frequency questionnaire and identified ESRD via record linkage with a nationwide registry. In all, 951 cases of ESRD occurred over a mean follow-up of 15.5 years. Regarding total protein intake, compared with the lowest quartile, the three higher quartiles combined had a hazard ratio for ESRD of 1.24 (95% confidence interval [95% CI], 1.05 to 1.46), but the dose-dependent association across the quartiles was not statistically significant (Ptrend=0.16). Red meat intake strongly associated with ESRD risk in a dose-dependent manner (hazard ratio for highest quartile versus lowest quartile,1.40 [95% CI, 1.15 to 1.71;Ptrend<0.001]). Intake of poultry, fish, eggs, or dairy products did not associate with risk of ESRD. In substitution analysis, replacing one serving of red meat with other food sources of protein associated with a maximum relative risk reduction of 62.4% (95% CI, 33.1 to 78.9; P<0.01). Our study shows that red meat intake may increase the risk of ESRD in the general population and substituting alternative sources of protein may reduce the incidence of ESRD.
Source : J Am Soc Nephrol.
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Ethanolic Ginkgo biloba leaf extract prevents renal fibrosis through Akt/mTOR signaling in diabetic nephropathy
- Qian Lu1,
- Wen-Zi Zuo1,
- Xiao-Jun Ji,
- Yue-Xian Zhou,
- Yu-Qing Liu,
- Xiao-Qin Yao,
- Xue-Yan Zhou,
- Yao-Wu Liu,
- Fan Zhang,
- Xiao-Xing Yin
Recently, extract of Ginkgo biloba leaves (GbE) have become widely known phytomedicines and have shown various pharmacological activities, including improvement of blood circulation, protection of oxidative cell damage, prevention of Alzheimer's disease, treatment of cardiovascular disease and diabetes complications. This study was designed to investigate the effects of an ethanolic GbE on renal fibrosis in diabetic nephropathy (DN) and to clarify the possible mechanism by which GbE prevents renal fibrosis.
We investigated the protective effects of GbE on renal fibrosis in STZ-induced diabetic rats. Rats were randomized into six groups termed normal control, diabetes mellitus, low dose of GbE (50 mg/kg/d), intermediate dose of GbE (100 mg/kg/d), high dose of GbE (200 mg/kg/d) and rapamycin (1 mg/kg/d).
After 12 weeks, the rats were sacrificed and then fasting blood glucose (FBG), creatinine (Cr), blood urea nitrogen (BUN), urine protein, relative kidney weight, glycogen and collagen accumulation, and collagen IV and laminin expression were measured by different methods. The amounts of E-cadherin, α-SMA and snail, as well as the phosphorylation of Akt, mTOR and p70S6K in the renal cortex of rats, were examined by western blotting.
Compared with diabetic rats, the levels of Cr, BUN, urine protein, relative kidney weight, accumulation of glycogen and collagen, and expression of collagen IV and laminin in the renal cortex were all decreased in GbE treated rats. In addition, GbE reduced the expression of E-cadherin, α-SMA, snail and the phosphorylation of Akt, mTOR and p70S6K in diabetic renal cortex.
GbE can prevent renal fibrosis in rats with diabetic nephropathy, which is most likely to be associated with its abilities to inhibit the Akt/mTOR signaling pathway.
Source : Journal Phytomedicine
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Lavender Essential Oil Reduces Renal Colic Pain in Female Patients
Irmak Sapmaz H, Uysal M, Taş U, et al. The effect of lavender oil in patients with renal colic: a prospective controlled study using objective and subjective outcome measurements. J Altern Complement Med. October 2015;21(10):617-622.
Renal colic, with severe flank, side, pelvic, abdominal, and/or back pain, develops secondary to stone formation in the ureter. About half of patients presenting with renal colic require acute hospital care, generally in emergency departments. There is currently no consensus on the ideal treatment protocol, but nonsteroidal anti-inflammatory drugs (NSAIDS) are the first-line treatment, with opioid analgesics used if response to NSAIDS is inadequate. Essential oil of lavender (Lavandula spp., Lamiaceae) has long been used in aromatherapy to decrease moderately severe depression, anxiety, and pain, and to support restful sleep. It has known comforting, anti-inflammatory, antiseptic, anticonvulsant, anxiolytic, and analgesic effects. While many studies have examined medical treatments that decrease the pain of renal colic, few have focused on alternative therapies like aromatherapy. The goal of this double-blind, randomized, placebo-controlled, interventional study was to evaluate the effects of lavender essential oil on renal colic.
The study, conducted in Tokat, Turkey, included 100 patients (59 men and 41 women) aged 19-64 years. Recruitment methods and study time frame were not reported, but all patients at the time of inclusion had flank pain and kidney stones. Patients were randomly divided into 2 groups and assigned to treatment in 1 of 2 separate but identical rooms. Patients in room 1 (group 1; 29 men and 21 women) received 75 mg intramuscular diclofenac and a placebo physiologic serum administered via electronic vaporizer. Patients in room 2 (group 2; 30 men and 20 women) received 75 mg intramuscular diclofenac and aromatherapy consisting of 2% lavender oil (LO; manufacturer not indicated) dispersed via electronic vaporizer. Degree of pain was evaluated by patients before treatment and at 10 and 30 minutes after treatment using a visual analog scale (VAS), with 0 representing no pain and 10 representing the most severe pain. Mean arterial pressure (MAP) and heartbeats per minute (BPM) also were recorded at the same time. Comparisons were made between groups and between male and female patients.
VAS scores before treatment and at 10 minutes after treatment did not differ significantly between the groups. However, group 2 VAS scores at 30 minutes after treatment were significantly lower than group 1 (P=0.022). When female and male patients' VAS scores were analyzed separately, there was no difference between group 1 and group 2 before treatment or, for men, at 10 or 30 minutes after; however, for women in group 2, VAS scores at 30 minutes after treatment were significantly lower than those of women in group 1 (P=0.0001). In vivo, aromatherapy has been observed to reduce pain-indicating behaviors in female rats more than male rats, perhaps due to the LO's effect on acetylcholine secretion, induced by pain stimuli. Additionally, it is known that estrogens have important limbic system effects. MAP and BPM before and at 10 and 30 minutes following treatment did not differ significantly between groups.
