Kidney & blood pressure research最新文献

{"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":"Impact of Interdialytic Intervals on Sudden Cardiac Death in Chronic Kidney Disease Stage 5D Patients on a Twice-Weekly Hemodialysis Schedule.","authors":"Prasanna Kumar, Kshama Savant, Athira Balakrishnan, Sreedharan Nair, Ravindra Prabhu Attur","doi":"10.1159/000546184","DOIUrl":"10.1159/000546184","url":null,"abstract":"<p><strong>Introduction: </strong>End-stage kidney disease patients on maintenance hemodialysis (HD) are prone to increase cardiovascular and non-cardiovascular mortality at long and short interdialytic intervals of an intermittent thrice-weekly schedule. Variations in fluid and electrolyte status during and in dialysis-free periods may predispose patients to sudden cardiac death (SCD). We studied SCD in HD in relation to the interdialytic interval in patients on a twice-weekly HD schedule.</p><p><strong>Methods: </strong>An ambispective cohort study was done and data of HD patients on a twice-weekly schedule were collected from January 2009 to December 2017. The primary outcome was cardiovascular mortality and the secondary outcome was an estimate of the standard mortality ratio (SMR) at each 12-h period interval of the HD schedule. Deaths were categorized as SCD, non-SCD, and non-cardiac death as per standard definitions.</p><p><strong>Results: </strong>Of 413 participants, 289 died. The rate of cardiovascular death accounted for 121 (42%), and non-cardiac death was 168 (58.1%). SCD was the most common cardiovascular event, accounting for 83 (28.7%) of overall mortality. SCD is more likely to occur in the first 12 h after dialysis following the 3-day-long interdialytic interval (SMR: 1.68) and in the 12 h before the next dialysis session after a short interval (SMR: 1.39).</p><p><strong>Conclusion: </strong>Occurrence of SCD was higher at two different time points, i.e., 12-h period from the starting with the dialysis procedure and 12-h period before the start of the next session of HD at the end of a short interval.</p>","PeriodicalId":17813,"journal":{"name":"Kidney & blood pressure research","volume":" ","pages":"420-428"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12176349/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144007273","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}

{"title":"Exploring the Link between Hypertension and Cerebral White Matter Changes in Chronic Kidney Disease.","authors":"Kung-Chao Chen, Feng-Ching Shen, Wen-Ching Chen, Hsiu-Fen Lin, Teng-Hui Huang, Ming-Yen Lin, Shu-Li Wang, Fan-Pei Gloria Yang, Mei-Chuan Kuo, Yi-Wen Chiu, Shang-Jyh Hwang, Ping-Hsun Wu, Yi-Ting Lin","doi":"10.1159/000545890","DOIUrl":"10.1159/000545890","url":null,"abstract":"<p><strong>Background: </strong>Patients diagnosed with chronic kidney disease (CKD) are at a higher risk of encephalopathy, a condition exacerbated by the presence of various chronic diseases. Hypertension is a significant risk factor for brain damage in the general population but is limitedly discussed in patients with CKD. Brain magnetic resonance imaging (MRI) is an excellent tool for evaluating cerebral white matter lesions. Most previous studies showed the association between hypertension and cerebral white matter lesions in the general population but were less focused on CKD patients. Therefore, the present study aims to investigate the effect of hypertension on the cerebral white matter lesions of brain MRI in patients with CKD.</p><p><strong>Methods: </strong>In this retrospective study, we enrolled 1,749 CKD patients who underwent brain MRIs to evaluate their brain lesions in Kaohsiung Medical University Hospital. The cerebral white matter hyperintensities (WMHs) on MRI were evaluated according to the Fazekas scale, including separate periventricular and deep white matter lesions from grade 0 to grade 3. The multivariable ordinal regression model was analyzed to determine the independent association between hypertension or blood pressure and cerebral WMHs with adjustment of controlling age, sex, education, comorbidities (hyperlipidemia, cerebrovascular disease, chronic heart failure), laboratory data (hemoglobin, albumin, triglyceride, estimated glomerular filtration rate).