Kidney & blood pressure research最新文献

{"title":"Advancing Precision Medicine for hypertensive nephropathy: a novel prognostic model incorporating pathological indicators.","authors":"Yunlong Qin, Jin Zhao, Yan Xing, Zixian Yu, Panpan Liu, Yuwei Wang, Anjing Wang, Yueqing Hui, Wei Zhao, Mei Han, Meng Liu, Xiaoxuan Ning, Shiren Sun","doi":"10.1159/000545524","DOIUrl":"https://doi.org/10.1159/000545524","url":null,"abstract":"<p><strong>Introduction: </strong>This study aims to assess the long-term renal prognosis of patients with hypertensive nephropathy (HN) diagnosed through renal biopsy, utilizing the random survival forest (RSF) algorithm.</p><p><strong>Methods: </strong>From December 2010 to December 2022, HN patients diagnosed by renal biopsy in Xijing Hospital were enrolled and randomly divided into training set and testing set at a ratio of 7∶3. The study's composite endpoint was defined as a ≥ 50% decline in estimated glomerular filtration rate (eGFR), ESRD, or death. RSF and Cox regression were used to establish a renal prognosis prediction model based on the factors screened by the RSF algorithm. The Concordance index (C-index), integrated brier score (IBS), net reclassification index (NRI), and integrated discrimination improvement (IDI) were used to evaluate discrimination, calibration, and risk classification, respectively.</p><p><strong>Results: </strong>A total of 225 patients were included in this study, with 72 (32.0%) patients experiencing combined events after a median follow-up of 29.9 (16.6, 52.1) months. Six eligible variables (overall chronicity grade of renal pathology, eGFR, high-density lipoprotein cholesterol, hematocrit, monocyte, and stroke volume) were selected from clinical data and introduced into the RSF model. The RSF model had a higher C-index in both the training set [0.904 (95%CI 0.842 - 0.938) vs 0.831 (95%CI 0.768 - 0.894), P < 0.001] and the testing set [0.893 (95%CI 0.770 - 0.944) vs 0.841 (95%CI 0.751 - 0.931), P = 0.021] compared to the Cox model. NRI and IDI indicated that the RSF model outperformed the Cox model regarding risk classification and discrimination.</p><p><strong>Conclusion: </strong>In this study, the RSF algorithm was employed to identify the risk factors affecting the prognosis of HN patients, and a clinical prognostic RSF model was constructed to predict the adverse outcomes of HN patients based on renal pathology. Compared to the traditional Cox regression model, the RSF model offers superior performance and can provide valuable new insights for clinical diagnosis and treatment strategies.</p>","PeriodicalId":17813,"journal":{"name":"Kidney & blood pressure research","volume":" ","pages":"1-21"},"PeriodicalIF":2.3,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relation of Serum Creatinine Twitches and Outcomes among STEMI Patients.","authors":"Shir Frydman, Ophir Freund, Lior Zornitzki, Nevo Barel, Shmuel Banai, Yacov Shacham","doi":"10.1159/000545523","DOIUrl":"https://doi.org/10.1159/000545523","url":null,"abstract":"<p><strong>Background: </strong>Acute kidney injury (AKI) is notoriously associated with adverse outcomes and mortality in patients with acute coronary syndrome. However, using the general cutoff of 0.3 mg/dL increase from baseline for AKI definition and neglecting smaller changes could result in late diagnosis and impaired prognostication. We aimed to assess the prognostic utility of minor creatinine changes (\"twitches\") in a large cohort of ST-segment-elevation myocardial infraction (STEMI) patients and determine an optimal cutoff value for future use.</p><p><strong>Methods: </strong>This retrospective analysis of a prospective database included 2933 consecutive patients admitted with STEMI between 2008-2022 to the cardiac intensive care unit of a large tertiary medical center. Renal function was assessed upon admission and at-least once daily thereafter. Creatinine twitches were defined as a change from baseline to peak creatinine level of between 0.1 to 0.3 mg/dl. 30-day and 1-year mortality were the main outcomes.