The authors conclude that these results are similar to other studies and that the effects may be due to linalool and linalyl acetate found in lavender essential oil. Both exhibit analgesic and anti-inflammatory properties in human and in vivo studies, and linalool inhibits prostaglandin production. Additionally, olfactory pathways are connected to the limbic system, the stimulation of which leads to emotional changes that may also be effective in reducing pain. This study was not truly blind since LO is easily distinguishable by smell and this may have impacted the results. In conclusion, the authors surmise that while additional research is needed, aromatherapy with LO can be used as an adjuvant therapy, with NSAIDS or opioid analgesics, in cases of renal colic.
Source : American Botanical Council - Herbclip
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Ashwagandha attenuates TNF-α- and LPS-induced NF-κB activation and CCL2 and CCL5 gene expression in NRK-52E cells
- Elizabeth Grunz-Borgmann,
- Valeri Mossine,
- Kevin Fritsche and
- Alan R. Parrish
The aging kidney is marked by a chronic inflammation, which may exacerbate the progression of renal dysfunction, as well as increase the susceptibility to acute injury. The identification of strategies to alleviate inflammation may have translational impact to attenuate kidney disease.
We tested the potential of ashwaganda, sutherlandia and elderberry on tumor necrosis factor-α (TNF-α) and lipopolysaccharide (LPS) induced chemokine (CCL2 and CCL5) expression in vitro.
Elderberry water-soluble extract (WSE) was pro-inflammatory, while sutherlandia WSE only partially attenuated the TNF-α-induced changes in CCL5. However, ashwaganda WSE completely prevented TNF-α-induced increases in CCL5, while attenuating the increase in CCL2 expression and NF-κB activation. The same pattern of ashwagandha protection was seen using LPS as the pro-inflammatory stimuli.
Taken together, these results demonstrate the ashwaganda WSE as a valid candidate for evaluation of therapeutic potential for the treatment of chronic renal dysfunction.
Source : BMC Complementary and Alternative Medicine
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The Effect of Lavender Oil in Patients with Renal Colic: A Prospective Controlled Study Using Objective and Subjective Outcome Measurements
Hilal Irmak Sapmaz, MD,1 Murat Uysal, MD,1 Ufuk Taş, MD,1 Mehmet Esen, MD,2 Mustafa Barut, MD,3Battal Tahsin Somuk, MD,4 Tufan Alatlı, MD,2 and Safiye Ayan, MD5
1Faculty of Medicine, Department of Anatomy, Gaziosmanpasa University, Tokat, Turkey.
2Faculty of Medicine, Department of Emergency Medicine, Gaziosmanpasa University, Tokat, Turkey.
3Clinic of Internal Medicine, Tokat State Hospital, Tokat, Turkey.
4Faculty of Medicine, Department of Ear, Nose and Throat Diseases, Gaziosmanpasa University, Tokat, Turkey.
5Faculty of Medicine, Department of Biochemistry, Gaziosmanpasa University, Tokat, Turkey.
Objective: To assess the usability of lavender oil as an adjuvant in the medical treatment of pain due to renal stones.
Methods: One hundred patients age 19–64 years diagnosed with renal colic were included in the study. Group 1 (n=50) received standard medical therapy (diclofenac sodium, 75 mg intramuscularly); group 2 (n=50) received aromatherapy (lavender oil) in addition to the standard medical treatment. In both groups, the severity of the pain was graded between 0 (no pain) and 10 (severe pain) by using the visual analogue scale (VAS).
Results: The VAS values at the beginning and at 10 and 30 minutes in group 1 were 7.70±1.61, 5.02±2.20, and 2.89±1.96, respectively; in group 2, the values were 7.83±2.02, 4.42±2.46, and 2.20±1.74, respectively. The VAS values for the male patients in group 1 at the beginning and at 10 and 30 minutes were 7.61±1.47, 4.80±2.00, and 2.67±1.74; in the female patients, the values were 7.81±1.80, 5.40±2.41, and 3.72±1.94. For the male patients in group 2, the VAS values at the beginning and at 10 and 30 minutes were 8.25±2.01, 4.93±2.72, and 2.96±1.90, respectively; for the female patients, the values were 7.52±1.94, 4.15±1.95, and 1.21±0.91, respectively. Results are presented as mean±SD. Although there was no significant difference between the VAS values at the beginning and at 10 minutes in both groups, the VAS values at 30 minutes in the group receiving aromatherapy plus conventional treatment were statistically significantly low.
Conclusion: These findings suggest that the use of aromatherapy, which is a nonpharmacologic treatment method, as an adjuvant to conventional treatment methods will help decrease pain, particularly in female patients.
Source : Journal Alternative and Complementary Medicine
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Gluten exacerbates IgA nephropathy in humanized mice through gliadin–CD89 interaction
Christina Papista1,2,3,4, Sebastian Lechner1,2,3,4, Sanae Ben Mkaddem1,2,3,4, Marie-Bénédicte LeStang1,2,3,4, Lilia Abbad1,2,3,4, Julie Bex-Coudrat1,2,3,4, Evangéline Pillebout5, Jonathan M Chemouny1,2,3,4, Mathieu Jablonski6, Martin Flamant1,2,4,7, Eric Daugas1,2,3,4,6, François Vrtovsnik1,2,3,4,6, Minas Yiangou8, Laureline Berthelot1,2,3,4,10 and Renato C Monteiro1,2,3,4,9,10
IgA1 complexes containing deglycosylated IgA1, IgG autoantibodies, and a soluble form of the IgA receptor (sCD89), are hallmarks of IgA nephropathy (IgAN). Food antigens, notably gluten, are associated with increased mucosal response and IgAN onset, but their implication in the pathology remains unknown. Here, an IgAN mouse model expressing human IgA1 and CD89 was used to examine the role of gluten in IgAN. Mice were given a gluten-free diet for three generations to produce gluten sensitivity, and then challenged for 30 days with a gluten diet. A gluten-free diet resulted in a decrease of mesangial IgA1 deposits, transferrin 1 receptor, and transglutaminase 2 expression, as well as hematuria. Mice on a gluten-free diet lacked IgA1-sCD89 complexes in serum and kidney eluates. Disease severity depended on gluten and CD89, as shown by reappearance of IgAN features in mice on a gluten diet and by direct binding of the gluten-subcomponent gliadin to sCD89. A gluten diet exacerbated intestinal IgA1 secretion, inflammation, and villous atrophy, and increased serum IgA1 anti-gliadin antibodies, which correlated with proteinuria in mice and patients. Moreover, early treatment of humanized mice with a gluten-free diet prevented mesangial IgA1 deposits and hematuria. Thus, gliadin–CD89 interaction may aggravate IgAN development through induction of IgA1–sCD89 complex formation and a mucosal immune response. Hence, early-stage treatment with a gluten-free diet could be beneficial to prevent disease.