</p><p><strong>Results: </strong>Hypertension was associated with the Fazekas scale of periventricular lesions in multivariable-adjusted ordinal regression analysis (odds ratio [OR] 1.63, 95% confidence interval [CI] 1.15-2.30) after full adjustment. However, the hypertension comorbidities did not associate with the Fazekas scale of deep white matter lesions in the fully adjusted model (OR 1.24, 95% CI [0.89-1.75]). A positive association between blood pressure (per 10 mm Hg increase) and the Fazekas scale was mainly on diastolic blood pressure rather than systolic blood pressure.</p><p><strong>Conclusions: </strong>In CKD patients, hypertension was associated with brain white matter damage; in particular, Fazekas scale of periventricular lesions. Further study is needed to evaluate adequate blood pressure control to decrease the risk of brain damage in CKD patients.</p>","PeriodicalId":17813,"journal":{"name":"Kidney & blood pressure research","volume":" ","pages":"408-419"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989100","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":"CFHR5 Nephropathy Case Report: A Novel Variant Characterized by Tubulointerstitial Kidney Disease.","authors":"Rita Santarsiere, Giulia Florio, Annalisa Gonnella, Pierluigi D'Angiò, Simona Laurino, Miriam Zacchia, Francesca Del Vecchio Blanco, Alessandra F Perna, Francesco Trepiccione, Giuseppe Gigliotti","doi":"10.1159/000546321","DOIUrl":"10.1159/000546321","url":null,"abstract":"<p><strong>Introduction: </strong>CFHR5 nephropathy is considered a subtype of C3 glomerulopathy. It was originally described in Greek Cypriot families and it is characterized by the time with the development of microscopic hematuria and proteinuria associated with a fast progression toward ESKD, especially in men. These symptoms present an autosomal dominant inheritance pattern and are associated with the exon 2 to 3 duplication of the CFHR5 gene.</p><p><strong>Case presentation: </strong>Here, we describe a novel clinical phenotype associated with a variant of the CFHR5. The affected subjects present the clinical features of autosomal dominant tubulo-interstitial kidney disease. They present with CKD of unknown origin with no hematuria nor proteinuria. Like the classical CFHR5 nephropathy, males have a worse prognosis than females, with a fast progression toward ESKD in the second-third decade of life. Kidney pathology shows severe tubular atrophy and interstitial fibrosis and infiltrate. Arteries involvement is characterized by thickening of the intima layer, while no major alterations are described at the glomerular level. Electron microscopy confirms no interstitial or glomerular filtration barrier alterations.</p><p><strong>Conclusion: </strong>The exact mechanism behind this phenomenon remains unclear; we hope that our case will encourage further investigation.</p>","PeriodicalId":17813,"journal":{"name":"Kidney & blood pressure research","volume":" ","pages":"429-432"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12187096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142946","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}

{"title":"Mortality of Patients with Heart Diseases and Unplanned Start of Maintenance Hemodialysis in the City of São Paulo, Brazil.","authors":"Farid Samaan, Luiz Minuzzo, Amanda Paz Loca, Amanda Souza Dias, Isabel Longo Oliveira Monteiro, Karla Lorena Campos Gonçalves, Larissa Moreira Rochel, Lina Ahamad Melhim, Veronica Paduam, Vitoria Falotico Ottoni Oliveira, Yara Lopes Souza Costa, Lucas Petri Damiani, Kleber Gomes Franchini, Fausto Feres, Gianna Mastroianni Kirsztajn, Ricardo Sesso","doi":"10.1159/000548462","DOIUrl":"10.1159/000548462","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic kidney disease worsens the prognosis of cardiovascular disease (CVD) and vice versa. This study aimed to evaluate the mortality of patients with a high CVD burden and unplanned start of maintenance hemodialysis (HD).