Advances in Chronic and Acute Renal Failure

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Nephrology & Urology".

Deadline for manuscript submissions: closed (31 May 2021) | Viewed by 4816

Special Issue Editors


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Guest Editor
Nephrology and Dialysis Unit, Belcolle Hospital, Via Sammartinese snc, 01100 Viterbo, Italy
Interests: renal biopsy; renal immunopathology; therapy of glomerulonephritis; tubulo-interstitial nephritis; Anderson-Fabry disease; clinical nephrology

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Guest Editor
Department of Medicine, Division of Nephrology, Ente Ospedaliero Cantonale, 6900 Lugano, Switzerland
Interests: CKD–MBD; cardiorenal disease; chronic kidney disease; vascular disease
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Special Issue Information

Dear Colleagues,

A considerable quantity of evidence has been produced on renal disease in recent years. Many of them had a minor or absent clinical impact, but some have contributed to improving the approach to nephropathic patients significantly.

Concerning chronic renal disease new evidence in the progression of histological change has been produced. The markers of cellular proliferation demonstrated there are some kinds of cell regulating the interstitial inflammation (T reg cells) in many different nephropathies.  New pathogenetic pathways have been described in focal segmental glomerulosclerosis involving the Apolipoprotein I and in fibrillary glomerulonephritis with BNAJB9. In glomerulonephritis, the study of the causing antigens has been implemented, and new therapeutical approaches based on the quantity and the sub-types of antigens have been proposed (membranous nephropathy). Moreover, the role of other proteins, such as uromodulin associated with chronic damage, has been clarified better. In addition to this, the COVID-19 pandemic explosion pointed out the renal involvement due to cytokines mediated-damage following the cellular virus invasion.

The acute renal disease in the course of systemic pathologies such as lupus or vasculitis was reviewed. New data above all the treatment and the assessment of the outcome were provided: promising data coming from studies with new monoclonal antibodies like belimumab might lead to an innovative therapeutic approach in lupus nephritis.

This special issue addresses to collecting innovative experiences and reviews from the nephrologists actively involved in nephrology research.

Prof. Sandro Feriozzi
Dr. Antonio Bellasi
Guest Editors

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Keywords

  • COVID19 and renal involvement
  • Acute kidney injury
  • Chronic renal diseases
  • Renal histology
  • Inflammation and renal diseases
  • Immune system involvement in renal diseases
  • Renal involvement in systemic diseases

Published Papers (2 papers)

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Research

13 pages, 1437 KiB  
Article
Urinary Cytokines Reflect Renal Inflammation in Acute Tubulointerstitial Nephritis: A Multiplex Bead-Based Assay Assessment
by Laura Martinez Valenzuela, Juliana Draibe, Oriol Bestard, Xavier Fulladosa, Francisco Gómez-Preciado, Paula Antón, Ernest Nadal, Maria Jové, Josep Maria Cruzado and Juan Torras
J. Clin. Med. 2021, 10(13), 2986; https://doi.org/10.3390/jcm10132986 - 04 Jul 2021
Cited by 3 | Viewed by 2447
Abstract
Background: Acute tubulointerstitial nephritis (ATIN) diagnosis lays on histological assessment through a kidney biopsy, given the absence of accurate non-invasive biomarkers. The aim of this study was to evaluate the accuracy of different urinary inflammation-related cytokines for the diagnostic of ATIN and its [...] Read more.
Background: Acute tubulointerstitial nephritis (ATIN) diagnosis lays on histological assessment through a kidney biopsy, given the absence of accurate non-invasive biomarkers. The aim of this study was to evaluate the accuracy of different urinary inflammation-related cytokines for the diagnostic of ATIN and its distinction from acute tubular necrosis (ATN). Methods: We included 33 patients (ATIN (n = 21), ATN (n = 12)), and 6 healthy controls (HC). We determined the urinary levels of 10 inflammation-related cytokines using a multiplex bead-based Luminex assay at the time of biopsy and after therapy, and registered main clinical, analytical and histological data. Results: At the time of biopsy, urinary levels of I-TAC/CXCL11, CXCL10, IL-6, TNFα and MCP-1 were significantly higher in ATIN compared to HC. A positive correlation between the extent of the tubulointerstitial cellular infiltrates in kidney biopsies and the urinary concentration of I-TAC/CXCL11, MIG/CXCL9, CXCL10, IL17, IFNα, MCP1 and EGF was observed. Notably, I-TAC/CXCL11, IL-6 and MCP-1 were significantly higher in ATIN than in ATN, with I-TAC/CXCL11 as the best discriminative classifier AUC (0.77, 95% CI 0.57–0.95, p = 0.02). A combinatory model of these three urinary cytokines increased the accuracy in the distinction of ATIN/ATN compared to the individual biomarkers. The best model resulted when combining the three cytokines with blood eosinophil and urinary leukocyte counts (LR = 9.76). Follow-up samples from 11ATIN patients showed a significant decrease in I-TAC/CXCL11, MIG/CXCL9 and CXCL10 levels. Conclusions: Urinary I-TAC/CXCL11, CXCL10, IL6 and MCP-1 levels accurately distinguish patients developing ATIN from ATN and healthy individuals and may serve as novel non-invasive biomarkers in this disease. Full article
(This article belongs to the Special Issue Advances in Chronic and Acute Renal Failure)
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7 pages, 271 KiB  
Article
Prevalence of Chronic Kidney Disease in Patients with Diabetes in Extremadura (Spain) during the Years 2012, 2013 and 2014: An Observational Study
by Leandro Fernández-Fernández, Alfonso Barquilla-García, Javier Sánchez-Vega, José Carlos Risco-Solanilla, Félix Suárez-González and Francisco Buitrago
J. Clin. Med. 2021, 10(13), 2886; https://doi.org/10.3390/jcm10132886 - 29 Jun 2021
Cited by 4 | Viewed by 1485
Abstract
Diabetes mellitus (DM) is one of the leading causes of chronic kidney disease (CKD). We analyzed the prevalence of CKD in the population with diabetes in Extremadura (Spain). retrospective observational study was carried in the diabetic population attended in the Extremadura Health System [...] Read more.
Diabetes mellitus (DM) is one of the leading causes of chronic kidney disease (CKD). We analyzed the prevalence of CKD in the population with diabetes in Extremadura (Spain). retrospective observational study was carried in the diabetic population attended in the Extremadura Health System in 2012–2014. A total of 38,253 patients, ≥18 years old were included. Estimated glomerular filtration rate (eGFR) was calculated using the CKD Epidemiology Collaboration equation. CKD was defined as follow: an eGFR <60 mL/min/1.73 m2 in a time period ≥ of three months or the presence of renal damage, with or without reduced eGFR, if the urine albumin-creatinine ratio (UACR) was ≥30 mg/g, also in a time period ≥ of three months. The prevalence rate of CKD was 25.3% (27.6% in women; 23.0% in men) and increases with age (34.0% in ≥65 years-olds). 24.9% of patients with CKD were in the very-high risk category for cardiovascular events (6.3% of the diabetic population). If CKD were diagnosed without requiring sustained eGFR <60 mL/min/1.73 m2 and/or sustained UACR ≥30 mg/g (as it is frequently found in the literature) this would overestimate the prevalence of CKD by 23%. Full article
(This article belongs to the Special Issue Advances in Chronic and Acute Renal Failure)
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