Source : Journal Kidney International
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A randomized controlled trial of the effects of n-3 fatty acids on resolvins in chronic kidney disease
Emilie Mas1 , Anne Barden1, Valerie Burke, Lawrence J. Beilin, Gerald F. Watts, Rae-Chi Huang, Ian B. Puddey,Ashley B. Irish
, Trevor A. Mori
Background and objectiveThe high incidence of cardiovascular disease (CVD) in chronic kidney disease (CKD) is related partially to chronic inflammation. n-3 Fatty acids have been shown to have anti-inflammatory effects and to reduce the risk of CVD. Specialized Proresolving Lipid Mediators (SPMs) derived from the n-3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) actively promote the resolution of inflammation. This study evaluates the effects of n-3 fatty acid supplementation on plasma SPMs in patients with CKD.
MethodsIn a double-blind, placebo-controlled intervention of factorial design, 85 patients were randomized to either n-3 fatty acids (4 g), Coenzyme Q10 (CoQ) (200 mg), both supplements, or control (4 g olive oil), daily for 8 weeks. The SPMs 18-HEPE, 17-HDHA, RvD1, 17R-RvD1, and RvD2, were measured in plasma by liquid chromatography–tandem mass spectrometry before and after intervention.
Seventy four patients completed the 8 weeks intervention. n-3 Fatty acids but not CoQ significantly increased (P < 0.0001) plasma levels of 18-HEPE and 17-HDHA, the upstream precursors to the E- and D-series resolvins, respectively. RvD1 was significantly increased (P = 0.036) after n-3 fatty acids, but no change was seen in other SPMs. In regression analysis the increase in 18-HEPE and 17-HDHA after n-3 fatty acids was significantly predicted by the change in platelet EPA and DHA, respectively.
SPMs are increased after 8 weeks n-3 fatty acid supplementation in patients with CKD. This may have important implications for limiting ongoing low grade inflammation in CKD.
Source : Clinical Nutrition
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Serum Metabonomic Analysis of Protective Effects of Curcuma aromatica Oil on Renal Fibrosis Rats
Liangcai Zhao equal contributor, Haiyan Zhang equal contributor, Yunjun Yang equal contributor,
Yongquan Zheng, Minjian Dong, Yaqiang Wang, Guanghui Bai, Xinjian Ye, Zhihan Yan mail, Hongchang Gao
(Curcuma aromatica (common name: wild turmeric) is a member of the Curcuma genus belonging to the family Zingiberaceae. Botanically close to Curcuma australasica, wild turmeric has been widely used as a cosmetic herbal in South Asia...)
Curcuma aromatica oil is a traditional herbal medicine demonstrating protective and anti-fibrosis activities in renal fibrosis patients. However, study of its mechanism of action is challenged by its multiple components and multiple targets that its active agent acts on.
Nuclear magnetic resonance (NMR)-based metabonomics combined with clinical chemistry and histopathology examination were performed to evaluate intervening effects of Curcuma aromatica oil on renal interstitial fibrosis rats induced by unilateral ureteral obstruction. The metabolite levels were compared based on integral values of serum 1H NMR spectra from rats on 3, 7, 14, and 28 days after the medicine administration. Time trajectory analysis demonstrated that metabolic profiles of the agent-treated rats were restored to control levels after 7 days of dosage. The results confirmed that the agent would be an effective anti-fibrosis medicine in a time-dependent manner, especially in early renal fibrosis stage. Targeted metabolite analysis showed that the medicine could lower levels of lipid, acetoacetate, glucose, phosphorylcholine/choline, trimethylamine oxide and raise levels of pyruvate, glycine in the serum of the rats. Serum clinical chemistry and kidney histopathology examination dovetailed well with the metabonomics data.
The results substantiated that Curcuma aromatica oil administration can ameliorate renal fibrosis symptoms by inhibiting some metabolic pathways, including lipids metabolism, glycolysis and methylamine metabolism, which are dominating targets of the agent working in vivo. This study further strengthens the novel analytical approach for evaluating the effect of traditional herbal medicine and elucidating its molecular mechanism.
Source : PLOS One
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Impact of Beverage Content on Health and the Kidneys
Johnson, Richard J. MD; Thomas, Jeffrey MD; Lanaspa, Miguel A. PhD
The last 50 years have witnessed an epidemic rise in obesity, diabetes, high blood pressure, and chronic kidney disease. Some animal research suggests the epidemic may in part be triggered by sugar. Sugar contains glucose and fructose, and studies suggest it is the fructose component that may have a role in chronic disease development. Animal studies indicate that fructose is distinct from other sugars by its ability to cause transient adenosine triphosphate (ATP) depletion in the cell with uric acid generation. The administration of fructose, or the raising of uric acid, can induce kidney disease and accelerate established kidney disease in animals. Therefore, we believe that the greatest risk from sugar is when it is given as a soft drink, as the rapidity of ingestion relates directly to the concentration of fructose that the cells are exposed to and hence govern the degree of ATP depletion and uric acid generation. Restricting sugar-sweetened beverages may be one strategy to combat obesity, diabetes, high blood pressure, and kidney disease, but human intervention studies are needed to support the theory.