</p><p><strong>Results: </strong>From the study cohort (mean age 62 ±13, 19% female, 16% with prior MI), 551 (19%) subjects presented creatinine twitches and 254 (9%) developed AKI. Compared to subjects with stable creatinine, those with creatinine twitches had higher rates of 30-day (1% vs. 2.5%, p<0.001) and 1-year (1.6% vs. 4.4%, p<0.001) mortality. In cox multivariate analysis, creatinine twitches had a higher hazard for 1-year mortality (HR 1.87, 95% CI 1.1-3.2) and only a trend for 30-day mortality (HR 1.52, 95% CI 0.96-2.96). Creatinine rise had an area under the curve of 0.780 (95% CI 0.73-0.83) for 1-year mortality prediction, and 0.12 mg/dl was the optimal cutoff for prediction, with a sensitivity of 71%, specificity of 79%. In sub-group multivariate analysis, only twitches that did not resolve during hospitalization had higher hazard for mortality (HR 3.42, 95% CI 1.65-7.05).</p><p><strong>Conclusion: </strong>Serum creatinine twitches are common among STEMI patients and correlate with elevated 30 days and 1-year mortality. These seemingly minor changes should prompt renal protective strategies for early detection and treatment.</p>","PeriodicalId":17813,"journal":{"name":"Kidney & blood pressure research","volume":" ","pages":"1-20"},"PeriodicalIF":2.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intercellular Communication Network of CellChat Uncovers Mechanisms of Kidney Fibrosis based on Single-Cell RNA Sequencing.","authors":"Lei Lei, Yun-Xiu Xiang, Mao-Lin Luo, Ze-Yu Zhang, Hong-Wei Wu, Chun Tang, Tian-Jiao Cui, Xue-Mei Zhang, Xiao-Hua Wang, Denis Delic, Thomas Klein, Yvonne Liu, Bernhard K Krämer, Zhi-Hua Zheng, Yong-Ping Lu, Berthold Hocher, Ting Zhu","doi":"10.1159/000545209","DOIUrl":"https://doi.org/10.1159/000545209","url":null,"abstract":"<p><strong>Background: </strong>Chronic kidney disease (CKD) is a global health concern, with renal fibrosis being a major pathological feature. Empagliflozin (Empa), a Sodium-glucose co-transporter-2 (SGLT2) inhibitor, has shown promise in protecting the kidney. This study aimed to investigate the effects of Empa on renal fibrosis in a non-diabetic CKD model and to elucidate the underlying mechanisms.</p><p><strong>Methods: </strong>We established a CKD model using 5/6 nephrectomy (5/6 Nx) rats and divided them into three groups: placebo-treated sham surgery rats, placebo-treated 5/6 Nx rats, and Empa-treated 5/6 Nx rats. Kidney function was assessed by measuring blood urea nitrogen, serum creatinine, and urinary albumin-to-creatinine ratio. Renal fibrosis was evaluated histologically. Single-cell RNA sequencing (scRNA-seq) was performed to analyze intercellular communication networks and identify alterations in ligand-receptor pairs and signaling pathways involved in fibrosis.</p><p><strong>Results: </strong>Empa treatment significantly improved kidney function and reduced renal interstitial fibrosis in 5/6 Nx rats. scRNA-seq revealed that Empa modulated the TGF-β signaling pathway, inhibited intercellular communication and reducing the expression of fibrotic genes such as COLLAGEN, FN1, THBS, and LAMININ. Furthermore, Empa down-regulated GRN gene expression and weakened signal transmission in the MIF pathway, consequently reduced the interaction between M2 macrophages and other cell types, such as endothelial cells, fibroblasts, and mesangial cells.</p><p><strong>Conclusion: </strong>This study elucidates the potential mechanisms by which Empa slows the progression of renal fibrosis in non-diabetic CKD. By reducing the number of M2 macrophages and inhibiting signal transduction in both pro-inflammatory and fibrotic pathways, Empa modulates the intercellular communication network in renal cells, offering a promising therapeutic strategy for CKD management.</p>","PeriodicalId":17813,"journal":{"name":"Kidney & blood pressure research","volume":" ","pages":"1-24"},"PeriodicalIF":2.3,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-steroidal mineralocorticoid receptor antagonists: a paradigm shift in the management of diabetic nephropathy.","authors":"Justine Huart, François Jouret","doi":"10.1159/000545286","DOIUrl":"10.1159/000545286","url":null,"abstract":"<p><strong>Background: </strong>Diabetic kidney disease (DKD) is the leading cause of chronic kidney disease (CKD) worldwide. The management of DKD relies on controlling glycaemia and blood pressure levels, as well as reducing proteinuria. While the traditional renin-angiotensin-aldosterone system inhibitors (RAASi) and the recently approved Type 2 Na+/Glucose co-transporter inhibitors (SGLT2i) have significantly improved patient outcomes, residual risks remain unaddressed.