</p><p><strong>Methods: </strong>A retrospective study was performed at a tertiary cardiological hospital in São Paulo, Brazil. Hospitalized patients ≥18 years old were identified by the public chronic kidney replacement therapy regulatory system between January 1, 2014, and December 31, 2018. In-hospital and post-discharge mortality, along with associated risk factors, were assessed. Death information up to December 31, 2022, was obtained from the state of São Paulo mortality database.</p><p><strong>Results: </strong>A total of 302 patients with unplanned start of HD were included. The mean age was 65 ± 13 years old; 68% were male. The heart conditions were as follows: 60% chronic heart failure, 27% coronary artery disease, 13% arrhythmia, and 7% valve disease. Comorbidities included: 93% hypertension, 62% diabetes, 31% dyslipidemia, and 27% known CKD. The mortality rate (deaths per 100 patient-years) was 71.4 between 0 and 3 months, 23.0 between 3 and 12 months, and 39.5 over the entire 0 to 12 months period. The factors independently associated with in-hospital death were age, heart valve disease, chronic obstructive pulmonary disease, positive serology for hepatitis B, and need for HD catheter replacement. The factors associated with post-discharge death (mean ± SD follow-up: 6.4 ± 1.4 years) were age, presence of two or more heart diseases, and HD catheter-related infection.</p><p><strong>Conclusion: </strong>Patients with a high burden of cardiovascular morbidity and an unplanned start of HD exhibit elevated mortality rates. Some factors independently related to poorer outcomes, such as HD catheter-related complications, could potentially be mitigated through adequate pre-dialysis care.</p>","PeriodicalId":17813,"journal":{"name":"Kidney & blood pressure research","volume":" ","pages":"700-711"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149740","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":"Fabry Disease Nephropathy: Compendium of \"in vitro\" and \"in vivo\" Renal Effects of Globotriaosylsphingosine.","authors":"Sebastián Pedro Antonio Jaurretche, María Victoria Del Rosal, María Luana Brajkovic, Juan Ignacio Isaac, Graciela Venera, Germán Pérez","doi":"10.1159/000547144","DOIUrl":"10.1159/000547144","url":null,"abstract":"<p><p><p>Background: Renal damage in Fabry disease (FD) is a consequence of pathological and progressive glycosphingolipids accumulation, which occurs in different magnitudes among FD phenotypes, but is a constant renal tissue phenomenon in all patients with renal involvement. A significant correlation between plasma Lyso-Gb3 (Gb3 analog) and disease severity has been described but, there is lack of information from clinical studies regarding the correlation between Lyso-Gb3 and renal events in humans and, the few results have certain discrepancies. In clinical practice, it is necessary to have disease-specific biomarkers, non-invasive and useful in diagnosis, prognosis and therapeutic response. Evidence relating to the prognostic value of lyso-GL3 is mixed.</p><p><strong>Summary: </strong>We reviewed the evidence on renal effect of plasma and/or urinary Lyso-Gb3 in FD patients and the usefulness as a biomarker of diagnostic and therapeutic response. Additionally, the in vitro renal effects of Lyso-Gb3 were reviewed. The literature search was conducted in PubMed, Embase, Scopus, Cochrane, and Google academic. Search terms were (Fabry disease + [Lyso-Gb3 or Lyso-GL3] + [\"renal\" or \"kidney\"]).</p><p><strong>Inclusion criteria: </strong>(i) \"in vitro\" studies in which a direct effect of Lyso-Gb3 on kidney tissue has been studied, both in animals and/or humans; (ii) retrospective, cross-sectional, or prospective \"in vivo\" studies in which a correlation between Lyso-Gb3 and renal clinical events or renal function biomarkers has been studied.</p><p><strong>Key messages: </strong>Ten studies presented evidence of \"in vitro\" renal damage due to Lyso-Gb3; 4 studies presented correlation between plasma Lyso-Gb3 and renal events in FD patients; and 3 studies reported correlation between urinary Lyso-Gb3 and renal events in FD patients.