Source : Journal Nutrition Today
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Preclinical Evaluation of Antiurolithiatic Activity of Viburnum opulus L. on Sodium Oxalate-Induced Urolithiasis Rat Model
Mert İlhan,1 Burçin Ergene,2 Ipek Süntar,1 Serkan Özbilgin,2 Gülçin Saltan Çitoğlu,2 M. Ayşe Demirel,3 Hikmet Keleş,4 Levent Altun,2 and Esra Küpeli Akkol1
1Department of Pharmacognosy, Faculty of Pharmacy, Gazi University, Etiler, 06330 Ankara, Turkey
2Department of Pharmacognosy, Faculty of Pharmacy, Ankara University, 06100 Ankara, Turkey
3Laboratory Animals Breeding and Experimental Researches Center, Faculty of Pharmacy, Gazi University, Etiler, 06330 Ankara, Turkey
4Department of Pathology, Faculty of Veterinary Medicine, Afyon Kocatepe University, 03200 Afyonkarahisar, Turkey
The aim of the present research is to evaluate the antiurolithiatic effect of the various extracts prepared from the fruits of Viburnum opulus L., in regard to its ethnobotanical record. To induce urolithiasis, 70 mg/kg sodium oxalate was injected to the rats which were housed individually in metabolic cages. The test materials were applied during 7 days. Biochemical (urine and serum parameters), histopathological and antioxidant (TBARs, TSH and GSH) assays were conducted. The urine samples were examined by light microscope for the determination of the calcium oxalate crystals. Lyophilized juice of V. opulus (LJVO) and lyophilized commercial juice of V. opulus (LCJVO) exerted potential antiurolithiatic activity which was attributed to its diuretic effect along with the inhibitory action on the oxalate levels and free radical production. We also determined the chlorogenic acid content of the LJVO by high-performance liquid chromatography (HPLC). Chlorogenic acid was determined by using Supelcosil LC-18 (250 x 4.6 mm, 5 µm) column and acetonitrile: water: 0.2% o-phosphoric acid as a mobile phase. The chlorogenic acid content of V. opulus was found to be 0.3227 mg/mL in fruit juice. The results obtained in this study have provided a scientific evidence for the traditional usage of V. opulus on passing kidney stones in Turkish folk medicine.
Source : Evidence Based Complementary and Alternative Medicine
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Auricular Acupressure Helps Improve Sleep Quality for Severe Insomnia in Maintenance Hemodialysis Patients:A Pilot Study
Yuchi Wu, MS,1,*Chuan Zou, PhD,2,*Xusheng Liu, MS,1Xiuqing Wu, BS,1and Qizhan Lin, MS2
Background:Insomnia is common in patients undergoing maintenance hemodialysis (MHD). Long-term use ofsedative-hypnotic agents is often correlated with increasing adverse effects. Auricular acupressure therapy(AAT) applied to specific auricular acupoints for managing insomnia has achieved favorable outcomes in ahemodialysis unit. This pilot study was performed to demonstrate the potential of AAT for insomnia in MHDpatients and to prepare for a future randomized controlled trial
Methods:Eligible patients were enrolled into this descriptive pilot study and received AAT designed to manage insomnia for 4 weeks. Questionnaires that used the Pittsburgh sleep quality index (PSQI) were completed at baseline, after a 4-week intervention, and 1 month after completion of treatment. Sleep quality and other clinical characteristics, including sleeping pills taken, were statistically compared between different time points.
Results:A total of 22 patients were selected as eligible participants and completed the treatment and questionnaires. The mean global PSQI score was significantly decreased after AAT intervention (p<0.05). Participants reported improved sleep quality (p<0.01), shorter sleep latency (p<0.05), less sleep disturbance(p<0.01), and less daytime dysfunction (p=0.01). They also exhibited less dependency on sleep medications,indicated by the reduction in weekly estazolam consumption from 6.98–4.44 pills to 4.23–2.66 pills(p<0.01). However, these improvements were not preserved 1 month after treatment.
Conclusion:In this single-center pilot study, complementary AAT for MHD patients with severe insomnia was feasible and well tolerated and showed encouraging results for sleep quality.
Source : Journal Alternative and Complementary Medicine
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Salvia miltiorrhiza Injection Ameliorates Renal Damage Induced by Lead Exposure in Mice
Lei Li,1,2 Yuanyuan Zhang,1 Juanjuan Ma,1 Weichong Dong,3 Qiongtao Song,1 Jianping Zhang,1 and Li Chu1
1Department of Pharmacology, School of Basic Medicine, Hebei Medical University, 326 Xinshi South Road, Shijiazhuang, Hebei 050091, China
2Department of Internal Medicine, Baoding First Hospital of Traditional Chinese Medicine, Yuhua Western Road, Baoding, Hebei 071000, China
3Department of Pharmaceutical Analysis, School of Pharmacy, Hebei Medical University, 361 Zhongshan East Road, Shijiazhuang, Hebei 050017, China
Exposure to lead (Pb) can induce kidney injury and our recent studies have found that Salvia miltiorrhiza (SM) injection, a traditional Chinese medicine, could protect against the organ injury induced by iron overload. This study was designed to investigate the protective effects of SM injection on nephrotoxicity induced by Pb acetate in mice and to elucidate the potential mechanism(s). Healthy male mice were randomly divided into four groups: control, Pb, low-dose Salvia miltiorrhiza (L-SM), and high-dose Salvia miltiorrhiza (H-SM). SM injection dose dependently reduced the Pb accumulation in the kidney, decreased kidney coefficients, and ameliorated renal structure and function from the morphology analysis. Meanwhile, SM administration downregulated serum levels of blood urea nitrogen (BUN) and creatinine (CR), decreased malondialdehyde (MAD) content, and increased activities of super oxide dismutase (SOD) and glutathione peroxidase (GSH-Px) in the kidney homogenate. Moreover, SM injection reduced the level of renal apoptosis by immunohistochemical staining analysis. Our findings implicate the therapeutic potential of SM injection for Pb-induced nephrotoxicity, which were at least partly due to the decrease of Pb accumulation, inhibition of lipid peroxidation, and suppression of renal apoptosis. These results provided preliminary experimental support for Danshen as a therapeutic drug for Pb poisoning diseases.
Source : The Scientific World Journal
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Nephro-protective effect of Kangqianling decoction on chronic renal failure rats.
He L1, Shen P, Fu Q, Li J, Dan M, Wang X, Jia W.Author information
ETHNOPHARMACOLOGICAL RELEVANCE: Kangqianling decoction (KQL), the modified formulation of a classical Chinese prescription named Taohongsiwu decoction, was clinically employed to treat renal fibrosis in chronic renal failure.
AIM OF THE STUDY: The present study was designed to examine whether KQL has a protective effect on renal function in association with transforming growth factor-beta (TGF-beta), angiotensin II (Ang II), tumor necrosis factor-alpha (TNF-alpha), nuclear factor-kappaB (NF-kappaB) in rats with 5/6 renal ablation (Nx)-induced chronic renal failure.