</p><p><strong>Summary: </strong>This review explores (i) the mechanisms of action of finerenone, a novel non-steroidal mineralocorticoid receptor antagonist (ns-MRA), (ii) the evidence of finerenone-induced kidney protection in clinical trials, and (iii) the comparative advantages over conventional MRAs. The potential synergy between finerenone and SGLT2i is also addressed, alongside research perspectives and practical considerations for implementation in clinical practice.</p><p><strong>Key messages: </strong>Finerenone has emerged as a breakthrough therapy in the management of DKD, demonstrating robust nephron- and cardio-protective effects.</p>","PeriodicalId":17813,"journal":{"name":"Kidney & blood pressure research","volume":" ","pages":"1-15"},"PeriodicalIF":2.3,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of renal artery stenosis on renovascular hypertension and the therapeutic role of renal artery stenting: a comprehensive review.","authors":"Changgang Shao, Guoqing Chi, Fang Li, Hongcheng Ren, Liyan Zhang, Jinming Yang, Bin Wang, Mingchao Ding","doi":"10.1159/000545135","DOIUrl":"https://doi.org/10.1159/000545135","url":null,"abstract":"<p><p>Background Renal artery stenosis (RAS) is characterized by reduced renal perfusion, activating the renin-angiotensin-aldosterone system (RAAS), which can lead to secondary hypertension, ischemic nephropathy, and cardiac destabilization syndrome. These conditions have significant healthcare implications. Renovascular hypertension (RVH) in RAS patients can be managed through medical therapy and revascularization, either endovascular or surgical. While renal artery stenting (RAS) was once viewed as the most effective treatment for atherosclerotic renovascular disease, recent trials suggest no significant difference in RVH management between medical therapy alone and combined with renal artery stenting. However, certain subgroups have exhibited favorable outcomes in blood pressure control post-stenting. Summary This comprehensive review synthesizes data, including findings from the HERCULES trial, which showed a reduction in blood pressure from 162.3±18.5/77.7±11.5 mmHg to 145.7±20.7/75.4±11.0 mmHg over 36 months (P<0.0001). Additionally, the ASPIRE-2 study demonstrated significant decreases in blood pressures from 168±25/82±13 mmHg to 149±25/77±12 mmHg at 24 months (P<0.001). The review delves into the prevalence, pathophysiology, clinical manifestations, diagnosis, and treatment of RAS-related RVH, specifically analyzing the efficacy and safety of renal artery stenting. Key Messages The analysis indicates that renal artery stenting may be particularly advantageous for certain patient subgroups, enhancing blood pressure outcomes and overall clinical status. Nevertheless, the criteria for selecting candidates for this intervention remain under debate. Future research should focus on high-risk RAS patients to explore long-term benefits and refine the utilization of renal artery stents, ultimately improving RVH management.</p>","PeriodicalId":17813,"journal":{"name":"Kidney & blood pressure research","volume":" ","pages":"1-15"},"PeriodicalIF":2.3,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Liver Blood Stagnation: An Overlooked but Significant Factor in Intradialytic Hypotension.","authors":"Takahito Ito, Takahiro Shinzato","doi":"10.1159/000545113","DOIUrl":"https://doi.org/10.1159/000545113","url":null,"abstract":"<p><p>〈Background〉Intradialytic hypotension (IDH) occurs suddenly and without warning, although it is generally reversible. While ultrafiltration rate, cardiac function, and vascular resistance have been widely studied, more attention should be given to venous blood return to the heart in relation to blood stagnation. Both existing literature and clinical observations suggest that as a hemodialysis session progresses, the vascular bed of the liver expands, reducing venous return to the heart. This decrease in cardiac output may further increase hepatic blood volume, potentially playing a central role in the development of IDH. 