</p><p><strong>Conclusion: </strong>The small number of publications and the methodological heterogeneity do not allow a statistical analysis of them. Regarding the \"in vivo\" and \"in vitro\" renal effects of Lyso-Gb3 in FD: There is evidence of harmful effects on renal cells in vitro due to Lyso-Gb3 but this evidence is not sufficient to use Lyso-Gb3 (neither plasma nor urinary) as a biomarker for monitoring renal damage in FD patients. Plasma Lyso-Gb3 is a useful biomarker in (i) FD diagnosis and (ii) stratification of phenotype and severity of FD. In FD \"classic\" patients receiving enzyme replacement therapy (ERT), it is useful to determine plasma Lyso-Gb3 periodically because an inconsistent reduction during ERT may indicate the formation of neutralizing anti-agalsidase antibodies. </p>.</p>","PeriodicalId":17813,"journal":{"name":"Kidney & blood pressure research","volume":" ","pages":"811-819"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12674653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145513208","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}

{"title":"Risk of Orthostatic Hypotension in Chronic Kidney Disease: A Community-Based Cohort Study.","authors":"Jong Hoon Seok, Chan Young Park, Seung Yoon Lee, Ji Eun Kim","doi":"10.1159/000549515","DOIUrl":"10.1159/000549515","url":null,"abstract":"<p><strong>Introduction: </strong>Patients with chronic kidney disease (CKD) often experience symptoms consistent with orthostatic hypotension (OH); however, not much is known about OH in this population. Therefore, study analyzed OH prevalence and risk according to renal function decline.</p><p><strong>Methods: </strong>A community-based cohort study was conducted using data from the Korean Genome and Epidemiology Study (KoGES). OH prevalence was assessed at baseline and at a 2-year follow-up across three estimated glomerular filtration rate (eGFR) categories: high (≥90 mL/min/1.73 m2, G1), moderate (60-89 mL/min/1.73 m2, G2), and low (<60 mL/min/1.73 m2, G3).</p><p><strong>Results: </strong>Among 9,597 participants, baseline OH, 2-year OH, and persistent OH were evaluated within each eGFR group: high (n = 6,743), moderate (n = 2,758), and low (n = 96). The low eGFR group demonstrated the highest prevalence of baseline OH (n = 52, p = 0.024) and 2-year OH (n = 42, p = 0.002). This group also exhibited the largest decline in systolic blood pressure at both baseline and follow-up. In adjusted logistic regression, participants aged <50 years with low eGFR had 3.54-fold higher odds of OH (p = 0.035). Additionally, adherence to a low-sodium diet was associated with increased 2-year OH prevalence across groups (p = 0.001).</p><p><strong>Conclusion: </strong>The low eGFR group showed a higher baseline and follow-up OH prevalence. A low-sodium diet was also associated with elevated OH risk, underscoring the need for careful dietary management in patients with CKD.</p>","PeriodicalId":17813,"journal":{"name":"Kidney & blood pressure research","volume":" ","pages":"843-854"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12707982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145534725","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}

{"title":"Monotherapy Blood Pressure Response and Control Rates in Treatment-Naïve Patients with Arterial Hypertension: A Randomized Comparison of Four Different Antihypertensive Drug Classes.","authors":"Annina Salome Vischer, Maria Bertsch, Vera Van der Velpen, Franziska Küng, Thenral Socrates, Michael Mayr, Manuel Haschke, Thilo Burkard","doi":"10.1159/000545908","DOIUrl":"10.1159/000545908","url":null,"abstract":"<p><strong>Introduction: </strong>Four different antihypertensive drug classes are equivalently recommended in the previous guidelines for first-line treatment of arterial hypertension (HTN). However, it is unclear, whether one of these drugs is more capable than the others to reach blood pressure (BP) control. We sought to compare response rates and BP control in these 4 classes.