RESULTS: In renal function deterioration progression, the high expression of serum creatinine (Scr), 24-h urine protein and systolic blood pressure were markedly (P<0.05 or P<0.01) restored by KQL, respectively, at 4 and 8 weeks. The increasing expressions of renal Ang II (P<0.05), angiotensin II1-receptor (AT1R) (P<0.05), TNF-alpha (P<0.05), NF-kappaB (P<0.001) and urine TGF-beta1 (P<0.05) were reduced by the treatment of KQL. Immunohistochemical study further confirmed the nephro-protective activity of KQL as compared to the control and Sham group.
CONCLUSIONS: The results indicate that KQL is able to protect renal function via ameliorating experimental rat renal failure as found in these renal functional parameters.
Source : Journal Ethnopharmacol.
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Protective Effects of Bu-Shen-Huo-Xue Formula against 5/6 Nephrectomy-Induced Chronic Renal Failure in Rats
Jian-Rao Lu,1 Hai-Yan Han,1 Jie Chen,1 Chong-Xiang Xiong,1 Xin-Hua Wang,1 Jing Hu,1 Xiu-Feng Chen,1 and Li Ma2
1Division of Nephrology, Shanghai Seventh People’s Hospital, Shanghai 200137, China
2School of Traditional Chinese Medicine, Capital Medical University, Beijing 100069, China
Chronic renal failure (CRF) is a serious disease related to increasing incidence and prevalence as well as decline in quality of life. Bu-Shen-Huo-Xue formula (BSHX), one of traditional herbal formulations, has been clinically employed to treat CRF for decades, but the mechanisms involved have not been investigated. In the present study, we investigated the effects of BSHX on some closely related parameters in 5/6 nephrectomy CRF rats. Rats with CRF were divided into five groups, namely, one control group, one enalapril group, and three BSHX treatment groups (0.25, 0.5, and 1 g/kg d). The rats subjected to sham operation were used as a normal control. After eight weeks of treatment, BSHX significantly decreased the levels of Scr and BUN, downregulated the mRNA expression levels of TGF- B1, CTGF, NF- KB, TNF- a , and OPN, upregulated the mRNA expression of PPARy , and reduced in situ expression of fibronectin and laminins. Histological findings also showed significant amelioration of the damaged renal tissue. BSHX protects 5/6 nephrectomy rats against chronic renal failure probably via regulating the expression of TNF- a, NF-KB, TGF- B1, CTGF, PPARy , OPN, fibronectin, and laminins and is useful for therapy of CRF.
Source : Evidence Based Complementary and Alternative Medicine
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Impact of Vitamin D Supplementation on Arterial Vasomotion, Stiffness and Endothelial Biomarkers in Chronic Kidney Disease Patients
- Nihil Chitalia,
- Tuan Ismail,
- Laura Tooth,
- Frances Boa,
- Geeta Hampson,
- David Goldsmith,
- Juan Carlos Kaski,
- Debasish Banerjee
Cardiovascular events are frequent and vascular endothelial function is abnormal in patients with chronic kidney disease (CKD). We demonstrated endothelial dysfunction with vitamin D deficiency in CKD patients; however the impact of cholecalciferol supplementation on vascular stiffness and vasomotor function, endothelial and bone biomarkers in CKD patients with low 25-hydroxy vitamin D [25(OH)D] is unknown, which this study investigated.
We assessed non-diabetic patients with CKD stage 3/4, age 17–80 years and serum 25(OH)D <75 nmol/L. Brachial artery Flow Mediated Dilation (FMD), Pulse Wave Velocity (PWV), Augmentation Index (AI) and circulating blood biomarkers were evaluated at baseline and at 16 weeks. Oral 300,000 units cholecalciferol was administered at baseline and 8-weeks.
Clinical characteristics of 26 patients were: age 50±14 (mean±1SD) years, eGFR 41±11 ml/min/1.73 m2, males 73%, dyslipidaemia 36%, smokers 23% and hypertensives 87%.
At 16-week serum 25(OH)D and calcium increased (43±16 to 84±29 nmol/L, p<0.001 and 2.37±0.09 to 2.42±0.09 mmol/L; p = 0.004, respectively) and parathyroid hormone decreased (10.8±8.6 to 7.4±4.4; p = 0.001). FMD improved from 3.1±3.3% to 6.1±3.7%, p = 0.001.
Endothelial biomarker concentrations decreased: E-Selectin from 5666±2123 to 5256±2058 pg/mL; p = 0.032, ICAM-1, 3.45±0.01 to 3.10±1.04 ng/mL; p = 0.038 and VCAM-1, 54±33 to 42±33 ng/mL; p = 0.006. eGFR, BP, PWV, AI, hsCRP, von Willebrand factor and Fibroblast Growth Factor-23, remained unchanged.
This study demonstrates for the first time improvement of endothelial vasomotor and secretory functions with vitamin D in CKD patients without significant adverse effects on arterial stiffness, serum calcium or FGF-23.
Source : PLOS One
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Combination of Boswellia and Curcumin in Chronic Kidney Disease
Moreillon JJ, Bowden RG, Deike E, et al.
The use of an anti-inflammatory supplement in patients with chronic kidney disease. J Complement Integr Med. 2013;10(1):1-10. doi: 10.1515/jcim-2012-0011.
Chronic kidney disease (CKD), which affects about 20 million Americans, is expected to rise in incidence because of the increase in diabetes, hypertension, and obesity. CKD is characterized by a chronic inflammatory state, with elevated levels of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in all stages of the disease. Patients with CKD also exhibit lower levels of plasma glutathione peroxidase (GPx) and other antioxidant enzymes. In most patients, CKD is not diagnosed early when the disease is asymptomatic, which is of concern because of the relationship between the systemic inflammation of the disease and the risk for cardiovascular disease (CVD). In addition to pharmaceuticals such as statins and angiotensin-converting enzyme inhibitors, complementary and alternative medicine therapies used to treat CKD are gaining interest in the scientific community. The authors conducted a study to evaluate the inflammatory and antioxidant responses of 8 weeks of curcumin (from turmeric; Curcuma longa) and boswellia (Indian frankincense; Boswellia serrata) supplementation in patients with mild-to-moderate CKD.