〈Summary〉This review explores the role of reduced venous return to the heart, caused by liver blood stagnation, as a key contributor to IDH. 〈Key Messages〉We tentatively name this pathophysiological mechanism \"liver circulation jam.\" The clinical significance of this concept requires validation through future research.</p>","PeriodicalId":17813,"journal":{"name":"Kidney & blood pressure research","volume":" ","pages":"1-14"},"PeriodicalIF":2.3,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differentiating the Whole Urine and Urine Supernatant Protein Profiles of Preterm Infants via Urine Proteomics.","authors":"Lulu Zhang, Xueyan Wang, Dan Wu, Jun Zheng, Fangrui Ding","doi":"10.1159/000543714","DOIUrl":"10.1159/000543714","url":null,"abstract":"<p><strong>Introduction: </strong>Urine proteomics plays an important role in the screening of biomarkers for infant diseases. However, there is no unified standard for the selection of urine samples for urine proteomics. It is also unclear whether there are differences in proteomics between whole urine and urine supernatant. Therefore, the urine of preterm infants was used as the research sample to explore the differences in protein profiles between the whole urine and urine supernatant of preterm infants by proteomics.</p><p><strong>Methods: </strong>Urine samples were collected from five preterm infants with a gestational age of <28 weeks at their corrected gestational age of 37 weeks. Each preterm urine was divided into whole urine and supernatant. Urine protein was extracted and analyzed by liquid chromatography-tandem mass spectrometry.</p><p><strong>Results: </strong>The two groups of urine samples did not show significant clustering in the principal component analysis. A total of 2,607 proteins were detected in the two groups of urine samples, of which 82 proteins were unique to whole urine samples and 56 proteins were unique to urine supernatant samples. The molecular functions, the main biological processes, and subcellular localization of the differential proteins were analyzed. In other neonatal-related diseases, there was no significant difference in protein enrichment between whole urine and urine supernatant.</p><p><strong>Conclusions: </strong>This study analyzed the differences between whole urine and urine supernatant in urine proteomics of preterm infants. In neonatal-related diseases, there is no significant difference in urinary protein biomarkers between whole urine and urine supernatant.</p>","PeriodicalId":17813,"journal":{"name":"Kidney & blood pressure research","volume":" ","pages":"198-209"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143408770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Interplay of Factors in Chronic Kidney Disease: Insights from The Malaysian Cohort Study.","authors":"Noraidatulakma Abdullah, Norfazilah Ahmad, Azmawati Mohammed Nawi, Mohd Rohaizat Hassan, Ying-Xian Goh, Norliza Ismail, Nazihah Abd Jalal, Raihannah Othman, Azwa Shawani Kamalul Arifin, Mohd Arman Kamaruddin, Rahman Jamal","doi":"10.1159/000542732","DOIUrl":"10.1159/000542732","url":null,"abstract":"<p><strong>Introduction: </strong>There is an increasing prevalence of chronic kidney disease (CKD) in Malaysia; hence, identifying factors associated with the early stage of CKD is crucial for preventive measures. This study investigated the association between various factors and their interaction in a multi-ethnic Malaysian cohort.</p><p><strong>Methods: </strong>A nested case-control analysis was conducted on 3,160 eligible participants with renal profile data from The Malaysian Cohort project. CKD status was determined by estimated glomerular filtration rate using the Chronic Kidney Disease Epidemiology Collaboration equation. Multiple logistic regression analysis using the likelihood ratio method was used to identify the factors and their interaction with CKD.</p><p><strong>Results: </strong>This study suggested five factors associated with CKD: gender, ethnicity, physical activity, atherogenic plasma index (AIP), and systolic blood pressure. There was an interaction between AIP and gender, with increased odds of CKD among men with high AIP.