</p><p><strong>Methods: </strong>Patients with newly diagnosed mild to moderate HTN on 24-h BP measurements (ABPM) were randomized in a 1:1:1:1 fashion to either perindopril, olmesartan, amlodipine, or hydrochlorothiazide (HCT). ABPM was completed at baseline (BL) and after 4 weeks of half dose (treatment period 1 [TP1]). If BP control was not reached after TP1, drug dose was doubled and another ABPM completed after 4 weeks (treatment period 2 [TP2]). Patients were classified as controlled if 24-h mean BP was <130/80 mm Hg, awake BP <135/85 mm Hg, and night BP <120/70 mm Hg, and as optimal if 24-h mean BP was 115-124/65-74 mm Hg.</p><p><strong>Results: </strong>88 patients were randomized: 20 (23%) to perindopril, 23 (26%) to olmesartan, 24 (27%) to amlodipine, and 21 (24%) to HCT. Median 24-h mean BP reduction from BL to TP1 was -11/-6 mm Hg and from TP1 to TP2 -4/-2 mm Hg. The highest BP reduction was reached with olmesartan (-15/-10 mm Hg), particularly for diastolic values, the lowest with HCT (-8/-1 mm Hg). 27% of patients reached systo-diastolic BP control, with the best control rate with perindopril and olmesartan (40 and 39%), the lowest with HCT (5%), and 21%/18% reached an optimal treatment goal for systolic/diastolic 24-h mean values, respectively, after TP1. Three additional participants (4%) reached BP control after TP2.</p><p><strong>Conclusion: </strong>Initial antihypertensive monotherapy failed in most patients (73% uncontrolled, 21%/18% reached optimal treatment goal at TP1) even in low-risk patients, with efficacy varying by drug class (inhibitors of the renin-angiotensin-aldosterone system best, HCT least). These findings support guideline-recommended combination therapy.</p>","PeriodicalId":17813,"journal":{"name":"Kidney & blood pressure research","volume":" ","pages":"325-340"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969525","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}

{"title":"Exploring the Multifaceted Role of WT1 in Kidney Development and Disease.","authors":"Jing Lu, Xiaohu Zhang, Hanmin Liu, Yang Liu","doi":"10.1159/000544025","DOIUrl":"10.1159/000544025","url":null,"abstract":"<p><strong>Background: </strong>The Wilms' tumor suppressor gene (WT1) is a critical regulator in kidney development and disease pathogenesis. With the identification of at least 36 isoforms in mammals, each potentially playing distinct roles, WT1's complexity is becoming increasingly apparent. The -KTS and +KTS isoforms, in particular, have been implicated in DNA and RNA regulation, respectively. This review consolidates recent insights into WT1's multifaceted role in renal morphogenesis and its implications in kidney diseases.</p><p><strong>Summary: </strong>Our review highlights WT1's expression during embryonic kidney development and its maintenance in postnatal kidney function. We discuss the association of WT1 mutations with genetic nephropathies like Denys-Drash and Frasier syndromes, emphasizing its genetic significance. Additionally, we explore the implications of WT1 expression alterations in glomerular diseases, such as IgA nephropathy and lupus nephritis, where its role extends beyond a mere biomarker to a potential therapeutic target.</p><p><strong>Key messages: </strong>The WT1 gene and its protein products are central to understanding kidney morphogenesis and the molecular basis of renal disorders. As our understanding of WT1's regulatory mechanisms expands, so does the potential for developing targeted therapies for kidney diseases. This review calls for further research to elucidate the precise functions of WT1 isoforms and to explore the upstream regulators of WT1 that could offer novel treatment strategies for kidney pathologies. The significance of WT1 in intricate signaling pathways governing kidney health and disease is underscored, highlighting the need for continued investigation into this pivotal gene.</p>","PeriodicalId":17813,"journal":{"name":"Kidney & blood pressure research","volume":" ","pages":"176-188"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391239","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}