Patients at a community health center in Central Texas who were older than 18 years of age and had CKD in stages 1 through 5 were recruited for the study. Patients completed a medical history questionnaire and underwent a general physical examination by their physician to determine eligibility. The patients were randomly chosen to receive an herbal supplement of curcumin and boswellia (824 mg purified turmeric extract, 95% curcuminoids, and 516 mg boswellia extract, 10% 3-acetyl-11-keto-β-boswellic acid) or placebo (roasted rice [Oryza sativa] powder). The study supplement was added to the patients' existing treatment protocols. The study outcome variables were plasma IL-6, TNF-α, GPx, and serum C-reactive protein (CRP).
The patients participated in 2 testing sessions 8 weeks apart. During session 1, they donated blood after a 12-hour fast and underwent measurements for height, weight, heart rate, blood pressure, and waist and hip circumferences. They were then given an 8-week supply of the supplement or placebo and instructed to ingest 2 capsules daily (1 in the morning with breakfast and 1 in the evening with dinner) and to continue their usual medications. After 8 weeks, the patients returned to the clinic for another blood draw and a pill count to determine compliance. The patients' diets were not standardized; they maintained their normal dietary habits during the study.
Sixteen patients (out of an original 23) completed the study. At baseline, the placebo group (n=7) had significantly higher values for height (P=0.05), body mass index (BMI) (P=0.01), waist circumference (P=0.03), and hip circumference (P=0.02). Glomerular filtration rate (GFR), used to determine kidney function, was not significantly different between the groups. The authors report that baseline data demonstrated elevated inflammation and low antioxidant levels.
A significant time effect (P=0.03; effect size [ES]=0.32) and time × compliance interaction effect (P=0.05; ES=0.30) were observed for IL-6, with a decrease in the treatment group and an increase in the placebo group. No significant group, time, or interaction effects were seen for any of the other outcome variables. Noting that these findings partially support earlier research on the anti-inflammatory effects of curcumin and boswellia, the authors write: "Reasons for [only] partial support of previous literature could be due to a dose-response relationship, short study duration, influence of anti-inflammatory medications, small sample size, or lack of interaction between curcumin, Boswellia serrata, and some markers of inflammation." CRP and IL-6 have been shown to be significantly correlated.1 The authors explain that the lack of change in CRP in this study may be due to the high prevalence of nonsteroidal anti-inflammatory drug use by the study subjects, as most patients were taking aspirin to reduce the risk for myocardial infarction, which may have inhibited curcumin's effectiveness against CRP.
According to the authors, the lack of a statistical change in GPx levels may be due to the study duration and sample size: "A supplementation period of 8 weeks may have been of insufficient magnitude to observe changes in GPx, and the sample size used in the present study was small, with larger studies needed to determine if curcumin's antioxidant benefits observed in animal studies carry over to humans."
Only minor adverse side effects were reported during the study.
These results support those of previous studies suggesting that CKD is associated with an ongoing inflammatory state and impaired antioxidant activity. The study treatment was well tolerated and resulted in decreased inflammation as measured by IL-6; however, no changes were observed in any other inflammatory or antioxidant markers.
1Heinrich PC, Castell JV, Andus T. Interleukin-6 and the acute phase response. Biochem J. 1990;265(3):621-636.
Source : American Botanical Council
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Acid Levels in the Diet Could Have Profound Effects on Kidney Health
Three new studies suggest that controlling dietary acid intake could help improve kidney health. Results of these studies will be presented at ASN Kidney Week 2013 November 5¬–10 at the Georgia World Congress Center in Atlanta, GA.
A diet rich in wheat flour and animal protein produces an acidic environment in the body that worsens with age as kidney function declines. This acid load can be detrimental to a variety of tissues and processes. Research suggests that consuming more fruits and vegetables—which are highly alkaline—may help counteract these effects.
In a new study, a team led by Nimrit Goraya, MD (Texas A&M College of Medicine) investigated whether consuming fruits and vegetables can protect the kidney health of individuals with hypertensive nephropathy, a condition in which damage to the kidneys occurs due to high blood pressure. In this study, 23 hypertensive patients received extra dietary fruits and vegetables, 23 patients received an oral alkaline medication, and 25 patients received nothing. One year later, kidney injury progressed in patients who received no intervention, but kidney health was preserved in those receiving fruits and vegetables or oral alkaline medication.
In another study, Eiichiro Kanda, MD, PhD (Tokyo Kyosai Hospital) and his colleagues investigated the role of dietary acid levels in chronic kidney disease (CKD) progression. The retrospective study analyzed data from 249 CKD patients in Japan. High acid levels were linked with accelerated kidney function decline, and patients with elevated acid levels had an increased risk of CKD progression compared with patients with low acid levels. The findings suggest that monitoring and control of dietary acid levels are necessary for the prevention of CKD progression.
Another study led by Deidra Crews, MD, FASN (Johns Hopkins University School of Medicine) looked to see whether the effect of dietary acid on risk of kidney failure differed by race in a group of 159 non-Hispanic black and 760 non-Hispanic white CKD patients who had an annual household income below 300% of the federal poverty guideline. Participants were taking part in the 1999-2004 National Health and Nutrition Examination Survey. Overall, 12.4% of participants (38.3% whites and 61.7% blacks) developed kidney failure during an average of 6.4 years of follow up. Blacks had higher acid levels than whites. They also had a 3-fold higher risk of developing kidney failure compared with whites after adjusting for factors such as age, sex, and caloric intake. Increased acid levels were more strongly associated with kidney failure among blacks than among whites. The findings indicate that among CKD patients with low socioeconomic status, the detrimental effect of high dietary acid levels on progression to kidney failure appears to be greater for blacks than for whites.
Source : Newswise
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Soft Drinks and Sugar in the Diet May Have Negative Effects on the Kidneys
Two new studies highlight the potential negative effects that soft drinks and sugar can have on kidney health. Results of these studies will be presented at ASN Kidney Week 2013 November 5¬–10 at the Georgia World Congress Center in Atlanta, GA.
In one study, researchers led by Ryohei Yamamoto, MD, PhD (Osaka Univ Graduate School of Medicine, in Japan) found that consuming at least two soft drinks per day is linked with proteinuria—or increased excretion of protein in the urine, which is a hallmark of kidney dysfunction. Among 3579, 3055, and 1342 university employees with normal kidney function at the start of the study who reported that they drink zero, one, and two or more soft drinks per day, 301 (8.4%), 272 (8.9%) and 144 (10.7%) employees developed proteinuria during a median of 2.9 years of follow-up, respectively.