</p><p><strong>Conclusions: </strong>As CKD is mainly asymptomatic until it is in the later stages, these five factors serve as valuable tools for predicting CKD and enhancing the identification of at-risk individuals, particularly among men with elevated AIP. Future studies should focus on using these factors, especially in preventing new CKD cases and their progression.</p>","PeriodicalId":17813,"journal":{"name":"Kidney & blood pressure research","volume":" ","pages":"210-220"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disease-Modifying Antirheumatic Drug Therapy of Inflammatory Rheumatic Diseases in End-Stage Kidney Disease.","authors":"Daniel Patschan, Igor Matyukhin, Friedrich Stasche, Oliver Ritter, Susann Patschan","doi":"10.1159/000544810","DOIUrl":"10.1159/000544810","url":null,"abstract":"<p><strong>Background: </strong>Inflammatory rheumatic diseases regularly require the use of disease-modifying antirheumatic drugs (DMARDs). The use of DMARDs in patients with end-stage chronic kidney disease (CKD stage 5D) is particularly challenging due to the lack of systematic studies available for this patient population. This narrative review aimed to address the aspect of DMARD therapy in CKD 5D.</p><p><strong>Summary: </strong>The current article is a narrative review. References were sourced from the following databases: PubMed, Web of Science, Cochrane Library, and Scopus. The search period spanned from 1975 to 2024. There is a notable lack of systematic data on this topic. The available literature was reviewed to provide insights, despite the limited availability of comprehensive studies. Individuals with terminal kidney disease can presumably be safely treated with leflunomide, mycophenolic acid, sulfasalazine, azathioprine, belimumab, and anti-CD20. For all other substances, there are either significant restrictions, insufficient data, or inadequate experience.</p><p><strong>Key messages: </strong>Some conventional and biologic DMARDs are available for the management of inflammatory rheumatic diseases in CKD stage 5D. It is essential to consider the limitations on kidney function, as they can significantly affect the pharmacokinetics of medications. Consequently, slightly more frequent checkups are recommended when using the defined preparations.</p>","PeriodicalId":17813,"journal":{"name":"Kidney & blood pressure research","volume":" ","pages":"249-258"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shikonin Inhibits Endoplasmic Reticulum Stress-Induced Apoptosis to Attenuate Renal Ischemia/Reperfusion Injury by Activating the Sirt1/Nrf2/HO-1 Pathway.","authors":"Qian Huang, Zilu Shi, Dandan Zheng, Huiqin Chen, Qiuhong Huang","doi":"10.1159/000542417","DOIUrl":"10.1159/000542417","url":null,"abstract":"<p><strong>Introduction: </strong>Shikonin is the major bioactive compound abundant in Lithospermum erythrorhizon and possesses diverse pharmacological properties. This study aimed to examine shikonin roles in experimental renal ischemia/reperfusion (I/R) injury.</p><p><strong>Methods: </strong>Renal tissues and blood were collected from experimental renal I/R injury models. Kidney functions, structural injuries, and cellular death were assessed. Markers of endoplasmic reticulum (ER) stress were evaluated by RT-qPCR and Western blotting. The effect of shikonin on Sirt1/Nrf2/HO-1 signaling was detected by Western blotting and immunofluorescence staining. HK-2 cells that underwent hypoxia/reoxygenation (H/R) process were used to perform CCK-8 and flow cytometry.</p><p><strong>Results: </strong>For in vivo analysis, renal dysfunctions and tissue structural damage induced by I/R were relieved by shikonin. Additionally, shikonin alleviated ER stress-induced apoptosis in I/R mice. For in vitro analysis, shikonin inhibited ER stress-stimulated apoptosis of H/R cells. Mechanistically, shikonin activated Sirt1/Nrf2/HO-1 signaling post-I/R, and inhibition of Sirt1 limited shikonin-mediated protection against ER stress-stimulated apoptosis in both animal and cellular models.</p><p><strong>Conclusion: </strong>By activating Sirt1/Nrf2/HO-1 signaling, shikonin inhibits apoptosis caused by ER stress and relieves renal I/R injury.</p>","PeriodicalId":17813,"journal":{"name":"Kidney & blood pressure research","volume":" ","pages":"131-146"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11844683/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}