Another study led by Agustin Gonzalez-Vicente (Case Western Reserve University) and conducted in rats found that moderate fructose intake increases the kidney’s sensitivity to angiotensin II, a protein that regulates salt balance. This leads to increased salt reabsorption by cells in the kidneys, a finding that might help explain why consumption of high-fructose corn syrup as a sweetener may contribute to the epidemic of diabetes, obesity, kidney failure, and hypertension.
Studies: “Soft Drink Intake and Prediction of Proteinuria: A Retrospective Cohort Study.” (Abstract 2458)
Disclosures: Hiromi Rakugi has an ownership interest in and receives research funding from Astellas Pharma Inc., Daiichi Sankyo Co., Ltd., Dainippon Sumitomo Pharma Co., Ltd., Eisai Co., Ltd., Kyowa Hakko Kirin Co., Ltd., Mitsubishi Tanabe Pharma Corporation, and Mochida Pharmaceutical Co., Ltd.; and receives research funding and honoraria from MSD K. K., Nippon Boehringer Ingelheim Co., Ltd., Novartis Pharma K.K., Ono Pharmaceutical Co., Ltd., Pfizer Japan Inc., Shionogi & Co., Ltd., and Takeda Pharmaceutical Co., Ltd., (All in Japan).
“Chronic Consumption of Fructose Increases Proximal Tubular Transport by Enhancing the Sensitivity to Angiotensin II.” (Abstract 3955)
Disclosures: Jeffery L. Garvin receives honoraria from APS and NIH.
Source : Newswise
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Vitamin D Does Not Contribute To Kidney Stones
Increased vitamin D levels may prevent a wide range of diseases, according to recent studies. However, some previous studies led to a concern that vitamin D supplementation could increase an individual’s risk of developing kidney stones.
However, a study of 2,012 participants – published in the American Journal of Public Health –found no statistically relevant association between 25-hydroxyvitamin D (25 (OH)D) serum level in the range of 20 to 100 ng/mL and the incidence of kidney stones.
This study – led by Cedric F. Garland, DrPH, adjunct professor in the Division of Epidemiology, Department of Family and Preventive Medicine at the University of California, San Diego School of Medicine – used data from the nonprofit public health promotion organization GrassrootsHealth to follow more than 2,000 men and women of all ages for 19 months.
Only 13 individuals self-reported a kidney stone diagnosis during the study.
“Mounting evidence indicates that a Vitamin D serum level in the therapeutic range of 40 to 50 ng/mL is needed for substantial reduction in risk of many diseases, including breast and colorectal cancer,” said Garland, adding that this serum level is generally only achieved by taking vitamin supplements. “Our results may lessen concerns by individuals about taking vitamin D supplements, as no link was shown between such supplementation and an increased risk for kidney stones.”
The study did show that older age, male gender and higher body mass index (BMI) were all risk factors for developing kidney stones. According to the researchers, individuals with high BMI need higher vitamin D intake than their leaner counterparts to achieve the same 25 (OH)D serum level.
Source : Newswise
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Light Exercise Still Cuts Kidney Stone Risk
Women who exercised even minimally had a significantly lower risk of kidney stones, according to an analysis of a large cohort study. Overall, physically active women had about a 30% lower risk of kidney stones compared with women who reported no exercise. The risk reduction ranged as high as 80% in one analysis, reported Mathew Sorensen, MD, of the University of Washington in Seattle, and colleagues at the American Urological Association (AUA) meeting.
The benefit for stone disease kicked in with only modest physical activity of just about any intensity, he added.
"The intensity of exercises does not matter," Sorensen said during an AUA press briefing. "There was no difference between women who performed primarily mild, moderate, or strenuous activity. The protective effect of increased activity was similar for all exercisers."
Almost 10% of the adult population in the U.S. will develop a kidney stone at some point. Kidney stone incidence has increased 70% over the past 15 years, and women have accounted for much of the increase, he explained, adding that the increase has been attributed to the rising prevalence of weight gain, obesity, and metabolic syndrome.
The association with obesity is nothing new, he continued, as obesity has a long-established association as a risk factor for kidney stones. Obesity is thought to predispose people to stone formation by altering urinary pH and electrolytes. However, the association involves more than increased solute load resulting from excess caloric intake.
Systemic inflammation fueled by obesity and metabolic syndrome contribute to the risk of stone formation, as do impaired lipid handling and dyslipidemia. Most risk factors for cardiovascular disease also are common to nephrolithiasis.
Body mass index (BMI), a marker of an imbalance between energy intake and expenditure, also contributes to kidney stone risk. Sorensen and colleagues hypothesized that changes in energy intake and expenditure -- restricted caloric intake and increased physical activity -- might alter the risk.
Adjusting for BMI
To test the hypothesis, investigators analyzed data from the Women's Health Initiative, which enrolled 93,676 women, ages 50 to 79, from 1993 to 1998 and had a median follow-up of 8 years. Information elicited at enrollment and follow-up included self-reported history of kidney stones, a food frequency questionnaire, and physical activity converted into metabolic equivalents (METs) per week.
After excluding participants with a history of stone disease or incomplete information, the final analysis included 84,225 women, 2,392 (2.8%) of whom developed kidney stones during follow-up. To adjust for bias in self-reported energy intake, investigators made adjustments in subgroup study of 544 participants in 2004 and 2005, which corrected for bias on the basis of measurements involving an energy intake biomarker.
Energy intake was further calibrated according to age, BMI, race/ethnicity, income, and physical activity.
Investigators developed two statistical models for the analysis, one of which adjusted only for BMI and the other which adjusted for activity, energy intake, and BMI.
Sorensen and colleagues performed two exploratory analyses: type and intensity of a participant's primary form of exercise and total weekly METs and their associations with stone risk.
The participants had a mean age of 64, mean BMI of 27.1, and mean METs/week of 14.0.
"We found that 87% of the women reported some type of physical activity, so this was active group of people," Sorensen said.
In the model that adjusted only for BMI, being underweight (BMI <18.5 kg/m2) afforded modest protection against kidney stones (hazard ratio 0.79), and normal-weight women (BMI 18.5 to 24.9 kg/m2) served as the reference.
The BMI range for overweight (25 to 29.9 kg/m2) was associated with a 30% increase in the hazard for stone formation, rising to 62% for moderately obese women (BMI 30 to 34.9 kg/m2) and 81% for severely obese women (BMI ≥35 kg/m2).
As compared with women who reported no physical activity, women who reported any physical activity had a significantly lower (P<0.001) risk of kidney stones:
- 0.1 to 4.9 METs/week: HR 0.84
- 5 to 9.9: HR 0.78
- 10 to 19.9: HR 0.69
- 20 to 29.9: HR 0.70
- ≥30: HR 0.69
Sorensen and colleagues also examined the association between daily energy intake in kilocalories (kcal) and stone risk in their model that incorporated physical activity, energy intake, and BMI. Using 1,800 to 1,999 kcal as the reference, they found that the HR for kidney stones increased as follows:
- 1.04 for daily energy intake of 2,000 to 2,199 kcal
- 1.26 for 2,200 to 2,499 kcal
- 1.42 for ≥2,500 kcal
"You don't have to run a marathon to reduce the risk of kidney stones," Sorensen said. "Mild to moderate amounts of activity decreased the risk by 16% to 31%. The amount of activity is what mattered, not the intensity of exercise."
As an example, he said 10 METs/week would require 3 hours of average walking, 4 hours of light gardening, or 1 hour of moderate jogging.
Theories about how exercise might reduce stone risk tend to focus on changes in vitamin and mineral handling induced by physical activity, including reduced sodium excretion, increased fluid intake, decreased sympathetic tone, and improved bone density. Noting a strong association between cardiovascular disease and stone formation, Sorensen said reducing cardiac risk factors favorably affects stone risk, including hypertension, diabetes, obesity, and cholesterol.
The findings require validation in men and in people who have a history of stone formation, said AUA press briefing moderator Tomas Griebling, MD, of the University of Kansas in Kansas City. Nonetheless, the lessons learned from the study can be applied immediately to clinical practice.
"Increasing physical activity and reducing energy intake is good advice for everyone," Griebling told MedPage Today. "More and more, we're learning that following common-sense lifestyle practices has a favorable effect on a wide range of conditions, and now we can add kidney stones to the list."
Source : MedPage Today
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Investigating the Effect of Aromatherapy in Patients with Renal Colic
Murat Ayan, MD,1 Ufuk Tas, MD,2 Erkan Sogut, MD,3 Mustafa Suren, MD,4 Levent Gurbuzler, MD,5 and Feridun Koyuncu, MD6
1Department of Emergency Medicine, Faculty of Medicine, Gaziosmanpasa University, Tokat, Turkey.
2Department of Anatomy, Faculty of Medicine, Gaziosmanpasa University, Tokat, Turkey.
3Department of Biochemistry, Faculty of Medicine, Gaziosmanpasa University, Tokat, Turkey.
4Department of Anesthesiology and Reanimation, Faculty of Medicine, Gaziosmanpasa University, Tokat, Turkey.
5Department of Ear, Nose and Throat, Faculty of Medicine, Gaziosmanpasa University, Tokat, Turkey
.6Department of Emergency Medicine, Faculty of Medicine, Bezmialem Vakıf University, Istanbul, Turkey.
Aim: The aim of the present study was to investigate the usefulness of rose essential oil as a supplementary and adjunctive therapy for the relief of renal colic, specifically because rose essential oil is soothing and can act as a muscle relaxant.
Materials: Eighty patients who were diagnosed with renal colic in the emergency room were included in the study, with ages ranging from 19 to 64 years. Half of the patients (n=40) were treated with conventional therapy (diclofenac sodium, 75 mg intramuscularly) plus placebo (physiological serum, 0.9% NaCl), while the other half (n=40) were given aromatherapy (rose essential oil) in addition to conventional therapy. In each patient, the severity of pain was evaluated using the Visual Analog Scale (VAS) (0 [no pain] to 10 [very severe pain]).
Findings: The VAS values prior to the start of therapy, and 10 and 30 minutes after therapy were 8.18±1.36, 5.60±2.02, and 3.75±2.08 for the conventional therapy plus placebo group, while for the conventional therapy plus aromatherapy group, the VAS values were 8.63±1.03, 4.25±1.72, and 1.08±1.07, respectively. There was no statistically significant difference between the starting VAS values of the two groups, but the VAS values 10 or 30 minutes after the initiation of therapy were statistically lower in the group that received conventional therapy plus aromatherapy.
Conclusion: This study demonstrated that rose essential oil therapy in addition to conventional therapy effectively reduces renal colic pain.
Source : The Journal of Alternative and Complementary Medicine
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Chronic kidney disease alters intestinal microbial flora
Nosratola D Vaziri1, Jakk Wong2, Madeleine Pahl1, Yvette M Piceno2, Jun Yuan1, Todd Z DeSantis3, Zhenmin Ni1, Tien-Hung Nguyen2 and Gary L Andersen2
- 1Division of Nephrology and Hypertension, UC Irvine Medical Center, Irvine, California, USA
- 2Center for Environmental Biotechnology, Lawrence Berkeley National Laboratory, Berkeley, California, USA
- 3Second Genome, San Bruno, California, USA
The population of microbes (microbiome) in the intestine is a symbiotic ecosystem conferring trophic and protective functions. Since the biochemical environment shapes the structure and function of the microbiome, we tested whether uremia and/or dietary and pharmacologic interventions in chronic kidney disease alters the microbiome. To identify different microbial populations, microbial DNA was isolated from the stools of 24 patients with end-stage renal disease (ESRD) and 12 healthy persons, and analyzed by phylogenetic microarray. There were marked differences in the abundance of 190 bacterial operational taxonomic units (OTUs) between the ESRD and control groups. OTUs from Brachybacterium, Catenibacterium, Enterobacteriaceae, Halomonadaceae, Moraxellaceae, Nesterenkonia, Polyangiaceae, Pseudomonadaceae, and Thiothrix families were markedly increased in patients with ESRD. To isolate the effect of uremia from inter-individual variations, comorbid conditions, and dietary and medicinal interventions, rats were studied 8 weeks post 5/6 nephrectomy or sham operation. This showed a significant difference in the abundance of 175 bacterial OTUs between the uremic and control animals, most notably as decreases in the Lactobacillaceae and Prevotellaceae families. Thus, uremia profoundly alters the composition of the gut microbiome. The biological impact of this phenomenon is unknown and awaits further investigation.
Source : Kidney International
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